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创伤暴露与共存的 ICD-11 创伤后应激障碍和复杂创伤后应激障碍在有精神障碍生活经历的成年人中。

Trauma exposure and co-occurring ICD-11 post-traumatic stress disorder and complex post-traumatic stress disorder in adults with lived experience of psychiatric disorder.

机构信息

National Centre for Mental Health, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK.

National Centre for Mental Health, PÂR, Cardiff University School of Medicine, Cardiff, UK.

出版信息

Acta Psychiatr Scand. 2022 Sep;146(3):258-271. doi: 10.1111/acps.13467. Epub 2022 Jul 13.

DOI:10.1111/acps.13467
PMID:35752949
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9543812/
Abstract

OBJECTIVE

To establish factors associated with ICD-11 post-traumatic stress disorder (PTSD) and complex PTSD (CPTSD) in a large sample of adults with lived experience of psychiatric disorder and examine the psychiatric burden associated with the two disorders.

METHODS

One thousand three hundred and five adults were recruited from the National Centre for Mental Health (NCMH) cohort. ICD-11 PTSD/CPTSD were assessed with the International Trauma Questionnaire (ITQ). Binary logistic regression was used to determine factors associated with both PTSD and CPTSD. One-way between-groups analysis of variance was conducted to examine the burden associated with the two disorders in terms of symptoms of anxiety, depression, and psychological wellbeing. For post-hoc pairwise comparisons, the Tukey HSD test was used, and the magnitude of between-group differences assessed using Cohen's d.

RESULTS

Probable ICD-11 CPTSD was more common than PTSD within the sample (PTSD 2.68%; CPTSD 12.72%). We found evidence that PTSD was associated with interpersonal trauma and household income under £20,000 a year. CPTSD was also associated with interpersonal trauma, higher rates of personality disorder, and lower rates of bipolar disorder. Those with probable-CPTSD had higher levels of current anxiety and depressive symptoms and lower psychological wellbeing in comparison to those with probable-PTSD and those with neither disorder.

CONCLUSIONS

CPTSD was more prevalent than PTSD in our sample of people with lived experience of psychiatric disorder. Our findings indicate a need for routine screening for trauma histories and PTSD/CPTSD in clinical settings and a greater focus on the need for interventions to treat CPTSD.

摘要

目的

在一个有精神障碍经历的成年人的大样本中,确定与 ICD-11 创伤后应激障碍(PTSD)和复杂创伤后应激障碍(CPTSD)相关的因素,并检查这两种障碍相关的精神负担。

方法

从国家精神卫生中心(NCMH)队列中招募了 1355 名成年人。使用国际创伤问卷(ITQ)评估 ICD-11 PTSD/CPTSD。使用二元逻辑回归确定与 PTSD 和 CPTSD 相关的因素。采用单向组间方差分析,根据焦虑、抑郁和心理健康症状检查两种障碍相关的负担。对于事后两两比较,使用 Tukey HSD 检验,并用 Cohen's d 评估组间差异的大小。

结果

在该样本中,可能的 ICD-11 CPTSD 比 PTSD 更常见(PTSD 2.68%;CPTSD 12.72%)。我们发现证据表明,PTSD 与人际创伤和年收入低于 20,000 英镑有关。CPTSD 还与人际创伤、更高的人格障碍率和更低的双相障碍率有关。与可能患有 PTSD 的患者相比,可能患有 CPTSD 的患者当前焦虑和抑郁症状水平更高,心理健康水平更低。

结论

在有精神障碍经历的人群样本中,CPTSD 比 PTSD 更为常见。我们的研究结果表明,在临床环境中需要常规筛查创伤史和 PTSD/CPTSD,并更加关注治疗 CPTSD 的干预措施的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7797/9543812/d5a455e4ac6a/ACPS-146-258-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7797/9543812/d5a455e4ac6a/ACPS-146-258-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7797/9543812/d5a455e4ac6a/ACPS-146-258-g001.jpg

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