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心肌梗死后创伤后应激障碍:患病率和危险因素。

Post-traumatic stress disorder following myocardial infarction: prevalence and risk factors.

机构信息

Département de psychologie, L'Université du Québec à Montréal.

出版信息

Can J Cardiol. 2010 May;26(5):e170-5. doi: 10.1016/s0828-282x(10)70386-x.

Abstract

BACKGROUND

Post-traumatic stress disorder (PTSD) is associated with negative impacts on physical health. Victims of a myocardial infarction (MI) who develop PTSD may be particularly affected by these impacts due to their cardiovascular vulnerability. Post-traumatic reactions in this population are not well known.

OBJECTIVES

To examine the prevalence of PTSD after MI and its risk factors, and to validate a prediction model for PTSD symptoms.

METHODS

Patients hospitalized for MI (n=477) were recruited in three hospitals. The Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and questionnaires concerning PTSD symptoms and general measures were administered to patients during hospitalization and at one-month follow-up.

RESULTS

Four per cent of the patients had PTSD and 12% had partial PTSD. The perception of a threat to life, the intensity of acute stress disorder and depression symptoms several days after the MI, a history of referral to a psychologist or psychiatrist, and female sex were risk factors for the intensity of PTSD symptoms in a sequential multiple regression analysis (R=0.634). The prediction model was validated by applying the regression equation to 48 participants who were not included in the initial regression (R=0.633).

CONCLUSIONS

The risk factors for development of PTSD symptoms identified in the present study could be used to facilitate the detection of patients at risk for developing PTSD symptoms so they can later be offered psychological interventions as needed.

摘要

背景

创伤后应激障碍(PTSD)与身体健康的负面影响有关。患有心肌梗死(MI)并出现 PTSD 的患者可能会因心血管脆弱而受到这些影响的特别影响。该人群中的创伤后反应尚不清楚。

目的

检查 MI 后 PTSD 的患病率及其危险因素,并验证 PTSD 症状的预测模型。

方法

在三家医院招募了因 MI 住院的患者(n=477)。在住院期间和一个月随访时,对患者进行了精神障碍诊断和统计手册,第四版的结构化临床访谈以及有关 PTSD 症状和一般措施的问卷。

结果

4%的患者患有 PTSD,12%的患者患有部分 PTSD。对生命受到威胁的感知,MI 后数天急性应激障碍和抑郁症状的强度,曾被转介给心理学家或精神科医生以及女性性别是序列多重回归分析中 PTSD 症状强度的危险因素(R=0.634)。通过将回归方程应用于 48 名未包含在初始回归中的参与者,对预测模型进行了验证(R=0.633)。

结论

本研究确定的 PTSD 症状发展的危险因素可用于帮助检测有发生 PTSD 症状风险的患者,以便以后根据需要提供心理干预。

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