The transition to civilian life: Impact of comorbid PTSD, chronic pain, and sleep disturbance on veterans' social functioning and suicidal ideation.
The transition to civilian life: Impact of comorbid PTSD, chronic pain, and sleep disturbance on veterans' social functioning and suicidal ideation.
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向平民生活的过渡：共病创伤后应激障碍、慢性疼痛和睡眠障碍对退伍军人社会功能和自杀意念的影响。
DOI：
10.1037/tra0001271
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Vogt,Dawne
中科院分区：
文献类型：
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作者：
Shor,Rachel;Borowski,Shelby;Zelkowitz,RachelL;Pineles,SuzanneL;Copeland,LaurelA;Finley,ErinP;Perkins,DanielF;Vogt,Dawne
目的创伤暴露的退伍军人可能更容易经历创伤后应激障碍（PTSD）、慢性疼痛和睡眠障碍，而不是孤立的。虽然这些情况独立地与痛苦和损害相关，但当经历共病时，它们与社会功能和自杀意念（SI）的关系尚不清楚。方法：使用来自退伍军人指标倡议研究的5461名创伤暴露的美国退伍军人的纵向数据和自我报告的疾病，我们评估了(a) PTSD与睡眠障碍和慢性疼痛（CP）共同发生的程度；(b) PTSD合并睡眠障碍和慢性疼痛与后期社会功能和SI的关系；(c)社会功能在多大程度上调节多重疾病对SI的影响。结果约15个月后，90.5%的可能患有PTSD的退伍军人报告睡眠障碍和/或CP。与没有可能患有PTSD的退伍军人相比，所有3种情况的退伍军人（n= 907）的社会功能最差（B=−）。56岁的p <。0.001)， SI风险更高（OR= 3.78, p< 0.001）。001);社会功能在多重发病与SI之间的关系中起部分中介作用。然而，与单独患有PTSD的患者相比，睡眠障碍和CP并没有增加SI的风险。结论：虽然这些发现强调了创伤后应激障碍对功能和精神创伤的影响，但它们也强调了多重疾病的复杂性和增强退伍军人社会功能的重要性。
ObjectiveTrauma-exposed veterans may be more likely to experience posttraumatic stress disorder (PTSD), chronic pain, and sleep disturbance together rather than in isolation. Although these conditions are independently associated with distress and impairment, how they relate to social functioning and suicidal ideation (SI) when experienced comorbidly is not clear.MethodUsing longitudinal data on 5,461 trauma-exposed US veterans from The Veterans Metrics Initiative study and self-reported disorders, we assessed (a) the extent to which PTSD co-occurs with sleep disturbance and chronic pain (CP);(b) the relationship of PTSD in conjunction with sleep disturbance and chronic pain with later social functioning and SI; and (c) the extent to which social functioning mediates the impact of multimorbidity on SI.ResultsAt approximately 15 months postseparation, 90.5% of veterans with probable PTSD also reported sleep disturbance and/or CP. Relative to veterans without probable PTSD, veterans with all 3 conditions (n= 907) experienced the poorest social functioning (B=−. 56, p<. 001) and had greater risk for SI (OR= 3.78, p<. 001); Social functioning partially mediated the relationship between multimorbidity and SI. However, relative to those with PTSD alone, sleep disturbance and CP did not confer greater risk for SI.ConclusionsAlthough these findings underscore the impact of PTSD on functioning and SI, they also highlight the complexity of multimorbidity and the importance of bolstering social functioning for veterans.