中国心身疾病患者中DSM-5与ICD-11关于创伤后应激障碍的比较  

A Comparison of ICD-11 and DSM-5 Criteria of Post-traumatic Stress Disorder among Psychosomatic Patients

作　　者：罗澍 刘平[3] 毕亚杰[3] 闫一民 方若蛟 曹成琦 王力[1,2] LUO Shu;LIU Ping;BI Ya-jie;YAN Yi-min;FANG Ruo-jao;CAO Cheng-qi;WANG Li(CAS Key Laboratory of Mental Health,Institute of Psychology,Beijing 100101,China;Department of Psychology,University of Chinese Academy of Sciences,Beijing 100049,China;Department of Psychosomatic Medicine,People's Hospital of Deyang City,Deyang 618099,China)

机构地区：[1]中国科学院心理研究所心理健康重点实验室,北京100101 [2]中国科学院大学心理学系,北京100049 [3]德阳市人民医院心身医学科,德阳618099

出　　处：《中国临床心理学杂志》2023年第6期1438-1441,共4页Chinese Journal of Clinical Psychology

基　　金：国家自然科学基金项目(U21A20364,31971020和32300918);国家社会科学基金重大项目(20ZDA079);应急管理部消防救援总局重点研发项目(2020XFZD07);中国科学院心理研究所自主部署项目(E2CX4115CX和E1CX161005)支持。

摘　　要：目的:比较我国心身疾病患者在DSM-5和ICD-11诊断标准下创伤后应激障碍发生率和共病率的差异。方法:被试为485名亲身经历过创伤事件的心身疾病患者。采用创伤后应激障碍症状清单(PTSD Checklist for DSM-5,PCL-5)评估创伤后应激障碍症状,采用病人健康问卷(Patient Health Questionnaire,PHQ-9)和广泛性焦虑量表(Generalized Anxiety Disorder-7,GAD-7)评估抑郁和焦虑症状。结果:DSM-5和ICD-11标准下PTSD的发生率分别为49.7%和38.4%,使用DSM-5标准PTSD发生率显著高于ICD-11标准。在仅符合DSM-5 PTSD阳性个体中与抑郁和焦虑的共病率分别为88.4%和81.2%,仅符合ICD-11阳性个体中与抑郁和焦虑的共病率分别为42.9%和64.3%。ICD-11标准可显著降低与抑郁的共病率,但是不能显著降低与焦虑的共病率。结论:使用DSM-5和ICD-11不同诊断标准在发病率及与抑郁共病率方面存在显著差异。Objective:This study aimed at comparing the prevalence and comorbidity differences of PTSD according to ICD-11 and DSM-5 definition among psychosomatic patients.Methods:A total of 485 adults exposed to traumatic events were included in this study.The PTSD Checklist for DSM-5 was used to measure PTSD symptoms.The Patient Health Questionnaire(PHQ-9)and the Generalized Anxiety Disorder-7(GAD-7)were used to measure depression,and anxiety symptoms.Results:The DSM-5 prevalence rate was significantly higher than ICD-11 criteria.The ICD-11 criteria could significantly reduce the rate of comorbidity with MDD but not GAD.Conclusion:The results revealed that the ICD-11 and DSM-5 provided different prevalence of PTSD and comorbidity rates with MDD.This study carries implications for understanding the nature of the definition of PTSD and adds to knowledge about organizing and application of these two global applied criteria of PTSD.

关 键 词：精神障碍诊断与统计手册(第五版) 国际疾病分类(第十一次修订版) 创伤后应激障碍 心身疾病患者 共病 

分 类 号：R395.2[哲学宗教—心理学]