Spinhoven Philip, Penninx Brenda W, van Hemert Albert M, de Rooij Mark, Elzinga Bernet M
Institute of Psychology, Leiden University, Leiden, The Netherlands; Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands.
Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands; Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands; Department of Psychiatry/EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
Child Abuse Negl. 2014 Aug;38(8):1320-30. doi: 10.1016/j.chiabu.2014.01.017. Epub 2014 Mar 13.
The present study aims to assess comorbidity of posttraumatic stress disorder (PTSD) in anxiety and depressive disorders and to determine whether childhood trauma types and other putative independent risk factors for comorbid PTSD are unique to PTSD or shared with anxiety and depressive disorders. The sample of 2402 adults aged 18-65 included healthy controls, persons with a prior history of affective disorders, and persons with a current affective disorder. These individuals were assessed at baseline (T0) and 2 (T2) and 4 years (T4) later. At each wave, DSM-IV-TR based anxiety and depressive disorder, neuroticism, extraversion, and symptom severity were assessed. Childhood trauma was measured at T0 with an interview and at T4 with a questionnaire, and PTSD was measured with a standardized interview at T4. Prevalence of 5-year recency PTSD among anxiety and depressive disorders was 9.2%, and comorbidity, in particular with major depression, was high (84.4%). Comorbidity was associated with female gender, all types of childhood trauma, neuroticism, (low) extraversion, and symptom severity. Multivariable significant risk factors (i.e., female gender and child sexual and physical abuse) were shared among anxiety and depressive disorders. Our results support a shared vulnerability model for comorbidity of anxiety and depressive disorders with PTSD. Routine assessment of PTSD in patients with anxiety and depressive disorders seems warranted.
本研究旨在评估创伤后应激障碍(PTSD)在焦虑症和抑郁症中的共病情况,并确定童年创伤类型以及其他假定的PTSD共病独立危险因素是PTSD所特有的,还是与焦虑症和抑郁症共有。2402名年龄在18 - 65岁的成年人样本包括健康对照者、有情感障碍既往史的人以及患有当前情感障碍的人。这些个体在基线(T0)以及2年(T2)和4年(T4)后接受评估。在每一波次中,评估基于《精神疾病诊断与统计手册》第四版修订版(DSM-IV-TR)的焦虑症和抑郁症、神经质、外向性以及症状严重程度。童年创伤在T0时通过访谈进行测量,在T4时通过问卷进行测量,PTSD在T4时通过标准化访谈进行测量。焦虑症和抑郁症中5年近期PTSD的患病率为9.2%,共病情况,尤其是与重度抑郁症的共病情况较高(84.4%)。共病与女性性别、所有类型的童年创伤、神经质、(低)外向性以及症状严重程度相关。多变量显著危险因素(即女性性别以及儿童性虐待和身体虐待)在焦虑症和抑郁症中是共有的。我们的结果支持焦虑症和抑郁症与PTSD共病的共同易感性模型。对焦虑症和抑郁症患者进行PTSD的常规评估似乎是有必要的。