Posttraumatic stress disorder and psychiatric comorbidity among detained youths.
Posttraumatic stress disorder and psychiatric comorbidity among detained youths.
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被拘留青少年的创伤后应激障碍和精神共病。
DOI：
10.1176/ps.2007.58.10.1311
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发表时间：
2007
期刊：
影响因子：
--
通讯作者：
McClelland,GaryM
中科院分区：
文献类型：
--
作者：
Abram,KarenM;Washburn,JasonJ;Teplin,LindaA;Emanuel,KristinM;Romero,ErinG;McClelland,GaryM
目的研究创伤后应激障碍(PTSD)及其共病精神障碍在少年犯中的患病率。方法采用分层随机抽样方法，对898名10~18岁在芝加哥被捕的青少年进行调查。结果创伤后应激障碍患者中93%有至少一种共病精神障碍，而非创伤后应激障碍者中有至少一种共病精神障碍。超过一半(54%)患有创伤后应激障碍的参与者患有两种或两种以上的共病障碍--即情感、焦虑、行为或物质使用障碍--11%的人患有所有四种类型的共病障碍。在男性中，有任何精神疾病诊断显著增加了患有共病创伤后应激障碍的几率。在女性中，酒精使用障碍以及酒精和药物使用障碍显著增加了患创伤后应激障碍的几率。在患有特定精神障碍的男性和女性之间，创伤后应激障碍的患病率没有显著差异。男性创伤后应激障碍患者的精神障碍患病率显著高于女性患者(OR=3.4，CI=1.1-10.6，p<；结论提高在押青少年创伤后应激障碍的检出水平。创伤后应激障碍经常被遗漏，因为创伤经历很少被包括在标准的屏幕上，也很少被患者自愿接受。在计划治疗时，临床医生必须考虑合并创伤后应激障碍的后果。
ObjectiveThis study examined the prevalence of posttraumatic stress disorder (PTSD) and comorbid psychiatric disorders among juvenile detainees.MethodsThe sample consisted of a stratified random sample of 898 youths aged ten to 18 years who were arrested and detained in Chicago.ResultsAmong participants with PTSD, 93% had at least one comorbid psychiatric disorder; however, among those without PTSD, 64% had at least one comorbid psychiatric disorder. Over half (54%) of the participants with PTSD had two or more types of comorbid disorders—that is, affective, anxiety, behavioral, or substance use disorders—and 11% had all four types of comorbid disorders. Among males, having any psychiatric diagnosis significantly increased the odds of having comorbid PTSD. Among females, alcohol use disorder and both alcohol and drug use disorders significantly increased the odds of having PTSD. No significant difference in prevalence rates of PTSD was found between males and females with specific psychiatric disorders. The prevalence of any comorbid psychiatric disorder was significantly greater for males with PTSD than that for females with PTSD (OR= 3.4, CI= 1.1–10.6, p<. 05).ConclusionsDetection of comorbid PTSD among detained youths must be im-proved. PTSD is often missed because traumatic experiences are rarely included in standard screens or volunteered by patients. When planning treatment, clinicians must consider ramifications of comorbid PTSD.(Psychiatric Services 58: 1311–1316, 2007)