美国退伍军人的创伤后应激障碍:2019-2020年退伍军人国家健康和复原力研究的结果

Blair E Wisco, Faith O Nomamiukor, Brian P Marx, John H Krystal, Steven M Southwick, Robert H Pietrzak
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引用次数: 14

摘要

目的:美国退伍军人人口变化迅速,缺乏DSM-5创伤后应激障碍(PTSD)患病率的当代数据。DSM-5明确了PTSD标准A来描述直接和间接的创伤暴露,但对PTSD的条件概率和功能障碍的影响仍然未知。本研究的目的是提供美国退伍军人群体中PTSD患病率和条件概率的当代估计,确定直接或间接暴露于潜在创伤性事件(pte)后发生PTSD的可能性,并检查直接和间接暴露于潜在创伤性事件和PTSD对功能损伤的影响。方法:分析2019-2020年全国退伍军人健康和恢复力研究(NHRVS)的数据,该研究是一项在线调查,于2019年11月至2020年3月(中位完成日期:2019年11月21日)对具有全国代表性的美国退伍军人样本进行的调查。创伤暴露用生活事件表-5进行评估,PTSD用DSM-5的PTSD检查表进行评估。结果:终生PTSD的加权患病率为9.4% (95% CI, 8.5%-10.3%),过去一个月PTSD的加权患病率为5.0% (95% CI, 4.3%-5.7%)。直接pte与寿命增加相关(比值比[OR] = 1.36;95% CI, 1.30-1.42)和过去一个月的PTSD (OR = 1.38;95% CI, 1.31-1.46),但间接pte没有发生(终生OR = 1.01;95% ci, 1.00-1.03;过去一个月OR = 0.99;95% ci, 0.97-1.00)。在调整人口统计学和精神病学变量后,PTSD(未标准化B = 6.11, SE = 0.35)和直接pte(未标准化B = 0.13, SE = 0.04)与功能障碍均显著相关,但间接pte与功能障碍无关。结论:美国退伍军人的终身PTSD患病率(9.4%)略高于2016年的估计(6.9%-8.1%)。直接和间接pte在美国退伍军人中普遍存在,只有直接pte与较高的过去一个月PTSD的条件概率和更大的功能损害有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Posttraumatic Stress Disorder in US Military Veterans: Results From the 2019-2020 National Health and Resilience in Veterans Study.

Objective: The US military veteran population is changing rapidly, and contemporary data on the prevalence of DSM-5 posttraumatic stress disorder (PTSD) are lacking. The DSM-5 clarified PTSD Criterion A to delineate direct and indirect trauma exposures, but effects on the conditional probability of PTSD and functional impairment remain unknown. The objectives of this study were to provide contemporary estimates of PTSD prevalence and conditional probabilities in the US military veteran population, determine the likelihood of developing PTSD following direct versus indirect exposures to potentially traumatic events (PTEs), and examine the effects of direct and indirect PTEs and PTSD on functional impairment.

Methods: Data were analyzed from the 2019-2020 National Health and Resilience in Veterans Study (NHRVS), an online survey of a nationally representative sample of US military veterans conducted from November 2019 to March 2020 (median completion date: November 21, 2019). Trauma exposures were assessed with the Life Events Checklist-5 and PTSD with the PTSD Checklist for DSM-5.

Results: The weighted prevalence of lifetime PTSD was 9.4% (95% CI, 8.5%-10.3%) and of past-month PTSD was 5.0% (95% CI, 4.3%-5.7%). Direct PTEs were associated with increased odds of lifetime (odds ratio [OR] = 1.36; 95% CI, 1.30-1.42) and past-month PTSD (OR = 1.38; 95% CI, 1.31-1.46), but indirect PTEs were not (lifetime OR = 1.01; 95% CI, 1.00-1.03; past-month OR = 0.99; 95% CI, 0.97-1.00). Both PTSD (unstandardized B = 6.11, SE = 0.35) and direct PTEs (unstandardized B = 0.13, SE = 0.04), but not indirect PTEs, were significantly associated with functional impairment after adjustment for demographic and psychiatric variables.

Conclusions: The prevalence of lifetime PTSD in US military veterans (9.4%) is slightly higher than 2016 estimates (6.9%-8.1%). Direct and indirect PTEs are prevalent in US military veterans, with only direct PTEs associated with higher conditional probability of past-month PTSD and greater functional impairment.

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