创伤后应激障碍

  目的  调查湖北省武汉市内艾滋病感染者创伤后应激障碍（PTSD）的发生率及影响因素，为改善艾滋病感染者心理状态和生活质量提供参考。  方法  在2015年10月 — 2016年1月对到武汉市医疗救治中心接受检查的535例艾滋病感染者进行问卷调查。  结果  武汉市艾滋病感染者PTSD患病率为26.5 %，再体验症状群、回避/情感麻木症状群以及高警觉症状群患病率分别为56.8 %、48.2 %、41.9 % 多因素分析显示，确诊带来的心理冲击和歧视感知程度与艾滋病感染者患PTSD 心理冲击非常大 OR = 10.033，95 % CI = 1.246～80.787 歧视感知 OR = 1.055，95 % CI = 1.036～1.073 ，以及出现再体验症状 心理冲击比较大 OR = 4.229，95 % CI = 1.526～11.723 心理冲击非常大 OR = 7.158，95 % CI = 2.585～19.823 歧视感知 OR = 1.039，95 % CI = 1.024～1.053 有关 确诊带来的心理冲击大 比较大 OR = 3.251，95 % CI = 1.044～10.126 非常大 OR = 5.112，95 % CI = 1.653～15.805 、高歧视感知（OR = 1.042，95 % CI = 1.028～1.057）和低社会资本 OR = 0.920，95 % CI = 0.883～0.959 的感染者更可能报告回避/情感麻木症状；高警觉症状也与感染者歧视感知程度 OR = 1.045，95 % CI = 1.030～1.060 和拥有的社会资本 OR = 0.950，95 % CI = 0.913～0.988 有关。  结论  武汉市艾滋病感染人群PTSD患病率以及3大症状共病率均较高，确诊带来的心理冲击、歧视感知和社会资本是与该人群患创伤后应激障碍相关的主要因素。

Future directions for interventions targeting PTSD in HIV-infected adults

  Objective  To explore the prevalence and influencing factors of post-traumatic stress disorder (PTSD) in people living with human immunodeficiency virus (HIV) infection (PLWH) in Wuhan city, and to provide evidences for improving mental health and living quality of PLWH.  Methods  We conducted a face-to-face questionnaire survey among 535 PLWH visiting Wuhan Municipal Medical Treatment Center between October 2015 and January 2016.  Results  Among all the PLWH, the prevalence of PTSD was 26.5% and the prevalence rates of PTSD-related symptoms were 56.8% for re-experiencing, 48.2% for avoidance/affective numbness, and 41.9% for high alertness, respectively. The results of multivariate logistic regression analysis revealed that significant influencing factors for occurrences of PTSD and its three domain symptoms included mental conflict at the first diagnosis of HIV positive (very strong conflict: odds ratio [OR] = 10.033, 95% confidence interval [95% CI]: 1.246 – 80.787 for PTSD; OR = 7.158, 95% CI: 2.585 – 19.823 for re-experiencing; OR = 5.112 , 95% CI: 1.653 – 15.805 for avoidance/affective numbness; strong conflict: OR = 4.229, 95% CI: 1.526 – 11.723 for re-experiencing and OR = 3.251, 95% CI: 1.044 – 10.126 for avoidance/affective numbness), highly perceived discrimination (OR = 1.055, 95% CI: 1.036 – 1.073 for PTSD; OR = 1.039, 95% CI: 1.024 – 1.053 for re-experiencing; OR = 1.042, 95% CI: 1.028 – 1.057 for avoidance/affective numbness; OR = 1.045, 95% CI: 1.030 – 1.060 for high alertness), and high possession of social capital (OR = 0.920, 95% CI: 0.883 – 0.959 for avoidance/affective numbness and OR = 0.950, 95% CI: 0.913 – 0.988 for high alertness).  Conclusion  The prevalence of PTSD and the comorbidity of the three major PTSD symptoms are high among PLWH; mental conflict of at first diagnosis of HIV infection, perceived discrimination and social capital are main factors associated with the occurrence of PTSD among the PLWH.