Southeast Louisiana Veterans Health Care System, 2400 Canal Street, New Orleans, LA 70119, USA; Tulane University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1430 Tulane Avenue, New Orleans, LA 70112, USA; South Central VA Mental Illness Research Education and Clinical Center, 2400 Canal Street, New Orleans, LA 70119, USA.
Southeast Louisiana Veterans Health Care System, 2400 Canal Street, New Orleans, LA 70119, USA; South Central VA Mental Illness Research Education and Clinical Center, 2400 Canal Street, New Orleans, LA 70119, USA.
Psychiatry Res. 2018 Mar;261:504-507. doi: 10.1016/j.psychres.2018.01.021. Epub 2018 Jan 11.
Posttraumatic stress disorder (PTSD) has been criticized for including symptoms that substantially overlap with other depression and anxiety disorders. To address this concern, Brewin et al. (2009) reformulated the diagnosis around a core symptom set. Although several studies have examined the utility of the core criteria in predicting diagnostic status, none have done so using a self-report screening instrument. The sample included 617 veterans presenting for outpatient psychological services. As a part of the intake process, veterans completed the PTSD Checklist for DSM-5 (PCL-5) and were assessed using the Clinician Administered PTSD Scale for DSM-5 (CAPS-5). Veterans meeting core criteria on the PCL-5 were over 22 times more likely to meet PCL-5 diagnosed PTSD than veterans who met the core criteria on the PCL-5 but did not meet PCL-5 diagnosed PTSD (OR = 22.94; CI [12.76, 41.25]). Further, veterans who met core criteria on the PCL-5 were over 2 times more likely (OR = 2.34; 95.0% CI [1.53, 3.59]) to meet CAPS-5 diagnosed PTSD than veterans who met the core criteria on the PCL-5 but did not meet CAPS-5 diagnosed PTSD. Findings from the current study have implications for the assessment and classification of PTSD.
创伤后应激障碍（PTSD）一直受到批评，因为它包含的症状与其他抑郁和焦虑障碍有很大的重叠。为了解决这个问题，Brewin 等人（2009 年）围绕核心症状集重新制定了诊断标准。尽管有几项研究检验了核心标准在预测诊断状况方面的效用，但没有一项研究使用自我报告筛查工具来进行。该样本包括 617 名因门诊心理服务而就诊的退伍军人。作为入组过程的一部分，退伍军人完成了《DSM-5 创伤后应激障碍检查表》（PCL-5），并使用《DSM-5 临床医生管理 PTSD 量表》（CAPS-5）进行评估。在 PCL-5 上符合核心标准的退伍军人患 PCL-5 诊断 PTSD 的可能性是在 PCL-5 上符合核心标准但未患 PCL-5 诊断 PTSD 的退伍军人的 22 倍以上（OR = 22.94；CI [12.76, 41.25]）。此外，在 PCL-5 上符合核心标准的退伍军人患 CAPS-5 诊断 PTSD 的可能性是在 PCL-5 上符合核心标准但未患 CAPS-5 诊断 PTSD 的退伍军人的 2.34 倍（OR = 2.34；95.0%CI [1.53, 3.59]）。本研究的结果对 PTSD 的评估和分类具有启示意义。
