Gómez-Beneyto Manuel, Salazar-Fraile José, Martí-Sanjuan Vicent, Gonzalez-Luján Luis
Facultad de Medicina, University of Valencia, Valencia, Spain.
Br J Gen Pract. 2006 May;56(526):349-54.
Posttraumatic stress disorder (PTSD) is a common and disabling disturbance in primary care. Few studies have been carried out in primary care samples and none have taken into consideration the association between PTSD and personality disorder.
To describe prevalence and risk factors of PTSD and its comorbidity with personality disorder.
General practice centre in Valencia (Spain).
Patients who had experienced at least one traumatic event in their lives were selected from a random sample attending a primary healthcare centre in Valencia and blindly assessed by trained professionals. Patients suffering from PTSD were compared with those who were not. PTSD and personality disorder diagnoses were established using CIDI and SCID-II interviews respectively. Sex, age at the time of experiencing trauma, frequency, multiplicity and type of trauma, dissociative symptoms, personality disorder and severity of PTSD were subjected to multivariate analysis to estimate the probability of developing PTSD and its duration.
Life prevalence rate was 14% and current prevalence 9%. Dissociative symptoms and personality disorder were significantly associated with PTSD. Cluster analysis based on age, frequency and type of trauma revealed the existence of one subgroup composed mainly of women who had experienced frequent body-contact trauma at an early age, developed severe PTSD and suffer from a variety of personality disorders, particularly paranoid personality disorder. Time to the complete disappearance of symptoms was only explained by the initial severity of PTSD.
PTSD is a frequent disorder in general practice and it is often associated with personality disorder. Women who experienced high frequency body-contact traumatic events at an early age often suffer from personality disorder and present a particularly severe form of PTSD deserving referral to specialised care.
创伤后应激障碍（PTSD）是基层医疗中一种常见且致残的病症。针对基层医疗样本开展的研究较少，且尚无研究考虑PTSD与人格障碍之间的关联。
描述PTSD的患病率、危险因素及其与人格障碍的共病情况。
西班牙巴伦西亚的全科医疗中心。
从巴伦西亚一家基层医疗中心的随机样本中选取一生中至少经历过一次创伤事件的患者，并由经过培训的专业人员进行盲法评估。将患有PTSD患者与未患PTSD患者进行比较。分别使用复合性国际诊断交谈检查表（CIDI）和精神障碍诊断与统计手册第四版轴II障碍定式临床访谈问卷（SCID-II）访谈来确立PTSD和人格障碍的诊断。对性别、经历创伤时的年龄、创伤的频率、多发性和类型、分离症状、人格障碍以及PTSD的严重程度进行多变量分析，以估计发生PTSD的概率及其持续时间。
终生患病率为14%，当前患病率为9%。分离症状和人格障碍与PTSD显著相关。基于年龄、创伤频率和类型的聚类分析显示存在一个主要由女性组成的亚组，这些女性在早年经历过频繁的身体接触创伤，患有严重的PTSD并患有多种人格障碍，尤其是偏执型人格障碍。症状完全消失的时间仅由PTSD的初始严重程度来解释。
PTSD在全科医疗中是一种常见病症，且常与人格障碍相关。早年经历高频身体接触创伤事件的女性常患有人格障碍，并呈现出特别严重的PTSD形式，值得转诊至专科护理。
