Reich J, Lyons M, Cai B
Department of Psychiatry, Harvard University, Cambridge, Massachusetts, USA.
Acta Psychiatr Scand. 1996 Feb;93(2):105-12. doi: 10.1111/j.1600-0447.1996.tb09810.x.
The question has been frequently raised about whether there are emotional disorders that predispose to post-traumatic stress disorder (PTSD). We do know that those with PTSD do have many comorbid disorders, but due to the difficulty in performing prospective studies it is hard to tell what is cause and what is effect. This study bypassed the problem caused by comorbidity by examining family history of four proband groups: PTSD, mixed anxiety disorders, coexisting anxiety and depressive disorders, and screened normal controls. Two questions were examined. First, whether family history predicted who experienced combat situations and second, whether the proband groups could be distinguished by family history. Logistic regression identified two variables that predicted the experience of combat: major depression (odds ratio 2.17) and the DSM-III dramatic personality disorder cluster (odds ratio 1.36). Although there was considerable overlap, family history variables distinguished PTSD from other proband groups. Overall, the pattern of psychopathology in the families of the PTSD probands most closely resembled that in the families of the coexisting anxiety and depressive disorders probands. We conclude that family history methods may be an addition to possible variables that predict who will be exposed to combat and also that family history variables may be able to distinguish a PTSD population from some other types of emotional disorders.
关于是否存在易患创伤后应激障碍(PTSD)的情绪障碍这一问题,人们经常提出。我们确实知道,患有PTSD的人确实有许多共病,但由于进行前瞻性研究存在困难,很难区分因果关系。本研究通过检查四个先证者组的家族史绕过了共病问题:PTSD、混合焦虑症、共存焦虑和抑郁症,以及经过筛选的正常对照组。研究了两个问题。第一,家族史是否能预测谁经历过战斗情况;第二,先证者组是否可以通过家族史来区分。逻辑回归确定了两个预测战斗经历的变量:重度抑郁症(优势比2.17)和DSM-III戏剧性人格障碍集群(优势比1.36)。尽管存在相当大的重叠,但家族史变量将PTSD与其他先证者组区分开来。总体而言,PTSD先证者家族中的精神病理学模式与共存焦虑和抑郁症先证者家族中的模式最为相似。我们得出结论,家族史方法可能是预测谁将暴露于战斗的可能变量之外的补充,并且家族史变量可能能够将PTSD人群与其他一些类型的情绪障碍区分开来。