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DSM-5 和 ICD-11 创伤后应激障碍患病率、共病和残疾的比较:对乌克兰境内流离失所者心理健康调查的分析。

A comparison of DSM-5 and ICD-11 PTSD prevalence, comorbidity and disability: an analysis of the Ukrainian Internally Displaced Person's Mental Health Survey.

机构信息

Psychology Research Institute, Ulster University, Londonderry, UK.

School of Business, National College of Ireland, Dublin, Ireland.

出版信息

Acta Psychiatr Scand. 2018 Feb;137(2):138-147. doi: 10.1111/acps.12840. Epub 2017 Dec 5.

Abstract

OBJECTIVE

Recently, the American Psychiatric Association (DSM-5) and the World Health Organization (ICD-11) have both revised their formulation of post-traumatic stress disorder (PTSD). The primary aim of this study was to compare DSM-5 and ICD-11 PTSD prevalence and comorbidity rates, as well as the level of disability associated with each diagnosis.

METHOD

This study was based on a representative sample of adult Ukrainian internally displaced persons (IDPs: N = 2203). Post-traumatic stress disorder prevalence was assessed using the PTSD Checklist for DSM-5 and the International Trauma Questionnaire (ICD-11). Anxiety and depression were measured using the Generalized Anxiety Disorder Scale and the Patient Health Questionnaire-Depression. Disability was measured using the WHO Disability Assessment Schedule 2.0.

RESULTS

The prevalence of DSM-5 PTSD (27.4%) was significantly higher than ICD-11 PTSD (21.0%), and PTSD rates for females were significantly higher using both criteria. ICD-11 PTSD was associated with significantly higher levels of disability and comorbidity.

CONCLUSION

The ICD-11 diagnosis of PTSD appears to be particularly well suited to identifying those with clinically relevant levels of disability.

摘要

目的

最近,美国精神病学协会(DSM-5)和世界卫生组织(ICD-11)都对创伤后应激障碍(PTSD)的定义进行了修订。本研究的主要目的是比较 DSM-5 和 ICD-11 PTSD 的患病率和共病率,以及与每种诊断相关的残疾程度。

方法

本研究基于乌克兰境内流离失所者(IDP:N=2203)的代表性成人样本。使用 PTSD 检查表 DSM-5 和国际创伤问卷(ICD-11)评估创伤后应激障碍的患病率。使用广泛性焦虑症量表和患者健康问卷-抑郁量表测量焦虑和抑郁。使用世界卫生组织残疾评估表 2.0 测量残疾程度。

结果

DSM-5 PTSD 的患病率(27.4%)明显高于 ICD-11 PTSD(21.0%),并且两种标准下女性的 PTSD 发生率均明显更高。ICD-11 PTSD 与更高水平的残疾和共病相关。

结论

ICD-11 创伤后应激障碍的诊断似乎特别适合识别那些有临床相关残疾程度的人。

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