Blanchard E B, Hickling E J, Taylor A E, Loos W
Center for Stress and Anxiety Disorders, University at Albany-SUNY 12203, USA.
J Nerv Ment Dis. 1995 Aug;183(8):495-504. doi: 10.1097/00005053-199508000-00001.
The primary purpose of this report was to determine the extent of psychiatric morbidity and comorbidity among a sample of recent victims of motor vehicle accidents (MVAs) in comparison to a nonaccident control population. Victims of recent MVAs (N = 158), who sought medical attention as a result of the MVA, were assessed in a University-based research clinic, 1 to 4 months after the accident for acute psychiatric and psychosocial consequences as well as for pre-MVA psychopathology using structured clinical interviews (Clinician-Administered PTSD Scale, SCID, SCID-II, LIFE Base). Age- and gender-matched controls (N = 93) who had had no MVAs in the past year served as controls. Sixty-two MVA victims (39.2%) met DSM-III-R criteria for posttraumatic stress disorder (PTSD), and 55 met DSM-IV criteria. The MVA victims who met the criteria for PTSD were more subjectively distressed and had more impairment in role function (performance at work/school/homemaking, relationships with family or friends) than the MVA victims who did not meet the PTSD criteria or the controls. A high percentage (53%) of the MVA-PTSD group also met the criteria for current major depression, with most of that developing after the MVA. A prior history of major depression appears to be a risk factor for developing PTSD after an MVA (p = .0004): 50% of MVA victims who developed PTSD had a history of previous major depression, as compared with 23% of those with a less severe reaction to the MVA. A prior history of PTSD from earlier trauma also is associated with developing PTSD or a subsyndromal form of it (25.2%) (p = .0012). Personal injury MVAs exact substantial psychosocial costs on the victims. Early intervention, especially in vulnerable populations, might prevent some of this.
本报告的主要目的是确定机动车事故（MVA）近期受害者样本中精神疾病发病率和共病情况，并与非事故对照人群进行比较。近期因MVA寻求医疗救治的受害者（N = 158）在事故发生1至4个月后，于一所大学的研究诊所接受评估，以了解急性精神和心理社会后果以及事故前的精神病理学情况，采用结构化临床访谈（临床医生管理的创伤后应激障碍量表、SCID、SCID-II、LIFE Base）。年龄和性别匹配的对照组（N = 93）在过去一年中未发生过MVA，作为对照。62名MVA受害者（39.2%）符合DSM-III-R创伤后应激障碍（PTSD）标准，55名符合DSM-IV标准。符合PTSD标准的MVA受害者比未符合PTSD标准的MVA受害者或对照组在主观上更痛苦，在角色功能（工作/学校/家务表现、与家人或朋友的关系）方面有更多损害。MVA-PTSD组中有很高比例（53%）也符合当前重度抑郁症标准，其中大多数是在MVA后发生的。重度抑郁症病史似乎是MVA后发生PTSD的一个危险因素（p = .0004）：发生PTSD的MVA受害者中有50%有既往重度抑郁症病史，而对MVA反应较轻的受害者中这一比例为23%。早期创伤导致的PTSD病史也与发生PTSD或其亚综合征形式相关（25.2%）（p = .0012）。涉及人身伤害的MVA给受害者带来了巨大的心理社会成本。早期干预，尤其是对弱势群体的干预，可能会预防其中一些情况。
