Gallipoli Medical Research Institute, Brisbane, QLD
Gallipoli Medical Research Institute, Brisbane, QLD.
Med J Aust. 2017 Apr 3;206(6):251-257. doi: 10.5694/mja16.00935.
To determine whether the prevalence of physical comorbidities in Australian Vietnam War veterans with post-traumatic stress disorder (PTSD) is higher than in trauma-exposed veterans without PTSD.
DESIGN, SETTING AND PARTICIPANTS: Cross-sectional analysis of the health status (based on self-reported and objective clinical assessments) of 298 Australian Vietnam War veterans enrolled by the Gallipoli Medical Research Institute (Brisbane) during February 2014 - July 2015, of whom 108 were confirmed as having had PTSD and 106 served as trauma-exposed control participants.Main outcomes and measures: Diagnostic psychiatric interview and psychological assessments determined PTSD status, trauma exposure, and comorbid psychological symptoms. Demographic data, and medical and sleep history were collected; comprehensive clinical examination, electrocardiography, spirometry, liver transient elastography, and selected pathology assessments and diagnostic imaging were performed. Outcomes associated with PTSD were identified; regression analysis excluded the effects of potentially confounding demographic and risk factors and comorbid symptoms of depression and anxiety.
The mean total number of comorbidities was higher among those with PTSD (17.7; SD, 6.1) than in trauma-exposed controls (14.1; SD, 5.2; P < 0.001). For 24 of 171 assessed clinical outcomes, morbidity was greater in the PTSD group, including for conditions of the gastrointestinal, hepatic, cardiovascular, and respiratory systems, sleep disorders, and laboratory pathology measures. In regression analyses including demographic factors, PTSD remained positively associated with 17 adverse outcomes; after adjusting for the severity of depressive symptoms, it remained significantly associated with ten.
PTSD in Australian Vietnam veterans is associated with comorbidities in several organ systems, independent of trauma exposure. A comprehensive approach to the health care of veterans with PTSD is needed.
确定澳大利亚越战退役军人中患有创伤后应激障碍（PTSD）的人群与未患 PTSD 的创伤暴露退役军人相比，是否存在更多的躯体共病。
设计、地点和参与者：2014 年 2 月至 2015 年 7 月，澳大利亚加里波利医学研究所（布里斯班）招募了 298 名澳大利亚越战退役军人，对他们的健康状况（基于自我报告和客观临床评估）进行横断面分析，其中 108 人被确诊患有 PTSD，106 人作为创伤暴露对照参与者。
通过诊断性精神科访谈和心理评估确定 PTSD 状态、创伤暴露和共病心理症状。收集人口统计学数据、医疗和睡眠史；进行全面的临床检查、心电图、肺功能检查、肝脏瞬时弹性成像以及选择的病理评估和诊断性影像学检查。确定与 PTSD 相关的结局；回归分析排除了潜在混杂的人口统计学和风险因素以及抑郁和焦虑共病症状的影响。
患有 PTSD 的患者（17.7；SD，6.1）的共病总数明显高于创伤暴露对照组（14.1；SD，5.2；P < 0.001）。在 171 项评估的临床结局中，有 24 项在 PTSD 组中发病率更高，包括胃肠道、肝脏、心血管和呼吸系统疾病、睡眠障碍和实验室病理测量。在包括人口统计学因素的回归分析中，PTSD 与 17 种不良结局呈正相关；在调整抑郁症状严重程度后，仍与其中 10 种显著相关。
澳大利亚越战退役军人 PTSD 与多个器官系统的共病有关，与创伤暴露无关。需要对患有 PTSD 的退役军人采取全面的医疗保健方法。
