Hapke Ulfert, Schumann Anja, Rumpf Hans-Juerger, John Ulrich, Meyer Christian
Institute of Epidemiology and Social Medicine, University of Greifswald, Walther-Rathenau-Strasse 48, 17487 Greifswald, Germany.
Eur Arch Psychiatry Clin Neurosci. 2006 Aug;256(5):299-306. doi: 10.1007/s00406-006-0654-6. Epub 2006 Jun 16.
The study is aimed at investigating the influence of trauma type, pre-existing psychiatric disorders with an onset before trauma, and gender on post-traumatic stress disorder (PTSD).
Traumas, PTSD and psychiatric disorders were assessed in a representative sample of 4075 adults aged 18-64 years using the Composite International Diagnostic Interview. Pre-existing DSM-IV diagnoses of anxiety disorders, depressive disorders, somatoform disorders, alcohol abuse and dependence, nicotine dependence, gender, and the type of trauma were analysed with logistic regressions to estimate the influence of these factors on the risk for developing PTSD.
The lifetime prevalence of exposure to any trauma did not vary by gender. The conditional probability of PTSD after exposure to trauma was higher in women (11.1% SE = 1.58) than men (2.9% SE = 0.83). Univariate analyses showed that pre-existing anxiety disorders, somatoform disorders and depressive disorders significantly increase the risk of PTSD. Multivariate analyses revealed that specific types of trauma, especially rape and sexual abuse, pre-existing anxiety disorders and somatoform disorders are predictors of an increased risk of PTSD, while gender and depressive disorder were not found to be independent risk factors.
Women do not have a higher vulnerability for PTSD in general. However, especially sexually motivated violence and pre-existing anxiety disorders are the main reasons for higher prevalences of PTSD in women.
本研究旨在调查创伤类型、创伤发生前已存在的精神障碍以及性别对创伤后应激障碍(PTSD)的影响。
使用复合国际诊断访谈对4075名年龄在18 - 64岁的成年人代表性样本进行创伤、PTSD和精神障碍评估。对预先存在的DSM-IV焦虑症、抑郁症、躯体形式障碍、酒精滥用和依赖、尼古丁依赖、性别以及创伤类型诊断进行逻辑回归分析,以估计这些因素对发生PTSD风险的影响。
任何创伤暴露的终生患病率在性别上无差异。女性创伤暴露后发生PTSD的条件概率(11.1%,标准误 = 1.58)高于男性(2.9%,标准误 = 0.83)。单因素分析显示,预先存在的焦虑症、躯体形式障碍和抑郁症显著增加PTSD风险。多因素分析表明,特定类型的创伤,尤其是强奸和性虐待、预先存在的焦虑症和躯体形式障碍是PTSD风险增加的预测因素,而性别和抑郁症未被发现是独立的风险因素。
一般而言,女性并非对PTSD具有更高的易感性。然而,特别是性动机暴力和预先存在的焦虑症是女性中PTSD患病率较高的主要原因。