Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, United Kingdom.
Directorate of Psychology and Psychological Therapies, Cardiff & Vale University Health Board, Cardiff, United Kingdom.
J Trauma Stress. 2021 Apr;34(2):375-383. doi: 10.1002/jts.22619. Epub 2020 Nov 10.
Posttraumatic stress disorder (PTSD) and physical health problems, particularly somatic symptom disorder, are highly comorbid. Studies have only examined this co-occurrence at the disorder level rather than assessing the associations between specific symptoms. Using network analysis to identify symptoms that act as bridges between these disorders may allow for the development of interventions to specifically target this comorbidity. We examined the association between somatization and PTSD symptoms via network analysis. This included 349 trauma-exposed individuals recruited through the National Centre for Mental Health PTSD cohort who completed the Clinician-Administered PTSD Scale for DSM-5 and the Patient Health Questionnaire-15. A total of 215 (61.6%) individuals met the DSM-5 diagnostic criteria for PTSD. An exploratory graph analysis identified four clusters of densely connected symptoms within the overall network: PTSD, chronic pain, gastrointestinal issues, and more general somatic complaints. Sleep difficulties played a key role in bridging PTSD and somatic symptoms. Our network analysis demonstrates the distinct nature of PTSD and somatization symptoms, with this association connected by disturbed sleep.
创伤后应激障碍（PTSD）和身体健康问题，特别是躯体症状障碍，高度共病。研究仅在疾病层面上检查了这种共病现象，而没有评估特定症状之间的关联。使用网络分析来识别这些疾病之间的桥梁症状，可能有助于开发专门针对这种共病的干预措施。我们通过网络分析研究了躯体化和 PTSD 症状之间的关联。这包括通过国家心理健康中心 PTSD 队列招募的 349 名创伤暴露个体，他们完成了 DSM-5 临床医生管理 PTSD 量表和患者健康问卷-15。共有 215 名（61.6%）个体符合 PTSD 的 DSM-5 诊断标准。探索性图分析在整个网络中确定了四个密集连接症状的集群：PTSD、慢性疼痛、胃肠道问题和更普遍的躯体抱怨。睡眠困难在 PTSD 和躯体症状之间起着关键的桥梁作用。我们的网络分析表明 PTSD 和躯体化症状具有明显的性质，这种关联与睡眠障碍有关。
