Spitzer Carsten, Barnow Sven, Völzke Henry, John Ulrich, Freyberger Harald J, Grabe Hans Joergen
Department of Psychiatry and Psychotherapy, Ernst-Moritz-Arndt-University, Greifswald/Stralsund, Germany.
J Clin Psychiatry. 2008 May;69(5):693-700. doi: 10.4088/jcp.v69n0501.
The present study assessed the risk of trauma exposure and subsequent posttraumatic stress disorder (PTSD) in an elderly community sample. Furthermore, gender differences and psychiatric comorbidity were analyzed.
3170 adults living in a German community were assessed by the PTSD module of the Structured Clinical Interview for DSM-IV and the Composite International Diagnostic-Screener. They were assigned to 3 age groups: young (44 years and younger; N = 997), middle-aged (45-64 years; N = 1322), and elderly (65 years and older; N = 851). Data for the present study were collected between December 2002 and December 2006.
At least 1 trauma was reported by 54.6%, and the odds for trauma exposure were almost 4-fold in the elderly compared to the younger age groups (OR = 3.74; 95% CI = 3.13 to 4.47). Among those traumatized, the lifetime and 1-month prevalence rates of PTSD in the elderly were 3.1% and 1.5%, respectively, and did not differ from the rates of the young and middle-aged adults. Elderly men had a significantly increased risk for trauma exposure in general than elderly women (p = .012), but there were no gender differences in PTSD prevalence rates. Elderly PTSD-positive participants had significantly higher odds for any psychiatric syndrome than those without PTSD (OR = 9.10; 95% CI = 2.64 to 31.28) with depression and anxiety being the most frequent conditions.
Our findings suggest that PTSD is certainly not rare in the elderly and that a lifetime diagnosis of PTSD is associated with symptoms of depression and anxiety. Assessment of trauma and PTSD should be integrated into routine examinations of the elderly to improve management and treatment provisions.
本研究评估了老年社区样本中遭受创伤的风险以及随后发生创伤后应激障碍（PTSD）的情况。此外，还分析了性别差异和精神共病情况。
采用《精神疾病诊断与统计手册》第四版（DSM-IV）的结构化临床访谈中的PTSD模块和综合国际诊断筛查工具，对居住在德国一个社区的3170名成年人进行评估。他们被分为3个年龄组：年轻人（44岁及以下；N = 997）、中年人（45 - 64岁；N = 1322）和老年人（65岁及以上；N = 851）。本研究的数据收集于2002年12月至2006年12月之间。
54.6%的人报告至少经历过1次创伤，与年轻年龄组相比，老年人遭受创伤的几率几乎高出4倍（OR = 3.74；95% CI = 3.13至4.47）。在那些遭受创伤的人中，老年人PTSD的终生患病率和1个月患病率分别为3.1%和1.5%，与年轻人和中年成年人的患病率没有差异。总体而言，老年男性遭受创伤的风险显著高于老年女性（p = 0.012），但PTSD患病率没有性别差异。PTSD呈阳性的老年参与者出现任何精神综合征的几率显著高于无PTSD者（OR = 9.10；95% CI = 2.64至31.28），其中抑郁和焦虑最为常见。
我们的研究结果表明，PTSD在老年人中肯定并不罕见，PTSD的终生诊断与抑郁和焦虑症状相关。创伤和PTSD的评估应纳入老年人的常规检查中，以改善管理和治疗措施。
