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成年烧伤患者烧伤三个月后的创伤后应激障碍和抑郁症:社会心理因素的作用。

PTSD and depression in adult burn patients three months postburn: The contribution of psychosocial factors.

作者信息

Su Yi-Jen

机构信息

Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan, ROC; Department of Psychiatry, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC.

出版信息

Gen Hosp Psychiatry. 2023 May-Jun;82:33-40. doi: 10.1016/j.genhosppsych.2023.03.004. Epub 2023 Mar 14.

Abstract

OBJECTIVE

Burn injuries can be traumatic and increase the risk of posttraumatic stress disorder (PTSD) and major depression (MDD). The current study examined the incremental contribution of established predictors of PTSD and theory-derived cognitive predictors to PTSD and depression early after burn.

METHODS

Participants were 118 adult burn patients consecutively admitted to the largest burn center in Taiwan who completed a baseline assessment, of which 101 (85.6%) were reassessed 3-month post-burn.

RESULTS

Three months after the burn, 17.8% and 17.8% of participants met probable DSM-5 PTSD and MDD, respectively. The rates rose to 24.8% and 31.7% using a cut-off of 28 on the Posttraumatic Diagnostic Scale for DSM-5 and 10 on the Patient Health Questionnaire-9, respectively. After controlling for potential confounders, the model with established predictors uniquely explained 26.0% and 16.5% of the variance of PTSD and depressive symptoms 3-month post-burn, respectively. The model with theory-derived cognitive predictors uniquely explained 17.4% and 14.4% of the variance, respectively. Posttrauma social support and thought suppression remained significant predictors of both outcomes.

CONCLUSION

A sizeable subset of burn patients suffer from PTSD and depression early after burn. Social and cognitive factors are implicated in the development and recovery of post-burn psychopathology.

摘要

目的

烧伤会造成创伤,并增加创伤后应激障碍(PTSD)和重度抑郁症(MDD)的风险。本研究探讨了PTSD既定预测因素及理论推导的认知预测因素对烧伤后早期PTSD和抑郁症的增量贡献。

方法

研究对象为118名连续入住台湾最大烧伤中心的成年烧伤患者,他们完成了基线评估,其中101名(85.6%)患者在烧伤后3个月接受了重新评估。

结果

烧伤后3个月,分别有17.8%和17.8%的参与者符合DSM-5中PTSD和MDD的可能诊断标准。使用DSM-5创伤后诊断量表28分及患者健康问卷-9的10分作为临界值时,这一比例分别升至24.8%和31.7%。在控制潜在混杂因素后,包含既定预测因素的模型分别独特地解释了烧伤后3个月PTSD和抑郁症状变异的26.0%和16.5%。包含理论推导认知预测因素的模型分别独特地解释了17.4%和14.4%的变异。创伤后社会支持和思想抑制仍然是这两种结果的显著预测因素。

结论

相当一部分烧伤患者在烧伤后早期患有PTSD和抑郁症。社会和认知因素与烧伤后精神病理学的发生和恢复有关。

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