Assessing the Predictive Validity of Early Post-injury CAPS-5 for Later Posttraumatic Stress Disorder Diagnosis.

IF 4.5 2区医学 Q1 PSYCHIATRY Journal of Clinical Psychiatry Pub Date : 2024-08-05 DOI:10.4088/JCP.24m15267

Jae-Min Kim, Ju-Wan Kim, Hee-Ju Kang, Ju-Yeon Lee, Hyunseok Jang, Inseok Jeong, Jung-Chul Kim, Sung-Wan Kim, Il-Seon Shin

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Abstract.

Objective: The Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) is a widely recognized tool with exceptional reliability and validity in evaluating and diagnosing PTSD. This study aimed to determine the predictive values of CAPS-5 assessed early postinjury for subsequent development of PTSD during a 2-year follow-up period.

Methods: Patients with moderate to severe physical injuries were recruited from a trauma center at a university hospital in South Korea between June 2015 and January 2021. At baseline, 1,142 patients underwent evaluations using CAPS-5 for the diagnosis of acute stress disorder (ASD) along with total scores. They were followed up for PTSD using the CAPS-5 evaluations at 3, 6, 12, and 24 months post-baseline. Area under receiver operating curve (AUROC) analyses were conducted to identify predictive values of the CAPS-5 for later PTSD development.

Results: CAPS-5 diagnosis of ASD at baseline displayed fair to failed performance (AUROCs: 0.555-0.722) for predicting follow-up PTSD. However, CAPS-5 scores of ≥15 exhibited good to fair predictive accuracy (AUROCs: 0.767-0.854) for later PTSD development. Notably, for patients with intentional injuries or a history of previous trauma, a higher CAPS-5 score of ≥16 showed improved predictive accuracy.

Conclusion: A CAPS-5 score of ≥15 would be an effective and practical cutoff for early prediction of PTSD following physical injuries. In cases of intentional injuries or a documented trauma history, a cutoff of ≥16 may offer enhanced predictive precision. Future research in diverse settings and populations is needed to confirm the generalizability of our findings.

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评估早期创伤后 CAPS-5 对后期创伤后应激障碍诊断的预测效力。

摘要.目的：DSM-5临床医师管理创伤后应激障碍量表（CAPS-5）是一种广受认可的工具，在评估和诊断创伤后应激障碍方面具有卓越的可靠性和有效性。本研究旨在确定伤后早期评估的 CAPS-5 在 2 年随访期间对创伤后应激障碍后续发展的预测价值：方法：2015 年 6 月至 2021 年 1 月期间，韩国一所大学医院的创伤中心招募了中度至重度肢体损伤患者。在基线阶段，1,142 名患者接受了使用 CAPS-5 进行的急性应激障碍（ASD）诊断和总分评估。在基线后的 3、6、12 和 24 个月，使用 CAPS-5 评估对他们进行创伤后应激障碍随访。进行接收者操作曲线下面积（AUROC）分析，以确定 CAPS-5 对创伤后应激障碍后期发展的预测价值：结果：CAPS-5基线诊断为ASD，在预测后续创伤后应激障碍方面表现一般至不及格（AUROC：0.555-0.722）。然而，CAPS-5得分≥15分对后期创伤后应激障碍发展的预测准确性为良好至一般（AUROCs：0.767-0.854）。值得注意的是，对于有故意伤害或既往创伤史的患者，CAPS-5得分≥16分的高分显示出更高的预测准确性：结论：CAPS-5评分≥15分是早期预测躯体损伤后创伤后应激障碍的有效且实用的分界线。在故意伤害或有创伤史记录的情况下，≥16 分的临界值可能会提高预测的准确性。未来需要在不同的环境和人群中进行研究，以确认我们的研究结果是否具有普遍性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Psychiatry 医学-精神病学

CiteScore

7.40

自引率

1.90%

发文量

审稿时长

3-8 weeks

期刊介绍： For over 75 years, The Journal of Clinical Psychiatry has been a leading source of peer-reviewed articles offering the latest information on mental health topics to psychiatrists and other medical professionals.The Journal of Clinical Psychiatry is the leading psychiatric resource for clinical information and covers disorders including depression, bipolar disorder, schizophrenia, anxiety, addiction, posttraumatic stress disorder, and attention-deficit/hyperactivity disorder while exploring the newest advances in diagnosis and treatment.