Gill Jessica M, Szanton S, Taylor T J, Page G G, Campbell J C
National Institute of Nursing Research, National Institutes of Health, Bethesda, MD 20892-1506, USA.
J Womens Health (Larchmt). 2009 Feb;18(2):261-7. doi: 10.1089/jwh.2008.0914.
Epidemiological studies have consistently reported rates of posttraumatic stress disorder (PTSD) in women that are twice that of men. In men and women, PTSD has been associated with comorbid medical conditions, medical symptoms and lower self-rating of health. In low-income urban women, rates of PTSD are even more elevated than in suburban women and may be related to observed health disparities.
In this study, 250 women seeking healthcare at an urban clinic were interviewed for a PTSD diagnosis, major depressive disorder (MDD), the experience of traumatic events, the experience of current and past common medical conditions and symptoms, and subjective rating of health. A chart review was used to assess healthcare use in the past year.
More current (5.2 vs. 3.8, p < 0.05) and past medical conditions (4.6 vs. 3.3, p < 0.05) were reported by women with a lifetime history of PTSD than by women without this history, after controlling for demographics and current depression. Women with lifetime PTSD also had more annual clinic appointments (5.9 vs. 3.8 p < 0.03) and were 2.4 times (p < 0.05) more likely to report lower appraisal of their physical health.
These findings suggest that urban health-seeking women with PTSD experience health impairments that may cause increased morbidity and that healthcare providers should consider the health ramifications of PTSD when providing medical care to women.
流行病学研究一直报告称,女性创伤后应激障碍(PTSD)的发病率是男性的两倍。在男性和女性中,PTSD都与合并的医疗状况、医学症状以及较低的健康自评相关。在低收入城市女性中,PTSD的发病率甚至比郊区女性更高,这可能与观察到的健康差距有关。
在本研究中,对250名在城市诊所寻求医疗服务的女性进行了访谈,以诊断PTSD、重度抑郁症(MDD)、创伤事件经历、当前和过去常见医疗状况及症状的经历,以及健康主观评分。通过查阅病历评估过去一年的医疗服务使用情况。
在控制了人口统计学特征和当前抑郁情况后,有PTSD终生病史的女性报告的当前(5.2对3.8,p<0.05)和过去医疗状况(4.6对3.3,p<0.05)比无此病史的女性更多。有PTSD终生病史的女性每年的门诊预约也更多(5.9对3.8,p<0.03),并且报告对自身身体健康评价较低的可能性是无此病史女性的2.4倍(p<0.05)。
这些发现表明,患有PTSD的城市就医女性存在健康损害,这可能导致发病率增加,医疗服务提供者在为女性提供医疗服务时应考虑PTSD对健康的影响。