被诊断患有创伤后应激障碍的平民成年人的病人旅程-A图表综述研究
Lori L Davis1, Annette Urganus2, Patrick Gagnon-Sanschagrin3
1Research Service, Tuscaloosa Veterans Affairs Medical Center, Tuscaloosa, AL, USA.
Current medical research and opinion
|January 23, 2024
概括
到达创伤后应激障碍 (PTSD) 诊断的旅程是漫长的,症状在创伤后几年才出现. 治疗提供有限的缓解,突出需要改进后应激障碍干预措施.
科学领域:
- 精神病学是一个精神病学.
- 临床心理学 临床心理学
- 神经科学是一个神经科学.
背景情况:
- 创伤后应激障碍 (PTSD) 是一种复杂的心理健康状况.
- 了解患者从创伤暴露到诊断和治疗的旅程对于有效的护理至关重要.
研究的目的:
- 评估患者从创伤事件到创伤后应激障碍 (PTSD) 的旅程症状发作,诊断和治疗.
- 确定诊断为PTSD的患者的特征及其治疗模式.
主要方法:
- 在2016年至2020年期间,对687名被诊断患有PTSD的成年平民患者进行了回顾性图表审查.
- 从273名精神病医生收集的关于患者人口统计,临床表现和治疗史的数据.
- 分析包括从创伤到诊断的时间,诊断时的症状和治疗反应.
主要成果:
- 从创伤事件到PTSD诊断的平均时间为8.7年,症状发作时间为6.5年.
- 在诊断时,侵入症状 (87.8%) 和认知/情绪变化 (78.9%) 是常见的;并发性抑郁症 (41.2%) 和焦虑症 (38.7%) 是常见的.
- 诊断后79.3%的患者发生治疗变化,选择性血清素再吸收抑制剂 (SSRI) 作为常见的第一线治疗.
- 在24个月内,缓解率很低 (34.4%);精神病医生对目前的治疗方式表示不满,并表示愿意使用未经批准的非典型抗精神病药物 (AAs).
结论:
- 创伤后应激障碍 (PTSD) 的诊断往往是延迟的,创伤和症状发作之间存在很大的差距.
- 目前的治疗选择产生较低的缓解率,表明需要更有效的治疗策略.
- 精神病医生对现有的PTSD治疗不满,强调迫切需要新的FDA批准的干预措施.
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