Kim Daeho, Kim Dongjoo, Lee Hyunji, Cho Yubin, Min Ji Young, Kim Seok Hyeon
Department of Psychiatry, Hanyang University College of Medicine, Seoul, South Korea.
Research - Industry Cooperation, Hanyang University, Seoul, South Korea.
Eur J Psychotraumatol. 2019 Sep 2;10(1):1657372. doi: 10.1080/20008198.2019.1657372. eCollection 2019.
: Previous studies on of the dissociative subtype of posttraumatic stress disorder (d-PTSD) have relied on specialized statistical methods (i.e. profile or class analyses) for diagnosis than clinical rating available to clinicians. : This study investigated the prevalence and covariates of d-PTSD diagnosed by a semi-structured interview in a cohort of outpatients with DSM-IV PTSD in a specialized trauma clinic in South Korea. : Data from 249 patients with civilian PTSD were examined, including demographics, clinical variables, Clinical Global Impression (CGI) Scale, and Clinician-Administered PTSD Scale (CAPS-IV). We defined d-PTSD as the presence of either depersonalization or derealization according to additional dissociative items of the CAPS. About one third (n = 82, 32.9%) of patients were designated as having d-PTSD. : Compared to the other patients with PTSD, those with d-PTSD were younger, had more severe PTSD symptoms, frequent interpersonal trauma, and a higher number of comorbid disorders. When these variables and their interactions were entered into a logistic regression model, younger age, severe PTSD symptoms and two or more comorbid conditions remained for the final model. We did not find a significant difference in improvement over the course of treatment between two groups. : This study highlights the high prevalence of d-PTSD in a clinical population. Associated features of d-PTSD were similar to those reported in the Euro-American literature. Further studies are needed to better understand mechanisms and treatment options for d-PTSD.
以往关于创伤后应激障碍分离亚型(d-PTSD)的研究依赖于专门的统计方法(即剖面图或类别分析)进行诊断,而非临床医生可用的临床评定。本研究调查了在韩国一家专门的创伤诊所中,通过半结构化访谈诊断出的d-PTSD在一组符合《精神疾病诊断与统计手册》第四版(DSM-IV)创伤后应激障碍的门诊患者中的患病率及相关因素。对249名患有平民创伤后应激障碍的患者的数据进行了检查,包括人口统计学、临床变量、临床总体印象(CGI)量表和临床医生施测的创伤后应激障碍量表(CAPS-IV)。根据CAPS的附加分离项目,我们将d-PTSD定义为存在人格解体或现实解体。约三分之一(n = 82,32.9%)的患者被认定患有d-PTSD。与其他创伤后应激障碍患者相比,患有d-PTSD的患者更年轻,创伤后应激障碍症状更严重,人际创伤频繁,共病障碍数量更多。当将这些变量及其相互作用纳入逻辑回归模型时,年龄较小、严重的创伤后应激障碍症状以及两种或更多的共病情况保留在最终模型中。我们未发现两组在治疗过程中的改善情况存在显著差异。本研究突出了d-PTSD在临床人群中的高患病率。d-PTSD的相关特征与欧美文献中报道的相似。需要进一步研究以更好地理解d-PTSD的机制和治疗选择。