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意大利急救人员中的《精神疾病诊断与统计手册》第五版创伤后应激障碍及创伤后应激谱系:与工作和社会适应的相关性

DSM-5 PTSD and posttraumatic stress spectrum in Italian emergency personnel: correlations with work and social adjustment.

作者信息

Carmassi Claudia, Gesi Camilla, Simoncini Marly, Favilla Luca, Massimetti Gabriele, Olivieri Maria Cristina, Conversano Ciro, Santini Massimo, Dell'Osso Liliana

机构信息

Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy.

Emergency Medicine and Emergency Room Unit, Azienda Ospedaliero-Universitaria Pisana (AOUP), Pisa, Italy.

出版信息

Neuropsychiatr Dis Treat. 2016 Feb 18;12:375-81. doi: 10.2147/NDT.S97171. eCollection 2016.

Abstract

The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) has recently recognized a particular risk for posttraumatic stress disorder (PTSD) among first responders (criterion A4), acknowledging emergency units as stressful places of employment. Little data is yet available on DSM-5 among emergency health operators. The aim of this study was to assess DSM-5 symptomatological PTSD and posttraumatic stress spectrum, as well as their impact on work and social functioning, in the emergency staff of a major university hospital in Italy. One hundred and ten subjects (doctors, nurses, and health-care assistants) were recruited at the Emergency Unit of the Azienda Ospedaliero-Universitaria Pisana (Italy) and assessed by the Trauma and Loss Spectrum-Self Report (TALS-SR) and Work and Social Adjustment Scale (WSAS). A 15.7% DSM-5 symptomatological PTSD prevalence rate was found. Nongraduated persons reported significantly higher TALS-SR Domain IV (reaction to loss or traumatic events) scores and a significantly higher proportion of individuals presenting at least one maladaptive behavior (TALS-SR Domain VII), with respect to graduate ones. Women reported significantly higher WSAS scores. Significant correlations emerged between PTSD symptoms and WSAS total scores among health-care assistants, nongraduates and women. Our results showed emergency workers to be at risk for posttraumatic stress spectrum and related work and social impairment, particularly among women and nongraduated subjects.

摘要

《精神疾病诊断与统计手册(第五版)》(DSM - 5)最近认识到急救人员患创伤后应激障碍(PTSD)的特定风险(标准A4),承认急救单位是压力较大的工作场所。关于急救卫生工作者中DSM - 5的可用数据仍然很少。本研究的目的是评估意大利一家大型大学医院急救人员中DSM - 5症状性PTSD和创伤后应激谱,以及它们对工作和社会功能的影响。在比萨大学医院(意大利)的急诊科招募了110名受试者(医生、护士和医疗保健助理),并通过创伤与丧失谱 - 自我报告(TALS - SR)和工作与社会适应量表(WSAS)进行评估。发现DSM - 5症状性PTSD患病率为15.7%。与有学位者相比,无学位者报告的TALS - SR第四领域(对丧失或创伤性事件的反应)得分显著更高,且表现出至少一种适应不良行为(TALS - SR第七领域)的个体比例显著更高。女性报告的WSAS得分显著更高。在医疗保健助理、无学位者和女性中,PTSD症状与WSAS总分之间存在显著相关性。我们的结果表明,急救人员存在创伤后应激谱以及相关工作和社会功能受损的风险,特别是在女性和无学位受试者中。

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