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创伤后应激障碍(PTSD)的终身患病率、共病和社会人口学预测因素:伊朗儿童和青少年精神障碍全国流行病学研究(IRCAP)。

Lifetime prevalence, comorbidities, and Sociodemographic predictors of post-traumatic stress disorder (PTSD): the National Epidemiology of Iranian Children and adolescents Psychiatric disorders (IRCAP).

机构信息

School of Psychology and Educational Sciences, University of Tehran, Tehran, Iran.

Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Eur Child Adolesc Psychiatry. 2024 Nov;33(11):3965-3978. doi: 10.1007/s00787-024-02441-7. Epub 2024 Apr 24.

Abstract

OBJECTIVE

The aims of this study were to (a) evaluate the lifetime prevalence of post-traumatic stress disorder (PTSD) according to sociodemographic characteristics, (b) determine sociodemographic factors associated with PTSD, (c) estimate the lifetime prevalence rates of comorbidities by age and gender, and (d) assess the proportion of traumatic events in the non-PTSD sample and the PTSD sample, according to gender.

METHODS

The data used for the present study were obtained from the IRCAP study which was a cross-sectional, community-based study on 29,250 children and adolescents aged 6-18 years from all provinces of Iran, which was done using multistage cluster sampling. Trained psychologists conducted diagnostic interviews with parents, children, and adolescents using the Persian version of the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL).

RESULTS

In this study, the prevalence of PTSD across the sample population was 0.6% (95% CI, 0.5-0.7%). Higher rates of PTSD were observed among girls (0.7%, CI 0.5-0.8%), adolescents aged 15-18 years (0.8%, CI 0.6-1.0%), and participants who had unemployed (1.5%, CI 0.8-2.8%), or farmer fathers (1.1%, CI 0.5-2.5%). Of the participants with PTSD, 65.1% met the criteria for at least one other psychiatric disorder. PTSD had a high rate of comorbidity with oppositional defiant disorder (22.9%, CI 17.5-29.4%), generalized anxiety disorder (20.8%, CI 15.7-27.1%), separation anxiety disorder (20.3%, CI 15.2-26.6%), and major depressive disorder (19.8%, CI 14.8-26.0%). We found 9.5% of non-PTSD sample experienced at least one traumatic event. Witness to domestic violence was the most common traumatic event experienced by 32.8% of PTSD sample.

CONCLUSION

Our results in the prevalence, comorbidities, and sociodemographic factors associated with PTSD supported findings of previous studies that used a structured diagnostic interview. It is recommended to use purposive sampling and to investigate comorbidities of PTSD and type of traumatic events in a large clinical population.

摘要

目的

本研究旨在:(a) 根据社会人口学特征评估创伤后应激障碍(PTSD)的终生患病率;(b) 确定与 PTSD 相关的社会人口学因素;(c) 按年龄和性别估计共病的终生患病率;(d) 根据性别评估非 PTSD 样本和 PTSD 样本中创伤事件的比例。

方法

本研究使用的是 IRCAP 研究的数据,这是一项针对伊朗所有省份 6-18 岁儿童和青少年的 29250 人的横断面、基于社区的研究,采用多阶段聚类抽样。经过培训的心理学家使用波斯语版本的儿童情绪障碍和精神分裂症诊断性访谈量表-学校年龄段儿童的现状和终生版本(K-SADS-PL)对父母、儿童和青少年进行诊断访谈。

结果

在这项研究中,整个样本人群的 PTSD 患病率为 0.6%(95%CI,0.5-0.7%)。女孩(0.7%,CI 0.5-0.8%)、15-18 岁青少年(0.8%,CI 0.6-1.0%)和失业(1.5%,CI 0.8-2.8%)或农民父亲(1.1%,CI 0.5-2.5%)的 PTSD 发生率较高。在 PTSD 患者中,65.1%符合至少一种其他精神障碍的标准。PTSD 与对立违抗障碍(22.9%,CI 17.5-29.4%)、广泛性焦虑障碍(20.8%,CI 15.7-27.1%)、分离焦虑障碍(20.3%,CI 15.2-26.6%)和重性抑郁障碍(19.8%,CI 14.8-26.0%)的共病率较高。我们发现,9.5%的非 PTSD 样本经历过至少一次创伤性事件。目睹家庭暴力是 PTSD 样本中最常见的创伤性事件,占 32.8%。

结论

我们在 PTSD 的患病率、共病和与 PTSD 相关的社会人口学因素方面的结果支持了使用结构化诊断访谈的先前研究的发现。建议在大型临床人群中使用目的性抽样,并研究 PTSD 的共病和创伤事件的类型。

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