在美国退伍军人中同时出现的慢性疼痛和PTSD:患病率,相关性和功能
David E Reed1,2, Ian C Fischer3,4, Rhonda M Williams5,6
1Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA. davider2@uw.edu.
Journal of general internal medicine
|May 23, 2024
概括
大约3.8%的美国退伍军人经历了慢性疼痛和创伤后应激障碍 (PTSD). 这种并发症显著增加了精神病学负担,并对心理社会功能产生了负面影响,突出了综合护理的需要.
科学领域:
- 精神病学是一个精神病学.
- 流行病学 流行病学
- 退伍军人健康 退伍军人的健康
背景情况:
- 美国退伍军人同时出现慢性疼痛和创伤后应激障碍 (PTSD) 的患病率尚未确立.
- 这些疾病对伴随性疾病的精神和功能负担的具体贡献在很大程度上是未知的.
研究的目的:
- 确定慢性疼痛,PTSD的患病率及其在美国退伍军人全国代表性样本中的共发生率.
- 检查患有慢性疼痛,PTSD或两者的退伍军人的精神病并发症和心理社会功能.
主要方法:
- 分析了来自美国退伍军人国家健康和弹性研究的数据,这是对美国退伍军人的全国调查.
- 将4069名退伍军人分为四组:控制组,仅慢性疼痛组,仅PTSD组,以及同时出现的慢性疼痛和PTSD组.
- 使用DSM-5的PTSD检查清单和通过自我报告诊断的慢性疼痛评估可能的PTSD;使用验证的尺度评估精神和功能状态.
主要成果:
- 3.8%的退伍军人报告了同时出现的慢性疼痛和可能的PTSD.
- 与仅患有慢性疼痛的退伍军人相比,患有慢性疼痛和PTSD的退伍军人表现出更高的精神疾病率 (ORs=2.59-9.88) 和较差的心理社会功能 (科恩s ds=0.38-1.43).
- 与PTSD单独相比,同时出现的慢性疼痛和PTSD与更高的自杀企图概率 (OR=4.79) 相关.
结论:
- 退伍军人的慢性疼痛和PTSD同时发生与显著的精神和功能障碍有关.
- 结果强调需要全面,整体的医疗保健方法.
- 针对多个健康和功能领域的综合评估和治疗对于患有慢性疼痛和PTSD的退伍军人来说至关重要.
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