An in-depth look into PTSD-depression comorbidity: A longitudinal study of chronically-exposed Detroit residents.
An in-depth look into PTSD-depression comorbidity: A longitudinal study of chronically-exposed Detroit residents.
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DOI：
10.1016/j.jad.2016.08.053
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发表时间：
2017-01-15
影响因子：
6.6
通讯作者：
Koenen KC
中科院分区：
文献类型：
--
作者：
Horesh D;Lowe SR;Galea S;Aiello AE;Uddin M;Koenen KC
尽管创伤后应激障碍-严重抑郁障碍(MDD)的共同发病率已经确立，但绝大多数研究都是在创伤后应激障碍总体严重程度的水平上检查共病，而不是在特定的创伤后应激障碍症状群水平上。本研究旨在探讨精神疾病与创伤后应激障碍症状群(侵扰、回避、过度觉醒)之间的长期关联，以及性别在这些关联中的调节作用。底特律市区的942名居民每隔一年分3次接受采访。在每一波中，他们都被评估了创伤后应激障碍、抑郁、创伤暴露和应激性生活事件。在所有波中，高度觉醒是与MDD关联最强的PTSD组。对于完整的样本，MDD和所有三个PTSD集群之间发现了随时间的互换关系。有趣的是，MDD和特定的PTSD集群之间的关联的相对强度随着时间的推移而变化。女性表现出与整个样本相同的双向MDD-PTSD模式，而男性有时在早期MDD和随后的PTSD集群之间显示出不显著的关联。首先，我们的分析是基于DSM-IV标准，因为这是本研究当时的现有版本。其次，虽然这是一项纵向研究，但关于一种疾病在时间上优先于另一种疾病的推论必须谨慎。创伤后早期识别创伤后应激障碍或MDD可能是至关重要的，以防止另一种疾病随着时间的推移而发展。过度觉醒的创伤后应激障碍可能需要特别的治疗关注。此外，还鼓励专业人员在创伤后制定更多针对性别的干预措施。
Although PTSD-major depressive disorder (MDD) co-morbidity is well-established, the vast majority of studies have examined comorbidity at the level of PTSD total severity, rather than at the level of specific PTSD symptom clusters. This study aimed to examine the long-term associations between MDD and PTSD symptom clusters (intrusion, avoidance, hyperarousal), and the moderating role of gender in these associations. 942 residents of urban Detroit neighborhoods were interviewed at 3 waves, 1 year apart. At each wave, they were assessed for PTSD, depression, trauma exposure, and stressful life events. At all waves, hyperarousal was the PTSD cluster most strongly correlated with MDD. For the full sample, a reciprocal relationship was found between MDD and all three PTSD clusters across time. Interestingly, the relative strength of associations between MDD and specific PTSD clusters changed over time. Women showed the same bidirectional MDD-PTSD pattern as in the entire sample, while men sometimes showed non-significant associations between early MDD and subsequent PTSD clusters. First, our analyses are based on DSM-IV criteria, as this was the existing edition at the time of this study. Second, although this is a longitudinal study, inferences regarding temporal precedence of one disorder over another must be made with caution. Early identification of either PTSD or MDD following trauma may be crucial in order to prevent the development of the other disorder over time. The PTSD cluster of hyper-arousal may require special therapeutic attention. Also, professionals are encouraged to develop more gender-specific interventions post-trauma.
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影响因子：
6.6
作者：
Elhai, Jon D.;Contractor, Ateka A.;Galea, Sandro
通讯作者：
Galea, Sandro
影响因子：
4.4
作者：
Bracke, P
通讯作者：
Bracke, P
影响因子：
10.6
作者：
Breslau, N;Davis, GC;Schultz, LR
通讯作者：
Schultz, LR
影响因子：
5
作者：
Charak R;Armour C;Elklit A;Angmo D;Elhai JD;Koot HM
通讯作者：
Koot HM
DOI：
10.1097/00004583-199510000-00021
发表时间：
1995-10-01
影响因子：
13.3
作者：
HOROWITZ, K;WEINE, S;JEKEL, J
通讯作者：
JEKEL, J