Abdelghaffar Wafa, Ouali Uta, Jomli Rabaa, Zgueb Yosra, Nacef Fethi
Clin Schizophr Relat Psychoses. 2018 Fall;12(3):105-112B. doi: 10.3371/csrp.ABOU.123015. Epub 2016 Jan 18.
The experience of psychosis or related treatment can be conceptualized as a traumatic event, which might lead to posttraumatic stress disorder (PTSD) or PTSD syndrome (which is defined as the presence of PTSD symptoms irrespective of the DSM-IV criterion A definition of a traumatic event as an actual or threatened harm). Few studies explored the subject so far.
This cross-sectional study included 52 clinically stabilized patients who were hospitalized for a first-psychotic episode during the two years preceding the study. Sociodemographic and clinical information were collected including past trauma history and drug and alcohol use. Patients were administered the Clinician-Administered PTSD Scale (CAPS), the Major Depression Inventory (MDI), the Positive and Negative Syndrome Scale (PANSS), the Global Assessment of Functioning scale (GAF), and the Brief COPE.
A total of 22 patients (42.3%) met full PTSD criteria and 36 patients (69.2%) met PTSD syndrome criteria. Full PTSD as well as PTSD syndrome were both associated with physical restraint, higher scores on the MDI and its maladaptive coping scales. The most distressing symptoms were paranoid delusions, and the most distressing treatment experiences involved physical restraint and problems with other hospitalized patients.
DISCUSSION/CONCLUSIONS: Our data showed high rates of psychosis-related PTSD. To prevent PTSD, conditions of hospitalization should be optimized and the use of coercive treatments should be limited. Subjects with recent-onset psychosis should be screened for PTSD symptoms. Improving coping abilities with a well-fitted therapy would be useful in these patients.
精神病发作或相关治疗经历可被视为创伤性事件，这可能导致创伤后应激障碍（PTSD）或PTSD综合征（其定义为存在PTSD症状，无论DSM-IV中关于创伤性事件的标准A将其定义为实际或威胁性伤害）。到目前为止，很少有研究探讨这个主题。
这项横断面研究纳入了52名临床病情稳定的患者，这些患者在研究前两年内因首次精神病发作而住院。收集了社会人口学和临床信息，包括既往创伤史以及药物和酒精使用情况。对患者进行了临床医生管理的PTSD量表（CAPS）、重度抑郁量表（MDI）、阳性和阴性症状量表（PANSS）、功能总体评定量表（GAF）以及简易应对方式问卷（Brief COPE）的评估。
共有22名患者（42.3%）符合PTSD全部标准，36名患者（69.2%）符合PTSD综合征标准。PTSD全部标准以及PTSD综合征均与身体约束、MDI及其适应不良应对量表上的较高得分相关。最令人痛苦的症状是偏执妄想，最令人痛苦的治疗经历涉及身体约束以及与其他住院患者的问题。
讨论/结论：我们的数据显示与精神病相关的PTSD发生率很高。为预防PTSD，应优化住院条件并限制强制治疗的使用。近期发病的精神病患者应筛查PTSD症状。采用合适的治疗方法提高应对能力对这些患者会很有帮助。
