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越战时期老年退伍军人创伤后应激障碍的患病率:退伍军人事务部合作研究569:越战时期退伍军人双胞胎创伤后应激障碍的病程及后果

Prevalence of Post-Traumatic Stress Disorder in Aging Vietnam-Era Veterans: Veterans Administration Cooperative Study 569: Course and Consequences of Post-Traumatic Stress Disorder in Vietnam-Era Veteran Twins.

作者信息

Goldberg Jack, Magruder Kathryn M, Forsberg Christopher W, Friedman Matthew J, Litz Brett T, Vaccarino Viola, Heagerty Patrick J, Gleason Theresa C, Huang Grant D, Smith Nicholas L

机构信息

Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, WA; Department of Epidemiology, University of Washington, Seattle, WA.

Mental Health Service, Ralph H. Johnson VA Medical Center, Charleston, SC; Department of Psychiatry, Medical University of South Carolina, Charleston, SC.

出版信息

Am J Geriatr Psychiatry. 2016 Mar;24(3):181-91. doi: 10.1016/j.jagp.2015.05.004. Epub 2015 May 16.

Abstract

OBJECTIVE

The prevalence of post-traumatic stress disorder (PTSD) among aging Vietnam-era veterans is not well characterized.

METHODS

In a cross-sectional study, 5,598 male Vietnam-era veterans and members of the Vietnam Era Twin Registry were assessed for PTSD using the Composite International Diagnostic Interview. Current symptoms were measured with the PTSD Checklist (PCL). PTSD was estimated according to age (<60 or ≥ 60) and Vietnam theater service.

RESULTS

The lifetime prevalence of PTSD in theater veterans aged at least 60 years was 16.9% (95% CI: 13.9%-20.5%) and higher than the 5.5% (95% CI: 4.3%-7.0%) among nontheater veterans. Among veterans younger than 60 years, the comparable prevalence was 22.0% for theater (95% CI: 16.7%-28.4%) and 15.7% for nontheater (95% CI: 13.4%-18.2%) veterans. Similar results were found for theater service and current PTSD prevalence (past 12 months). PCL scores were significantly higher in theater compared with nontheater veterans in both younger and older cohorts. In both the younger and older cohorts significant differences in lifetime and current PTSD prevalence and PCL scores persisted in theater service discordant twin pairs.

CONCLUSION

Vietnam service is related to elevated PTSD prevalence and current symptom burden in aging veterans. More than 30 years after the end of the Vietnam conflict, many veterans continue to suffer from PTSD, which highlights the need for continuing outreach throughout the life course.

摘要

目的

越战时期退伍军人中创伤后应激障碍(PTSD)的患病率尚无明确特征描述。

方法

在一项横断面研究中,使用复合国际诊断访谈对5598名越战时期男性退伍军人及越战时期双胞胎登记处成员进行PTSD评估。用PTSD检查表(PCL)测量当前症状。根据年龄(<60岁或≥60岁)和在越南战区服役情况评估PTSD。

结果

至少60岁的战区退伍军人中PTSD的终生患病率为16.9%(95%CI:13.9%-20.5%),高于非战区退伍军人的5.5%(95%CI:4.3%-7.0%)。在60岁以下的退伍军人中,战区退伍军人的可比患病率为22.0%(95%CI:16.7%-28.4%),非战区退伍军人的患病率为15.7%(95%CI:13.4%-18.2%)。在战区服役情况和当前PTSD患病率(过去12个月)方面也发现了类似结果。在年轻和年长队列中,战区退伍军人的PCL得分均显著高于非战区退伍军人。在年轻和年长队列中,战区服役情况不一致的双胞胎对在终生和当前PTSD患病率及PCL得分方面均存在显著差异。

结论

在越战时期服役与老年退伍军人中PTSD患病率升高及当前症状负担有关。越南冲突结束30多年后,许多退伍军人仍患有PTSD,这凸显了在整个生命过程中持续开展外联工作的必要性。

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