Jellestad Lena, Vital Nicolà A, Malamud Jolanda, Taeymans Jan, Mueller-Pfeiffer Christoph
Department of Consultation-Psychiatry and Psychosomatics, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Department of Consultation-Psychiatry and Psychosomatics, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
J Psychiatr Res. 2021 Apr;136:14-22. doi: 10.1016/j.jpsychires.2021.01.039. Epub 2021 Jan 25.
Posttraumatic Stress Disorder (PTSD) is a serious and debilitating condition often associated with significant impairments in daily functioning. To date, research on the complexity of functional impairment in individuals with PTSD is scarce and only limited. Yet, a quantitative synthesis and comprehensive review of existing evidence is needed to better characterize the magnitude of functional impairment in PTSD in distinct domains. We conducted a systematic literature search including observational studies comparing functioning of individuals with and without PTSD. Random effects meta-analyses were performed for the different functional domains according to the WHO International Classification of Functioning, Disability and Health (ICF). The protocol followed the MOOSE guidelines for systematic reviews. A total of thirty-four studies comprising 14 206 participants were included in the study. Compared to healthy individuals, subjects with PTSD showed significant (ps < 0.001) impairments with large to very large effect sizes (ds > 1) in all domains. Subjects with, compared to without, PTSD showed significant (ps < 0.001) impairments with medium to large effect sizes (ds > 0.5) in the domains General Tasks and Demands, Mobility, Self Care, Domestic Life, Interpersonal Interactions and Relationships, Major Life Areas and Community, Social and Civic Life. Significant impairments with small to medium effect sizes in the same domains were observed comparing PTSD to other mental disorders. In conclusion, PTSD has a significant impact on most areas of daily functioning as conceptualized in the International Classification of Functioning, Disability and Health (ICF) of the WHO. Early detection and targeted treatment of functional deficits is warranted in this patient population.
创伤后应激障碍（PTSD）是一种严重且使人衰弱的病症，常与日常功能的显著受损相关。迄今为止，关于PTSD患者功能受损复杂性的研究稀缺且有限。然而，需要对现有证据进行定量综合和全面综述，以更好地描述PTSD在不同领域功能受损的程度。我们进行了一项系统的文献检索，纳入了比较有和没有PTSD的个体功能的观察性研究。根据世界卫生组织《国际功能、残疾和健康分类》（ICF）对不同功能领域进行随机效应荟萃分析。该方案遵循系统综述的MOOSE指南。共有34项研究、14206名参与者纳入本研究。与健康个体相比，PTSD患者在所有领域均表现出显著（p<0.001）受损，效应量为大到非常大（d>1）。与无PTSD的个体相比，有PTSD的个体在一般任务与要求、移动性、自我照料、家庭生活、人际互动与关系、主要生活领域与社区、社会与公民生活等领域表现出显著（p<0.001）受损，效应量为中到大型（d>0.5）。将PTSD与其他精神障碍进行比较时，在相同领域观察到效应量为小到中型的显著受损。总之，PTSD对世界卫生组织《国际功能、残疾和健康分类》（ICF）概念化的大多数日常功能领域有显著影响。对该患者群体进行早期功能缺陷检测和针对性治疗是必要的。
