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创伤后应激障碍

Post-traumatic Stress Disorder.

作者信息

Javidi H, Yadollahie M

机构信息

Islamic Azad University, Marvdasht Branch, Department of Psychology, Marvdasht, Iran.

出版信息

Int J Occup Environ Med. 2012 Jan;3(1):2-9.

Abstract

Unexpected extreme sudden traumatic stressor may cause post-traumatic stress disorder (PTSD). Important traumatic events include war, violent personal assault (e.g., sexual assault, and physical attack), being taken hostage or kidnapped, confinement as a prisoner of war, torture, terrorist attack, severe car accidents, and natural disasters. In childhood age sexual abuse or witnessing serious injuries or unexpected death of a beloved one are among important traumatic events.PTSD can be categorized into two types of acute and chronic PTSD: if symptoms persist for less than three months, it is termed "acute PTSD," otherwise, it is called "chronic PTSD." 60.7% of men and 51.2% of women would experience at least one potentially traumatic event in their lifetime. The lifetime prevalence of PTSD is significantly higher in women than men. Lifetime prevalence of PTSD varies from 0.3% in China to 6.1% in New Zealand. The prevalence of PTSD in crime victims are between 19% and 75%; rates as high as 80% have been reported following rape. The prevalence of PTSD among direct victims of disasters was reported to be 30%-40%; the rate in rescue workers was 10%-20%. The prevalence of PTSD among police, fire, and emergency service workers ranged from 6%-32%. An overall prevalence rate of 4% for the general population, the rate in rescue/recovery occupations ranged from 5% to 32%, with the highest rate reported in search and rescue personnel (25%), firefighters (21%), and workers with no prior training for facing disaster. War is one of the most intense stressors known to man. Armed forces have a higher prevalence of depression, anxiety disorders, alcohol abuse and PTSD. High-risk children who have been abused or experienced natural disasters may have an even higher prevalence of PTSD than adults.Female gender, previous psychiatric problem, intensity and nature of exposure to the traumatic event, and lack of social support are known risk factors for work-related PTSD. Working with severely ill patients, journalists and their families, and audiences who witness serious trauma and war at higher risk of PTSD.The intensity of trauma, pre-trauma demographic variables, neuroticism and temperament traits are the best predictors of the severity of PTSD symptoms. About 84% of those suffering from PTSD may have comorbid conditions including alcohol or drug abuse; feeling shame, despair and hopeless; physical symptoms; employment problems; divorce; and violence which make life harder. PTSD may contribute to the development of many other disorders such as anxiety disorders, major depressive disorder, substance abuse/dependency disorders, alcohol abuse/dependence, conduct disorder, and mania. It causes serious problems, thus its early diagnosis and appropriate treatment are of paramount importance.

摘要

意外的极端突发创伤性应激源可能导致创伤后应激障碍(PTSD)。重要的创伤性事件包括战争、暴力人身攻击(如性侵犯和身体攻击)、被劫持或绑架、作为战俘被囚禁、酷刑、恐怖袭击、严重车祸和自然灾害。在儿童时期,性虐待或目睹亲人严重受伤或意外死亡属于重要的创伤性事件。PTSD可分为急性和慢性PTSD两种类型:如果症状持续时间少于三个月,则称为“急性PTSD”,否则称为“慢性PTSD”。60.7%的男性和51.2%的女性在一生中至少会经历一次潜在的创伤性事件。女性PTSD的终生患病率显著高于男性。PTSD的终生患病率在中国为0.3%,在新西兰为6.1%。犯罪受害者中PTSD的患病率在19%至75%之间;据报道,强奸案后的患病率高达80%。据报道,灾难直接受害者中PTSD的患病率为30%-40%;救援人员中的患病率为10%-20%。警察、消防和应急服务人员中PTSD的患病率在6%-32%之间。一般人群的总体患病率为4%,救援/恢复职业中的患病率在5%至32%之间,其中搜索和救援人员(25%)、消防员(21%)以及没有应对灾难预先培训的工作人员的患病率最高。战争是人类已知的最强烈的应激源之一。武装部队中抑郁症、焦虑症、酗酒和PTSD的患病率较高。遭受虐待或经历自然灾害的高危儿童PTSD的患病率可能比成年人更高。女性、先前的精神问题、接触创伤性事件的强度和性质以及缺乏社会支持是与工作相关的PTSD的已知风险因素。与重症患者、记者及其家人以及目睹严重创伤和战争的观众打交道的人患PTSD的风险更高。创伤强度、创伤前人口统计学变量、神经质和气质特征是PTSD症状严重程度的最佳预测指标。约84%的PTSD患者可能伴有其他疾病,包括酗酒或药物滥用;感到羞耻、绝望和无助;身体症状;就业问题;离婚;以及暴力行为,这些都会使生活更加艰难。PTSD可能导致许多其他疾病的发生,如焦虑症、重度抑郁症、物质滥用/依赖症、酗酒/依赖症、品行障碍和躁狂症。它会引发严重问题,因此早期诊断和适当治疗至关重要。

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