Helzer J E, Robins L N, McEvoy L
Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110.
N Engl J Med. 1987 Dec 24;317(26):1630-4. doi: 10.1056/NEJM198712243172604.
There have been numerous studies of post-traumatic stress disorder in trauma victims, war veterans, and residents of communities exposed to disaster. Epidemiologic studies of this syndrome in the general population are rare but add an important perspective to our understanding of it. We report findings on the epidemiology of post-traumatic stress disorder in 2493 participants examined as part of a nationwide general-population survey of psychiatric disorders. The prevalence of a history of post-traumatic stress disorder was 1 percent in the total population, about 3.5 percent in civilians exposed to physical attack and in Vietnam veterans who were not wounded, and 20 percent in veterans wounded in Vietnam. Post-traumatic stress disorder was associated with a variety of other adult psychiatric disorders. Behavioral problems before the age of 15 predicted adult exposure to physical attack and (among Vietnam veterans) to combat, as well as the development of post-traumatic stress disorder among those so exposed. Although some symptoms of post-traumatic stress disorder, such as hyperalertness and sleep disturbances, occurred commonly in the general population, the full syndrome as defined by the Diagnostic and Statistical Manual of Mental Disorders, third edition, was common only among veterans wounded in Vietnam.
针对创伤受害者、退伍军人以及遭受灾难社区的居民，已有大量关于创伤后应激障碍的研究。对普通人群中该综合征的流行病学研究较为罕见，但为我们理解它增添了重要视角。我们报告了作为全国性精神疾病普通人群调查一部分而接受检查的2493名参与者的创伤后应激障碍流行病学研究结果。创伤后应激障碍病史在总人口中的患病率为1%，在遭受人身攻击的平民和未受伤的越南退伍军人中约为3.5%，在越南受伤的退伍军人中为20%。创伤后应激障碍与多种其他成人精神疾病相关。15岁之前的行为问题预示着成年后遭受人身攻击以及（在越南退伍军人中）参与战斗的可能性，以及在这些遭受此类经历者中创伤后应激障碍的发生。尽管创伤后应激障碍的一些症状，如过度警觉和睡眠障碍，在普通人群中较为常见，但《精神疾病诊断与统计手册》第三版所定义的完整综合征仅在越南受伤的退伍军人中较为常见。
