有一系列的有效的筛选工具有助于创伤后应激障碍的检测,但是,没有任何证据支持使用这些工具在人群中的筛查方案。
指南推荐对创伤后应激障碍有高风险的人可考虑常规使用简短的筛选工具,如在重大灾害之后或由于他们的难民或政治避难者的身份。[63]Australian Centre for Posttraumatic Mental Health. Australian guidelines for the treatment of acute stress disorder and posttraumatic stress disorder. 2013. http://phoenixaustralia.org/ (last accessed 7 October 2016).http://phoenixaustralia.org/wp-content/uploads/2015/03/Phoenix-ASD-PTSD-Guidelines.pdf[64]National Institute for Health and Care Excellence (NICE). Post-traumatic stress disorder: management. March 2005. http://www.nice.org.uk/ (last accessed 7 October 2016).http://www.nice.org.uk/guidance/CG26这些指南也建议在了解患者有过创伤性体验的情况下使用简单的筛查工具,而且建议心理健康专家应考虑询问有无法解释的临床症状且反复接受初级治疗的患者是否曾经历过创伤性事件。[63]Australian Centre for Posttraumatic Mental Health. Australian guidelines for the treatment of acute stress disorder and posttraumatic stress disorder. 2013. http://phoenixaustralia.org/ (last accessed 7 October 2016).http://phoenixaustralia.org/wp-content/uploads/2015/03/Phoenix-ASD-PTSD-Guidelines.pdf[64]National Institute for Health and Care Excellence (NICE). Post-traumatic stress disorder: management. March 2005. http://www.nice.org.uk/ (last accessed 7 October 2016).http://www.nice.org.uk/guidance/CG26特别对于表达有困难者,可考虑罗列症状或创伤性事件列表。一些筛选工具包含列表。
美国精神病学会认可使用事件影响量表 (IES),戴维森创伤量表 (DTS),PTSD 症状列表。[57]Benedek DM, Friedman MJ, Zatzick D, et al. Guideline watch (March 2009): Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder. 2009. http://psychiatryonline.org/ (last accessed 7 October 2016).http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/acutestressdisorderptsd-watch.pdf[58]Ursano RJ, Bell C, Eth S, et al; American Psychiatric Association. Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder. Am J Psychiatry. 2004;161(suppl 11):3-31.http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/acutestressdisorderptsd.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/15617511?tool=bestpractice.com
US Department of Veterans Affairs: Impact of Event Scale - revised (IES-R)
US Department of Veterans Affairs: PTSD checklist for DSM-5 (PCL-5)
US Department of Veterans Affairs: Davidson Trauma Scale (DTS)
作战和维和行动的军事人员,有时会有多次暴露于创伤性事件的经历。有报道称退伍军人创伤后应激障碍的患病率较高。[65]Hoge CW, Terhakopian A, Castro CA, et al. Association of posttraumatic stress disorder with somatic symptoms, health care visits, and absenteeism among Iraq war veterans. Am J Psychiatry. 2007;164:150-153.http://www.ncbi.nlm.nih.gov/pubmed/17202557?tool=bestpractice.com[66]Iversen AC, van Staden L, Hughes JH, et al. The prevalence of common mental disorders and PTSD in the UK military: using data from a clinical interview-based study. BMC Psychiatry. 2009;9:68.http://bmcpsychiatry.biomedcentral.com/articles/10.1186/1471-244X-9-68http://www.ncbi.nlm.nih.gov/pubmed/19878538?tool=bestpractice.com[67]Bliese PD, Wright KM, Adler AB, et al. Timing of postcombat mental health assessments. Psychol Services. 2007;4:141-148.针对此类高风险职业人群的干预已显示出潜力。[68]Adler AB, Bliese PD, McGurk D, et al. Battlemind debriefing and battlemind training as early interventions with soldiers returning from Iraq: randomization by platoon. J Consult Clin Psychol. 2009;77:928-940.http://www.ncbi.nlm.nih.gov/pubmed/19803572?tool=bestpractice.com