Beckham J C, Moore S D, Feldman M E, Hertzberg M A, Kirby A C, Fairbank J A
Department of Psychiatry, Duke University Medical Center, Durham, N.C., USA.
Am J Psychiatry. 1998 Nov;155(11):1565-9. doi: 10.1176/ajp.155.11.1565.
A two-part study was conducted to examine the health status of Vietnam veterans with posttraumatic stress disorder (PTSD). In part 1, veterans with and without PTSD were compared on health behaviors and on self-reported and physician-rated health problems. Consistency of self-report with physician rating for health problems across the two groups was compared. In part 2, the association between health status and PTSD symptom severity, depression, somatization, and health behaviors in PTSD patients was evaluated.
In part 1, 276 combat veterans (225 with PTSD and 51 without PTSD) provided health status information, and medical records were reviewed. In part 2, 225 PTSD patients completed standardized PTSD severity, somatization, and depression measures.
When analyses controlled for age, socioeconomic status, minority status, combat exposure, alcohol use, and pack-year history, veterans with PTSD reported and were rated as having a greater number of health problems than veterans without PTSD. Agreement between self-report and physician ratings for both groups ranged from low to moderate. Level of agreement between patient and physician was similar across groups. In the analysis of veterans with PTSD, somatization and PTSD symptom severity were significantly related to self-report of health problems, whereas only PTSD symptom severity was related to physician-rated health. Pack-year history was significantly related to self-reported health status in both groups.
The presence and severity of PTSD in veterans were associated with greater physical health problems and conditions. Psychological variables (e.g., PTSD status, PTSD severity, somatization) and a behavioral variable (pack-year history) were related to health status.
开展一项分为两部分的研究，以检查患有创伤后应激障碍（PTSD）的越南退伍军人的健康状况。在第一部分中，比较了患有和未患有PTSD的退伍军人的健康行为以及自我报告和医生评定的健康问题。比较了两组在健康问题上自我报告与医生评定的一致性。在第二部分中，评估了PTSD患者的健康状况与PTSD症状严重程度、抑郁、躯体化及健康行为之间的关联。
在第一部分中，276名参战退伍军人（225名患有PTSD，51名未患有PTSD）提供了健康状况信息，并对医疗记录进行了审查。在第二部分中，225名PTSD患者完成了标准化的PTSD严重程度、躯体化和抑郁测量。
在对年龄、社会经济地位、少数族裔身份、战斗经历、饮酒情况和吸烟包年史进行分析控制后，患有PTSD的退伍军人报告并被评定为比未患有PTSD的退伍军人有更多的健康问题。两组自我报告与医生评定之间的一致性从低到中等。两组患者与医生之间的一致程度相似。在对患有PTSD的退伍军人的分析中，躯体化和PTSD症状严重程度与健康问题的自我报告显著相关，而只有PTSD症状严重程度与医生评定的健康状况相关。吸烟包年史在两组中均与自我报告的健康状况显著相关。
退伍军人中PTSD的存在和严重程度与更多的身体健康问题和状况相关。心理变量（如PTSD状态、PTSD严重程度、躯体化）和一个行为变量（吸烟包年史）与健康状况相关。
