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创伤后应激障碍患者健康相关生活质量效用的预测因素。

Predictors of health-related quality-of-life utilities among persons with posttraumatic stress disorder.

机构信息

Leonard D. Schaeffer Center for Health Policy and Economics, School of Pharmacy, University of Southern California, 1540 East Alcazar St., CHP140, Los Angeles, CA 90089, USA.

出版信息

Psychiatr Serv. 2011 Mar;62(3):272-7. doi: 10.1176/ps.62.3.pss6203_0272.

Abstract

OBJECTIVES

This study had two objectives: to elicit preferences for current health in a sample of persons with posttraumatic stress disorder (PTSD ) in order to establish quality-of-life estimates for this disorder and to identify symptoms and problems that predict these estimates.

METHODS

The authors used the standard gamble (SG), time tradeoff (TTO), and visual analog scale (VAS) methods for quality-of-life estimation at baseline among 184 individuals with chronic PTSD who were participating in a multisite clinical trial. Descriptive statistics were used to characterize quality-of-life estimates for the sample. A linear mixed-effects regression model was conducted to evaluate predictors of quality of life.

RESULTS

The modal participant was a single, white female (77%). The mean ± SD age of the sample was 37.31 ± 11.33. On a scale where full health is 1.0 and death is 0.0, mean quality-of-life estimates for living with PTSD were .87 ±.25, .66 ± .28, and .64 ± .20 for SG, TTO, and VAS, respectively. Linear mixed-effects model regression revealed that elicitation method (SG, TTO, and VAS), arousal (a symptom of PTSD), and endorsement of anxiety or depressive symptoms were the strongest predictors of lower quality-of-life scores. Avoidance and re-experiencing of trauma were not predictive of reduced quality of life.

CONCLUSIONS

Significant decrements in health-related quality of life were found among persons seeking treatment for PTSD. Although arousal and anxiety and depressive symptoms were predictive of quality-of-life estimates, avoidance and re-experiencing were not. These findings identify targets for symptom resolution that may improve quality of life among persons with PTSD.

摘要

目的

本研究有两个目的:在创伤后应激障碍(PTSD)患者样本中引出对当前健康的偏好,以确定该障碍的生活质量估计值,并确定预测这些估计值的症状和问题。

方法

作者在参与多地点临床试验的 184 名慢性 PTSD 患者中,在基线时使用标准博弈(SG)、时间权衡(TTO)和视觉模拟量表(VAS)方法进行生活质量估计。使用描述性统计来描述样本的生活质量估计值。进行线性混合效应回归模型以评估生活质量的预测因素。

结果

典型参与者是单身白人女性(77%)。样本的平均年龄±SD 为 37.31±11.33。在全健康为 1.0 和死亡为 0.0 的量表上,患有 PTSD 的生活质量估计的平均值分别为 SG、TTO 和 VAS 的.87±.25、.66±.28 和.64±.20。线性混合效应模型回归显示,引出方法(SG、TTO 和 VAS)、唤醒(PTSD 的一种症状)以及焦虑或抑郁症状的存在是生活质量评分较低的最强预测因素。回避和创伤再体验与生活质量下降无关。

结论

在寻求 PTSD 治疗的患者中发现健康相关生活质量显著下降。尽管唤醒、焦虑和抑郁症状是生活质量估计的预测因素,但回避和创伤再体验不是。这些发现确定了可能改善 PTSD 患者生活质量的症状缓解目标。

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