全球成年战争幸存者群体中创伤后应激障碍(PTSD)和重度抑郁症的患病率:基于荟萃分析的绝对数估计
The prevalence of PTSD and major depression in the global population of adult war survivors: a meta-analytically informed estimate in absolute numbers.
作者信息
Hoppen Thole Hilko, Morina Nexhmedin
机构信息
Institute of Psychology, University of Münster, Münster, Germany.
出版信息
Eur J Psychotraumatol. 2019 Feb 22;10(1):1578637. doi: 10.1080/20008198.2019.1578637. eCollection 2019.
: Elevated prevalences of post-traumatic stress disorder (PTSD) and major depression (MD) have been reported in populations exposed to war. However, no global estimates of war survivors suffering from PTSD and/or MD in absolute numbers have been reported. : We made the first attempt to estimate in absolute numbers how many adult war survivors globally may suffer PTSD and/or MD, which should inform local and global mental health programmes. : Drawing on the Uppsala Conflict Database, we reviewed all countries that suffered at least one war within their own territory between 1989 and 2015 (time span chosen on availability of geo-referenced data and population estimates). We then conducted a meta-analysis of current randomized epidemiological surveys on prevalence of PTSD and/or MD among war survivors. Finally, we extrapolated our results from the meta-analysis on the global population of adult war survivors by means of using general population data from the United Nations. : We estimate that about 1.45 billion individuals worldwide have experienced war between 1989 and 2015 and were still alive in 2015, including one billion adults. On the basis of our meta-analysis, we estimate that about 354 million adult war survivors suffer from PTSD and/or MD. Of these, about 117 million suffer from comorbid PTSD and MD. : Based on the slim available evidence base, the global number of adult war survivors suffering PTSD and/or MD is vast. Most war survivors live in low-to-middle income countries with limited means to handle the enormous mental health burden. Since representative high quality data is lacking from most of these countries, our results contain a large margin of uncertainty and should be interpreted with caution.
据报道,经历过战争的人群中创伤后应激障碍(PTSD)和重度抑郁症(MD)的患病率有所上升。然而,尚未有关于战争幸存者中患有PTSD和/或MD的绝对人数的全球估计报告。
我们首次尝试以绝对数字估算全球有多少成年战争幸存者可能患有PTSD和/或MD,这应为地方和全球心理健康计划提供参考。
利用乌普萨拉冲突数据库,我们回顾了1989年至2015年期间(根据地理参考数据和人口估计的可得性选择的时间跨度)在其境内至少经历过一场战争的所有国家。然后,我们对当前关于战争幸存者中PTSD和/或MD患病率的随机流行病学调查进行了荟萃分析。最后,我们通过使用联合国的一般人口数据,将荟萃分析的结果外推到全球成年战争幸存者群体。
我们估计,1989年至2015年期间全球约有14.5亿人经历过战争,到2015年仍然在世,其中包括10亿成年人。根据我们的荟萃分析,我们估计约有3.54亿成年战争幸存者患有PTSD和/或MD。其中,约1.17亿人患有PTSD和MD共病。
基于现有的有限证据基础,患有PTSD和/或MD的全球成年战争幸存者数量巨大。大多数战争幸存者生活在中低收入国家,应对巨大心理健康负担的手段有限。由于这些国家中的大多数缺乏具有代表性的高质量数据,我们的结果存在很大的不确定性,应谨慎解释。