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创伤后应激障碍和躯体化主诉:对比越战和伊拉克/阿富汗老兵的经历。

Posttraumatic stress disorder and somatic complaints: Contrasting Vietnam and OIF/OEF Veterans' experiences.

机构信息

VA Ann Arbor Healthcare System, Ann Arbor, MI, United States; University of Michigan Medical School Department of Psychiatry, Ann Arbor, MI, United States.

Emory University School of Medicine, Atlanta, GA, United States; Atlanta VA Medical Center, Atlanta, GA, United States.

出版信息

J Psychosom Res. 2016 Mar;82:35-40. doi: 10.1016/j.jpsychores.2016.01.009. Epub 2016 Jan 29.

Abstract

OBJECTIVE

To replicate and expand upon the relationship of somatic symptoms and posttraumatic stress disorder (PTSD) by comparing symptoms among service eras in US Veterans.

METHOD

Data were collected from 226 Vietnam and 132 Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) Veterans who were referred to a Veterans Affairs (VA) hospital PTSD outpatient clinic between 2005 and 2013. Veterans were administered self-report inventories and a clinical interview to measure somatic symptoms and PTSD severity. A subset of Veterans (n=185) screening positive for PTSD were administered the Clinician Administered PTSD Scale (CAPS) to measure PTSD severity. Multiple moderated linear regressions were used to examine the influence of service era on the relationship between somatic and PTSD symptoms.

RESULTS

There were no significant differences between service eras in pain severity, pain interference, and total somatic symptoms reported. Vietnam Veterans were more likely to report limb/join pain (p<.05), fainting (p<.01), and shortness of breath (p<.001), whereas OIF/OEF Veterans were more likely to complain of headaches (p<.001). A significant interaction effect occurred between service era and dizziness (p<.05) and chest pain (p<.01), with OIF/OEF Veterans reporting higher levels of these symptoms significantly more likely than Vietnam Veterans to also experience more severe PTSD.

CONCLUSION

Findings are consistent with previous research demonstrating the relationship of somatic symptoms and PTSD across service eras but provide additional data concerning similarities and differences of somatic symptoms between eras. Potential explanations for observed service era differences in somatic symptoms are discussed.

摘要

目的

通过比较美国退伍军人不同服役时期的躯体症状,复制和扩展躯体症状与创伤后应激障碍(PTSD)之间的关系。

方法

本研究的数据来自于 2005 年至 2013 年间,转诊至退伍军人事务部(VA)医院 PTSD 门诊的 226 名越战和 132 名伊拉克自由行动/持久自由行动(OIF/OEF)退伍军人。退伍军人接受了自我报告量表和临床访谈,以测量躯体症状和 PTSD 严重程度。一小部分(n=185)筛查出 PTSD 的退伍军人接受了临床医生管理 PTSD 量表(CAPS),以测量 PTSD 严重程度。采用多元调节线性回归分析,检验了服务时期对躯体症状与 PTSD 症状之间关系的影响。

结果

不同服役时期的疼痛严重程度、疼痛干扰和总躯体症状报告没有显著差异。越战退伍军人更有可能报告四肢/关节疼痛(p<.05)、晕厥(p<.01)和呼吸急促(p<.001),而 OIF/OEF 退伍军人更有可能抱怨头痛(p<.001)。服务时期与头晕(p<.05)和胸痛(p<.01)之间存在显著的交互效应,OIF/OEF 退伍军人报告这些症状的水平较高,与越战退伍军人相比,他们也更有可能经历更严重的 PTSD。

结论

这些发现与之前的研究一致,证明了躯体症状与 PTSD 在不同服役时期的关系,但提供了关于不同时期躯体症状之间的相似性和差异的额外数据。对观察到的躯体症状在服务时期差异的潜在解释进行了讨论。

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