Trauma and PTSD in the WHO World Mental Health Surveys.
Trauma and PTSD in the WHO World Mental Health Surveys.
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DOI：
10.1080/20008198.2017.1353383
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发表时间：
2017
影响因子：
5
通讯作者：
Koenen KC
中科院分区：
文献类型：
--
作者：
Kessler RC;Aguilar-Gaxiola S;Alonso J;Benjet C;Bromet EJ;Cardoso G;Degenhardt L;de Girolamo G;Dinolova RV;Ferry F;Florescu S;Gureje O;Haro JM;Huang Y;Karam EG;Kawakami N;Lee S;Lepine JP;Levinson D;Navarro-Mateu F;Pennell BE;Piazza M;Posada-Villa J;Scott KM;Stein DJ;Ten Have M;Torres Y;Viana MC;Petukhova MV;Sampson NA;Zaslavsky AM;Koenen KC
背景：尽管创伤后应激障碍(PTSD)的发病-持久性被认为因创伤类型的不同而有很大差异，但大多数流行病学调查无法评估这一点，因为他们只评估受访者提名为最严重创伤的终生PTSD。目的：回顾世界卫生组织《世界精神卫生调查》中有关创伤类型与创伤后应激障碍关系的研究，这是一系列获得创伤特有创伤后应激障碍代表性数据的流行病学调查。方法：在24个国家(n=68,894)进行的WMH调查评估了29个终生创伤，并对每个受访者的创伤后应激障碍进行了两次评估：一次针对最严重的终生创伤，另一次针对随机选择的创伤，并根据创伤暴露的个体差异进行加权调整。创伤后应激障碍的发病-持久性通过世界卫生组织综合国际诊断访谈进行评估。结果：总体而言，70.4%的受访者经历过终身创伤，平均每人暴露于3.2次创伤。创伤间的差异在创伤后应激障碍的发病中被发现，但在持续性上较少。涉及人际暴力的创伤风险最高。创伤后应激障碍的负担，通过将创伤患病率乘以创伤特有的创伤后应激障碍风险和持续性来确定，为77.7人年/100名受访者。最高比例的创伤类型是强奸(13.1%)、其他性侵犯(15.1%)、被跟踪(9.8%)和亲人意外死亡(11.6%)。这四个创伤中的前三个是相对不常见的创伤，具有较高的创伤后应激障碍风险，最后三个是非常常见的创伤，但创伤后应激障碍风险较低。亲密伴侣的性暴力行为占创伤后应激障碍患者总人数的近42.7%。既往创伤史可以预测未来的创伤暴露和未来的创伤后应激障碍风险。结论：创伤暴露在世界各地很常见，分布不均，在创伤后应激障碍风险方面在不同创伤类型之间存在差异。虽然相当少数的PTSD病例在发病后几个月内缓解，但平均症状持续时间比以前认识到的要长得多。
Background: Although post-traumatic stress disorder (PTSD) onset-persistence is thought to vary significantly by trauma type, most epidemiological surveys are incapable of assessing this because they evaluate lifetime PTSD only for traumas nominated by respondents as their ‘worst.’ Objective: To review research on associations of trauma type with PTSD in the WHO World Mental Health (WMH) surveys, a series of epidemiological surveys that obtained representative data on trauma-specific PTSD. Method: WMH Surveys in 24 countries (n = 68,894) assessed 29 lifetime traumas and evaluated PTSD twice for each respondent: once for the ‘worst’ lifetime trauma and separately for a randomly-selected trauma with weighting to adjust for individual differences in trauma exposures. PTSD onset-persistence was evaluated with the WHO Composite International Diagnostic Interview. Results: In total, 70.4% of respondents experienced lifetime traumas, with exposure averaging 3.2 traumas per capita. Substantial between-trauma differences were found in PTSD onset but less in persistence. Traumas involving interpersonal violence had highest risk. Burden of PTSD, determined by multiplying trauma prevalence by trauma-specific PTSD risk and persistence, was 77.7 person-years/100 respondents. The trauma types with highest proportions of this burden were rape (13.1%), other sexual assault (15.1%), being stalked (9.8%), and unexpected death of a loved one (11.6%). The first three of these four represent relatively uncommon traumas with high PTSD risk and the last a very common trauma with low PTSD risk. The broad category of intimate partner sexual violence accounted for nearly 42.7% of all person-years with PTSD. Prior trauma history predicted both future trauma exposure and future PTSD risk. Conclusions: Trauma exposure is common throughout the world, unequally distributed, and differential across trauma types with respect to PTSD risk. Although a substantial minority of PTSD cases remits within months after onset, mean symptom duration is considerably longer than previously recognized.
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影响因子：
6.9
作者：
Koenen KC;Ratanatharathorn A;Ng L;McLaughlin KA;Bromet EJ;Stein DJ;Karam EG;Meron Ruscio A;Benjet C;Scott K;Atwoli L;Petukhova M;Lim CCW;Aguilar-Gaxiola S;Al-Hamzawi A;Alonso J;Bunting B;Ciutan M;de Girolamo G;Degenhardt L;Gureje O;Haro JM;Huang Y;Kawakami N;Lee S;Navarro-Mateu F;Pennell BE;Piazza M;Sampson N;Ten Have M;Torres Y;Viana MC;Williams D;Xavier M;Kessler RC
通讯作者：
Kessler RC
影响因子：
3.1
作者：
Hatch, Stephani L.;Dohrenwend, Bruce P.
通讯作者：
Dohrenwend, Bruce P.
影响因子：
3.7
作者：
Daskalakis, Nikolaos P.;Bagot, Rosemary C.;Parker, Karen J.;Vinkers, Christiaan H.;de Kloet, E. R.
通讯作者：
de Kloet, E. R.
影响因子：
1.9
作者：
LANDIS, JR;KOCH, GG
通讯作者：
KOCH, GG
影响因子：
10.5
作者：
Kessler, Ronald C.;McLaughlin, Katie A.;Williams, David R.
通讯作者：
Williams, David R.