三种创伤后应激障碍筛查工具在重症监护后应用的比较验证。
Comparative validation of three screening instruments for posttraumatic stress disorder after intensive care.
机构信息
Jena University Hospital, Friedrich Schiller-University Jena, Institute of Psychosocial Medicine and Psychotherapy, Jena, Germany; Jena University Hospital, Friedrich Schiller-University Jena, Center for Sepsis Control and Care, Jena, Germany.
Jena University Hospital, Friedrich Schiller-University Jena, Institute of Psychosocial Medicine and Psychotherapy, Jena, Germany.
出版信息
J Crit Care. 2019 Oct;53:149-154. doi: 10.1016/j.jcrc.2019.06.016. Epub 2019 Jun 18.
PURPOSE
Aim of the present study was to compare the validity of three screening instruments to assess symptoms of posttraumatic stress disorder (PTSD) after intensive care of sepsis.
MATERIAL AND METHODS
Participants were recruited within a large multicenter patient cohort study on long-term sequelae of sepsis. Adult patients (n = 83) on average four months after intensive care of (severe) sepsis or septic shock were included (median age 64 years, 60% male). PTSD symptom severity was assessed by three different self-report measures: two versions of the Posttraumatic Stress Scale (PTSS-10; PTSS-14), and the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5). A clinical PTSD diagnosis was derived by using the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5).
RESULTS
Ten patients (12%) were diagnosed with PTSD. PTSS-10, PTSS-14, and PCL-5 revealed good reliability and concurrent validity. PTSS-14 showed the best accuracy in screening patients at risk for PTSD after intensive care with 80% sensitivity and 92% specificity at the recommended cutoff of 40.
CONCLUSIONS
Compared to PTSS-10 and PCL-5, PTSS-14 appeared more appropriate for post-ICU PTSD screening when validated against a DSM-5 diagnostic interview.
目的
本研究旨在比较三种用于评估脓毒症重症监护后创伤后应激障碍（PTSD）症状的筛查工具的有效性。
材料和方法
参与者是在一项关于脓毒症长期后遗症的大型多中心患者队列研究中招募的。纳入了脓毒症或感染性休克重症监护后平均四个月的成年患者（n=83）（中位年龄 64 岁，60%为男性）。使用三种不同的自我报告量表评估 PTSD 症状严重程度：创伤后应激量表（PTSS-10；PTSS-14）的两个版本，以及 DSM-5 创伤后应激障碍检查表（PCL-5）。通过使用 DSM-5 临床医生管理 PTSD 量表（CAPS-5）得出临床 PTSD 诊断。
结果
10 名患者（12%）被诊断为 PTSD。PTSS-10、PTSS-14 和 PCL-5 显示出良好的可靠性和同时效度。PTSS-14 在筛查重症监护后 PTSD 风险患者方面具有最佳准确性，在推荐的 40 分截点处具有 80%的敏感性和 92%的特异性。
结论
与 PTSS-10 和 PCL-5 相比，PTSS-14 在与 DSM-5 诊断访谈相比较时，在 ICU 后 PTSD 筛查中似乎更合适。
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