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老年人创伤后应激障碍及其与抑郁和躯体化的共病情况——一项基于德国社区的研究。

Posttraumatic stress disorder and its comorbidity with depression and somatisation in the elderly - a German community-based study.

机构信息

Department of Medical Psychology and Medical Sociology, University of Leipzig, Germany.

出版信息

Aging Ment Health. 2012;16(4):403-12. doi: 10.1080/13607863.2011.615740. Epub 2011 Dec 8.

DOI:10.1080/13607863.2011.615740
PMID:22149362
Abstract

OBJECTIVES

Even 60 years after World War II, the German elderly population is significantly more often affected by posttraumatic symptomatology compared to the younger cohorts. This study is addressing prevalence rates of posttraumatic symptomatology and its comorbidity with depression and somatisation.

METHODS

This study examines posttraumatic stress disorder (PTSD) according to DSM-IV, partial PTSD, depression and somatisation in a randomly selected sample of the German general population aged 60-85 years (N = 1.659) using self-rating instruments (Patient Health Questionnaire, PHQ; Post Traumatic Diagnostic Scale, PTDS).

RESULTS

One-month prevalence rate was 4.0% for DSM-IV PTSD; another 12.2% fulfilled the criteria of partial PTSD. A significant increase across the age groups was found for partial PTSD. 11.5% of the persons affected by posttraumatic symptomatology fulfil the criteria of a somatoform syndrome, 8.6% fulfil the criteria of major depression and 10.4% fulfil the criteria of other depressive syndromes according to the PHQ. A current posttraumatic symptomatology is associated with increased prevalence rates of somatoform and depressive disorders. Moreover, traumatic experiences without a current PTSD are associated with increased rates of somatoform disorders.

CONCLUSION

Posttraumatic symptomatology is a common phenomenon in the German elderly population. Especially, subsyndromal disorders are very common and increasing across the age groups. Posttraumatic symptomatology is associated with an increased risk of depressive and somatoform disorders. As posttraumatic symptoms are often neglected in geriatric health care, future effort should address the recognition and treatment of posttraumatic symptoms in elderly patients.

摘要

目的

即使在第二次世界大战结束 60 年后,与年轻人群相比,德国老年人群受到创伤后症状的影响仍然明显更为频繁。本研究旨在探讨创伤后症状的患病率及其与抑郁和躯体化的共病情况。

方法

本研究使用自评工具(患者健康问卷,PHQ;创伤后诊断量表,PTDS),在年龄在 60-85 岁的德国普通人群中随机抽取样本,调查创伤后应激障碍(PTSD)按照 DSM-IV 标准、部分 PTSD、抑郁和躯体化情况。

结果

DSM-IV PTSD 的一个月患病率为 4.0%;另有 12.2%符合部分 PTSD 的标准。部分 PTSD 在各年龄组中均显著增加。有创伤后症状的人中,11.5%符合躯体形式综合征的标准,8.6%符合重度抑郁的标准,10.4%符合 PHQ 中的其他抑郁综合征的标准。当前的创伤后症状与躯体形式和抑郁障碍的患病率增加有关。此外,没有当前 PTSD 的创伤经历与躯体形式障碍的发生率增加有关。

结论

创伤后症状在德国老年人群中是一种常见现象。特别是亚综合征障碍非常常见,且在各年龄组中呈上升趋势。创伤后症状与抑郁和躯体形式障碍的风险增加有关。由于创伤后症状在老年保健中经常被忽视,未来的努力应针对老年患者中创伤后症状的识别和治疗。

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