Posttraumatic stress disorder in the World Mental Health Surveys.
Posttraumatic stress disorder in the World Mental Health Surveys.
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DOI：
10.1017/s0033291717000708
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发表时间：
2017-10
影响因子：
6.9
通讯作者：
Kessler RC
中科院分区：
文献类型：
--
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
创伤事件在全球很常见；然而，缺乏关于创伤后应激障碍(PTSD)流行病学的全面跨国数据，创伤后应激障碍(PTSD)是与创伤相关的典型精神障碍。数据分析来自世界卫生组织《世界精神健康调查》中的26项人口调查。共有71083名年龄在18岁以上的受访者参与。综合国际诊断性访谈评估了暴露于创伤性事件以及30天、12个月和终生创伤后应激障碍。受访者还在调查前12个月接受了治疗评估。发病年龄分布按国家收入水平进行检查。创伤后应激障碍的关联性与国家收入、世界地区和被调查者的人口统计数据进行了检验。创伤后应激障碍的跨国终生患病率在总样本中为3.9%，在创伤暴露者中为5.6%。一半患有创伤后应激障碍的受访者报告了持续的症状。在高收入国家寻求治疗的人(53.5%)大约是中低收入国家(22.8%)和中上收入国家(28.7%)的两倍。在暴露的创伤中，社会劣势，包括年轻、女性、未婚、受教育程度低、家庭收入低和失业，与终身创伤后应激障碍的风险增加有关。创伤后应激障碍是跨国家流行的，全球一半的病例是持续性的。据报道，患有严重创伤后应激障碍的人中只有一半接受了治疗，只有一小部分人接受了专门的心理健康护理。创伤后应激障碍的治疗因国家收入水平而存在显著差异。增加获得有效治疗的机会，特别是在低收入和中等收入国家，对于减轻创伤后应激障碍的人口负担仍然至关重要。
Traumatic events are common globally; however, comprehensive population-based cross-national data on the epidemiology of posttraumatic stress disorder (PTSD), the paradigmatic trauma-related mental disorder, are lacking. Data were analyzed from 26 population surveys in the World Health Organization World Mental Health Surveys. A total of 71 083 respondents ages 18+ participated. The Composite International Diagnostic Interview assessed exposure to traumatic events as well as 30-day, 12-month, and lifetime PTSD. Respondents were also assessed for treatment in the 12 months preceding the survey. Age of onset distributions were examined by country income level. Associations of PTSD were examined with country income, world region, and respondent demographics. The cross-national lifetime prevalence of PTSD was 3.9% in the total sample and 5.6% among the trauma exposed. Half of respondents with PTSD reported persistent symptoms. Treatment seeking in high-income countries (53.5%) was roughly double that in low-lower middle income (22.8%) and upper-middle income (28.7%) countries. Social disadvantage, including younger age, female sex, being unmarried, being less educated, having lower household income, and being unemployed, was associated with increased risk of lifetime PTSD among the trauma exposed. PTSD is prevalent cross-nationally, with half of all global cases being persistent. Only half of those with severe PTSD report receiving any treatment and only a minority receive specialty mental health care. Striking disparities in PTSD treatment exist by country income level. Increasing access to effective treatment, especially in low- and middle-income countries, remains critical for reducing the population burden of PTSD.