Posttraumatic Stress Disorder Among Women Receiving Prenatal Care at Three Federally Qualified Health Care Centers
Posttraumatic Stress Disorder Among Women Receiving Prenatal Care at Three Federally Qualified Health Care Centers
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DOI：
10.1007/s10995-013-1333-7
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发表时间：
2014-07-01
影响因子：
2.3
通讯作者：
Muzyka, Charlene N.
中科院分区：
文献类型：
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作者：
Kim, Helen G.;Harrison, Patricia A.;Muzyka, Charlene N.
本研究评估了三个城市联邦合格医疗保健中心服务的孕妇中创伤后应激障碍 (PTSD)、前期创伤和社会心理危险因素的患病率和相互关系。该分析是产前风险概述验证研究的一部分，这是一项结构化的心理社会风险筛查访谈。研究样本包括三个诊所的 745 名产前患者，他们还接受了 DSM-IV 结构化临床访谈 (SCID) 的重度抑郁、创伤后应激障碍、酒精和药物使用模块。大多数参与者是有色人种女性 (89.1%)、25 岁以下女性 (67.8%) 和未婚女性 (86.2%)。当前 PTSD 诊断率为 6.6%，阈下 PTSD 诊断率为 4.2%。超过一半（54%）的参与者报告了符合创伤后应激障碍（PTSD）标准的创伤； 21% 的人称自己是暴力或虐待的受害者或目击者，其中 78% 的女性患有创伤后应激障碍 (PTSD)。与没有 PTSD 的人相比，患有 PTSD 的人面临住房不稳定（AOR 4.15；95 % CI 1.76，9.80）和抑郁症（AOR3.91；95 % CI 2.05，7.47）的风险高出 4 倍，患吸毒障碍的风险高出 2 倍（AOR 1.96，95 % CI 1.04， 3.71）以及参与儿童保护服务（AOR 2.27； 95% CI 1.06, 4.89）。 25 岁或以上的女性符合 PTSD 诊断标准的可能性是年轻女性的两倍（AOR2.27；95%CI 1.21，4.28）。创伤暴露和普遍的创伤后应激障碍（PTSD）在这一人群中很常见。即使没有专门针对这种疾病的问题，系统的心理社会风险筛查也可以识别患有创伤后应激障碍的人群。
This study assessed the prevalence and interrelationships of posttraumatic stress disorder (PTSD), antecedent trauma, and psychosocial risk factors among pregnant women served at three urban Federally Qualified Health Care Centers. This analysis was part of a validation study of the prenatal risk overview, a structured psychosocial risk screening interview. The study sample included 745 prenatal patients at three clinics who also were administered the major depression, PTSD, alcohol, and drug use modules of the Structured Clinical Interview for DSM-IV (SCID). Most participants were women of color (89.1 %), under the age of 25 years (67.8 %), and unmarried (86.2 %). The rate for a current PTSD diagnosis was 6.6 % and for subthreshold PTSD 4.2 %. More than half (54 %) of participants reported a trauma that met PTSD criteria; 21 % reported being a victim of or witness to violence or abuse, including 78 % of women with PTSD. Compared to those without PTSD, those with PTSD were 4 times more likely to be at risk for housing instability (AOR 4.15; 95 %CI 1.76, 9.80) and depression (AOR3.91; 95 %CI 2.05, 7.47) and 2 times as likely to be at risk for a drug use disorder (AOR 1.96, 95 %CI 1.04, 3.71) and involvement with child protective services (AOR 2.27; 95 % CI 1.06, 4.89). Women age 25 or older were twice as likely to meet PTSD diagnostic criteria as younger women (AOR2.27; 95 %CI 1.21, 4.28). Trauma exposure and pervasive PTSD were common in this population. Systematic psychosocial risk screening may identify the population with PTSD even without questions specific to this disorder.