Sex differences in posttraumatic stress disorder.
Sex differences in posttraumatic stress disorder.
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DOI：
10.1001/archpsyc.1997.01830230082012
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发表时间：
1997-11
影响因子：
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通讯作者：
N. Breslau;G. Davis;P. Andreski;E. L. Peterson;L. Schultz
中科院分区：
文献类型：
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作者：
N. Breslau;G. Davis;P. Andreski;E. L. Peterson;L. Schultz
在一般人群中进行的流行病学调查显示，女性创伤后应激障碍（PTSD）的发病率高于男性。到目前为止，这一发现几乎没有引起科学界的关注。本研究探讨了PTSD的性别差异在多大程度上可以用先前确定的风险因素来解释，以及PTSD的性别差异是否因暴露于创伤事件的年龄而异。方法采用NIMH-DIS（NIMH诊断访谈表，第三版修订版）对随机抽取的1007名年轻人进行DSM-IIIR疾病评估。考克斯比例风险模型被用来估计潜在的危险因素时，与性别相关的创伤后应激障碍的风险比的变化。结果：一生中创伤性事件暴露的患病率和创伤性事件的数量没有因性别而异。女性创伤后应激障碍的患病率高于男性（风险比，2.3; 95%置信区间，1.5-3.6）。先前存在的焦虑症或重度抑郁症在观察到的PTSD性别差异中发挥了作用。焦虑症家族史和早期与父母分离，虽然在男女受试者中是PTSD的重要危险因素，但与PTSD的性别差异无关。PTSD的性别差异显着更大，如果暴露发生在童年比later on. CONCLUSIONS创伤后应激障碍是更容易发展的女性比男性暴露后的创伤性事件。女性在儿童时期对PTSD的易感性可能比15岁以后更大。性别差异的解释可能涉及到个体的特征和创伤经历。
BACKGROUND Epidemiologic surveys in the general population documented a higher rate of posttraumatic stress disorder (PTSD) in women than in men. To date, the finding has received little scientific attention. This study examines the extent to which sex differences in PTSD might be explained by previously identified risk factors and whether the sex difference in PTSD varied by age at exposure to traumatic events. METHODS The NIMH-DIS (NIMH Diagnostic Interview Schedule, Version III Revised) was used to measure DSM-IIIR disorders in a random sample of 1007 young adults. Cox proportional hazards models were used to estimate changes in the hazards ratio for PTSD associated with sex when potential risk factors were included. RESULTS Lifetime prevalence of exposure to traumatic events and number of traumatic events did not vary by sex. The prevalence of PTSD was higher for women than for men exposed to traumatic events (hazards ratio, 2.3; 95% confidence interval, 1.5-3.6). Preexisting anxiety disorders or major depressive disorders played a part in the observed sex difference in PTSD. Family history of anxiety disorder and early separation from parents, although significant risk factors for PTSD in subjects of both sexes, were unrelated to the sex difference in PTSD. The sex difference in PTSD was markedly greater if exposure occurred in childhood than later on. CONCLUSIONS Posttraumatic stress disorder is more likely to develop in females than in males after exposure to a traumatic event. Susceptibility to PTSD in females might be greater in childhood than after age 15 years. Explanations of the sex difference might involve characteristics of individuals and of the traumatic experiences.