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潜在创伤性事件对先前存在的焦虑和抑郁症状恢复的影响,以及 PTSD 的风险。

The effects of potentially traumatic events on the recovery from pre-existing anxiety and depression symptomatology and the risk of PTSD.

机构信息

Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.

Centerdata, Tilburg, The Netherlands.

出版信息

Psychiatry Clin Neurosci. 2024 Nov;78(11):696-702. doi: 10.1111/pcn.13725. Epub 2024 Aug 20.

Abstract

AIM

The extent to which recent potentially traumatic events (PTEs) hinder the recovery from pre-existing mental health problems is largely unknown. The same applies to the extent to which non-recovery from pre-existing mental health problems increases the risk of posttraumatic stress disorder (PTSD). The aim of the present study is to gain insight in these effects.

METHODS

Data were extracted from six annual surveys of the Dutch population-based Victims in Modern Society (VICTIMS) study. Of the adult respondents who participated in two subsequent surveys (labeled T1 and T2, n = 6942), those with severe anxiety and depression symptoms (ADS) at T1 (n = 487) were selected. We distinguished respondents exposed to PTEs (PTE-group, n = 162) and not exposed to PTEs (comparison group, n = 325) between T1 and T2. We applied five indicators of recovery [based on the Reliable Change Index (RCI), degrees of symptom reduction, and the cut-off score at T2]. Differences in the recovery from ADS and probable PTSD at T2 were examined using multivariate logistic regression.

RESULTS

The PTE group less often recovered from severe ADS between T1 and T2 than the comparison group according to all five indicators of recovery, while controlling for 11 different variables (0.40 ≤ adjusted OR's ≤ 0.66). Those in the PTE group who did not recover, considerably more often suffered from probable PTSD at T2 (63%-82%) than those who did recover (0%-29%; 8.96 ≤ adjusted OR ≤ 26.33).

CONCLUSION

Recent potentially traumatic events hinder the recovery from pre-existing anxiety and depression symptomatology and thereby increase the risk of probable PTSD.

摘要

目的

最近的潜在创伤性事件(PTE)在多大程度上阻碍了先前存在的心理健康问题的恢复,在很大程度上尚不清楚。同样不清楚的是,先前存在的心理健康问题的未恢复在多大程度上增加了创伤后应激障碍(PTSD)的风险。本研究的目的是深入了解这些影响。

方法

从荷兰基于人群的现代社会受害者(VICTIMS)研究的六项年度调查中提取数据。在参加了两次后续调查(标记为 T1 和 T2,n=6942)的成年受访者中,选择了 T1 时患有严重焦虑和抑郁症状(ADS)的受访者(n=487)。我们区分了 T1 和 T2 之间暴露于 PTE(PTE 组,n=162)和未暴露于 PTE(对照组,n=325)的受访者。我们应用了五种恢复指标[基于可靠变化指数(RCI)、症状减轻程度和 T2 的截止分数]。使用多变量逻辑回归检查 T2 时 ADS 和可能 PTSD 的恢复差异。

结果

与对照组相比,在控制了 11 个不同变量后(0.40≤调整后的 OR≤0.66),PTE 组在 T1 和 T2 之间从严重 ADS 恢复的比例较低,根据所有五种恢复指标。在 PTE 组中,未恢复的患者在 T2 时更可能患有可能的 PTSD(63%-82%),而恢复的患者(0%-29%)则较少(8.96≤调整后的 OR≤26.33)。

结论

最近的潜在创伤性事件会阻碍先前存在的焦虑和抑郁症状的恢复,从而增加患可能的 PTSD 的风险。

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本文引用的文献

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Treatment of Posttraumatic Stress Disorder: A State-of-the-art Review.创伤后应激障碍的治疗:最新综述。
Curr Neuropharmacol. 2024;22(4):557-635. doi: 10.2174/1570159X21666230428091433.

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