POSTER: Travma sonrası stres bozukluğunda tanısal farklılıklar
1999 Marmara depremini yaşayan kişilerle yapılan bu çalışmada depremle ilişkili kaygısı yüksek, kaçınmaları bulunan, sinirlilik, dikkat kaybı, uykusuzluk, depremi hatırladığında bedensel ve ruhsal rahatsızlık hisseden ancak herhangi bir hastalık tanısı almayan kişilerde belirtiler incelenmiştir. Araştırma sonucuna göre kullanılan mevcut tanı sistemlerine göre hastalık tanısı alınmasa bile bu belirtiler bir hastalığın parçası olabilir. Bu bilgiler ışığında yeni bir ruhsal bozukluk kategorisi tanımlanmış ve çalışma sonuçları Amerikan Psikiyatri Birliği’nin Kanada’da yapılan 2006 yılı toplantısında sunulmuştur.
Subthreshold PTSD and Related Factors Following Marmara Earthquake in Turkey
Dr. Gökben Hızlı, NPİstanbul Neyropsychiatry Hospital, İstanbul, Turkey Canada - 2006
Introduction: PTSD diagnosis criteria may be highly restrictive in DSM-IV. Some trauma victims may have symptoms although they do not meet the DSM criteria. Some authors have suggested the diagnoses partial PTSD and subthreshold PTSD (1,2). Results of previous research have led to dispute whether subthreshold PTSD is a clinical diagnosis or not (2). We hypothesized that no differences exist in quality of life, disability, and psychiatric comorbidity between subthreshold PTSD and PTSD and suggest that the three avoidance criteria for PTSD diagnosis be reduced to two.
Methods: The study group was composed of people present at the Marmara earthquake in 1999. People who took part in the study were given the Composite International Diagnostic Interview, Clinician Administered PTSD Scale, Short Form-36 , Brief Disability Scale, and the Beck Depression Inventory. The subthreshold PTSD group was defined according to CAPS results for PTSD diagnosis using two instead of three group-C avoidance criteria.
Results: The study group consisted of 77 women and 35 men (mean age, 37.9 ± 13.3 years). Four subgroups included PTSD (n = 25), subthreshold-PTSD (n = 29), healthy subjects who survived a major trauma (n = 36), and healthy subjects who did not survive a major trauma (n = 22). People with subthreshold PTSD who survived the earthquake had the same quality of life points compared with people with PTSD. Quality of life points and disability were higher for persons in the subthreshold PTSD group than they were for healthy subjects who did not survive a major trauma. Conclusions: The results of the current research demonstrate that a subthreshold PTSD group exists, which was different from chronic PTSD in terms of disability and psychiatric comorbidity. However, in agreement with previous research, the current study points to the fact that DSM-IV diagnostic criteria for PTSD should be reviewed.