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创伤后应激障碍症状的特异性:对寻求治疗的退伍军人中创伤后应激障碍症状与抑郁症共病情况的调查。

Specificity of posttraumatic stress disorder symptoms: an investigation of comorbidity between posttraumatic stress disorder symptoms and depression in treatment-seeking veterans.

作者信息

Gros Daniel F, Simms Leonard J, Acierno Ron

机构信息

Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC 29401, USA.

出版信息

J Nerv Ment Dis. 2010 Dec;198(12):885-90. doi: 10.1097/NMD.0b013e3181fe7410.

Abstract

In response to high levels of comorbidity and symptom overlap between posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and other disorders, much attention has been devoted to the role of specific and nonspecific symptoms among the disorders. The present study investigated the overlapping symptoms of PTSD and MDD in treatment-seeking veterans. Exploratory factor analyses were used to identify latent factors of both self-reported and clinician-rated symptoms of PTSD and MDD. Results of exploratory factor analyses supported a 2-factor model representing symptoms of depression and PTSD; however, a subset of PTSD symptoms, characterized by emotional numbing and dysphoria, loaded onto the depression factor, rather than the PTSD factor. These nonspecific PTSD symptoms were predictive of comorbid MDD and increased depression symptomatology in patients with PTSD. Together, these findings demonstrate the importance of accounting for nonspecific symptoms in diagnosis and treatment of PTSD, highlighting a need for revisions to our current diagnostics.

摘要

由于创伤后应激障碍(PTSD)、重度抑郁症(MDD)和其他疾病之间存在高度共病性和症状重叠,特定症状和非特定症状在这些疾病中的作用受到了广泛关注。本研究调查了寻求治疗的退伍军人中PTSD和MDD的重叠症状。探索性因素分析用于识别PTSD和MDD自我报告症状及临床医生评定症状的潜在因素。探索性因素分析结果支持了一个代表抑郁和PTSD症状的双因素模型;然而,以情感麻木和烦躁不安为特征的一部分PTSD症状,归入抑郁因素而非PTSD因素。这些非特定的PTSD症状可预测共病的MDD,并加重PTSD患者的抑郁症状。总之,这些发现证明了在PTSD诊断和治疗中考虑非特定症状的重要性,凸显了对当前诊断进行修订的必要性。

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