老年人创伤和创伤后应激障碍的健康状况和寻求治疗的耻辱感

Anica Pless Kaiser, Antonia Seligowski, Avron Spiro, Mohit Chopra
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引用次数: 13

摘要

本研究比较了四个创伤/创伤后应激障碍(PTSD)组的健康状况,这些老年人患有抑郁、焦虑和/或有饮酒风险,他们参加了初级保健预约(N = 1199;平均年龄= 73.5岁),主要在退伍军人事务部医院。创伤和PTSD分类为PTSD (n = 81)、部分PTSD (n = 127)、仅创伤(n = 323)和无创伤(n = 668)。比较各组之间与身心健康有关的生活质量(HQL)、社会和经济损害指数以及与寻求治疗有关的耻辱。功能损害的多项指标存在组间差异;创伤后应激障碍组的亲密朋友更少,寻求治疗的耻辱感更高。线性混合模型检验创伤/创伤后应激障碍组与HQL之间的关系。在考虑协变量后,创伤/创伤后应激障碍组在医疗结果研究短表36量表和成分得分上存在差异(通过量表相互作用以显著组表示)。各组之间的差异仅限于心理健康指标;PTSD患者的HQL更差。事后分析检查了创伤/创伤后应激障碍组共病精神诊断的数量。总体而言,研究结果表明,精神HQL在患有创伤和创伤后应激障碍的老年人中有所不同,尽管治疗相关的耻辱感在组间没有差异,但它确实会影响HQL。
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Health status and treatment-seeking stigma in older adults with trauma and posttraumatic stress disorder.

This study compared health status across four trauma/posttraumatic stress disorder (PTSD) groups of older adults with depression, anxiety, and/or at-risk drinking who attended primary care appointments (N = 1,199; mean age = 73.5 yr), mostly at Department of Veterans Affairs hospitals. The trauma and PTSD categories were PTSD (n = 81), partial PTSD (n = 127), trauma only (n = 323), and no trauma (n = 668). Physical and mental health-related quality of life (HQL), indices of social and economic impairment and stigma regarding treatment-seeking were compared among groups. Group differences were found for several indicators of functional impairment; the PTSD group had fewer close friends and higher treatment-seeking stigma beliefs related to having a disorder. Linear mixed modeling examined associations between trauma/PTSD group and HQL. After accounting for covariates, the trauma/PTSD groups differed across the Medical Outcome Study Short Form-36 scales and component scores (indicated by significant group by scale interaction). Differences among groups were confined to mental health measures; those with PTSD had worse HQL. Post hoc analyses examined the number of comorbid psychiatric diagnoses by trauma/PTSD group. Overall, findings indicate that mental HQL varies among older adults with trauma and PTSD and that although treatment-related stigma does not differ among groups, it does affect HQL.

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