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60多年后:创伤及创伤后应激障碍在二战时期被迫流离失所与老年躯体化关联中的中介作用

More than 60 years later: the mediating role of trauma and posttraumatic stress disorder for the association of forced displacement in world war II with somatization in old age.

作者信息

Kuwert Philipp, Braehler Elmar, Freyberger Harald J, Glaesmer Heide

机构信息

Department of Psychiatry and Psychotherapy, Ernst-Moritz-Arndt-University Greifswald, HELIOS Hansehospital Stralsund, Germany.

出版信息

J Nerv Ment Dis. 2012 Oct;200(10):911-4. doi: 10.1097/NMD.0b013e31826ba129.

Abstract

Up to now, it has remained unclear whether displacement itself is the pathogenetic factor for the impairment of mental health in uprooted individuals or whether the effect is mediated by the amount of traumatic events experienced during forced displacement and/or by the development of posttraumatic stress disorder (PTSD). A total of 1657 participants were included in this population-based study, who were then administered with the Patient Health Questionnaire, a modified trauma list of the PTSD module of the Munich Composite International Diagnostic Interview, and the Posttraumatic Diagnostic Scale. Displacement was associated with increased rates of traumatic events. The displaced participants were significantly more affected by somatoform symptoms and PTSD than the nondisplaced population. It was not displacement itself but the amount of trauma experienced during displacement that predicts current somatization in the population-based sample. The results highlight the necessity for prevention and treatment of posttraumatic conditions in displaced individuals and underpin the importance to understand somatization as one condition of the posttraumatic symptoms spectrum in the elderly.

摘要

到目前为止,尚不清楚流离失所本身是否是背井离乡者心理健康受损的致病因素,或者这种影响是否由被迫流离失所期间经历的创伤事件数量和/或创伤后应激障碍(PTSD)的发展所介导。这项基于人群的研究共纳入了1657名参与者,随后对他们进行了患者健康问卷、慕尼黑综合国际诊断访谈PTSD模块的改良创伤清单以及创伤后诊断量表的评估。流离失所与创伤事件发生率增加相关。与未流离失所人群相比,流离失所的参与者受躯体形式症状和PTSD的影响明显更大。在基于人群的样本中,并非流离失所本身,而是流离失所期间经历的创伤数量预测了当前的躯体化症状。研究结果凸显了预防和治疗流离失所者创伤后状况的必要性,并强调了将躯体化理解为老年人创伤后症状谱中的一种状况的重要性。

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