Wu K K, Cheng J P, Leung J, Chow L P, Lee C C
Kwai Chung Hospital, Hong Kong.
East Asian Arch Psychiatry. 2020 Mar;30(1):3-11. doi: 10.12809/eaap1880.
To determine the prevalence of traumatic experience (TE) among patients in psychiatric settings in Hong Kong and the associations between TE and levels of distress and anxiety and depressive symptoms.
129 patients who have received inpatient psychiatric services were recruited. Their lifetime TE was assessed using the Life Event Checklist (LEC), and TE in psychiatric settings using the Psychiatric Experiences Questionnaire (PEQ). Their level of distress symptoms was assessed using the Impact of Event Scale-Revised (IES-R), and the level of anxiety and depressive symptoms using the Hospital Anxiety and Depression Scale (HADS).
The prevalence of direct and indirect TE was 84.5%, as was the prevalence of TE in psychiatric settings. Common TE in psychiatric settings included witnessing another patient being taken down (61.2%), being put in restraints of any kind (41.1%), and witnessing another patient being physically assaulted by another patient (36.4%). TE in psychiatric settings associated with high prevalence of severe or extreme distress 1 week after the event included being forced to take medication against their will (52.2%), being threatened with physical violence (52.2%), and experiencing a physical assault (50.0%). Lifetime TE (the total number of LEC items reported) was associated with severity of distress and anxiety and depressive symptoms, whereas TE in psychiatric settings (the total number of PEQ items reported) was associated with severity of distress only. The total number of LEC items reported is the only predictor of levels of distress and anxiety and depressive symptoms.
Lifetime TE and TE in psychiatric settings are common among patients with SMI. Trauma-informed care is suggested for mental health services.
确定香港精神科环境中患者创伤经历（TE）的患病率，以及TE与痛苦、焦虑和抑郁症状水平之间的关联。
招募了129名接受过住院精神科服务的患者。使用生活事件清单（LEC）评估他们一生的TE，使用精神科经历问卷（PEQ）评估精神科环境中的TE。使用事件影响量表修订版（IES-R）评估他们的痛苦症状水平，使用医院焦虑抑郁量表（HADS）评估焦虑和抑郁症状水平。
直接和间接TE的患病率为84.5%，精神科环境中TE的患病率也是如此。精神科环境中常见的TE包括目睹另一名患者被制服（61.2%）、被施加任何形式的约束（41.1%）以及目睹另一名患者被另一名患者身体攻击（36.4%）。事件发生1周后，精神科环境中与严重或极度痛苦高患病率相关的TE包括被迫违心地服药（52.2%）、受到身体暴力威胁（52.2%）以及遭受身体攻击（50.0%）。一生的TE（报告的LEC项目总数）与痛苦、焦虑和抑郁症状的严重程度相关，而精神科环境中的TE（报告的PEQ项目总数）仅与痛苦的严重程度相关。报告的LEC项目总数是痛苦、焦虑和抑郁症状水平的唯一预测因素。
严重精神疾病患者中一生的TE和精神科环境中的TE很常见。建议精神卫生服务采用创伤知情护理。
