Department of Clinical Research, St. John's Rehab Hospital, Toronto, Ontario, Canada.
Arch Phys Med Rehabil. 2012 Apr;93(4):623-8. doi: 10.1016/j.apmr.2011.11.015. Epub 2012 Feb 24.
To determine the profile of posttraumatic stress disorder (PTSD) among outpatients with burn injuries referred to psychology in a rehabilitation hospital, and the utility of the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C) as a screening measure for PTSD.
Retrospective psychological chart review.
Outpatient burn clinic of a rehabilitation hospital.
Outpatients (N=132) with burns referred to psychology between December 1999 and January 2010.
Psychological evaluation and self-report questionnaires measuring PTSD and depression.
The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition to assess clinical diagnosis of disorders, PCL-C to measure PTSD, and the Beck Depression Inventory-II to measure depression.
Of 132 outpatients, 127 (96%) had work-related injuries, 116 (88%) were men, and 16 (12%) were women. Mean age ± SD at injury was 39.0±11.1 years. Mean time from injury to assessment was 15.7±42.7 months. Burn etiology included: electrical (46.2%), scald (28.0%), flame (16.7%), chemical (5.3%), and contact (3.8%). Most patients (75%) were diagnosed with PTSD, either clinical (39.4%) or subclinical (35.6%). PTSD (clinical or subclinical) was frequently diagnosed in the following etiology groups: scald (85.7%), flame (77.3%), and electrical (74.6%). There were significant relationships between PTSD and depression (P<.001), and between subclinical PTSD and adjustment disorder (P<.03). PCL-C mean scores ± SD in the clinical and subclinical PTSD groups were 59.7±8.9 and 43.5±15.6, respectively. A PCL-C total score of 50 or higher had a sensitivity of 90% and specificity of 79% for PTSD diagnosis.
There was a high prevalence of PTSD (clinical or subclinical) among outpatients with burns referred to psychology. Prospective screening of psychological symptoms, clinical assessment, and intervention is warranted, especially for patients with work-related burn injuries. Our results suggest that PCL-C is a useful screening measure for PTSD in patients with burns.
确定在康复医院的心理门诊就诊的烧伤患者中创伤后应激障碍（PTSD）的特征，并评估平民版创伤后应激障碍检查表（PCL-C）作为 PTSD 筛查工具的效用。
回顾性心理图表审查。
康复医院的门诊烧伤科。
1999 年 12 月至 2010 年 1 月期间被转诊至心理科的门诊烧伤患者（N=132）。
心理评估和自我报告问卷，用于测量 PTSD 和抑郁。
《精神障碍诊断与统计手册》第四版用于评估障碍的临床诊断，PCL-C 用于测量 PTSD，贝克抑郁自评量表 II 用于测量抑郁。
在 132 名门诊患者中，127 名（96%）有工作相关的损伤，116 名（88%）为男性，16 名（12%）为女性。损伤时的平均年龄±标准差为 39.0±11.1 岁。从损伤到评估的平均时间为 15.7±42.7 个月。烧伤病因包括：电（46.2%）、烫伤（28.0%）、火焰（16.7%）、化学（5.3%）和接触（3.8%）。大多数患者（75%）被诊断为 PTSD，无论是临床（39.4%）还是亚临床（35.6%）。在以下病因组中经常诊断出 PTSD（临床或亚临床）：烫伤（85.7%）、火焰（77.3%）和电（74.6%）。PTSD（临床或亚临床）与抑郁之间存在显著的关系（P<.001），以及亚临床 PTSD 与适应障碍之间的关系（P<.03）。在临床和亚临床 PTSD 组中，PCL-C 的平均得分±标准差分别为 59.7±8.9 和 43.5±15.6。PCL-C 总分≥50 分对 PTSD 诊断的敏感性为 90%，特异性为 79%。
在被转诊至心理科的烧伤门诊患者中，PTSD（临床或亚临床）的患病率很高。需要对心理症状进行前瞻性筛查、临床评估和干预，尤其是对与工作有关的烧伤患者。我们的结果表明，PCL-C 是烧伤患者 PTSD 的一种有用的筛查工具。
