Orsillo S M, Weathers F W, Litz B T, Steinberg H R, Huska J A, Keane T M
Department of Veterans Affairs Medical Center, Boston, Massachusetts, USA.
J Nerv Ment Dis. 1996 May;184(5):307-13. doi: 10.1097/00005053-199605000-00007.
Previous research has found high rates of psychiatric disorders among veterans with war zone-related posttraumatic stress disorder (PTSD). However, many studies in this area are methodologically limited in ways that preclude unambiguous interpretation of their results. The purpose of this study was to address some of these limitations to clarify the relationship between war zone-related PTSD and other disorders. Participants were 311 male Vietnam theater veterans assessed at the National Center for PTSD at the Boston Veterans Affairs Medical Center. The Clinician-Administered PTSD Scale and the Structured Clinical Interview for DSM-III-R were used to derive current and lifetime diagnoses of PTSD, other axis I disorders (mood, anxiety, substance use, psychotic, and somatoform disorders), and two axis II disorders (borderline and antisocial personality disorders only). Participants also completed several self-report measures of PTSD and general psychopathology. Relative to veterans without PTSD, veterans with PTSD had significantly higher rates of current major depression, bipolar disorder, panic disorder, and social phobia, as well as significantly higher rates of lifetime major depression, panic disorder, social phobia, and obsessive-compulsive disorder. In addition, veterans with PTSD scored significantly higher on all self-report measures of PTSD and general psychopathology. These results provide further evidence that PTSD is associated with high rates of additional psychiatric disorders, particularly mood disorders and other anxiety disorders. The implications of these findings and suggestions about the direction of future research in this area are discussed.
以往的研究发现,患有与战区相关创伤后应激障碍(PTSD)的退伍军人中精神障碍的发生率很高。然而,该领域的许多研究在方法上存在局限性,这使得无法对其结果进行明确的解释。本研究的目的是解决其中一些局限性,以阐明与战区相关的PTSD与其他障碍之间的关系。研究对象为311名在波士顿退伍军人事务医疗中心的国家PTSD中心接受评估的越南战区男性退伍军人。使用临床医生管理的PTSD量表和DSM-III-R结构化临床访谈来得出PTSD、其他轴I障碍(情绪、焦虑、物质使用、精神病性和躯体形式障碍)以及两种轴II障碍(仅边缘型和反社会人格障碍)的当前和终生诊断。参与者还完成了几项关于PTSD和一般精神病理学的自我报告测量。与没有PTSD的退伍军人相比,患有PTSD的退伍军人当前患重度抑郁症、双相情感障碍、惊恐障碍和社交恐惧症的发生率显著更高,终生患重度抑郁症、惊恐障碍、社交恐惧症和强迫症的发生率也显著更高。此外,患有PTSD的退伍军人在所有关于PTSD和一般精神病理学的自我报告测量中的得分显著更高。这些结果进一步证明,PTSD与其他精神障碍的高发生率相关,尤其是情绪障碍和其他焦虑障碍。本文讨论了这些发现的意义以及关于该领域未来研究方向的建议。