越南退伍男性军人在部署50年后与战斗相关的创伤后应激障碍（PTSD）、医疗及社会功能障碍的持续情况和模式
Persistence and Patterns of Combat-Related Posttraumatic Stress Disorder (PTSD), Medical, and Social Dysfunction in Male Military Veterans 50 Years After Deployment to Vietnam.
作者信息
Stellman Steven D, Pless Kaiser Anica, Smith Brian N, Spiro Avron, Stellman Jeanne Mager
机构信息
From the Department of Epidemiology, Mailman School of Public Health , Columbia University, New York, New York (S.D.S.); National Center for PTSD Behavioral Science Division, VA Boston Healthcare System, Boston, Massachusetts (A.P.K.); VA New England Geriatric Research Education and Clinical Center, Boston, Massachusetts (A.P.K.); Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts (A.P.K., B.N.S., A.S.); National Center for PTSD Women's Health Sciences Division, VA Boston Healthcare System, Boston, Massachusetts (B.N.S.); Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, Massachusetts (A.S.); Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts (A.S.); and Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, New York (J.M.S.).
出版信息
J Occup Environ Med. 2025 May 1;67(5):306-312. doi: 10.1097/JOM.0000000000003321.
OBJECTIVES
We examined long-term patterns of posttraumatic stress disorder (PTSD) and behavioral outcomes in Vietnam veterans.
METHODS
A random sample of 12,400 veterans was surveyed in 1984, 1998, and a deployed subset (n = 729) in 2020. Outcomes included PTSD, psychological well-being, health functioning, and disability.
RESULTS
Four PTSD patterns emerged over 35 years: current PTSD (9.1%, rising to 15.5% in heavy combat), prior PTSD (9.7%), subthreshold PTSD (25.2%), and never PTSD (56.0%). A strong combat-PTSD dose-response relationship persisted across time points. Veterans with current PTSD showed the worst outcomes; those with subthreshold or prior PTSD had intermediate outcomes, while never-PTSD veterans fared best. Community support mitigated adverse effects.
CONCLUSIONS
Findings highlight the enduring impact of combat, with PTSD and related dysfunction affecting veterans even below clinical thresholds, leaving many ineligible for Department of Veterans Affairs (DVA) programs.
目的
我们研究了越战退伍军人创伤后应激障碍（PTSD）的长期模式和行为结果。
方法
1984年、1998年对12400名退伍军人进行了随机抽样调查，2020年对其中一个部署子集（n = 729）进行了调查。结果包括创伤后应激障碍、心理健康、健康功能和残疾情况。
结果
在35年中出现了四种创伤后应激障碍模式：当前创伤后应激障碍（9.1%，在激烈战斗中升至15.5%）、既往创伤后应激障碍（9.7%）、亚阈值创伤后应激障碍（25.2%）和从未患创伤后应激障碍（56.0%）。在各个时间点，战斗与创伤后应激障碍之间都存在着强烈的剂量反应关系。患有当前创伤后应激障碍的退伍军人结果最差；患有亚阈值或既往创伤后应激障碍的退伍军人结果中等，而从未患创伤后应激障碍的退伍军人情况最佳。社区支持减轻了不良影响。
结论
研究结果凸显了战斗的持久影响，创伤后应激障碍及相关功能障碍即使在临床阈值以下也会影响退伍军人，导致许多人无资格参加退伍军人事务部（DVA）的项目。
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