基于变量中心和个体中心分析我国退役人员创伤后应激障碍的症状特点及影响因素

Characteristics and influencing factors of post-traumatic stress disorder symptoms in Chinese veterans:variablecentered and person-centered perspectives

目的基于变量中心和个体中心研究我国退役人员创伤后应激障碍(PTSD)症状特点、潜在类别及影响因素。方法采用分层方便抽样方法对我国12个城市2428名退役人员进行问卷调查,调查工具为自编个人信息问卷和《精神障碍诊断与统计手册(第五版)》标准PTSD筛查量表(PCL-5),运用变量中心方法研究PTSD症状发生率及其特点,运用个体中心方法研究其潜在类别,采用多元logistic回归方法分析各类别的影响因素。结果我国退役人员PTSD症状发生率为13.7%(333/2428),其危险因素包括女性(OR=1.96,95%CI 1.21~3.20)、25~30岁(OR=3.08,95%CI 1.01~9.36)、离婚(OR=2.64,95%CI 1.19~5.89)、目前患重病(OR=2.73,95%CI1.86~4.00)、特殊作业环境服役(OR=1.56,95%CI 1.13~2.16)。我国退役人员PTSD症状存在3个潜在类别(轻度症状组、中度症状组、重度症状组);以轻度症状组为参照,中度症状组的危险因素为高人均国内生产总值地区(OR=3.15,95%CI 1.25~7.93)、目前患重病(OR=2.83,95%CI 1.27~6.33)、立功受奖(三等功及以上OR=6.30,95%CI 1.51~26.31;嘉奖OR=4.83,95%CI 1.30~17.93),重度症状组的危险因素为目前患重病(OR=8.08,95%CI1.66~39.43)、参战(OR=15.03,95%CI 1.41~159.82)。结论人口学因素是我国退役人员PTSD症状发生的主要影响因素,服役时的军事应激事件是其严重程度的主要影响因素。

Objective To study the characteristics,potential categories and influencing factors of post-traumatic stress disorder(PTSD)symptoms in Chinese veterans based on variable-centered and person-centered settings.Methods Stratified sampling and convenient sampling methods were used.A total of 2428 veterans from 12 cities of China were investigated through self-compiled general questionnaire and PTSD checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition(PCL-5).Variable-centered method was used to calculate the incidence and characteristics of PTSD symptoms,and person-centered method was used to classify the potential categories,and multiple logistic regression was used to analyze the influencing factors of each category.Results The positive rate of PTSD symptoms was 13.7%(333/2428)in Chinese veterans.The risk factors were as follows:female(odds ratio[OR]=1.96,95%confidence interval[CI]1.21-3.20),25-30 years old(OR=3.08,95%CI 1.01-9.36),divorce(OR=2.64,95%CI 1.19-5.89),suffering from serious illness(OR=2.73,95%CI 1.86-4.00),and serving in special military environment(OR=1.56,95%CI 1.13-2.16).PTSD symptoms of Chinese veterans were divided into 3 potential categories:mild symptom group,moderate symptom group,and severe symptom group.With the mild symptoms group as the reference,high per capita gross domestic product(OR=3.15,95%CI 1.25-7.93),suffering from serious illness(OR=2.83,95%CI 1.27-6.33)and awards during service(third class and above:OR=6.30,95%CI 1.51-26.31;commendation:OR=4.83,95%CI 1.30-17.93)were the risk factors of the moderate symptom group,while suffering from serious illness(OR=8.08,95%CI 1.66-39.43)and participation in war(OR=15.03,95%CI 1.41-159.82)were the risk factors of the severe symptom group.Conclusion Demographic variables are the main factors affecting the development of PTSD symptoms of Chinese veterans,and military stress events during service are the main factors influencing the severity.