Krishnakumari K, Munivenkatappa Manjula, Hegde Shantala, Muralidharan Kesavan
Dept. of Clinical Psychology, M.V. Govindaswamy Centre, National Institute of Mental Health & Neurosciences (NIMHANS), Bengaluru, Karnataka, India.
Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India.
Indian J Psychol Med. 2022 Jul;44(4):378-383. doi: 10.1177/02537176211035074. Epub 2021 Oct 3.
Post-traumatic stress disorder (PTSD) is an understudied construct in the psychiatric setting. The majority of existing Indian studies on PTSD focus on the general population or disaster-stricken communities. Here, we present data from a five-year retrospective chart review from a tertiary care psychiatric center in India.
Medical records of adult patients (≥18 years) who had attended psychiatry outpatient services between April 1, 2015 and March 31, 2020 (five years) and were diagnosed with PTSD, as per ICD-10 criteria, were reviewed ( = 113). The relevant sociodemographic and clinical details were extracted using a semistructured pro-forma.
The percentage of adult patients with PTSD diagnosis in the five years was 0.22%. PTSD was more common in females (n = 65, 57.5%). Most patients had interpersonal trauma (n = 85, 75.2%), specifically sexual abuse (n = 47, 41.6%). The median age of onset was 22 years. All the patients had re-experiencing symptoms, with an equally high rate of avoidance (n = 109, 96.5%) and arousal symptoms (n = 110, 97.3%). 82%(93) had a comorbid psychiatric disorder, with mood disorder being the most common (n = 44, 38.9%). Males had a higher rate of comorbid substance use disorder (n = 14, 29.2%) and depression (n = 20,42%), and females had a higher rate of comorbid dissociative disorder (n = 13,20%). Most of the patients received non-trauma-focused psychological interventions, and only 18% (20) received evidence-based trauma-focused psychological interventions.
Interpersonal trauma, specifically sexual abuse, largely contributes to PTSD among adults attending psychiatric services. The need for trauma-focused psychological interventions is underscored.
创伤后应激障碍（PTSD）在精神科环境中是一个研究较少的概念。印度现有的大多数关于PTSD的研究都集中在一般人群或受灾社区。在此，我们展示了来自印度一家三级护理精神科中心的五年回顾性病历审查数据。
回顾了2015年4月1日至2020年3月31日（五年）期间在精神科门诊就诊且根据ICD - 10标准被诊断为PTSD的成年患者（≥18岁）的病历（n = 113）。使用半结构化表格提取相关的社会人口统计学和临床细节。
五年中成年PTSD诊断患者的百分比为0.22%。PTSD在女性中更常见（n = 65，57.5%）。大多数患者有人际创伤（n = 85，75.2%），特别是性虐待（n = 47，41.6%）。发病的中位年龄为22岁。所有患者都有再次体验症状，回避症状（n = 109，96.5%）和觉醒症状（n = 110，97.3%）的发生率同样高。82%（93）有共病精神障碍，情绪障碍最为常见（n = 44，38.9%）。男性共病物质使用障碍（n = 14，29.2%）和抑郁症（n = 20，42%）的发生率较高，女性共病解离障碍（n = 13，20%）的发生率较高。大多数患者接受了非创伤聚焦心理干预措施，只有18%（20）接受了循证创伤聚焦心理干预措施。
人际创伤，特别是性虐待，在很大程度上导致了精神科就诊成年患者的PTSD。强调了对创伤聚焦心理干预措施需求。
