Division of Behavioral Science, National Defense Medical College Research Institute, Saitama, Japan.
Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands.
JAMA Netw Open. 2024 Jul 1;7(7):e2424388. doi: 10.1001/jamanetworkopen.2024.24388.
Peacekeepers in United Nations missions experience potentially traumatic events, resulting in increased risk for posttraumatic stress disorder (PTSD). Understanding the course and risk factors of PTSD symptom severity is crucial to ensure personnel safety.
To investigate the incidence of PTSD, symptom severity trajectories, and potential risk factors associated with adverse trajectories among Japanese peacekeepers deployed in South Sudan.
DESIGN, SETTING, AND PARTICIPANTS: Data for this 6-year prospective cohort study were collected from December 2011 to December 2018 from Japan Ground Self-Defense Force personnel deployed at the United Nations Mission in South Sudan, corresponding to before and up to 78 months after deployment. Of 3799 potential participants, 80 were excluded because of multiple deployments and 757 because of missing data, incomplete responses, or not providing informed consent. Therefore, 2962 participants were included in the analysis. Data analysis was performed from February 2022 to February 2024.
The participants were deployed to United Nations Mission in South Sudan for 6 months.
The 22-item Impact of Event Scale-Revised was used to assess PTSD symptoms, with 25 or more points indicating probable PTSD (p-PTSD). Sociodemographic data were collected, and the 30-item General Health Questionnaire was administered before deployment to identify risk factors for PTSD symptom severity.
In the 2962 participants studied (2901 [97.9%] male; mean [SD] age, 33.9 [7.2] years), the incidence of p-PTSD was 3.95%. Latent growth mixture models identified 4 symptom severity trajectories: resilient (2143 [72.3%]), recovery (479 [16.2%]), protracted (182 [6.1%]), and delayed (158 [5.3%]). Multinomial logistic regression showed that sleep disturbance was a common risk factor for the 2 most severe trajectories (protracted: odds ratio [OR], 1.29; 95% CI, 1.08-1.54; delayed: OR, 1.26; 95% CI, 1.03-1.53), whereas older age (OR, 1.25; 95% CI, 1.06-1.48), anxiety and dysphoria (OR, 1.45; 95% CI, 1.20-1.75), and general illness (OR, 1.30; 95% CI, 1.06-1.59) were associated with the protracted trajectory.
This cohort study found that approximately 4% of the participants developed p-PTSD and identified 4 distinct PTSD symptom trajectories. The findings suggest that addressing sleep disturbance and general health issues could effectively prevent PTSD symptoms among peacekeepers.
联合国维和任务中的维和人员可能会经历创伤性事件，从而增加患创伤后应激障碍（PTSD）的风险。了解 PTSD 症状严重程度的过程和风险因素对于确保人员安全至关重要。
调查日本派驻南苏丹的维和人员 PTSD 的发生率、症状严重程度轨迹以及与不良轨迹相关的潜在风险因素。
设计、地点和参与者：本 6 年前瞻性队列研究的数据于 2011 年 12 月至 2018 年 12 月从派驻在南苏丹的日本陆上自卫队人员中收集，对应于部署前和最多 78 个月后。在 3799 名潜在参与者中，80 名因多次部署而被排除，757 名因数据缺失、不完整的回复或未提供知情同意而被排除。因此，2962 名参与者被纳入分析。数据分析于 2022 年 2 月至 2024 年 2 月进行。
参与者被部署到联合国南苏丹特派团 6 个月。
使用 22 项事件影响量表修订版评估 PTSD 症状，得分为 25 分或以上表示可能患有 PTSD（p-PTSD）。在部署前收集人口统计学数据，并进行 30 项一般健康问卷，以确定 PTSD 症状严重程度的风险因素。
在 2962 名研究参与者（2901[97.9%]名男性；平均[SD]年龄，33.9[7.2]岁）中，p-PTSD 的发生率为 3.95%。潜在增长混合模型确定了 4 种症状严重程度轨迹：韧性（2143[72.3%]）、恢复（479[16.2%]）、持续（182[6.1%]）和延迟（158[5.3%]）。多变量逻辑回归显示，睡眠障碍是最严重的两种轨迹（持续：比值比[OR]，1.29；95%置信区间[CI]，1.08-1.54；延迟：OR，1.26；95%CI，1.03-1.53）的常见风险因素，而年龄较大（OR，1.25；95%CI，1.06-1.48）、焦虑和烦躁（OR，1.45；95%CI，1.20-1.75）和一般疾病（OR，1.30；95%CI，1.06-1.59）与持续轨迹相关。
本队列研究发现，约有 4%的参与者出现 p-PTSD，并确定了 4 种不同的 PTSD 症状轨迹。研究结果表明，解决睡眠障碍和一般健康问题可以有效预防维和人员的 PTSD 症状。
