The postdisaster prevalence of major depression relative to PTSD in survivors of the 9/11 attacks on the world trade center selected from affected workplaces
The postdisaster prevalence of major depression relative to PTSD in survivors of the 9/11 attacks on the world trade center selected from affected workplaces
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DOI：
10.1016/j.comppsych.2015.02.009
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发表时间：
2015-07-01
影响因子：
7.3
通讯作者：
Pfefferbaum, Betty
中科院分区：
文献类型：
--
作者：
North, Carol S.;Pollio, David E.;Pfefferbaum, Betty
背景资料：对2001年9月11日纽约市世贸中心袭击事件幸存者的研究表明，灾难后抑郁症可能至少与创伤后应激障碍（PTSD）一样普遍，甚至更普遍，这与大多数其他灾难研究的结果不同。本研究采用全面诊断评估方法和基于DSM-IV-TR创伤后应激障碍标准的暴露组仔细分类，对373名受9/11影响的纽约市工作场所的员工进行了检查。在整个样本中，灾难后新的MDD发作（26%）比9/11相关的PTSD（14%）明显更普遍（p <0.001）。限制与9/11创伤暴露的参与者的比较，灾后新的MDD发作和9/11相关的PTSD的患病率没有差异（p = 0.446）。在9/11创伤暴露组中，MDD和PTSD的相对患病率存在显著差异的唯一一个9/11创伤暴露组是那些与9/11创伤暴露密切相关的人，他们在灾难后新发MDD发作（45%）更为普遍（p = 0.046）比9/11相关的PTSD（31%）。由于PTSD的条件定义需要创伤暴露，这不是MDD标准的一部分，这两种疾病的患病率比较必须限于有资格的创伤暴露组才有意义。这项研究的结果表明，这两种疾病的不同机制与直接暴露于创伤与灾难的严重程度以及个人与灾难和社区影响的联系有关。(C)2015 Elsevier Inc. All rights reserved.
Background: Studies of survivors of the September 11, 2001 attacks on the World Trade Center in New York City suggest that postdisaster depressive disorders may be at least as prevalent, or even more prevalent, than posttraumatic stress disorder (PTSD), unlike findings from most other disaster studies. The relative prevalence and incidence of major depressive disorder (MDD) and PTSD were examined after the 9/11 attacks relative to trauma exposures.Methods: This study used full diagnostic assessment methods and careful categorization of exposure groups based on DSM-IV-TR criteria for PTSD to examine 373 employees of 9/11-affected New York City workplaces.Results: Postdisaster new MDD episode (26%) in the entire sample was significantly more prevalent (p < .001) than 9/11-related PTSD (14%). Limiting the comparison to participants with 9/11 trauma exposures, the prevalence of postdisaster new MDD episode and 9/11-related PTSD did not differ (p = .446). The only 9/11 trauma exposure group with a significant difference in relative prevalence of MDD and PTSD were those with a 9/11 trauma-exposed close associate, for whom postdisaster new MDD episode (45%) was more prevalent (p = .046) than 9/11-related PTSD (31%).Conclusions: Because of the conditional definition of PTSD requiring trauma exposure that is not part of MDD criteria, prevalence comparisons of these two disorders must be limited to groups with qualifying trauma exposures to be meaningful. Findings from this study suggest distinct mechanisms underlying these two disorders that differentially relate to direct exposure to trauma vs. the magnitude of the disaster and personal connectedness to disaster and community-wide effects. (C) 2015 Elsevier Inc. All rights reserved.