Menninger Clinic, Baylor College of Medicine, 2801 Gessner Drive, Houston, TX 77080, USA.
Aust N Z J Psychiatry. 2010 Jan;44(1):4-19. doi: 10.3109/00048670903393597.
The aim of the present study was to provide a critical review of prevalence estimates of combat-related post-traumatic stress disorder (PTSD) among military personnel and veterans, and of the relevant factors that may account for the variability of estimates within and across cohorts, including methodological and conceptual factors accounting for differences in prevalence rates across nations, conflicts/wars, and studies. MEDLINE and PsycINFO databases were examined for literature on combat-related PTSD. The following terms were used independently and in combinations in this search: PTSD, combat, veterans, military, epidemiology, prevalence. The point prevalence of combat-related PTSD in US military veterans since the Vietnam War ranged from approximately 2% to 17%. Studies of recent conflicts suggest that combat-related PTSD afflicts between 4% and 17% of US Iraq War veterans, but only 3-6% of returning UK Iraq War veterans. Thus, the prevalence range is narrower and tends to have a lower ceiling among combat veterans of non-US Western nations. Variability in prevalence is likely due to differences in sampling strategies; measurement strategies; inclusion and measurement of the DSM-IV clinically significant impairment criterion; timing and latency of assessment and potential for recall bias; and combat experiences. Prevalence rates are also likely affected by issues related to PTSD course, chronicity, and comorbidity; symptom overlap with other psychiatric disorders; and sociopolitical and cultural factors that may vary over time and by nation. The disorder represents a significant and costly illness to veterans, their families, and society as a whole. Further carefully conceptualized research, however, is needed to advance our understanding of disorder prevalence, as well as associated information on course, phenomenology, protective factors, treatment, and economic costs.
本研究旨在对军事人员和退伍军人中与战斗相关的创伤后应激障碍（PTSD）的流行率进行批判性评估，并对可能导致队列内和队列间估计值差异的相关因素进行评估，包括导致各国、冲突/战争和研究之间流行率差异的方法学和概念因素。对与战斗相关的 PTSD 的文献进行了 MEDLINE 和 PsycINFO 数据库检索。在这个搜索中，使用了以下术语的独立和组合：PTSD、战斗、退伍军人、军事、流行病学、流行率。自越南战争以来，美国退伍军人中与战斗相关的 PTSD 的时点患病率约为 2%至 17%。最近冲突的研究表明，与战斗相关的 PTSD 影响了 4%至 17%的美国伊拉克战争退伍军人，但只有 3-6%的返回英国的伊拉克战争退伍军人。因此，患病率范围较窄，且在非美国西方国家的战斗退伍军人中患病率上限往往较低。患病率的差异可能是由于抽样策略、测量策略、DSM-IV 临床显著障碍标准的纳入和测量、评估的时间和潜伏期以及潜在的回忆偏差以及战斗经历的不同所致。患病率也可能受到与 PTSD 病程、持续性和共病性相关的问题、与其他精神障碍的症状重叠以及随时间和国家而变化的社会政治和文化因素的影响。这种疾病对退伍军人、他们的家人和整个社会来说是一种重大且代价高昂的疾病。然而，需要进一步进行精心概念化的研究，以增进我们对疾病流行率的理解，以及与病程、现象学、保护因素、治疗和经济成本相关的信息。
