抑郁和焦虑对格鲁吉亚仆人创伤后应激障碍躯体主诉的中介作用

G. Sikharulidze, Mariam Sordia, E. Vermetten
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摘要

背景与目的:创伤后应激障碍(PTSD)与躯体症状之间的关系以及共病抑郁和焦虑的作用已经在许多研究中得到证实。以下研究探讨抑郁和焦虑在多大程度上影响格鲁吉亚维和人员创伤后应激障碍与躯体抱怨的关系。设计与方法:采用《精神障碍诊断与统计手册》第五版(DSM-5)中的PTSD检查表(PCL-5)和患者健康问卷(PHQ)对服役6个月的75名退伍军人进行问卷调查。采用SPSS PROCESS宏的两种平行中介模型4来检验抑郁和焦虑对PTSD对躯体抱怨间接效应的不同影响和共同影响。结果:当单独分析可能的介质时,PTSD对躯体主诉有显著的间接影响:通过抑郁0.21,95% CI[0.13, 0.28],通过焦虑0.13,95% CI[0.06, 0.21]。将两种介质置于平行模型后,只有抑郁保持统计学显著性:0.18,95% CI[0.09, 0.28]。间接效应与总效应之比为0.66,95% CI[0.59, 0.75]。结论:本研究初步发现PTSD与躯体主诉之间的关系可能主要是抑郁的潜在症状,而不是焦虑的潜在症状,这突出了在诊断和治疗PTSD与躯体主诉共病时针对抑郁症状的重要性。这些新的结果可能会影响创伤后应激障碍的管理和治疗,因为它们承认焦虑和抑郁症状在躯体疾病中的重要性。
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MEDIATING ROLE OF DEPRESSION AND ANXIETY ON SOMATIC COMPLAINTS IN GEORGIAN SERVANTS WITH POST TRAUMATIC STRESS DISORDER
Background and Objectives: The relationship between Post Traumatic Stress Disorder (PTSD) and somatic symptoms and the role of comorbid depression and anxiety has been demonstrated in many studies. The following research explores to what extent depression and anxiety influence the relationship between PTSD and somatic complaints in Georgian peacekeepers. Design and Methods: PTSD Checklist (PCL-5) for The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and Patient Health Questionnaire (PHQ) was used to collect data in the sample of 75 veterans examined after a 6-month deployment. Two types of parallel mediation model 4 of the SPSS PROCESS macro were used to check different and also joint influences of depression and anxiety on the indirect effect of PTSD on somatic complaints.  Results: When probable mediators were analyzed separately, there was a significant indirect effect of PTSD on somatic complaints: through depression 0.21, 95% CI [0.13, 0.28], and through anxiety 0.13, 95% CI [0.06, 0.21]. After placing both mediators in a parallel model, only depression maintained statistical significance: 0.18, 95% CI [0.09, 0.28]. The ratio of indirect to total effect was 0.66, 95% CI [0.59, 0.75]. Conclusions: The primary finding is that the relationship between PTSD and somatic complaints may be mainly accounted for underlying symptoms of depression rather than anxiety, highlighting the importance of targeting depression symptoms when diagnosing and treating comorbid PTSD and somatic complaints. These new results may affect both the management and treatment of PTSD as they acknowledge the importance of anxiety and depression symptoms in somatic complaints.
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