Neuroscience Center for Anxiety, Stress, and Trauma, Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan, USA.
Department of Psychological Science, University of California, Irvine, California, USA.
Depress Anxiety. 2021 Sep;38(9):882-885. doi: 10.1002/da.23209.
The ongoing coronavirus disease 2019 (COVID-19) pandemic is a globally significant crisis with a rapid spread worldwide, high rates of illness and mortality, a high degree of uncertainty, and a disruption of daily life across the sociodemographic spectrum. The clinically relevant psychological consequences of this catastrophe will be long-lasting and far-reaching. There is an emerging body of empirical literature related to the mental health aspects of this pandemic and this body will likely expand exponentially. The COVID-19 pandemic is an example of a historic catastrophe from which we can learn much and from which the field will need to archive, interpret, and synthesize a multitude of clinical and research observations.
In this commentary, we discuss situations and contexts in which a diagnosis of posttraumatic stress disorder (PTSD) may or may not apply within the context of diagnostic and statistical manual of mental disorders, fifth edition (DSM-5) criteria.
Our consensus is that a COVID-related event cannot be considered traumatic unless key aspects of DSM-5's PTSD Criterion A have been established for a specific type of COVID-19 event (e.g., acute, life-threatening, and catastrophic).
The application of a more liberal interpretation of Criterion A will dilute the PTSD diagnosis, increase heterogeneity, confound case-control research, and create an overall sample pool with varying degrees of risk and vulnerability factors.
当前的 2019 年冠状病毒病（COVID-19）大流行是一场具有全球重要意义的危机，其在全球范围内迅速传播，发病率和死亡率高，不确定性高，并且打乱了社会人口统计学范围内的日常生活。这场灾难带来的具有临床意义的心理后果将是持久而深远的。与这场大流行的心理健康方面相关的实证文献不断涌现，而且这方面的文献数量可能会呈指数级增长。COVID-19 大流行是一个历史性灾难的例子，我们可以从中吸取很多经验教训，并且该领域需要对大量的临床和研究观察进行存档、解释和综合。
在这篇评论中，我们讨论了在符合《精神障碍诊断与统计手册》第五版（DSM-5）标准的情况下，创伤后应激障碍（PTSD）诊断可能适用或不适用的情况和背景。
我们的共识是，只有在 COVID-19 事件的特定类型（例如急性、危及生命和灾难性）中确立了 DSM-5 中 PTSD 标准 A 的关键方面，才能将 COVID 相关事件视为创伤性事件。
对标准 A 进行更宽松的解释的应用会使 PTSD 诊断变得更加复杂，增加异质性，混淆病例对照研究，并创建一个具有不同风险和脆弱性因素的总体样本池。
