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创伤后应激障碍筛查:两种创伤后应激障碍自评量表诊断效率的比较。

Screening for Posttraumatic Stress Disorder in Refugees: Comparison of the Diagnostic Efficiency of Two Self-Rating Measures of Posttraumatic Stress Disorder.

机构信息

Department of Psychology, University of Hildesheim, Hildesheim, Germany.

Department of Psychology, Technical University of Braunschweig, Braunschweig, Germany.

出版信息

J Trauma Stress. 2019 Feb;32(1):148-155. doi: 10.1002/jts.22358. Epub 2019 Jan 29.

Abstract

There is a high prevalence of posttraumatic stress disorder (PTSD) in the refugee population. In order to identify affected individuals and offer targeted help, there is an urgent need for easily understandable, reliable, valid, and efficient screening measures. The aim of the present study was to compare the diagnostic efficiency of the Process of Recognition and Orientation of Torture Victims in European Countries to Facilitate Care and Treatment (PROTECT) questionnaire (PQ) to that of the eight-item short-form Posttraumatic Diagnostic Scale (PDS-8) and the Patient Health Questionnaire (PHQ-9). Using structured clinical interviews, the prevalence rates of PTSD and major depression episode (MDE) were assessed in a refugee sample (N = 118), and receiver operating characteristic analyses were determined and compared. Of participants in the sample, 29.7%, 95% CI [22.0%, 38.5%], were diagnosed with PTSD and 33.1%, 95% CI [24.4%, 41.9%], were diagnosed with MDE. The area under the curve (AUC) for all measures was moderate, AUCs = 0.79-0.86; hence, measures did not differ in terms of their discriminatory abilities. Using the favored cutoff points, sensitivity and specificity were 80-97% and 60-70%, respectively. In terms of their discriminatory abilities, none of the investigated measures can be favored more than the others. Thus, for detection of these two disorders, the shorter PQ could be more efficient. Because the high co-occurrence of PTSD and MDE might limit the explanatory power of results in the present study, the findings should be cross-validated in the future.

摘要

创伤后应激障碍(PTSD)在难民群体中普遍存在。为了识别受影响的个体并提供有针对性的帮助,迫切需要易于理解、可靠、有效且高效的筛选措施。本研究的目的是比较欧洲国家酷刑受害者识别和定位过程以促进护理和治疗(PROTECT)问卷(PQ)与八项简短创伤后诊断量表(PDS-8)和患者健康问卷(PHQ-9)的诊断效率。使用结构化临床访谈,在难民样本(N=118)中评估了 PTSD 和主要抑郁发作(MDE)的患病率,并确定和比较了受试者工作特征分析。在样本参与者中,29.7%,95%置信区间[22.0%,38.5%]被诊断为 PTSD,33.1%,95%置信区间[24.4%,41.9%]被诊断为 MDE。所有措施的曲线下面积(AUC)均为中度,AUCs=0.79-0.86;因此,这些措施在区分能力方面没有差异。使用首选截断点,灵敏度和特异性分别为 80-97%和 60-70%。就其区分能力而言,没有一种被调查的措施可以比其他措施更有优势。因此,对于这两种疾病的检测,较短的 PQ 可能更有效。由于 PTSD 和 MDE 的高共病可能限制本研究结果的解释能力,因此未来应进行交叉验证。

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