创伤、创伤后应激障碍和品行障碍的关联：系统评价和荟萃分析。
Association of trauma, Posttraumatic Stress Disorder and Conduct Disorder: A systematic review and meta-analysis.
机构信息
Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Deutschordenstraße 50, 60528 Frankfurt am Main, Germany.
Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Deutschordenstraße 50, 60528 Frankfurt am Main, Germany.
出版信息
Neurosci Biobehav Rev. 2018 Aug;91:153-169. doi: 10.1016/j.neubiorev.2016.12.019. Epub 2016 Dec 23.
OBJECTIVE
To summarize findings of previous studies on the prevalence of trauma and Posttraumatic Stress Disorder (PTSD) in Conduct Disorder (CD).
METHOD
We conducted a systematic review and meta-analysis following the PRISMA guidelines. EBSCOhost, PubMed, CDSR and ARIF databases were searched in October 2016, employing relevant keywords.
RESULTS
19 studies met inclusion criteria. Meta-analysis resulted in a lifetime PTSD prevalence of 11% (95% CI: 7-17%) in children and adolescents with CD, 14% (95% CI: 12-15%) in adults with pre-existing CD and 32% (95% CI: 25-40%) in juvenile offenders with CD. Higher lifetime PTSD prevalence was observed in individuals with than without CD, and in females compared to males with CD.
CONCLUSIONS
Studies focusing on the association of trauma, PTSD and CD are still relatively rare. Possible comorbidity models are discussed considering psychological and biological risk factors in a comprehensive model. The high rate of PTSD in CD may be due to shared risk factors; furthermore, CD might increase the risk for comorbid PTSD due to CD inherent risk taking behavior. To study pathways of risk, especially longitudinal studies are necessary.
目的
总结以往关于品行障碍（CD）患者创伤和创伤后应激障碍（PTSD）患病率的研究结果。
方法
我们按照 PRISMA 指南进行了系统评价和荟萃分析。2016 年 10 月，我们使用相关关键词在 EBSCOhost、PubMed、CDSR 和 ARIF 数据库中进行了检索。
结果
有 19 项研究符合纳入标准。荟萃分析结果显示，患有 CD 的儿童和青少年终生 PTSD 患病率为 11%（95%CI：7-17%），患有既往 CD 的成年人为 14%（95%CI：12-15%），患有 CD 的少年犯为 32%（95%CI：25-40%）。与没有 CD 的个体相比，患有 CD 的个体以及女性 CD 患者的终生 PTSD 患病率更高。
结论
目前仍相对较少有研究关注创伤、PTSD 和 CD 之间的关联。考虑到心理和生物风险因素，在综合模型中讨论了可能的共病模型。CD 中 PTSD 的高发生率可能是由于存在共同的风险因素；此外，由于 CD 本身具有冒险行为，CD 可能会增加共患 PTSD 的风险。为了研究风险途径，特别是需要进行纵向研究。
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