实弹训练者创伤性脑损伤症状与精神障碍的关联研究

Association between traumatic brain injury symptoms and mental disorders in live-fire trainers

目的评估军事训练人员实弹训练导致的创伤性脑损伤(traumatic brain injury,TBI)症状,及其与各类精神心理症状的相关性。方法对某部军事训练人员进行问卷调查,统计一般资料、实弹训练情况、TBI症状和心理症状(焦虑、抑郁和创伤后应激症状),并研究TBI症状与心理症状的相关性。结果实弹训练后约60.5%人员出现TBI症状,其中12.5%出现3种或以上的症状。TBI症状的数量与焦虑、抑郁的阳性率密切相关,但未发现与创伤后应激障碍(post-traumatic stress disorder,PTSD)的显著相关性。TBI症状数量与焦虑、抑郁阳性率的ROC曲线显示,当TBI症状分界值取3时,筛查焦虑与抑郁的效果最好,两者灵敏度分别为48.1%、29.7%,特异度分别为89.7%、87.1%。结论军人在实弹训练后出现TBI症状的情况较常见,多重TBI症状(3种或以上)可能与较高的焦虑、抑郁阳性率有关。

Objective To evaluate the symptoms of traumatic brain injury(TBI)caused by live-fire training in military training personnel and its correlation with various psychological symptoms.Methods A questionnaire survey was conducted among military training personnel in a certain unit,and general information,live-fire training,TBI symptoms,and psychological symptoms(anxiety,depression,and post-traumatic stress symptoms)were collected and analyzed.The correlation between TBI symptoms and psychological symptoms was also studied.Results Approximately 60.5%of personnel experienced TBI symptoms after live-fire training,with 12.5%experiencing three or more symptoms.The number of TBI symptoms was strongly correlated with the positive rates of anxiety and depression,but no significant correlation with PTSD was found.The ROC curves of the number of TBI symptoms and the positive rates of anxiety and depression showed that screening for anxiety and depression was best when the TBI symptom was 3,with a sensitivity of 48.1%and 29.7%,and a specificity of 89.7%and 87.1%,respectively.Conclusion It is common for military personnel to experience TBI symptoms after live-fire training,and multiple TBI symptoms(3 or more)may be associated with higher rates of positive anxiety and depression.