Department of Psychiatry, Hanyang University Medical Center, Seoul, Republic of Korea.
Department of Biostatistics, Seoul Metropolitan Government, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
Depress Anxiety. 2020 Apr;37(4):375-385. doi: 10.1002/da.22998. Epub 2020 Feb 3.
Firefighters are at high risk for subthreshold and full-threshold posttraumatic stress disorder (PTSD) due to their frequent exposure to various traumatic events. Although individuals with subthreshold PTSD have increased impairment, often needing treatment, the rates of subthreshold PTSD in firefighters remain unknown. Moreover, there is currently no consensus regarding the definition of subthreshold PTSD. The purpose of this study was to investigate the rates and clinical impairment of subthreshold PTSD according to various definitions in a national sample of firefighters.
A total of 45,698 Korean firefighters completed self-reported questionnaires to assess the severity of PTSD symptoms, suicidal behavior, depression, alcohol use problems, and PTS-related functional impairment. Six different definitions used in the literature were used to calculate the prevalence rate of subthreshold PTSD. Multivariable linear regression and analysis of variance were performed to identify the relationship of subthreshold PTSD with suicidal behavior, depression, alcohol use problems, and PTS-related functional impairment.
The rate of full-threshold PTSD was 2.63%, and the rate of subthreshold PTSD ranged from 1.79% to 17.98%. The individuals with subthreshold PTSD most commonly failed the D criteria, which included negative alterations in cognition and mood. Regardless of the definition used, subthreshold PTSD was found to be associated with increased suicidal behavior, depression, alcohol use problems, and functional impairment.
Subthreshold PTSD appears to be equal to or more frequent than full-threshold PTSD in Korean firefighters and associated with various negative clinical outcomes. Further effort to detect and treat subthreshold PTSD in firefighters may be essential.
消防员因频繁接触各种创伤性事件而处于亚阈值和全阈值创伤后应激障碍（PTSD）的高风险之中。尽管亚阈值 PTSD 个体的损伤增加，通常需要治疗，但消防员中亚阈值 PTSD 的发生率仍不清楚。此外，目前对于亚阈值 PTSD 的定义尚未达成共识。本研究的目的是在全国消防员样本中根据各种定义调查亚阈值 PTSD 的发生率和临床损伤。
共有 45698 名韩国消防员完成了自我报告问卷，以评估 PTSD 症状严重程度、自杀行为、抑郁、酒精使用问题和 PTS 相关功能障碍。使用文献中使用的六种不同定义来计算亚阈值 PTSD 的患病率。进行多变量线性回归和方差分析，以确定亚阈值 PTSD 与自杀行为、抑郁、酒精使用问题和 PTS 相关功能障碍的关系。
全阈值 PTSD 的发生率为 2.63%，亚阈值 PTSD 的发生率范围为 1.79%至 17.98%。亚阈值 PTSD 个体最常见的是未能通过 D 标准，其中包括认知和情绪的负性改变。无论使用哪种定义，亚阈值 PTSD 均与自杀行为、抑郁、酒精使用问题和功能障碍的增加有关。
亚阈值 PTSD 似乎在韩国消防员中与全阈值 PTSD 一样常见或更为常见，并且与各种负面临床结局相关。进一步努力检测和治疗消防员中的亚阈值 PTSD 可能至关重要。
