Neria Yuval, Gross Raz, Olfson Mark, Gameroff Marc J, Wickramaratne Priya, Das Amar, Pilowsky Daniel, Feder Adriana, Blanco Carlos, Marshall Randall D, Lantigua Rafael, Shea Steven, Weissman Myrna M
Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
Gen Hosp Psychiatry. 2006 May-Jun;28(3):213-22. doi: 10.1016/j.genhosppsych.2006.02.002.
To screen for posttraumatic stress disorder (PTSD) in primary care patients 7-16 months after 9/11 attacks and to examine its comorbidity, clinical presentation and relationships with mental health treatment and service utilization.
A systematic sample (n=930) of adult primary care patients who were seeking primary care at an urban general medicine clinic were interviewed using the PTSD Checklist: the Primary Care Evaluation of Mental Disorders (PRIME-MD) Patient Health Questionnaire and the Medical Outcome Study 12-Item Short Form Health Survey (SF-12). Health care utilization data were obtained by a cross linkage to the administrative computerized database.
Prevalence estimates of current 9/11-related probable PTSD ranged from 4.7% (based on a cutoff PCL-C score of 50 and over) to 10.2% (based on the DSM-IV criteria). A comorbid mental disorder was more common among patients with PTSD than patients without PTSD (80% vs. 30%). Patients with PTSD were more functionally impaired and reported increased use of mental health medication as compared to patients without PTSD (70% vs. 18%). Among patients with PTSD there was no increase in hospital and emergency room (ER) admissions or outpatient care during the first year after the attacks.
In an urban general medicine setting, 1 year after 9/11, the frequency of probable PTSD appears to be common and clinically significant. These results suggest an unmet need for mental health care in this clinical population and are especially important in view of available treatments for PTSD.
在9·11袭击事件发生7至16个月后，对初级保健患者进行创伤后应激障碍（PTSD）筛查，并检查其共病情况、临床表现以及与心理健康治疗和服务利用的关系。
采用创伤后应激障碍检查表、精神障碍初级保健评估（PRIME-MD）患者健康问卷和医学结局研究12项简短健康调查（SF-12），对在城市综合内科诊所寻求初级保健的930名成年初级保健患者进行系统抽样访谈。通过与行政计算机数据库交叉链接获取医疗保健利用数据。
当前与9·11事件相关的可能患有创伤后应激障碍的患病率估计在4.7%（基于PCL-C评分50及以上的临界值）至10.2%（基于《精神疾病诊断与统计手册》第四版标准）之间。患有创伤后应激障碍的患者比未患创伤后应激障碍的患者更常伴有共病精神障碍（80%对30%）。与未患创伤后应激障碍的患者相比，患有创伤后应激障碍的患者功能受损更严重，且报告使用精神健康药物的情况增加（70%对18%）。在患有创伤后应激障碍的患者中，袭击发生后的第一年，住院和急诊室就诊或门诊护理并未增加。
在9·11事件发生一年后，在城市综合内科环境中，可能患有创伤后应激障碍的频率似乎很高且具有临床意义。这些结果表明该临床人群对心理健康护理存在未满足的需求，鉴于现有的创伤后应激障碍治疗方法，这一点尤为重要。
