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全国青少年前期儿童样本中的创伤后应激障碍:患病率、相关因素、临床后遗症及治疗利用情况

Post-traumatic stress disorder in a national sample of preadolescent children: Prevalence, correlates, clinical sequelae, and treatment utilization.

作者信息

Levin Rachel, Liu Richard

机构信息

University of Rochester.

Harvard Medical School.

出版信息

Res Sq. 2023 Nov 15:rs.3.rs-3303568. doi: 10.21203/rs.3.rs-3303568/v1.

Abstract

Although posttraumatic stress disorder (PTSD) has been well characterized in adults, its epidemiology in children is unclear. The current study provides the first population-based examination of the prevalence of PTSD, sociodemographic and psychiatric correlates, clinical sequelae, and associations with psychiatric treatment in preadolescents in the United States. Data from the Adolescent Brain and Cognitive Development (ABCD) Study (release 5.0) was analyzed. Participants (unweighted = 11, 875) were recruited from 21 sites across the United States. Current and lifetime PTSD prevalence were estimated, as was treatment use among children with PTSD. Sociodemographic, psychiatric correlates and sequelae of PTSD were analyzed using logistic regression, as was the association between PTSD and psychiatric treatment. Lifetime prevalence of PTSD was 2.17%. Sexual minority status, being multiracial, having unmarried parents, and family economic insecurity were associated with greater odds of PTSD. Among psychiatric disorders, separation anxiety was most strongly associated with PTSD, although general comorbid psychopathology was associated with greater odds of PTSD. Prior history of PTSD predicted new onset of other psychiatric disorders after PTSD remission. Nearly one in three children with lifetime PTSD did not receive psychiatric treatment, despite negative long-term outcomes of PTSD and significant psychiatric comorbidity. Even among preadolescents who experience full remission of PTSD, significant risk for future psychiatric illness remains. Further, the current findings underscore the need for improved efforts to reduce unmet treatment needs among those with PTSD at this age.

摘要

尽管创伤后应激障碍(PTSD)在成年人中已有充分的特征描述,但其在儿童中的流行病学情况尚不清楚。当前的研究首次对美国青春期前儿童PTSD的患病率、社会人口统计学和精神科相关因素、临床后遗症以及与精神科治疗的关联进行了基于人群的调查。分析了青少年大脑与认知发展(ABCD)研究(第5.0版)的数据。参与者(未加权=11875人)从美国21个地点招募。估计了当前和终生PTSD患病率,以及PTSD儿童的治疗使用情况。使用逻辑回归分析了PTSD的社会人口统计学、精神科相关因素和后遗症,以及PTSD与精神科治疗之间的关联。PTSD的终生患病率为2.17%。性少数群体身份、多种族、父母未婚以及家庭经济不安全与PTSD的较高几率相关。在精神障碍中,分离焦虑与PTSD关联最为密切,尽管一般共病精神病理学与PTSD的较高几率相关。PTSD的既往史预示着PTSD缓解后其他精神障碍的新发病例。近三分之一有终生PTSD的儿童未接受精神科治疗,尽管PTSD有负面的长期后果且存在显著的精神科共病。即使在经历PTSD完全缓解的青春期前儿童中,未来患精神疾病的重大风险仍然存在。此外,当前的研究结果强调需要加大力度,以减少这个年龄段PTSD患者未满足的治疗需求。

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