BACKGROUND This study is one of the longest postdisaster prospective longitudinal studies of disaster-related psychopathology, completed nearly a quarter century after a terrorist bombing, and the longest follow-up study ever conducted using full diagnostic assessment in highly exposed disaster survivors. METHODS Oklahoma City bombing survivors (87% injured) were randomly selected from a state survivor registry and interviewed approximately 6 months postdisaster (N = 182; 71% participation) and again nearly 25 years later (N = 103; 72% participation). Interviews were conducted using the Diagnostic Interview Schedule (a structured interview assessing full diagnostic criteria) for panic disorder, generalized anxiety disorder, and substance use disorder at baseline and also for posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) at follow-up. The Disaster Supplement assessed disaster trauma exposure and subjective experience. RESULTS At follow-up, 37% of participants exhibited bombing-related PTSD (34% at baseline) and 36% had MDD (23% at baseline). More new cases of PTSD than MDD developed over time. Nonremission rates were 51% for bombing-related PTSD and 33% for MDD. One-third of participants reported long-term nonemployability. CONCLUSIONS The presence of long-term medical problems among survivors parallels the persistence of psychopathology. Ongoing medical problems might have contributed to psychiatric morbidity. Because no major variables predicted remission from bombing-related PTSD and MDD, all survivors with postdisaster psychopathology likely need access to long-term evaluation and care.

中文翻译：

---

灾难发生后第一个四分之一世纪对俄克拉荷马城爆炸案幸存者的纵向跟踪研究。

背景 这项研究是最长的灾难相关精神病理学灾后前瞻性纵向研究之一，在恐怖爆炸发生近四分之一个世纪后完成，并且是有史以来对高度暴露的灾难幸存者使用全面诊断评估进行的最长的后续研究。方法 俄克拉荷马城爆炸案幸存者（87% 受伤）是从州幸存者登记处随机选择的，并在灾后约 6 个月（N = 182；71% 参与）和将近 25 年后再次接受采访（N = 103；72% 参与）。访谈是使用诊断访谈计划（评估完整诊断标准的结构化访谈）进行的，用于恐慌症、广泛性焦虑症、和物质使用障碍在基线以及创伤后应激障碍 (PTSD) 和重度抑郁症 (MDD) 在后续行动中。灾难补充评估了灾难创伤暴露和主观体验。结果 在随访中，37% 的参与者表现出与爆炸相关的 PTSD（基线时为 34%），36% 的参与者患有 MDD（基线时为 23%）。随着时间的推移，出现的 PTSD 新病例多于 MDD。与爆炸有关的 PTSD 的非缓解率为 51%，而 MDD 的非缓解率为 33%。三分之一的参与者表示长期无法就业。结论 幸存者中长期医疗问题的存在与精神病理学的持续存在是平行的。持续的医疗问题可能导致精神疾病的发病率。因为没有主要变量预测与爆炸相关的 PTSD 和 MDD 的缓解，