True W R, Goldberg J, Eisen S A
Psychiatry Service, Medical Center, St. Louis, MO 63125.
Am J Epidemiol. 1988 Jul;128(1):85-92. doi: 10.1093/oxfordjournals.aje.a114962.
In 1979, the US Veterans Administration conducted a health survey of 11,230 veterans. The present analysis of these data focuses on the association between Vietnam service and combat experience with eight post-traumatic stress disorder symptoms among the 1,787 Vietnam era veterans who entered military service between 1965 and 1975. The advantages of this study are that it includes a large random sample selected from the total US population, had a high interview response rate (93%), and collected data prior to the recent public controversy surrounding the issue of the health effects of possible exposure of Vietnam veterans to Agent Orange. After adjustment for the potential confounding effects of military service and demographic factors, the level of combat exposure was significantly associated with all eight symptoms of post-traumatic stress disorder in a dose response pattern. For seven of the eight symptoms, a twofold increase in the factor-adjusted prevalence odds ratio was observed when non-Vietnam service veterans were compared with Vietnam veterans who experienced the most intense combat experience. Being younger, less well educated, or nonwhite at the time of military service are factors which independently further increased the probability of stress symptoms.
1979年，美国退伍军人管理局对11230名退伍军人进行了健康调查。本次对这些数据的分析聚焦于1965年至1975年期间入伍的1787名越战时期退伍军人中，越南服役经历和战斗经历与八种创伤后应激障碍症状之间的关联。这项研究的优势在于，它包括了从美国总人口中随机抽取的大量样本，访谈回复率很高（93%），并且是在最近围绕越战退伍军人可能接触橙剂对健康影响问题引发公众争议之前收集的数据。在对服役和人口统计学因素的潜在混杂效应进行调整后，战斗暴露水平与创伤后应激障碍的所有八种症状均呈剂量反应模式显著相关。在八种症状中的七种症状上，当将非越战服役退伍军人与经历最激烈战斗的越战退伍军人进行比较时，观察到经因素调整后的患病率比值比增加了两倍。服役时年龄较小、受教育程度较低或为非白人是独立进一步增加出现应激症状可能性的因素。
