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奥地利寄养儿童和青少年中《国际疾病分类第11版》(ICD - 11)与《精神疾病诊断与统计手册第5版》(DSM - 5)创伤后应激障碍的发生率比较:患病率、共病情况及预测因素

Comparing rates of ICD-11 and DSM-5 Posttraumatic Stress Disorder in Austrian children and adolescents in foster care: prevalence, comorbidity and predictors.

作者信息

Bruckmann Paul, Haselgruber Alexander, Sölva Katharina, Lueger-Schuster Brigitte

机构信息

Department of Psychology, University of Vienna, Vienna, Austria.

出版信息

Eur J Psychotraumatol. 2020 Jul 14;11(1):1767988. doi: 10.1080/20008198.2020.1767988.

Abstract

BACKGROUND

The diagnostic criteria for Posttraumatic Stress Disorder (PTSD) differ between the DSM-5 and the ICD-11, affecting prevalence and associated metrics of PTSD.

OBJECTIVE

Investigating the effects of the diverging DSM-5 and ICD-11 PTSD conceptualizations on prevalence and comorbidity rates, as well as predictor impact in a sample of foster children and adolescents using manual-specific measures.

METHOD

The sample consisted of = 145 foster children and adolescents. PTSD rates were assessed and compared utilizing the International Trauma Questionnaire - Child and Adolescent Version (ICD-11) and the Child and Adolescent Trauma Screen (DSM-5). PTSD comorbidities with Generalized Anxiety Disorder (GAD) and Major Depressive Disorder (MDD) were assessed. The predictive value of age, gender and cumulative trauma for PTSD was determined.

RESULTS

A non-significant trend for higher DSM-5 (21.4%) vs. ICD-11 (16.7%) PTSD prevalence was observed. Significantly elevated DSM-5 vs. ICD-11 diagnostic rates were recorded in the re-experience (diff. = 18.3%) and hyperarousal (diff. = 10.1%) clusters. DSM-5 PTSD showed a non-significant trend for higher comorbidities with GAD and MDD. Gender and cumulative trauma predicted PTSD significantly and approximately equally according to both taxonomies.

CONCLUSION

The study supports the assumption that utilizing manual-specific PTSD measures in children and adolescents leads to higher rates of DSM-5 PTSD compared to ICD-11 PTSD. The exact methodological reasons for diverging diagnostic rates need to be analysed.

摘要

背景

《精神疾病诊断与统计手册》第5版(DSM - 5)和《国际疾病分类》第11版(ICD - 11)中创伤后应激障碍(PTSD)的诊断标准不同,这影响了PTSD的患病率及相关指标。

目的

使用特定手册的测量方法,研究DSM - 5和ICD - 11对PTSD不同概念化定义对寄养儿童和青少年样本中患病率、共病率以及预测因素影响。

方法

样本包括145名寄养儿童和青少年。使用《国际创伤问卷 - 儿童和青少年版》(ICD - 11)和《儿童和青少年创伤筛查》(DSM - 5)评估并比较PTSD发生率。评估PTSD与广泛性焦虑障碍(GAD)和重度抑郁症(MDD)的共病情况。确定年龄、性别和累积创伤对PTSD的预测价值。

结果

观察到DSM - 5的PTSD患病率(21.4%)高于ICD - 11(16.7%),但差异无统计学意义。在再体验(差异 = 18.3%)和过度警觉(差异 = 10.1%)集群中,DSM - 5的诊断率显著高于ICD - 11。DSM - 5的PTSD与GAD和MDD共病率有升高趋势,但差异无统计学意义。根据两种分类法,性别和累积创伤对PTSD的预测作用显著且大致相同。

结论

该研究支持以下假设:与ICD - 11的PTSD相比,在儿童和青少年中使用特定手册的PTSD测量方法会导致更高的DSM - 5的PTSD发生率。诊断率差异的确切方法学原因需要分析。

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