创伤后应激障碍患者的临床特点及社会支持分析

An Analysis of the Clinical Characters and Social Support in Patients with Post-traumatic Stress Disorder

目的:分析创伤后应激障碍(PTSD)患者的临床特点及社会支持。方法:对30例符合《中国精神障碍分类与诊断标准(第三版)CCMD-3》PTSD诊断标准的患者进行常规治疗,并于入院时和治疗4周末评定社会支持评定量表(SSRS),然后分析其临床特点及治疗前后的社会支持情况。结果:PTSD患者的主要精神症状为:痛苦和不由自主地反复回想创伤体验、情境回避和持续的警觉性增高、选择性遗忘和对未来失去信心,多伴焦虑、抑郁等负性情绪。抗抑郁药和联合用药治疗效果较佳,显好率分别达90.9%和83.3%。治疗前的SSRS总分、主观支持和对支持利用度两个因子分均显著低于治疗4周末(P<0.05或P<0.01)。结论:PTSD患者具有接触创伤性事件、重现创伤体验、回避和警觉性增高四个特点,主观支持不足和对支持利用度差,需及时给予心理干预和适当抗抑郁药物治疗。

Objective： To analyze the clinical characters and social support in patients with post- traumatic stress disorder （ PTSD ）. Method ： Totally 30 patients with PTSD of Chinese Criterias of Mental Disorders 3rd edition （CCMD -3） were performed routine treatment. The social support rating scale （ SSRS） was evaluated at hospitalized time and after 4 weeks＇ treatment. The data of the clinical characters and social support were analyzed. Result： The main psychology symptoms of PTSD were distress, involuntarily and repeatedly recalling trauma experience, avoiding circumstances, sustained higher vigilance, selectance forgetting and losing confidence in the future. Most of them were with negative mood of anxiety and depression. Anti -depression drugs and combination drugs＇ treatment showed fine efficacy with 90.9% and 83.3% significant improvement. The total score of SSRS, subjective support and the utilization of social support before treatment showed significantly lower than those after 4 weeks＇ treatment （ P 〈 0.05 or 0.01 ）. Conclusion： Patients with PTSD had four characters such as suffering from trauma history, involuntarily and repeatedly re- calling trauma experience, avoiding circumstances and higher vigilance. They also showed lower subjective support and worse utilization of social support. They needed mental intervention and proper Anti - depression drugs treatment.