Gellis Les A, Mavandadi Shahrzad, Oslin David W
Philadelphia Veterans Affairs Medical Center and VISN 4 Mental Illness Research, Education, and Clinical Center, Philadelphia, Pennsylvania, USA.
Prim Care Companion J Clin Psychiatry. 2010;12(3). doi: 10.4088/PCC.09m00823blu.
This study assessed mental and health functioning in full versus partial posttraumatic stress disorder (PTSD) among newly returning veterans from Iraq (Operation Iraqi Freedom [OIF]) and Afghanistan (Operation Enduring Freedom [OEF]) who were referred by primary care providers for a behavioral health assessment and reported an emotional trauma.
Participants included OEF/OIF veterans receiving care in 2 veterans' affairs medical centers and affiliated community-based outpatient clinics who reported behavioral health issues to their primary care providers. All veterans underwent a clinical behavioral health assessment of Axis I disorders and functioning via telephone between June 2007 and April 2008. Functioning was measured using the 12-item Short-Form Health Survey (SF-12). Those reporting a previous emotional trauma were subsequently assessed for PTSD using the PTSD Patient Checklist (PCL).
The final sample (N=201) was 88.1% male with a mean age of 34.2 years (SD=10.1). Individuals with full PTSD (n=120, 59.7%) reported worse mental health functioning compared to those with partial PTSD (n=37, 18.4%). Individuals with partial PTSD reported worse mental health functioning scores than the trauma exposed-only group (n=44, 21.9%). Compared to national norms, patients with partial PTSD reported mental health functioning scores that were worse than 75% of individuals within a similar age range. After controlling for other psychiatric factors, there was no difference between partial PTSD and the trauma-only group.
OEF/OIF veterans with partial PTSD referred for a behavioral health assessment may incur significant problems with functioning. These complaints may be better attributed to psychiatric comorbidity as opposed to symptoms specifically related to trauma.
本研究评估了从伊拉克（伊拉克自由行动[OIF]）和阿富汗（持久自由行动[OEF]）新近回国的退伍军人中，完全型与部分型创伤后应激障碍（PTSD）患者的心理和健康功能状况。这些退伍军人由初级保健提供者转介进行行为健康评估，并报告有情感创伤经历。
参与者包括在两家退伍军人事务医疗中心及其附属社区门诊接受治疗的OEF/OIF退伍军人，他们向初级保健提供者报告了行为健康问题。所有退伍军人在2007年6月至2008年4月期间通过电话接受了关于轴I障碍和功能的临床行为健康评估。功能状况采用12项简短健康调查问卷（SF-12）进行测量。那些报告有既往情感创伤经历的退伍军人随后使用PTSD患者清单（PCL）进行PTSD评估。
最终样本（N = 201）中88.1%为男性，平均年龄34.2岁（标准差 = 10.1）。与部分型PTSD患者（n = 37，18.4%）相比，完全型PTSD患者（n = 120，59.7%）报告的心理健康功能状况更差。部分型PTSD患者报告的心理健康功能得分比仅暴露于创伤的组（n = 44，21.9%）更差。与全国常模相比，部分型PTSD患者报告的心理健康功能得分比同年龄范围内75%的个体更差。在控制了其他精神因素后，部分型PTSD患者与仅暴露于创伤的组之间没有差异。
因行为健康评估而被转介的部分型PTSD的OEF/OIF退伍军人可能在功能方面存在重大问题。这些主诉可能更好地归因于精神共病，而非与创伤特异性相关的症状。
