Objective: The Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) is a widely recognized tool with exceptional reliability and validity in evaluating and diagnosing PTSD. This study aimed to determine the predictive values of CAPS-5 assessed early postinjury for subsequent development of PTSD during a 2-year follow-up period.
Methods: Patients with moderate to severe physical injuries were recruited from a trauma center at a university hospital in South Korea between June 2015 and January 2021. At baseline, 1,142 patients underwent evaluations using CAPS-5 for the diagnosis of acute stress disorder (ASD) along with total scores. They were followed up for PTSD using the CAPS-5 evaluations at 3, 6, 12, and 24 months post-baseline. Area under receiver operating curve (AUROC) analyses were conducted to identify predictive values of the CAPS-5 for later PTSD development.
Results: CAPS-5 diagnosis of ASD at baseline displayed fair to failed performance (AUROCs: 0.555-0.722) for predicting follow-up PTSD. However, CAPS-5 scores of ≥15 exhibited good to fair predictive accuracy (AUROCs: 0.767-0.854) for later PTSD development. Notably, for patients with intentional injuries or a history of previous trauma, a higher CAPS-5 score of ≥16 showed improved predictive accuracy.
Conclusion: A CAPS-5 score of ≥15 would be an effective and practical cutoff for early prediction of PTSD following physical injuries. In cases of intentional injuries or a documented trauma history, a cutoff of ≥16 may offer enhanced predictive precision. Future research in diverse settings and populations is needed to confirm the generalizability of our findings.
目的:DSM-5临床医师管理的PTSD量表(CAPS-5)是一种广泛认可的工具,在评估和诊断PTSD方面具有出色的可靠性和有效性。这项研究旨在确定CAPS-5在2年随访期内评估创伤后早期发展的预测值。
方法:2015年6月至2021年1月,从韩国一所大学医院的创伤中心招募了中度至重度身体损伤的患者。在基线,使用CAPS-5对1,142例患者进行了评估,以诊断急性应激障碍(ASD)以及总分。在基线后3、6、12和24个月使用CAPS-5评估对他们进行PTSD随访。进行受试者工作曲线下面积(AUROC)分析以鉴定CAPS-5对后期PTSD发展的预测值。
结果:基线时CAPS-5对ASD的诊断显示出正常或失败的表现(AUROC:0.555-0.722),用于预测随访PTSD。然而,≥15的CAPS-5评分对以后的PTSD发展表现出良好至公平的预测准确性(AUROC:0.767-0.854)。值得注意的是,对于有故意伤害或既往外伤史的患者,较高的CAPS-5评分≥16显示预测准确性提高.
结论:CAPS-5评分≥15将是早期预测创伤后应激障碍的有效和实用的临界值。在故意伤害或有创伤史的情况下,≥16的临界值可提高预测精度.未来需要在不同环境和人群中进行研究,以证实我们研究结果的普遍性。