车祸事件后创伤后应激障碍的研究

PTSD after Traffic Accident

目的 :研究车祸事件后创伤后应激障碍的发生情况及特点。方法 :应用中国精神疾病分类方案与诊断标准第二版修订本中的急性应激障碍 (ASR)和创伤后应激障碍 (PTSD)诊断标准 ,对因车祸住我院治疗的 81例患者进行诊断 ,采用症状自评量表 (SCL -90 ) ,艾森克个性问卷 (EPQ)及症状记录表等进行测评。结果 :车祸后 3个月 ,81例中有 33例 ( 4 0 7%)曾经符合ASR诊断标准 ,31例 ( 38 3%)符合PTSD诊断标准。与非PTSD组比较 ,PTSD组SCL -90总分、总均分、阳性项目数、阴性项目数及躯体化、强迫症状、人际关系敏感、抑郁、焦虑、敌对、恐怖、其它因子分均显著高于非PTSD组 (P <0 0 5～ 0 0 1)。PTSD组情绪稳定度倾向不稳定型 ( 38 71%)的比率高于非PTSD组 (P <0 0 1)。与PTSD发病有关的影响因素为EPQ问卷中神经质、L量表及性别。结论 :车祸事件后PTSD并非罕见 ,与性别及个性心理特征有关。

Objective: To study the rate of PTSD after traffic accident in orthopedics and do retrospective analysis. Method: Eighty one patients wounded by traffic accident in orthopedic ward were surveyed. Acute stress reaction (ASR) and posttraumatic stress disorder (PTSD) were diagnosed according to CCMD-2-R criteria. SCL-90 and EPQ were also applied. Results: 33 cases (40.7%) were diagnosed as ASR and 31 (38.3%) as PTSD among all subjects. SCL-90 score and nearly all subscores were higher in patients with PTSD than patients without (P<0.05 or 0.01). Compared with patients without PTSD, more patients with PTSD were inclined to unstable mood in EPQ (38.7% vs 4%, χ 2=16.13, P<0.01). Conclusion: PTSD is a common disorder in orthopedic patients wounded by traffic accident and need psychosocial intervention.