McFarlane A C, Browne D, Bryant R A, O'Donnell M, Silove D, Creamer M, Horsley K
Centre for Military and Veterans' Health, University of Adelaide, South Australia, Australia.
J Affect Disord. 2009 Nov;118(1-3):166-72. doi: 10.1016/j.jad.2009.01.017. Epub 2009 Feb 23.
Previous studies investigating the impact of alcohol ingestion on the emergence of posttraumatic psychological symptoms have generated contradictory findings.
One thousand forty-five patients, admitted to hospital following traumatic injury were assessed during hospitalisation for patterns of alcohol consumption prior to the injury and also during the month prior to reassessment at 3 months. Anxiety, depression and posttraumatic stress disorder (PTSD) were assessed post accident and at 3 months. In a sub sample (n=167), blood alcohol levels were measured at the time of admission to emergency departments.
Moderate alcohol consumption prior to and following the accident predicted lower levels of psychological distress at 1 week and 3 months. No significant relationship was found between the blood alcohol level and psychiatric outcomes. PTSD predicted the emergence of alcohol abuse following the accident, suggesting self-medication in a subgroup of survivors.
The impact of alcohol consumption upon injury severity and the nature of injury was not controlled for and some non-participation may have been related to patterns of alcohol consumption. We relied on retrospective reports of alcohol use obtained shortly after the traumatic injury to index prior alcohol use and these reports may have been influenced by mood states at the time of recall. Our follow-up was limited to 3 months and there is a need for longer-term assessment of the relationship between prior alcohol use and subsequent posttraumatic adjustment.
Given the potential impact of alcohol use on traumatic injury and post-injury recovery, we advocate active screening and early intervention strategies that focus on moderate alcohol usage.
以往关于饮酒对创伤后心理症状出现的影响的研究得出了相互矛盾的结果。
1045名因创伤性损伤入院的患者在住院期间接受了评估，以了解受伤前以及在3个月重新评估前一个月的饮酒模式。在事故后和3个月时评估焦虑、抑郁和创伤后应激障碍（PTSD）。在一个子样本（n = 167）中，在急诊科入院时测量了血液酒精水平。
事故前后适度饮酒预示着1周和3个月时心理困扰水平较低。未发现血液酒精水平与精神科结果之间存在显著关系。PTSD预示着事故后会出现酒精滥用，这表明一部分幸存者存在自我用药情况。
未控制饮酒对损伤严重程度和损伤性质的影响，一些未参与者可能与饮酒模式有关。我们依靠创伤性损伤后不久获得的饮酒回顾性报告来索引先前的饮酒情况，这些报告可能受到回忆时情绪状态的影响。我们的随访仅限于3个月，需要对先前饮酒与随后创伤后调整之间的关系进行长期评估。
鉴于饮酒对创伤性损伤和损伤后恢复的潜在影响，我们提倡积极筛查和早期干预策略，重点关注适度饮酒。
