Eslami Bahareh
Division of Public Health Science, Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
Department of Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
Congenit Heart Dis. 2017 May;12(3):357-363. doi: 10.1111/chd.12452. Epub 2017 Feb 20.
The aims of this study were to compare the level of posttraumatic stress disorder between adults with and without congenital heart disease, and to examine the correlates of posttraumatic stress disorder (e.g., sociodemographics).
Cross-sectional.
Two university-affiliated heart hospitals in Tehran, Iran.
A sample of 347 adults with congenital heart disease aged 18-64 years (52% women), and 353 adults without congenital heart disease matched by sex and age (±2 years) was recruited.
The PTSD Scale: Self-report version was used to assess the diagnosis and severity of posttraumatic stress disorder. Hierarchical multivariate logistic regression analyses were performed to explore correlates of likely posttraumatic stress disorder diagnosis among each group of participants.
The posttraumatic stress disorder in the patients was comparable to those of the control group, except for increased arousal (P = .027) which was scored higher among the patients. Over 52% of adults with congenital heart disease met the criteria for a likely posttraumatic stress disorder diagnosis compared with 48% of adults without congenital heart disease. The regression analyses among patients revealed that elevated depressive symptoms (OR = 1.27) and a positive history of cardiac surgery (OR = 2.02) were significantly associated with posttraumatic stress disorder. The model could explain 29% of the variance in posttraumatic stress disorder.
The high and comparable prevalence of posttraumatic stress disorder among patients and nonpatients highlight the significance of the context in which adults with congenital heart disease may face other/additional stressors than disease-related ones, an issue that clinicians need also take into account. Furthermore, the association of posttraumatic stress disorder with elevated depressive symptoms warrant a comprehensive psychological assessment and management of adults with congenital heart disease, in particular among those with a history of invasive procedures.
本研究旨在比较患有和未患有先天性心脏病的成年人创伤后应激障碍的水平，并探讨创伤后应激障碍的相关因素（如社会人口统计学因素）。
横断面研究。
伊朗德黑兰的两家大学附属医院。
招募了347名年龄在18 - 64岁的患有先天性心脏病的成年人（52%为女性），以及353名按性别和年龄（±2岁）匹配的未患有先天性心脏病的成年人。
使用创伤后应激障碍量表：自我报告版来评估创伤后应激障碍的诊断和严重程度。进行分层多变量逻辑回归分析，以探索每组参与者中可能的创伤后应激障碍诊断的相关因素。
患者的创伤后应激障碍与对照组相当，但觉醒增加方面（P = 0.027）患者得分更高。超过52%的患有先天性心脏病的成年人符合可能的创伤后应激障碍诊断标准，而未患有先天性心脏病的成年人这一比例为48%。患者中的回归分析显示，抑郁症状加重（OR = 1.27）和心脏手术阳性史（OR = 2.02）与创伤后应激障碍显著相关。该模型可以解释创伤后应激障碍中29%的变异。
患者和非患者中创伤后应激障碍的高患病率且相当，这凸显了先天性心脏病成年人可能面临除疾病相关压力源之外的其他/额外压力源的背景的重要性，这也是临床医生需要考虑的问题。此外，创伤后应激障碍与抑郁症状加重之间的关联表明，需要对先天性心脏病成年人进行全面的心理评估和管理，特别是那些有侵入性操作史的患者。
