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美国老年人创伤后应激障碍相关的身体健康状况:来自全国酒精相关情况流行病学调查第二波的结果。

Physical health conditions associated with posttraumatic stress disorder in U.S. older adults: results from wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions.

机构信息

National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut 06516, USA.

出版信息

J Am Geriatr Soc. 2012 Feb;60(2):296-303. doi: 10.1111/j.1532-5415.2011.03788.x. Epub 2012 Jan 27.

Abstract

OBJECTIVES

To present findings on past-year medical conditions associated with lifetime trauma exposure and full and partial posttraumatic stress disorder (PTSD) in a nationally representative sample of U.S. older adults.

DESIGN

Face-to-face diagnostic interviews.

SETTING

Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions.

PARTICIPANTS

Nine thousand four hundred sixty-three adults aged 60 and older.

MEASUREMENTS

Logistic regression analyses adjusting for sociodemographic characteristics and psychiatric comorbidity were used to evaluate associations between PTSD status and past-year medical disorders; linear regression models evaluated associations with past-month physical functioning.

RESULTS

After adjustment for sociodemographic characteristics and comorbid lifetime mood, anxiety, substance use, attention-deficit/hyperactivity, and personality disorders, respondents with lifetime PTSD were more likely than respondents who reported experiencing one or more traumatic life events but who did not meet lifetime criteria for full or partial PTSD (trauma controls) to report being diagnosed with hypertension, angina pectoris, tachycardia, other heart disease, stomach ulcer, gastritis, and arthritis (odds ratios (ORs) = 1.3-1.8) by a healthcare professional; they also scored lower on a measure of physical functioning than controls and respondents with partial PTSD. Respondents with lifetime partial PTSD were more likely than controls to report past-year diagnoses of gastritis (OR = 1.7), angina pectoris (OR = 1.5), and arthritis (OR = 1.4) and reported worse physical functioning. Number of lifetime traumatic event types was associated with most of the medical conditions assessed; adjustment for these events reduced the magnitudes of and rendered nonsignificant most associations between PTSD status and medical conditions.

CONCLUSION

Older adults with lifetime PTSD have high rates of several physical health conditions, many of which are chronic disorders of aging, and poorer physical functioning. Older adults with lifetime partial PTSD have higher rates of gastritis, angina pectoris, and arthritis and poorer physical functioning.

摘要

目的

在全美具有代表性的老年人群体中,报告与既往创伤暴露及完全和部分创伤后应激障碍(PTSD)相关的既往一年医疗状况。

设计

面对面的诊断访谈。

设置

国家酒精与相关条件流行病学调查第 2 波。

参与者

9463 名年龄在 60 岁及以上的成年人。

测量

使用逻辑回归分析调整社会人口统计学特征和精神共病情况,以评估 PTSD 状况与既往一年医疗障碍之间的关系;线性回归模型评估与过去一个月身体功能的关系。

结果

在调整社会人口统计学特征和共病性终生心境、焦虑、物质使用、注意力缺陷/多动、人格障碍后,与报告经历过一次或多次创伤性生活事件但未达到完全或部分 PTSD 终生标准的创伤对照组相比,有终生 PTSD 的受访者更有可能被诊断患有高血压、心绞痛、心动过速、其他心脏病、胃溃疡、胃炎和关节炎(比值比[OR]为 1.3-1.8);他们在身体功能测量上的得分也低于对照组和部分 PTSD 受访者。与对照组相比,有终生部分 PTSD 的受访者更有可能报告过去一年被诊断为胃炎(OR=1.7)、心绞痛(OR=1.5)和关节炎(OR=1.4),并且身体功能更差。一生中经历的创伤事件类型与评估的大多数医疗状况有关;调整这些事件后,大多数 PTSD 状况与医疗状况之间的关联程度降低且不再具有统计学意义。

结论

有终生 PTSD 的老年人有多种身体健康状况的高发病率,其中许多是与年龄相关的慢性疾病,并且身体功能更差。有终生部分 PTSD 的老年人有更高的胃炎、心绞痛和关节炎发病率,以及更差的身体功能。

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