Hines Lindsey A, Sundin Josefin, Rona Roberto J, Wessely Simon, Fear Nicola T
Research Assistant, King's Centre for Mental Health Research, King's College London, London, England.
Post-doctoral Researcher, Academic Centre for Defence Mental Health, King's College London, London, England.
Can J Psychiatry. 2014 Sep;59(9):468-79. doi: 10.1177/070674371405900903.
A large body of research has been produced in recent years investigating posttraumatic stress disorder (PTSD) among military personnel following deployment to Iraq and Afghanistan, resulting in apparent differences in PTSD prevalence. We compare prevalence estimates for current PTSD between military subgroups, providing insight into how groups may be differentially affected by deployment. Systematic literature searches using the terms PTSD, stress disorder, and acute stress, combined with terms relating to military personnel, identified 49 relevant papers. Studies with a sample size of less than 100 and studies based on data for treatment seeking or injured populations were excluded. Studies were categorized according to theatre of deployment (Iraq or Afghanistan), combat and noncombat deployed samples, sex, enlistment type (regular or reserve and [or] National Guard), and service branch (for example, army, navy, and air force). Meta-analysis was used to assess PTSD prevalence across subgroups. There was large variability in PTSD prevalence between studies, but, regardless of heterogeneity, prevalence rates of PTSD were higher among studies of Iraq-deployed personnel (12.9%; 95% CI 11.3% to 14.4%), compared with personnel deployed to Afghanistan (7.1%; 95% CI 4.6% to 9.6%), combat deployed personnel, and personnel serving in the Canadian, US, or UK army or the navy or marines (12.4%; 95% CI 10.9% to 13.4%), compared with the other services (4.9%; 95% CI 1.4% to 8.4%). Contrary to findings from within-study comparisons, we did not find a difference in PTSD prevalence for regular active-duty and reserve or National Guard personnel. Categorizing studies according to deployment location and branch of service identified differences among subgroups that provide further support for factors underlying the development of PTSD.
近年来,针对部署到伊拉克和阿富汗的军事人员创伤后应激障碍(PTSD)展开了大量研究,结果显示PTSD患病率存在明显差异。我们比较了不同军事亚组中当前PTSD的患病率估计值,以深入了解不同亚组受部署影响的差异情况。通过使用PTSD、应激障碍和急性应激等术语,并结合与军事人员相关的术语进行系统的文献检索,共识别出49篇相关论文。样本量少于100的研究以及基于寻求治疗或受伤人群数据的研究被排除。研究根据部署地区(伊拉克或阿富汗)、参战和非参战部署样本、性别、入伍类型(正规军或预备役以及[或]国民警卫队)和军种(例如陆军、海军和空军)进行分类。采用荟萃分析来评估各亚组中的PTSD患病率。不同研究之间PTSD患病率存在很大差异,但无论异质性如何,与部署到阿富汗的人员(7.1%;95%置信区间4.6%至9.6%)、参战部署人员以及在加拿大、美国或英国陆军、海军或海军陆战队服役的人员(12.4%;95%置信区间10.9%至13.4%)相比,部署到伊拉克的人员研究中的PTSD患病率更高(12.9%;95%置信区间11.3%至14.4%),而与其他军种(4.9%;95%置信区间1.4%至8.4%)相比则更高。与研究内比较的结果相反,我们没有发现正规现役人员与预备役或国民警卫队人员在PTSD患病率上存在差异。根据部署地点和军种对研究进行分类,发现各亚组之间存在差异,这进一步支持了PTSD发展背后的因素。