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荷兰法医精神病门诊患者创伤后应激障碍的相关因素。

Correlates of posttraumatic stress disorder in forensic psychiatric outpatients in the Netherlands.

机构信息

International Victimology Institute, Tilburg University, Tilburg, The Netherlands.

出版信息

J Trauma Stress. 2012 Jun;25(3):315-22. doi: 10.1002/jts.21706. Epub 2012 Jun 12.

DOI:10.1002/jts.21706
PMID:22692955
Abstract

Using a sample of 154 Dutch forensic psychiatric outpatients aged 18-62 years, this study investigated whether risk factors of posttraumatic stress disorder (PTSD), mainly identified in nonforensic research, forensic psychiatric factors, and potential comorbid mental disorders were associated with PTSD. Data on demographics, victimization during childhood or adolescence, and forensic psychiatric factors were derived from electronic medical records. Mental disorders were assessed using structured psychiatric interviews and consensus diagnoses were established during weekly case consultations. The PTSD rate was 75% in the sample. Whereas the PTSD group was significantly more likely to be older, female, not Dutch, and to have a history of victimization, previously perpetrated family violence, and lower psychosocial and occupational functioning than the non-PTSD group, the latter group had significantly higher rates of psychiatric history, attention-deficit/hyperactivity disorder (ADHD), antisocial personality disorder, drug abuse, and previous repeated nonfamily violence perpetration. Effect sizes ranged from Nagelkerke R(2) = .04 for psychosocial and occupational functioning to Nagelkerke R(2) = .70 for ADHD. This study demonstrated differences between those with and without PTSD in demographic, victim, forensic, and psychological characteristics. Future studies should examine the complexity between early victimization, delinquency patterns, and psychopathology regarding the prediction of PTSD among forensic psychiatric outpatients.

摘要

本研究使用了 154 名年龄在 18 至 62 岁之间的荷兰法医精神病门诊患者作为样本,旨在探讨创伤后应激障碍(PTSD)的风险因素,这些因素主要在非法医研究中确定,如法医精神病学因素和潜在的合并精神障碍,是否与 PTSD 相关。人口统计学数据、儿童或青少年时期的受害经历以及法医精神病学因素均来自电子病历。使用结构化精神病学访谈评估精神障碍,并在每周的病例讨论会上进行共识诊断。在该样本中,PTSD 的发生率为 75%。与非 PTSD 组相比,PTSD 组的年龄更大、女性更多、非荷兰人、有受害史、先前有家庭暴力史、社会心理和职业功能较低,而非 PTSD 组的精神病史、注意力缺陷多动障碍(ADHD)、反社会人格障碍、药物滥用和以前非家庭暴力的重复发生率更高。效应大小范围从社会心理和职业功能的 Nagelkerke R(2) =.04 到 ADHD 的 Nagelkerke R(2) =.70。本研究表明,在人口统计学、受害、法医和心理特征方面,患有 PTSD 和未患有 PTSD 的患者存在差异。未来的研究应探讨早期受害、犯罪模式和精神病理学之间的复杂性,以预测法医精神病门诊患者的 PTSD。

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