Leidos, Reston, Virginia, USA.
Health and Behavioral Sciences Department, Naval Health Research Center, San Diego, California, USA.
J Trauma Stress. 2018 Dec;31(6):837-844. doi: 10.1002/jts.22337. Epub 2018 Nov 6.
Among active duty service members, posttraumatic stress disorder (PTSD) diagnoses have increased dramatically since 2000. Because psychiatric comorbidity is more common for PTSD than for other mental health disorders, we examined the prevalence estimates of disorders comorbid or trimorbid with PTSD in this study. The medical records of 523,626 female and male active duty Sailors and Marines who entered the U.S. military between 2006 and 2013 were examined for diagnoses of PTSD and 14 potentially comorbid disorders. Results showed that 1.8% of military members had a PTSD diagnosis; among those with PTSD, 83.3% had a comorbid mental health disorder, and 62.2% had a third (i.e., trimorbid) disorder. Most frequently, PTSD co-occurred with depressive disorder (49.0%), adjustment disorder (37.0%), generalized anxiety disorder (36.1%), and alcohol use disorder (26.9%). All disorders we examined were significantly more likely to be diagnosed in service members with PTSD than in those without PTSD, odds ratios = 1.52-29.63. For service members with PTSD, comorbid mental health disorders are the rule rather than the exception. Consequently, it is important that clinicians also assess for other disorders and select treatment options that address both PTSD and comorbid conditions.
在现役军人中，创伤后应激障碍（PTSD）的诊断自 2000 年以来显著增加。由于 PTSD 的精神共病比其他精神健康障碍更为常见，因此我们在这项研究中检查了 PTSD 共病或三重共病的障碍的患病率估计。对 2006 年至 2013 年间入伍的 523626 名男女现役水手和海军陆战队员的医疗记录进行了检查，以诊断 PTSD 和 14 种潜在共病障碍。结果表明，1.8%的军人患有 PTSD；在患有 PTSD 的军人中，83.3%患有共病精神健康障碍，62.2%患有第三（即三重）障碍。最常见的是，PTSD 与抑郁障碍（49.0%）、适应障碍（37.0%）、广泛性焦虑障碍（36.1%）和酒精使用障碍（26.9%）共同发生。我们检查的所有障碍在患有 PTSD 的军人中被诊断的可能性都明显高于没有 PTSD 的军人，优势比=1.52-29.63。对于患有 PTSD 的军人来说，共病精神健康障碍是常态而不是例外。因此，临床医生评估其他障碍并选择同时解决 PTSD 和共病情况的治疗方案非常重要。
