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在土耳其安卡拉的一家大学医院,对经历过创伤性生活事件的军事人员进行法医精神健康评估。

Forensic mental health evaluations of military personnel with traumatic life event, in a university hospital in Ankara, Turkey.

作者信息

Balandiz Huseyin, Bolu Abdullah

机构信息

Department of Forensic Medicine, Gulhane Training and Research Hospital, Ankara, Turkey.

Department of Psychiatry, Gulhane Training and Research Hospital, Ankara, Turkey.

出版信息

J Forensic Leg Med. 2017 Oct;51:51-56. doi: 10.1016/j.jflm.2017.07.018. Epub 2017 Jul 25.

Abstract

INTRODUCTION

The definition of psychological trauma has been rephrased with the DSM-5. From now on, witnessing someone else's traumatic event is also accepted as a traumatic life event. Therefore, the psychiatric examination of forensic cases gains importance for not overlooking a psychiatric trauma. This research aims to discuss the psychiatric examinations of military personnel who had a traumatic life event and to reveal psychiatric states of soldiers after trauma.

MATERIALS AND METHODS

The forensic reports prepared at Gulhane Military Medical Academy (GMMA), Forensic Medicine polyclinic between January 1, 2011 and November 30, 2014 were examined, and among them the cases sent to GMMA Psychiatry polyclinic for psychiatric examination were analyzed retrospectively.

RESULTS

There were a total of 2408 cases who applied for the arrangement of a judicial report and 167 of them required a psychological examination. Among 167 cases, 165 were male and 2 were female, and the mean age was 25.6 years. Anxiety disorder (53.9%) was the most common diagnosis as a result of the psychiatric examination, following posttraumatic stress disorder (PTSD) (18.6%), and 3.6% had no psychopathology. It was determined that injuries caused by firearms (38.3%) and explosive materials (26.3%) had caused psychological trauma the most. On the other hand, 11 (6.6%) cases were determined to have undergone a psychological trauma on account of being a witness to their friends' injuries during the conflict without experiencing any physical injury. There were not any statistically significant relationships between the severity of physical injury and being PTSD or anxiety disorder.

DISCUSSION

Development of PTSD risk is directly correlated with the nature of trauma. The trauma types of the cases in our study were in the high-risk group because of the military population. Our study is of importance in terms of putting forward the psychiatric disorders seen in the military population with traumatic life history associated with war (combat-related). In this research, 26.1% of the cases followed up due to combat-related trauma were diagnosed with PTSD. Interestingly, this ratio was lower than the studies that have larger case numbers. There is still the need to conduct studies that will involve larger participants.

摘要

引言

《精神疾病诊断与统计手册》第五版(DSM - 5)对心理创伤的定义进行了重新表述。从现在起,目睹他人的创伤性事件也被视为创伤性生活事件。因此,法医案件的精神病学检查对于不忽视精神创伤变得至关重要。本研究旨在探讨经历过创伤性生活事件的军事人员的精神病学检查情况,并揭示创伤后士兵的精神状态。

材料与方法

对2011年1月1日至2014年11月30日期间在盖勒哈内军事医学院法医门诊所编写的法医报告进行了检查,并对其中送往盖勒哈内军事医学院精神病科门诊进行精神病学检查的病例进行了回顾性分析。

结果

共有2408例申请司法报告安排,其中167例需要进行心理检查。在这167例病例中,男性165例,女性2例,平均年龄为25.6岁。精神病学检查结果显示,焦虑症(53.9%)是最常见的诊断,其次是创伤后应激障碍(PTSD)(18.6%),3.6%没有精神病理学问题。确定枪支造成的伤害(38.3%)和爆炸物造成的伤害(26.3%)导致心理创伤的情况最为常见。另一方面,有11例(6.6%)被确定因在冲突期间目睹朋友受伤而遭受心理创伤,自身未遭受任何身体伤害。身体伤害的严重程度与患PTSD或焦虑症之间没有任何统计学上的显著关系。

讨论

PTSD风险的发展与创伤的性质直接相关。由于研究对象为军事人员,本研究中病例的创伤类型属于高风险组。我们的研究对于提出在与战争相关的创伤性生活史的军事人员中出现的精神障碍具有重要意义。在本研究中,因与战斗相关的创伤而接受随访的病例中有26.1%被诊断为PTSD。有趣的是,这个比例低于病例数量较多的研究。仍然需要进行涉及更多参与者的研究。

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