Woods Cate F, McIntosh Virginia V W, Frampton Christopher M, Carter Frances A, Colhoun Helen C, Jordan Jennifer, Smith Rebekah A, Bell Caroline
School of Psychology, Speech and Hearing, University of Canterbury, New Zealand.
Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.
BJPsych Open. 2024 Dec 27;11(1):e13. doi: 10.1192/bjo.2024.819.
History of prior mental disorder, particularly post-traumatic stress disorder (PTSD), increases risk for PTSD following subsequent trauma exposure. However, limited research has examined differences associated with specific prior mental disorders among people with PTSD.
The current study examined whether different prior mental disorders were associated with meaningful differences among individuals presenting to a specialist service for severe earthquake-related distress following the Canterbury earthquakes ( = 177).
Two sets of comparisons were made: between participants with no history of prior disorder and participants with history of any prior disorder; and between participants with history of prior PTSD and those with history of other prior disorders. Comparisons were made in relation to sociodemographic factors, earthquake exposure, peri-traumatic distress, life events and current psychological functioning.
Participants with any prior mental disorder had more current disorders than those with no prior disorder. Among participants with history of any prior disorder, those with prior PTSD reported more life events in the past 5 years than those with other prior disorders.
Findings suggest a history of any prior mental disorder contributes to increased clinical complexity, but not increased PTSD severity, among people with PTSD seeking treatment. Although post-disaster screening efforts should include those with prior mental disorders, it should also be recognised that those with no prior disorders are also at risk of developing equally severe PTSD.
既往精神障碍史，尤其是创伤后应激障碍（PTSD），会增加后续遭受创伤后发生PTSD的风险。然而，仅有有限的研究探讨了PTSD患者中与特定既往精神障碍相关的差异。
本研究调查了不同的既往精神障碍是否与在坎特伯雷地震后因严重地震相关困扰而寻求专科服务的个体（n = 177）之间的显著差异有关。
进行了两组比较：一组是无既往精神障碍史的参与者与有任何既往精神障碍史的参与者之间的比较；另一组是有既往PTSD史的参与者与有其他既往精神障碍史的参与者之间的比较。比较内容涉及社会人口学因素、地震暴露情况、创伤期间的困扰、生活事件及当前的心理功能。
有任何既往精神障碍的参与者比无既往精神障碍的参与者有更多当前的精神障碍。在有任何既往精神障碍史的参与者中，有既往PTSD史的参与者在过去5年中报告的生活事件比有其他既往精神障碍史的参与者更多。
研究结果表明，在寻求治疗的PTSD患者中，任何既往精神障碍史都会导致临床复杂性增加，但不会导致PTSD严重程度增加。尽管灾后筛查工作应包括有既往精神障碍的人群，但也应认识到，无既往精神障碍的人群同样有患严重PTSD的风险。
