Department of Psychological Medicine, King's College London, Weston Education Centre, SE5 9RJ, London, United Kingdom.
BMC Psychiatry. 2024 Jan 9;24(1):37. doi: 10.1186/s12888-023-05460-x.
Many people will experience a potentially traumatic event in their lifetime and a minority will go on to develop post-traumatic stress disorder (PTSD). A wealth of literature explores different trajectories of PTSD, focusing mostly on resilient, chronic, recovered and delayed-onset trajectories. Less is known about other potential trajectories such as recurring episodes of PTSD after initial recovery, and to date there has been no estimate of what percentage of those who initially recover from PTSD later go on to experience a recurrence. This systematic review aimed to synthesise existing literature to identify (i) how 'recurrence' of PTSD is defined in the literature; (ii) the prevalence of recurrent episodes of PTSD; and (iii) factors associated with recurrence.
A literature search of five electronic databases identified primary, quantitative studies relevant to the research aims. Reference lists of studies meeting pre-defined inclusion criteria were also hand-searched. Relevant data were extracted systematically from the included studies and results are reported narratively.
Searches identified 5,398 studies, and 35 were deemed relevant to the aims of the review. Results showed there is little consensus in the terminology or definitions used to refer to recurrence of PTSD. Because recurrence was defined and measured in different ways across the literature, and prevalence rates were reported in numerous different ways, it was not possible to perform meta-analysis to estimate the prevalence of recurrence. We also found no consistent evidence regarding predictors of PTSD recurrence.
A clear and consistent evidence-based definition of recurrence is urgently needed before the prevalence and predictors of recurrence can be truly understood.
许多人在一生中都会经历潜在的创伤性事件，少数人会发展为创伤后应激障碍（PTSD）。大量文献探讨了 PTSD 的不同轨迹，主要集中在韧性、慢性、恢复和延迟发作轨迹上。对于其他潜在轨迹，如初始恢复后 PTSD 的反复发作，了解较少，迄今为止，尚无关于最初从 PTSD 中恢复的人中，有多少百分比后来会经历复发的估计。本系统综述旨在综合现有文献，以确定：（i）文献中 PTSD“复发”的定义；（ii）PTSD 反复发作的患病率；以及（iii）与复发相关的因素。
对五个电子数据库进行文献检索，确定了与研究目的相关的主要定量研究。还对符合预先确定纳入标准的研究的参考文献进行了手工检索。从纳入的研究中系统地提取了相关数据，并以叙述性方式报告结果。
搜索共确定了 5398 项研究，其中 35 项被认为与本综述的目的相关。结果表明，术语或用于指代 PTSD 复发的定义缺乏共识。由于复发在文献中以不同的方式定义和测量，并且患病率以多种不同的方式报告，因此无法进行荟萃分析来估计复发的患病率。我们也没有发现 PTSD 复发预测因素的一致证据。
在真正了解复发的患病率和预测因素之前，迫切需要一个明确和一致的基于证据的复发定义。
