Bleich A, Dolev A, Koslowski M, Vozner Y, Lerer B
Mental Health Dept., Israel Defence Forces.
Harefuah. 1994 May 1;126(9):493-6, 562.
Psychiatric morbidity following trauma of combat origin was studied in 60 Israeli veterans who applied for treatment 4-6 years after the war in Lebanon. Diagnostic tools were structured interviews for psychiatric disorders. In all subjects multiple psychiatric disorders had been diagnosed, most of which developed following the traumatic experience. Post-traumatic stress disorder (PTSD) was the most prevalent condition (100%-ever; 87%-present). Comorbidity included major depression with a very high prevalence (95%-ever; 50%-present) and anxiety disorders: phobic disorder, obsessive-compulsive disorder, panic attacks and generalized anxiety (prevalence range 12-25%-ever and 8-18%-present). The prevalence of minor affective disorders (specifically alcoholism or drug abuse) was considerably less. These findings suggest a possible link between PTSD and depressive and anxiety disorders, beyond a mere sharing of common symptoms. They also support the diagnostic validity of PTSD as an independent nosologic category. In addition, the lack of specific pharmacotherapy for PTSD on the one hand and the high prevalence of depressive and anxiety comorbidity on the other, support a special focus on antidepressive and anxiolytic medication for PTSD.
对60名在黎巴嫩战争结束4至6年后申请治疗的以色列退伍军人进行了源于战斗创伤的精神疾病发病率研究。诊断工具为针对精神疾病的结构化访谈。所有受试者均被诊断出患有多种精神疾病,其中大多数是在创伤经历后患上的。创伤后应激障碍(PTSD)是最普遍的病症(曾经患病率100%;目前患病率87%)。共病包括患病率极高的重度抑郁症(曾经患病率95%;目前患病率50%)和焦虑症:恐惧症、强迫症、惊恐发作和广泛性焦虑症(曾经患病率范围为12%至25%,目前患病率范围为8%至18%)。轻度情感障碍(特别是酗酒或药物滥用)的患病率则低得多。这些发现表明,PTSD与抑郁和焦虑症之间可能存在联系,而不仅仅是共同症状的重叠。它们还支持PTSD作为一个独立疾病分类的诊断有效性。此外,一方面缺乏针对PTSD的特定药物治疗,另一方面抑郁和焦虑共病的高患病率,支持了对PTSD抗抑郁和抗焦虑药物的特别关注。