Tsai Jack, Armour Cherie, Southwick Steven M, Pietrzak Robert H
United States Department of Veterans Affairs, New England Mental Illness Research, Education, and Clinical Center, West Haven, CT, United States; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States.
Psychology Research Institute, University of Ulster, Coleraine, Northern Ireland, UK.
J Psychiatr Res. 2015 Jul-Aug;66-67:67-74. doi: 10.1016/j.jpsychires.2015.04.017. Epub 2015 Apr 30.
The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) formally introduced a dissociative subtype of posttraumatic stress disorder (PTSD). This study examined the proportion of U.S. veterans with DSM-5 PTSD that report dissociative symptoms; and compared veterans with PTSD with and without the dissociative subtype and trauma-exposed controls on sociodemographics, clinical characteristics, and quality of life. Multivariable analyses were conducted on a nationally representative sample of 1484 veterans from the National Health and Resilience in Veterans Study (second baseline survey conducted September-October, 2013). Of the 12.0% and 5.2% of veterans who screened positive for lifetime and past-month DSM-5 PTSD, 19.2% and 16.1% screened positive for the dissociative subtype, respectively. Among veterans with PTSD, those with the dissociative subtype reported more severe PTSD symptoms, comorbid depressive and anxiety symptoms, alcohol use problems, and hostility than those without the dissociative subtype. Adjusting for PTSD symptom severity, those with the dissociative subtype continued to report more depression and alcohol use problems. These results underscore the importance of assessing, monitoring, and treating the considerable proportion of veterans with PTSD and dissociative symptoms.
《精神疾病诊断与统计手册》第5版（DSM - 5）正式引入了创伤后应激障碍（PTSD）的解离亚型。本研究调查了报告有解离症状的美国退伍军人中符合DSM - 5 PTSD诊断标准者的比例；并在社会人口统计学、临床特征和生活质量方面，对有和解离亚型的PTSD退伍军人以及经历过创伤的对照者进行了比较。对来自退伍军人健康与恢复力研究（2013年9月至10月进行的第二次基线调查）的1484名具有全国代表性的退伍军人样本进行了多变量分析。在终生和过去一个月符合DSM - 5 PTSD筛查阳性的退伍军人中，分别有19.2%和16.1%符合解离亚型筛查阳性。在患有PTSD的退伍军人中，有解离亚型者比没有解离亚型者报告有更严重的PTSD症状、共病的抑郁和焦虑症状、酒精使用问题及敌意。在调整PTSD症状严重程度后，有解离亚型者仍报告有更多的抑郁和酒精使用问题。这些结果强调了评估、监测和治疗相当比例有PTSD和解离症状的退伍军人的重要性。
