ABSTRACT

Background: Despite growing support for the distinction between posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) as separate diagnoses within the ICD-11 psychiatric taxonomy, the prevalence and treatment implications of CPTSD among current and ex-serving military members have not been established.

Objective: The study aims were to a) establish the prevalence of provisional ICD-11 CPTSD diagnosis relative to PTSD in an Australian sample of treatment-seeking current and ex-serving military members, and b) examine the implications of CPTSD diagnosis for intake profile and treatment response.

Methods: The study analysed data collected routinely from Australian-accredited treatment programmes for military-related PTSD. Participants were 480 current and ex-serving military members in this programmes who received a provisional ICD-11 diagnosis of PTSD or CPTSD at intake using proxy measures. Measures of PTSD symptoms, disturbances in self-organisation, psychological distress, mental health and social relationships were considered at treatment intake, discharge, and 3-month follow-up.

Results: Among participants with a provisional ICD-11 diagnosis, 78.2% were classified as having CPTSD, while 21.8% were classified as having PTSD. When compared to ICD-11 PTSD, participants with CPTSD reported greater symptom severity and psychological distress at intake, and lower scores on relationship and mental health dimensions of the quality of life measure. These relative differences persisted at each post-treatment assessment. Decreases in PTSD symptoms between intake and discharge were similar across PTSD (d _RM  = −0.81) and CPTSD (d _RM  = −0.76) groups, and there were no significant post-treatment differences between groups when controlling for initial scores.

Conclusions: CPTSD is common among treatment-seeking current and ex-serving military members, and is associated with initially higher levels of psychiatric severity, which persist over time. Participants with CPTSD were equally responsive to PTSD treatment; however, the tendency for those with CPTSD to remain highly symptomatic post-treatment suggests additional treatment components should be considered.

摘要

背景：尽管越来越多的人支持将创伤后应激障碍 (PTSD) 和复杂性 PTSD (CPTSD) 区分为 ICD-11 精神病学分类学中的独立诊断，但 CPTSD 在现役和退役军人中的患病率和治疗影响尚未明确已确立的。

目标: 本研究的目的是 a) 在澳大利亚寻求治疗的现任和退役军人样本中确定与 PTSD 相关的临时 ICD-11 CPTSD 诊断的流行率，以及 b) 检查 CPTSD 诊断对摄入情况的影响和治疗反应。

方法：该研究分析了从澳大利亚认可的军事相关 PTSD 治疗计划中常规收集的数据。参与者是该计划中的 480 名现役和退役军人，他们在入职时使用代理措施接受了 PTSD 或 CPTSD 的临时 ICD-11 诊断。在治疗开始、出院和 3 个月的随访中考虑了 PTSD 症状、自我组织障碍、心理困扰、心理健康和社会关系的测量。

结果：在临时 ICD-11 诊断的参与者中，78.2% 被归类为 CPTSD，而 21.8% 被归类为 PTSD。与 ICD-11 PTSD 相比，患有 CPTSD 的参与者在摄入时报告了更严重的症状和心理困扰，并且在生活质量测量的关系和心理健康方面得分较低。这些相对差异在每次治疗后评估中都存在。_{PTSD (d RM}  = −0.81) 和 CPTSD (d _RM = −0.76) 组在摄入和排放之间的 PTSD 症状减少相似 ，并且在控制初始分数时，组间没有显着的治疗后差异。

结论：CPTSD 在寻求治疗的现役和退役军人中很常见，并且与最初较高水平的精神病严重程度相关，并随着时间的推移持续存在。患有 CPTSD 的参与者对 PTSD 治疗同样敏感；然而，患有 CPTSD 的人在治疗后仍存在高度症状的趋势表明应考虑额外的治疗成分。