Partial PTSD versus full PTSD:: an empirical examination of associated impairment
Partial PTSD versus full PTSD:: an empirical examination of associated impairment
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DOI：
10.1017/s0033291704002594
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发表时间：
2004-10-01
影响因子：
6.9
通讯作者：
Davis, GC
中科院分区：
文献类型：
--
作者：
Breslau, N;Lucia, VC;Davis, GC
背景。部分创伤后应激障碍，最初用于越南退伍军人，最近已扩展到平民创伤受害者。我们检查了部分PTSD与完整的DSM-PTSD在损伤程度上的区别程度。通过电话访问2181人的代表性样本，记录一生的创伤事件并评估DSM-IV PTSD标准。部分PTSD定义为三个症状组（标准B、C和D）中每组症状均大于或等于1个，且持续时间大于或等于1个月。创伤后应激障碍和部分创伤后应激障碍患者的损害是通过在被调查者最受创伤困扰的30天内工作和个人残疾天数来衡量的。与既没有PTSD也没有部分PTSD的暴露者相比，与PTSD相关的失业天数增加了11.4天（S.E. = 0.6），与部分PTSD相关的失业天数增加了3.3天（S.E. = 0.4）（根据性别、教育和就业调整）。在其他损伤指标中也发现了类似的差异。逃避和麻木症状不符合PTSD标准的人报告的失业天数增加了5.0 (S.E. = 0.7)，比完全PTSD少6.0。在控制症状数量的情况下，PTSD与过度损伤有关。部分PTSD患者症状持续2年以上的比例明显低于完全PTSD患者。部分创伤后应激障碍患者比完全创伤后应激障碍患者发生高程度病因事件的比例更低。创伤后应激障碍识别最严重的创伤受害者，他们与阈下创伤后应激障碍的受害者有明显区别。
Background. Partial PTSD, employed initially in relation to Vietnam veterans, has been recently extended to civilian victims of trauma. We examined the extent to which partial PTSD is distinguishable from full DSM-PTSD with respect to level of impairment.Method. A representative sample of 2181 persons was interviewed by telephone to record lifetime traumatic events and to assess DSM-IV PTSD criteria. Partial PTSD was defined as greater than or equal to1 symptom in each of three symptom groups (criteria B, C and D) and duration of greater than or equal to1 month. Impairment in persons with PTSD and partial PTSD was measured by number of work-related and personal disability days during the 30-day period when the respondent was most upset by the trauma.Results. Compared to exposed persons with neither PTSD nor partial PTSD, increment in work-loss days associated with PTSD was 11.4 (S.E. = 0.6) days and with partial PTSD, 3.3 (S.E. = 0.4) days (adjusted for sex, education and employment). Similar disparities were found across other impairment indicators. Persons who fell short of PTSD criteria by one symptom of avoidance and numbing reported an increment of 5.0 (S.E. = 0.7) work-loss days, 6.0 fewer than full PTSD. PTSD was associated with excess impairment, controlling for number of symptoms. A significantly lower proportion of persons with partial PTSD than full PTSD experienced symptoms for more than 2 years. A lower proportion of persons with partial PTSD than full PTSD had an etiologic event of high magnitude.Conclusions. PTSD identifies the most severe trauma victims, who are markedly distinguishable from victims with subthreshold PTSD.