Dunn Andrew S, Julian Terri, Formolo Lance R, Green Bart N, Chicoine David R
Department of Veterans Affairs (VA) Western New York Healthcare System, Buffalo VA Medical Center, Buffalo, NY 14215, USA.
J Rehabil Res Dev. 2011;48(5):493-502. doi: 10.1682/jrrd.2010.05.0104.
Escalating prevalence estimates of posttraumatic stress disorder (PTSD) among recently returning Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) veterans highlight the need for early detection and management for reducing chronic mental illness and disability. Because PTSD and chronic pain are common comorbid conditions among veterans, PTSD screening within specialty clinic settings addressing musculoskeletal pain may be of value. This retrospective study evaluated measures of diagnostic value for the PTSD Checklist (PCL) for a sample (n = 79) of OIF/OEF veterans seeking care for neck or back pain within a Department of Veterans Affairs specialty clinic. Because published accounts of optimal PCL cutoff scores vary considerably, we used receiver operating characteristic curves to identify whether the optimal PCL cutoff score for the sample differed from a conventional cutoff score of 50. A clinical psychologist experienced in diagnosing and managing PTSD confirmed the diagnosis of PTSD for 37 veterans through a review of clinical records. The prevalence of diagnosed PTSD was 46.8%, with an optimal PCL cutoff score of 44. These findings may guide future research and influence clinical practice regarding PTSD screening for recently returning veterans with chronic pain.
伊拉克自由行动/持久自由行动(OIF/OEF)退伍军人回国后创伤后应激障碍(PTSD)患病率估计不断攀升,这凸显了早期检测和管理对于减少慢性精神疾病和残疾的必要性。由于PTSD和慢性疼痛在退伍军人中是常见的共病情况,在处理肌肉骨骼疼痛的专科诊所环境中进行PTSD筛查可能具有价值。这项回顾性研究评估了PTSD检查表(PCL)对在退伍军人事务部专科诊所寻求颈部或背部疼痛治疗的OIF/OEF退伍军人样本(n = 79)的诊断价值测量。由于已发表的关于最佳PCL临界值分数的描述差异很大,我们使用了受试者工作特征曲线来确定该样本的最佳PCL临界值分数是否与传统的50分临界值分数不同。一位在诊断和管理PTSD方面经验丰富的临床心理学家通过审查临床记录确认了37名退伍军人患有PTSD。确诊的PTSD患病率为46.8%,最佳PCL临界值分数为44。这些发现可能会指导未来的研究,并影响对近期回国的慢性疼痛退伍军人进行PTSD筛查的临床实践。