Prevalence rate, predictors and long-term course of probable posttraumatic stress disorder after major trauma a prospective cohort study 英文参考文献.docVIP

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Prevalence rate, predictors and long-term course of probable posttraumatic stress disorder after major trauma a prospective cohort study 英文参考文献.doc

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Prevalence rate, predictors and long-term course of probable posttraumatic stress disorder after major trauma a prospective cohort study 英文参考文献

Haagsmaetal.BMCPsychiatry2012,12:236 /1471-244X/12/236 RESEARCH ARTICLE OpenAccess Prevalencerate,predictorsandlong-termcourse ofprobableposttraumaticstressdisorderafter majortrauma:aprospectivecohortstudy JuanitaAHaagsma1*,AkkieNRingburg2,4,EstherMMvanLieshout2,EdFvanBeeck1,PeterPatka2, IngerBSchipper3andSuzannePolinder1 Abstract Background:Amongtraumapatientsrelativelyhighprevalenceratesofposttraumaticstressdisorder(PTSD)have beenfound.Toidentifyopportunitiesforpreventionandearlytreatment,predictorsandcourseofPTSDneedtobe investigated.Long-termfollow-upstudiesofinjurypatientsmayhelpgainmoreinsightintothecourseofPTSD andsubgroupsatriskforPTSD.Theaimofourlong-termprospectivecohortstudywastoassesstheprevalence rateandpredictors,includingpre-hospitaltraumacare(assistanceofphysicianstaffedEmergencyMedicalServices (EMS)atthesceneoftheaccident),ofprobablePTSDinasampleofmajortraumapatientsatoneandtwoyears afterinjury.Thesecondaimwastoassessthelong-termcourseofprobablePTSDfollowinginjury. Methods:Aprospectivecohortstudywasconductedof332majortraumapatientswithanInjurySeverityScore (ISS)of16orhigher.Weuseddatafromthehospitaltraumaregistryandself-assessmentsurveysthatincludedthe ImpactofEventScale(IES)tomeasureprobablePTSDsymptoms.AnIES-scoreof35orhigherwasusedas indicationforthepresenceofprobablePTSD. Results:Oneyearafterinjurymeasurementsof226majortraumapatientswereobtained(responserate68%).Of thesepatients23%hadanIES-scoreof35orhigher,indicatingprobablePTSD.Attwoyearsaftertraumathe prevalencerateofprobablePTSDwas20%.Femalegenderandco-morbiddiseasewerestrongpredictorsof probablePTSDoneyearfollowinginjury,whereasminortomoderateheadinjuryandinjuryoftheextremities (AISlessthan3)werestrongpredictorsofthisdisorderattwoyearfollow-up.OfthepatientswithprobablePTSD atoneyearfollow-up79%hadpersistentPTSDsymptomsayearlater. Conclusions:UptotwoyearsafterinjuryprobablePTSDishighlyprevalentinapopulationofpatientswithmajor trauma.ThemajorityofpatientssufferedfromprolongedeffectsofPTSD,