暴露于创伤的儿童和青少年中创伤后应激障碍的发生率:更新的三级元分析
Ilse Visser1,2,3, Malindi van der Mheen1,2,3, Hannah Dorsman1
1Levvel, Academic Centre for Child and Adolescent Psychiatry, Amsterdam, The Netherlands.
概括
在遭受创伤后,大量儿童和青少年患上创伤后应激障碍 (PTSD),根据DSM-IV标准的患病率为20%,根据DSM-5标准的患病率为12%. 女孩和经历人际创伤的人特别容易受到伤害,这强调了早期干预和治疗的必要性.
科学领域:
- 儿童和青少年精神病学 儿童和青少年精神病学
- 创伤心理学 创伤心理学
- 精神卫生流行病学 精神卫生流行病学
背景情况:
- 没有最近的元分析估计了青年的创伤后应激障碍 (PTSD) 患病率.
- 更新的诊断标准 (DSM-5) 需要新的流行率估计.
- 许多关于儿童和青少年PTSD的研究已经出现.
研究的目的:
- 用DSM-IV和DSM-5标准估计创伤暴露的年轻人中PTSD患病率.
- 检查患病率如何因创伤类型,性别,暴露后的时间,告密者和诊断方法而异.
- 为儿童群体提供创伤后应激障碍的最新元分析估计.
主要方法:
- 系统的文献搜索,将以前的元分析研究与新研究结合起来.
- 包括95项研究,包括64个独立样本 (DSM-IV的N=6745,DSM-5的N=12,644),超过30年.
- 三级随机效应模型来计算患病率和对主持人的测试.
主要成果:
- DSM-IV元分析:203%的PTSD患病率 (56个样本,年龄0-18岁),根据性别,创伤类型和面试类型进行适度.
- DSM-5元分析:12.0%的PTSD患病率 (8个样本,年龄为1-18岁).
- 对于DSM-5调节分析的数据不足.
结论:
- 虽然大多数年轻人不会患上PTSD,但很大一部分会患上PTSD,尤其是女孩和那些经历过人际关系创伤的人.
- 这些发现支持持续预防,早期查和有效治疗儿童和青少年PTSD的需要.
- 这项研究强调了儿科创伤后应激障碍对公共健康的重大负担.
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