School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; National Taiwan University Hospital, Taipei, Taiwan.
School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.
Sci Rep. 2017 Jan 27;7:41276. doi: 10.1038/srep41276.
Nature disasters and terrorist attacks have occurred globally in recent years. Posttraumatic stress disorder (PTSD) has gained increasing attention, but its incidence and comorbidities in the general population are different from those inside the disaster areas. The present study estimated incident PTSD and comorbid diseases for over a decade in a cohort from a community-based integrated screening program. Factors associated with the incidence of PTSD were analyzed using Cox regression models. PTSD incidence was estimated as 81 per 10 person-years. Incidence was higher in females than in males and one-year increments in age lowered the risk for PTSD by 3%. Adjusting for other factors, cardiovascular heart disease (adjusted hazard ratio (aHR) = 1.45, 95% confidence interval (CI): 1.03-2.04), bipolar disorder (aHR = 1.86, 95% CI: 1.07-3.24) and major depressive disorder (aHR = 7.03, 95% CI: 5.02-9.85) all significantly increased 45%, 86% and 603%, respectively, the risk of developing PTSD. The low rate of people with incident PTSD receiving treatment in this community health screening population implies there is room for improvement in terms of early detection and intervention. Clinical preventive efforts may be made for patients seeking general medical help, especially those with cardiovascular disorders or mood disorders.
近年来,全球范围内发生了自然灾害和恐怖袭击事件。创伤后应激障碍(PTSD)越来越受到关注,但它在普通人群和灾区人群中的发病率和合并症不同。本研究通过社区综合筛查项目中的队列研究,估计了十多年来 PTSD 的发病率和合并疾病。使用 Cox 回归模型分析了与 PTSD 发病率相关的因素。PTSD 的发病率估计为每 10 人年 81 例。女性的发病率高于男性,年龄每增加一岁,PTSD 的风险就降低 3%。在调整其他因素后,心血管心脏病(调整后的危险比(aHR)= 1.45,95%置信区间(CI):1.03-2.04)、双相情感障碍(aHR = 1.86,95% CI:1.07-3.24)和重度抑郁症(aHR = 7.03,95% CI:5.02-9.85)均显著增加了 45%、86%和 603%,分别增加了 PTSD 的发病风险。在这个社区健康筛查人群中,患有 PTSD 的新发患者接受治疗的比例较低,这意味着在早期发现和干预方面还有改进的空间。对于寻求一般医疗帮助的患者,特别是患有心血管疾病或情绪障碍的患者,可以进行临床预防措施。