Department of Psychiatry, University Hospital, Zurich, Switzerland.
J Trauma Stress. 2009 Dec;22(6):540-8. doi: 10.1002/jts.20453.
The relationship between acute stress disorder (ASD), posttraumatic stress disorder symptoms (PTSD), and chronic pain was investigated in a longitudinal study of injured accident victims (N = 323, 64.7% men). Assessments took place 5 days (T1), 6 (T2) months, and 12 (T3) months postaccident. Relations between pain and posttraumatic stress symptoms were tested by structural equation modeling. Subjects diagnosed with full or subsyndromal PTSD at T2 and at T3 (14 and 19%) reported significantly higher pain intensity. Cross-lagged panel analysis yielded a mutual maintenance of pain intensity and ASD or PTSD symptoms across T2. Across the second half year, PTSD symptoms impacted significantly on pain but not vice versa. Clinicians need to pay careful attention to PTSD symptoms in accident survivors suffering from chronic pain.
本纵向研究调查了急性应激障碍（ASD）、创伤后应激障碍症状（PTSD）与慢性疼痛之间的关系，研究对象为受伤事故的受害者（N=323，64.7%为男性）。评估在事故后 5 天（T1）、6（T2）和 12（T3）个月进行。通过结构方程模型测试疼痛与创伤后应激症状之间的关系。在 T2 和 T3 时（分别为 14%和 19%）诊断为完全或亚综合征 PTSD 的患者报告疼痛强度显著更高。交叉滞后面板分析表明，在 T2 时，疼痛强度和 ASD 或 PTSD 症状相互维持。在下半年，PTSD 症状显著影响疼痛，但反之则不然。临床医生需要仔细关注患有慢性疼痛的事故幸存者的 PTSD 症状。
