The prevalence of traumatic experiences and PTSD according to DSM-5 and ICD-11 in the German general population.

IF 6.1 2区 医学 Q1 PSYCHIATRY
Amelie Pettrich, Yuriy Nesterko, Heide Glaesmer
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引用次数: 0

Abstract

Aims: The Diagnostic and Statistical Manual of Mental Disorders - 5th Edition (DSM-5) and International Classification of Diseases - 11th Revision (ICD-11) employ different post-traumatic stress disorder (PTSD) criteria, necessitating updated prevalence estimates. Most of the existing evidence is still based on ICD-Tenth Revision and DSM-Fourth Edition criteria, leading to varied estimates across populations. This study provides current PTSD prevalence rates in the German general population, comparing DSM-5 and ICD-11 criteria and examines variations by age and gender.

Methods: In a 2016 cross-sectional survey of 2404 adults (18-94 years) representative of the German general population, participants completed the Life-Events-Checklist for DSM-5 (LEC-5) for trauma exposure and the PTSD Checklist for DSM-5 (PCL-5) for PTSD symptoms. Probable PTSD diagnoses were based on DSM-5-, ICD-11-algorithms and suggested cut-off scores. Chi-square and McNemar's tests were used to test differences in prevalence rates by diagnostic framework, age and gender.

Results: Of the total sample, 47.2% (n = 1135) reported experiencing at least one lifetime traumatic event (TE), with transportation accidents (7.3%) and life-threatening injuries (4.9%) being most common. Probable PTSD prevalence was 4.7% under both DSM-5 and ICD-11 criteria, and 2.6% based on a conservative cut-off normed for prevalence estimation. Gender and age were not significantly associated with TE exposure or PTSD prevalence, though trauma types varied: female participants more often reported sexual violence and severe suffering, while more male participants reported physical assaults and various types of accidents. DSM-5 and ICD-11 diagnostic algorithms had substantial yet not perfect agreement (κ = 0.62). Particularly within the re-experiencing symptoms, cluster agreement was only moderate (κ = 0.57). The cut-off method aligned more closely with DSM-5 (κ = 0.60) than ICD-11 algorithm (κ = 0.42).

Conclusions: This study provides updated PTSD prevalence estimates for the German general population and underscores differences between DSM-5 and ICD-11 in identifying cases, particularly with respect to re-experiencing symptoms. These findings emphasize that while overall PTSD prevalence rates under DSM-5 and ICD-11 criteria are similar, the diagnostic frameworks identify partially distinct cases, reflecting differences in symptom definitions. This highlights the need to carefully consider the impact of evolving diagnostic criteria when interpreting prevalence estimates and comparing results across studies.

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根据DSM-5和ICD-11,德国普通人群中创伤经历和PTSD的患病率。
目的:精神障碍诊断与统计手册-第5版(DSM-5)和国际疾病分类-第11修订版(ICD-11)采用不同的创伤后应激障碍(PTSD)标准,有必要更新患病率估计。大多数现有证据仍然基于icd第十版和dsm第四版标准,导致不同人群的估计不同。本研究提供了目前德国普通人群中PTSD的患病率,比较了DSM-5和ICD-11的标准,并检查了年龄和性别的差异。方法:在2016年对2404名代表德国普通人群的成年人(18-94岁)进行横断面调查,参与者完成了DSM-5 (LEC-5)创伤暴露生活事件检查表和DSM-5 (PCL-5) PTSD症状检查表。可能的PTSD诊断基于DSM-5-, icd -11算法和建议的截止分数。使用卡方检验和McNemar检验来检验诊断框架、年龄和性别的患病率差异。结果:在总样本中,47.2% (n = 1135)报告至少经历过一次终身创伤性事件(TE),其中交通事故(7.3%)和危及生命的伤害(4.9%)最为常见。根据DSM-5和ICD-11标准,PTSD的可能患病率为4.7%,根据保守的患病率估计标准,可能患病率为2.6%。性别和年龄与创伤暴露或创伤后应激障碍患病率没有显著关系,尽管创伤类型各不相同:女性参与者更多地报告性暴力和严重痛苦,而更多的男性参与者报告身体攻击和各种类型的事故。DSM-5和ICD-11的诊断算法有大量但不完全的一致性(κ = 0.62)。特别是在再经历症状中,聚类一致性仅为中等(κ = 0.57)。与ICD-11算法(κ = 0.42)相比,截断法与DSM-5 (κ = 0.60)更接近。结论:这项研究为德国普通人群提供了最新的PTSD患病率估计,并强调了DSM-5和ICD-11在识别病例方面的差异,特别是在再次经历症状方面。这些发现强调,虽然DSM-5和ICD-11标准下的PTSD总体患病率相似,但诊断框架识别出部分不同的病例,反映了症状定义的差异。这突出表明,在解释患病率估计值和比较研究结果时,需要仔细考虑不断发展的诊断标准的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.80
自引率
1.20%
发文量
121
审稿时长
>12 weeks
期刊介绍: Epidemiology and Psychiatric Sciences is a prestigious international, peer-reviewed journal that has been publishing in Open Access format since 2020. Formerly known as Epidemiologia e Psichiatria Sociale and established in 1992 by Michele Tansella, the journal prioritizes highly relevant and innovative research articles and systematic reviews in the areas of public mental health and policy, mental health services and system research, as well as epidemiological and social psychiatry. Join us in advancing knowledge and understanding in these critical fields.
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