King's Centre for Military Health Research, Department of Psychological Medicine, King's College, Weston Education Centre, Cutcombe Rd., London SE5 9RJ, UK.
J Psychiatr Res. 2012 Sep;46(9):1191-8. doi: 10.1016/j.jpsychires.2012.05.009. Epub 2012 Jun 8.
In a longitudinal study we assessed which baseline risk factors are associated with persistent and partially remitted PTSD in comparison to fully remitted PTSD. 6427 (68%) of a randomly selected sample of UK service personnel completed the PTSD checklist (PCL) between 2004 and 2006 (Phase 1) and between 2007 and 2009 (Phase 2). 230 (3.9%) had possible PTSD at baseline. 66% of those with possible PTSD at baseline remitted (PCL score <30) or partially remitted (PCL score 30-49) by phase 2 of the study. Associations of persistent PTSD with the fully remitted group for risk factors at phase 1 adjusted for confounders were having discharged from service (OR 2.97, 95% CI 1.26-6.99), higher educational qualification (OR 2.74, 95% 1.23-6.08), feeling unsupported on return from deployment (OR 10.97, 95% CI 3.13-38.45), deployed not with parent unit (OR 5.63, 95% CI 1.45-21.85), multiple physical symptoms (OR 3.36, 95% CI 1.44-7.82), perception of poor or fair health (OR 2.84, 95% CI 1.28-6.27), older age and perception of risk to self (increasing with the number of events reported, p = 0.04). Deploying but not with a parent unit and psychological distress were associated in the partially remitted PTSD when compared to the fully remitted group. The positive and negative likelihood ratios for the factors most highly associated with persistent PTSD indicated they were of marginal value to identify those whose presumed PTSD would be persistent. Many factors contribute to the persistence of PTSD but none alone is useful for clinical prediction.
在一项纵向研究中，我们评估了哪些基线风险因素与持续性和部分缓解的 PTSD 相关，而不是完全缓解的 PTSD。2004 年至 2006 年（第 1 阶段）和 2007 年至 2009 年（第 2 阶段）期间，在英国随机选择的服务人员样本中，有 6427 人（68%）完成了 PTSD 检查表（PCL）。基线时，有 230 人（3.9%）可能患有 PTSD。在研究的第 2 阶段，那些基线时可能患有 PTSD 的人中，有 66%（PCL 评分<30）或部分缓解（PCL 评分 30-49）。在调整混杂因素后，将第 1 阶段持续性 PTSD 与完全缓解组的风险因素相关联，发现退役（OR 2.97，95%CI 1.26-6.99）、较高的教育程度（OR 2.74，95%CI 1.23-6.08）、从部署中返回时感到不被支持（OR 10.97，95%CI 3.13-38.45）、未与父母单位一起部署（OR 5.63，95%CI 1.45-21.85）、多种身体症状（OR 3.36，95%CI 1.44-7.82）、对健康状况的不良或一般的感知（OR 2.84，95%CI 1.28-6.27）、年龄较大和对自我风险的感知（随着报告事件数量的增加而增加，p=0.04）。与完全缓解组相比，部分缓解 PTSD 与未与父母单位一起部署和心理困扰有关。与持续性 PTSD 最相关的因素的阳性和阴性似然比表明，它们对于识别那些假定的 PTSD 将持续存在的人来说，其价值是边缘性的。许多因素导致 PTSD 的持续存在，但没有一个因素对临床预测有用。
