Post-traumatic stress symptoms 5 years after military deployment to Afghanistan: an observational cohort study
Post-traumatic stress symptoms 5 years after military deployment to Afghanistan: an observational cohort study
复制标题
从军阿富汗 5 年后的创伤后应激症状：一项观察性队列研究
DOI：
10.1016/s2215-0366(15)00368-5
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发表时间：
2016-01-01
影响因子：
64.3
通讯作者：
Geuze, Elbert
中科院分区：
文献类型：
--
作者：
Eekhout, Iris;Reijnen, Alieke;Geuze, Elbert
部署可能会使士兵面临出现创伤后应激症状的风险。尽管有几项纵向研究，但相对于部署前，人们对创伤后应激症状增加的时间知之甚少。在部署前开始的纵向研究中，参与者在一段时间内被反复测量，有必要评估症状增加的时间，以最终评估部署后治疗需求增加的时间。方法采用创伤后应激障碍自评量表（SRIP）对2005年3月至2008年9月期间作为国际安全援助部队一部分被部署到阿富汗的荷兰军事人员进行创伤后应激症状评估。参与者在部署前1个月进行评估，并在部署后1个月、6个月、12个月、2年和5年进行随访，使用混合模型分析与部署前比较SRIP评分的变化。主要结果是使用SRIP在部署前和五次随访评估中测量的创伤后应激症状的总分，得分为38分作为表明严重创伤后应激症状的分数线。在2005年3月至2008年9月期间，1007名参与者被招募到这项研究中。结果显示了部署对创伤后应激症状的两个重要影响。在部署后的前6个月内出现短期症状增加（SRIP评分与部署前的症状增加系数[beta] 0.99, 95% CI 0.50-1.48）；在部署后5年，长期症状增加（β -1.67, 1.14-2.20）。这项研究强调了部署后长期监测士兵心理健康的重要性，因为早期发现症状对于早期治疗至关重要，这与改善心理健康有关。
Background Deployment can put soldiers at risk of developing post-traumatic stress symptoms. Despite several longitudinal studies, little is known about the timing of an increase in post-traumatic stress symptoms relative to pre-deployment. Longitudinal studies starting pre-deployment, in which participants are repeatedly measured over time, are warranted to assess the timing of an increase in symptoms to ultimately assess the timing of an increase in treatment demand after deployment.Methods In this large observational cohort study, Dutch military personnel who were deployed to Afghanistan as part of the International Security Assistance Forces between March, 2005, and September, 2008, were assessed for post-traumatic stress symptoms with the Self-Rating Inventory for Post-traumatic Stress Disorder (SRIP) questionnaire. Participants were assessed 1 month before deployment and followed up at 1 month, 6 months, 12 months, 2 years, and 5 years after deployment, with changes in SRIP scores compared with pre-deployment using a mixed model analysis. The primary outcome was the total score of post-traumatic stress symptoms measured with SRIP at pre-deployment and the five follow-up assessments, with a score of 38 used as the cutoff to indicate substantial post-traumatic stress symptoms.Findings Between March, 2005, and September, 2008, 1007 participants were recruited to this study. The results show two important effects of deployment on post-traumatic stress symptoms. A short-term symptom increase within the first 6 months after deployment (symptom increase coefficient for SRIP score vs pre-deployment [beta] 0.99, 95% CI 0.50-1.48); and a long-term symptom increase at 5 years after deployment (beta -1.67, 1.14-2.20).Interpretation This study underlines the importance of long-term monitoring of the psychological health of soldiers after deployment because early detection of symptoms is essential to early treatment, which is related to improved psychological health.