Havermans Demi C D, Coeur Estelle M N, Jiaqing O, Rippey Colton S, Cook Joan M, Olff Miranda, Hoeboer Chris, Sobczak Sjacko, Lawrence Karen A
Department of Neuropsychology and Psychopharmacology, Maastricht University, Maastricht, the Netherlands.
TanteLouise, Bergen op Zoom, the Netherlands.
Eur J Psychotraumatol. 2025 Dec;16(1):2498191. doi: 10.1080/20008066.2025.2498191. Epub 2025 May 14.
As the number of older adults increases worldwide, understanding their mental health is crucial, including the impact of traumatic experiences that can lead to posttraumatic stress disorder (PTSD). However, validated screening and diagnostic instruments for PTSD in older adults are limited. We sought to provide a comprehensive summary of the diagnostic accuracy of PTSD screening and diagnostic instruments used in older adults ( ≥ 60 years). A systematic search of MEDLINE, EMBASE, PsycINFO and Web of Science databases was conducted for January 1980 through 10 January 2025. Studies that focused on the psychometric properties of PTSD instruments in older adults were included. Out of 21,197 publications screened, only 40 studies including 24 instruments met the eligibility criteria. Only seven were conducted with participants from the general population or primary care patient samples. There were 14 relevant studies in the last ten years, with only six based on the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) criteria. Validation studies conducted in non-Western and/or non-English speaking older adult samples are rare. There is a shortage of validation studies of PTSD screening and diagnostic tools in the general older adult population. We recommend using the Clinician-Administered PTSD Scale for DSM-5 in clinical practice. It is the gold standard for assessing current and lifetime PTSD in the general population. Further research is required to establish evidence-based clinical cut-off scores and cross-cultural validity for PTSD screening in different populations of older adults. Future studies should also assess measures that consider the multimorbidity in this population (e.g. cognitive impairment and other psychiatric or medical disorders) and are easy to administer in clinical practice.
随着全球老年人口数量的增加，了解他们的心理健康至关重要，这包括创伤经历可能导致创伤后应激障碍（PTSD）的影响。然而，针对老年人PTSD的经过验证的筛查和诊断工具非常有限。我们试图全面总结用于老年人（≥60岁）的PTSD筛查和诊断工具的诊断准确性。对1980年1月至2025年1月10日期间的MEDLINE、EMBASE、PsycINFO和科学网数据库进行了系统检索。纳入了关注老年人PTSD工具心理测量特性的研究。在筛选的21,197篇出版物中，只有40项研究（包括24种工具）符合纳入标准。只有7项研究的参与者来自普通人群或初级保健患者样本。在过去十年中有14项相关研究，其中只有6项基于《精神疾病诊断与统计手册》第五版（DSM-5）标准。在非西方和/或非英语老年成人样本中进行的验证研究很少。在普通老年人群中，PTSD筛查和诊断工具的验证研究不足。我们建议在临床实践中使用DSM-5的临床医生管理的PTSD量表。它是评估普通人群当前和终身PTSD的金标准。需要进一步研究以建立基于证据的临床临界值分数以及不同老年人群中PTSD筛查的跨文化有效性。未来的研究还应评估考虑该人群中多种合并症（如认知障碍和其他精神或医学疾病）且易于在临床实践中实施的测量方法。
