Letica-Crepulja Marina, Stevanović Aleksandra, Protuđer Marina, Grahovac Juretić Tanja, Rebić Jelena, Frančišković Tanja
Department for Psychiatry and Psychological Medicine, Faculty of Medicine, University of Rijeka, Rijeka, Croatia.
Department of Psychiatry, Clinical Hospital Center Rijeka, Referral Center for Posttraumatic Stress Disorder of the Ministry of Health of the Republic of Croatia, Rijeka, Croatia.
Eur J Psychotraumatol. 2020 Feb 26;11(1):1716593. doi: 10.1080/20008198.2020.1716593. eCollection 2020.
: In the ICD-11 hierarchical classification structure, posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) are separate and distinct but also 'sibling' disorders, meaning that the diagnoses follow from the parent category of traumatic stress disorders. : The aim of this study was to examine the prevalence of CPTSD in treatment-seeking war veterans with PTSD more than 20 years after the exposure to cumulative war-related trauma(s). The second aim was to examine if there was an association between demographic and psychosocial variables and CPTSD or PTSD. : A sample of 160 male war veterans with PTSD referred to the outpatient service of the PTSD Referral Centre at the Clinical Hospital Centre (CHC) Rijeka participated in a cross-sectional study. Psychiatric comorbidity was assessed using the Mini-International Neuropsychiatric Interview (MINI) and participants completed validated self-report measures: The Life Events Checklist for DSM-5 (LEC-5), International Trauma Questionnaire (ITQ). : In total, 80.63% of the sample met criteria for a probable diagnosis of CPTSD. The study revealed that there was no significant difference in the length of deployment, in the intensity of the PTSD symptoms, types of trauma exposure and pharmacotherapeutic treatment between PTSD and CPTSD group. It was found that veterans with PTSD were more likely to be divorced and to participate in PTSD clubs. On the other hand, veterans with CPTSD were significantly more likely to have higher levels of functional impairment and comorbidity with general anxiety disorder (GAD) compared to the PTSD group. : This study supports the proposition that a prolonged trauma of severe interpersonal intensity such as war is related to high rates of CPTSD among treatment-seeking veterans, years after the war. The distinction between PTSD and complex PTSD may help the selection of person-centred treatment interventions that would target specific mental health and functional problems in patients.
在《国际疾病分类第11版》的分层分类结构中，创伤后应激障碍（PTSD）和复杂性创伤后应激障碍（CPTSD）是相互独立且不同的，但也是“姐妹”疾病，这意味着这两种诊断都源自创伤性应激障碍这一母类别。本研究的目的是调查在遭受累积性战争相关创伤20多年后寻求治疗的患有PTSD的退伍军人中CPTSD的患病率。第二个目的是研究人口统计学和心理社会变量与CPTSD或PTSD之间是否存在关联。160名被转介到里耶卡临床医院中心（CHC）PTSD转诊中心门诊服务的患有PTSD的男性退伍军人参与了一项横断面研究。使用迷你国际神经精神访谈（MINI）评估精神共病情况，参与者完成了经过验证的自我报告量表：《精神疾病诊断与统计手册第5版》生活事件清单（LEC - 5）、国际创伤问卷（ITQ）。总体而言，80.63%的样本符合可能诊断为CPTSD的标准。研究表明，PTSD组和CPTSD组在部署时长、PTSD症状强度、创伤暴露类型和药物治疗方面没有显著差异。研究发现，患有PTSD的退伍军人更有可能离婚并参加PTSD俱乐部。另一方面，与PTSD组相比，患有CPTSD的退伍军人功能损害水平更高且更易患广泛性焦虑障碍（GAD）。本研究支持这样一种观点，即像战争这样严重人际强度的长期创伤与战后多年寻求治疗的退伍军人中CPTSD的高发病率有关。PTSD和复杂性PTSD之间的区别可能有助于选择以患者为中心的治疗干预措施，这些措施将针对患者特定的心理健康和功能问题。
