BACKGROUND Firefighters are at high risk for subthreshold and full-threshold posttraumatic stress disorder (PTSD) due to their frequent exposure to various traumatic events. Although individuals with subthreshold PTSD have increased impairment, often needing treatment, the rates of subthreshold PTSD in firefighters remain unknown. Moreover, there is currently no consensus regarding the definition of subthreshold PTSD. The purpose of this study was to investigate the rates and clinical impairment of subthreshold PTSD according to various definitions in a national sample of firefighters. METHODS A total of 45,698 Korean firefighters completed self-reported questionnaires to assess the severity of PTSD symptoms, suicidal behavior, depression, alcohol use problems, and PTS-related functional impairment. Six different definitions used in the literature were used to calculate the prevalence rate of subthreshold PTSD. Multivariable linear regression and analysis of variance were performed to identify the relationship of subthreshold PTSD with suicidal behavior, depression, alcohol use problems, and PTS-related functional impairment. RESULTS The rate of full-threshold PTSD was 2.63%, and the rate of subthreshold PTSD ranged from 1.79% to 17.98%. The individuals with subthreshold PTSD most commonly failed the D criteria, which included negative alterations in cognition and mood. Regardless of the definition used, subthreshold PTSD was found to be associated with increased suicidal behavior, depression, alcohol use problems, and functional impairment. CONCLUSIONS Subthreshold PTSD appears to be equal to or more frequent than full-threshold PTSD in Korean firefighters and associated with various negative clinical outcomes. Further effort to detect and treat subthreshold PTSD in firefighters may be essential.

中文翻译：

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在韩国消防员的国家样本中，使用DSM-5标准对亚阈PTSD的患病率和临床损害进行了评估。

背景技术由于消防员经常暴露于各种创伤事件中，因此其存在阈下和全阈创伤后应激障碍（PTSD）的高风险。尽管患有PTSD阈下值的人的损伤增加，经常需要治疗，但是消防员中PTSD阈值的比率仍然未知。此外，当前关于阈下PTSD的定义尚无共识。这项研究的目的是根据国家消防员样本中的各种定义，调查阈下PTSD的发生率和临床损害。方法共有45698名韩国消防员完成了自我报告的问卷调查，以评估PTSD症状，自杀行为，抑郁，饮酒问题以及与PTS相关的功能障碍的严重性。文献中使用了六个不同的定义来计算亚阈PTSD的患病率。进行多变量线性回归和方差分析，以确定阈下PTSD与自杀行为，抑郁，酒精使用问题以及与PTS相关的功能障碍的关系。结果全阈值PTSD率为2.63％，亚阈值PTSD的范围为1.79％至17.98％。亚阈值PTSD的个体最常无法通过D标准，该标准包括认知和情绪的负面变化。不管使用什么定义，亚阈PTSD都与自杀行为增加，抑郁，酒精使用问题和功能障碍有关。结论在韩国消防员中，阈下PTSD似乎等于或高于阈值PTSD，并且与各种不良临床结果相关。在消防员中发现和治疗阈下PTSD的进一步努力可能至关重要。