Risk factors and comorbidity of ICD-11 PTSD and complex PTSD: Findings from a trauma-exposed population based sample of adults in the United Kingdom
Risk factors and comorbidity of ICD-11 PTSD and complex PTSD: Findings from a trauma-exposed population based sample of adults in the United Kingdom
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DOI：
10.1002/da.22934
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发表时间：
2019-07-03
影响因子：
7.4
通讯作者：
Shevlin, Mark
中科院分区：
文献类型：
--
作者：
Karatzias, Thanos;Hyland, Philip;Shevlin, Mark
根据最近出版的第11版世界卫生组织国际疾病分类（ICD-11），我们试图研究与创伤后应激障碍（PTSD）和复杂PTSD （CPTSD）相关的危险因素和合并症。方法采用横断面和回顾性设计。样本由1051名创伤暴露的参与者组成，这些参与者来自英国成年人的全国代表性小组。结果5.3%（95%可信区间[CI] = 4.0 ~ 6.7%）的患者符合PTSD诊断标准，12.9% （95% CI = 10.9 ~ 15.0%）的患者符合CPTSD诊断标准。创伤后应激障碍的诊断与女性、处于恋爱关系和最近的创伤暴露有独立的关系。CPTSD与低龄、儿童期人际创伤和成年期人际创伤独立相关。在城市环境中长大与PTSD和CPTSD的诊断有关。PTSD和CPTSD的身体和心理健康共病发生率高。CPTSD患者更有可能认可反映重度抑郁症（比值比[OR] = 21.85, 95 CI = 12.51-38.04）和广泛性焦虑症（OR = 24.63, 95 CI = 14.77-41.07）的症状。PTSD （OR = 3.13, 95 CI = 1.81-5.41）和CPTSD （OR = 3.43, 95 CI = 2.37-4.70）的存在使自杀的可能性增加了三倍以上。近一半患有PTSD和CPTSD的参与者报告存在慢性疾病。结论：与创伤后应激障碍相比，CPTSD是一种更为常见、合并症和衰弱性疾病。现在需要进一步研究以确定有效的治疗干预措施。
Background Following the recently published 11th version of the WHO International Classification of Diseases (ICD-11), we sought to examine the risk factors and comorbidities associated with posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD). Method Cross-sectional and retrospective design. The sample consisted of 1,051 trauma-exposed participants from a nationally representative panel of the UK adult population. Results A total of 5.3% (95% confidence interval [CI] = 4.0-6.7%) met the diagnostic criteria for PTSD and 12.9% (95% CI = 10.9-15.0%) for CPTSD. Diagnosis of PTSD was independently associated with being female, being in a relationship, and the recency of traumatic exposure. CPTSD was independently associated with younger age, interpersonal trauma in childhood, and interpersonal trauma in adulthood. Growing up in an urban environment was associated with the diagnosis of PTSD and CPTSD. High rates of physical and mental health comorbidity were observed for PTSD and CPTSD. Those with CPTSD were more likely to endorse symptoms reflecting major depressive disorder (odds ratio [OR] = 21.85, 95 CI = 12.51-38.04) and generalized anxiety disorder (OR = 24.63, 95 CI = 14.77-41.07). Presence of PTSD (OR = 3.13, 95 CI = 1.81-5.41) and CPTSD (OR = 3.43, 95 CI = 2.37-4.70) increased the likelihood of suicidality by more than three times. Nearly half the participants with PTSD and CPTSD reported the presence of a chronic illness. Conclusions CPTSD is a more common, comorbid, debilitating condition compared to PTSD. Further research is now required to identify effective interventions for its treatment.