急性心肌梗死患者创伤后应激障碍的患病率及预测因素
Prevalence and predictors of posttraumatic stress disorder in patients with acute myocardial infarction.
作者信息
Wiedemar Lina, Schmid Jean-Paul, Müller Julia, Wittmann Lutz, Schnyder Ulrich, Saner Hugo, von Känel Roland
机构信息
Department of General Internal Medicine, University Hospital Berne, Switzerland.
出版信息
Heart Lung. 2008 Mar-Apr;37(2):113-21. doi: 10.1016/j.hrtlng.2007.03.005.
OBJECTIVE
We estimated the prevalence of posttraumatic stress disorder (PTSD) and identified predictors of self-rated PTSD symptoms in patients post-myocardial infarction (MI).
METHODS
We recruited 400 patients (mean age 60 +/- 12 years, 79% were men) with a previous acute index MI who were referred to a tertiary cardiology clinic. PTSD was assessed by the Clinician-administered PTSD Scale, and self-rated severity of PTSD symptom levels were assessed by the Posttraumatic Diagnostic Scale.
RESULTS
Of the 190 patients who completed the Posttraumatic Diagnostic Scale, 34 met the cutoff for clinically significant PTSD symptomatology and 32 agreed to be interviewed. Among these patients, the Clinician-administered PTSD Scale interview yielded a prevalence of full and subsyndromal PTSD of 9.5% (95% confidence interval 7.4-11.6). Retrospectively rated feelings of helplessness (beta = .47, P < .001) and pain intensity during MI (beta = .15, P = .019) independently predicted PTSD symptom level.
CONCLUSIONS
Approximately 10% of patients post-MI had full or subsyndromal PTSD. Subjective perception of MI predicted self-rated PTSD symptom level.
目的
我们评估了心肌梗死（MI）后患者创伤后应激障碍（PTSD）的患病率，并确定了自评PTSD症状的预测因素。
方法
我们招募了400例曾发生过急性心肌梗死且被转诊至三级心脏病诊所的患者（平均年龄60±12岁，79%为男性）。通过临床医生管理的PTSD量表评估PTSD，并通过创伤后诊断量表评估PTSD症状水平的自评严重程度。
结果
在完成创伤后诊断量表的190例患者中，34例达到临床显著PTSD症状学的临界值，32例同意接受访谈。在这些患者中，临床医生管理的PTSD量表访谈得出完全型和亚综合征型PTSD的患病率为9.5%（95%置信区间7.4 - 11.6）。回顾性评定的无助感（β = 0.47，P < 0.001）和心肌梗死期间的疼痛强度（β = 0.15，P = 0.019）独立预测PTSD症状水平。
结论
约10%的心肌梗死后患者患有完全型或亚综合征型PTSD。对心肌梗死的主观感受预测了自评PTSD症状水平。
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