汶川地震灾民的心理健康状况及影响因素
|
摘要
【目的】评估汶川地震后第2周转移安置点灾民的心理健康状况并探索其影响因素。【方法】对江油市太平镇安置点灾民随机抽样后,利用创伤后应激障碍(PTSD)症状清单平民版(PCL-C)和汉密尔顿抑郁量表(HRSD)及自编调查问卷进行评估。【结果】完成调查的223人中,PTSD筛查阳性率为14.1%,抑郁症状阳性率为31.1%,12.9%报告有自杀观念;PCL-C总分和HRSD总分呈正相关(r=0.809,P<0.01);PCL-C和HRSD总分均不存在有统计学意义的性别差异;亲属遇难组PCL-C总分(44±14)、HRSD总分(24±12)高于仅经济损失组(33±13,P<0.001;14±10,P<0.001);两种总分各年龄组比较,儿童(30±13;10±9)、青少年(13～18岁)为(37±13;16±13)、青年(33±10;14±9)、中年(36～55岁)为(38±14;19±12)、老年前期(56～65岁)为(40±15;20±12)和老年(35±13;17±9)6个年龄组组间差异有统计学意义(P=0.015;P<0.001)。以PCL-C总分为因变量,一般资料为自变量进行线性逐步回归,烦扰程度、最糟糕天数、绝望感进入方程(R2=0.708,P<0.001)。【结论】PTSD症状群、抑郁症状群是转移安置点灾民的主要心理问题,遇难者亲属、36～65岁人群、青少年更为严重或突出。绝望感、最糟糕天数和烦扰程度是反映和预测PTSD症状及其程度的重要指标。
【Objective】 To investigate the mental health status of victims of Wenchuan Earthquake in temporary settlements and main factors affecting it.【Method】 A total of 223 people from more than 5000 victims in temporary settlements at Jiangyou City of Sichuan Province were randomly chosen and interviewed.PTSD Checklist-Civilian Version(PCL-C),Hamilton Rating Scale for Depression(HRSD) and a self-designed questionnaire were used as assessment instruments.【Result】 A prevalence of 14.1% for PTSD symptoms and 31.1% for depression symptoms were revealed.12.9% participants reported suicide ideation.Total scores of PCL-C and HRSD positively correlate(r=0.809,P < 0.01).Neither PCL-C nor HRSD scores had significant gender difference.Those who had family member died had higher average scores of both PCL-C(44 ± 14 vs 33 ± 13,P < 0.001) and HRSD(24 ± 12 vs 14 ± 10,P < 0.001) than those who lost property only.One-way ANOVA revealed significant differences of total scores of PCL-C(P = 0.015) and HRSD(P < 0.001) among 6 groups,children(30 ± 13;10 ± 9),adolescence(13 ～ 18 years)(37 ± 13;16 ± 13),youth(33 ± 10;14 ± 9),middle age(36 ～ 55 years)(38 ± 14;19 ± 12),pre-elderly(56 ～ 65 years)(40 ± 15;20 ± 12) and senescence(35 ± 13;17 ± 9).Using total scores of PCL-C as dependent variable and general data as independent variables,the Linear Regression was performed and "disturbing level","days experiencing the worst symptoms of distress" and "hopelessness feeling" entered equation(R2=0.708,P < 0.001).【Conclusion】A portion of victims in temporary settlements suffer from PTSD symptoms or depression symptoms,especially family members of the dead in earthquake,people aged 36 ～ 65 years and the adolescent.Hopelessness feelings,days experiencing the worst symptoms of distress and disturbing degree are the core indexes of PTSD symptoms.
【Objective】 To investigate the mental health status of victims of Wenchuan Earthquake in temporary settlements and main factors affecting it.【Method】 A total of 223 people from more than 5000 victims in temporary settlements at Jiangyou City of Sichuan Province were randomly chosen and interviewed.PTSD Checklist-Civilian Version(PCL-C),Hamilton Rating Scale for Depression(HRSD) and a self-designed questionnaire were used as assessment instruments.【Result】 A prevalence of 14.1% for PTSD symptoms and 31.1% for depression symptoms were revealed.12.9% participants reported suicide ideation.Total scores of PCL-C and HRSD positively correlate(r=0.809,P < 0.01).Neither PCL-C nor HRSD scores had significant gender difference.Those who had family member died had higher average scores of both PCL-C(44 ± 14 vs 33 ± 13,P < 0.001) and HRSD(24 ± 12 vs 14 ± 10,P < 0.001) than those who lost property only.One-way ANOVA revealed significant differences of total scores of PCL-C(P = 0.015) and HRSD(P < 0.001) among 6 groups,children(30 ± 13;10 ± 9),adolescence(13 ～ 18 years)(37 ± 13;16 ± 13),youth(33 ± 10;14 ± 9),middle age(36 ～ 55 years)(38 ± 14;19 ± 12),pre-elderly(56 ～ 65 years)(40 ± 15;20 ± 12) and senescence(35 ± 13;17 ± 9).Using total scores of PCL-C as dependent variable and general data as independent variables,the Linear Regression was performed and "disturbing level","days experiencing the worst symptoms of distress" and "hopelessness feeling" entered equation(R2=0.708,P < 0.001).【Conclusion】A portion of victims in temporary settlements suffer from PTSD symptoms or depression symptoms,especially family members of the dead in earthquake,people aged 36 ～ 65 years and the adolescent.Hopelessness feelings,days experiencing the worst symptoms of distress and disturbing degree are the core indexes of PTSD symptoms.
引文
Jordan NN,Hoge CW,Tobler SK,et al.Mental health impact of9/11Pentagon attack:Validation of a rapidassessment tool[J].Am J Prev Med,2004,26(4):284-293.
Ehlers A,Clark DM,Hackmann A,et al.A randomizedcontrolled trial of cognitive therapy,a self-help booklet,and repeated assessments as early interventions forposttraumatic stress disorder[J].Arch Gen Psychiat,2003,60(10):1024-1032.
Blanchard EB,Jones-alexander J,Buckley TC,et al.Psychometric properties of the PTSD checklist(PCL)[J].Behav Res Ther,1996,34(8):669-673.
Dobie DJ,Kivlahan DR,Maynard C,et al.Screeningfor post-traumatic stress disorder in female Veteran′sAffairs patients:validation of the PTSD checklist[J].Gen Hosp Psychiatry,2002,24(6):367-374.
Kuo HW,Wu SJ,Ma TC,et al.Posttraumaticsymptoms were worst among quake victims with injuriesfollowing the Chi-chi quake in Taiwan[J].J PsychosomRes,2007,62(4):495-500.
赵丞智,汪向东,高岚,等.张北尚义地震后创伤后应激障碍随访研究[J].中国心理卫生杂志,2000,14(6):361-363.
侯彩兰,李凌江,张燕,等.矿难后2个月和10个月创伤后应激障碍的发生率及相关因素[J].中南大学学报:医学版,2008,33(4):279-283.
Calderoni ME,Alderman EM,Silver EJ,et al.Themental health impact of9/11on inner-city high schoolstudents20miles north of ground zero[J].J AdolescHealth,2006,39(1):57-65.
Chen CC,Yeh TL,YangYK,et al.Psychiatric morbidityand post-traumatic symptoms among survivors in theearly stage following the1999earthquake in Taiwan[J].Psychiatry Res,2001,105(1-2):13-22.
Green BL,Lindy JD,Grace MC.Posttraumatic stressdisorder.toward DSM-IV[J].J Nerv Ment Dis,1985,173(7):406-411.
Rhoads J,Mitchell FA,Rick S.Posttraumatic stressdisorder after hurricane Katrina[J].J Nurse Pract,2006,2(1):18-26.
Yilmaz V,Cangur S,Clik HE.Sex difference andearthquake experience effects on earthquake victims[J].Pers Individ Dif,2005,39(2):341-348.
关念红,王昆,魏钦令,等.汶川地震异地治疗伤员创伤后应激症状及影响因素分析[J].中山大学学报:医学科学版,2008,29(4):361-366.
Ehlers A,Clark DM,Hackmann A,et al.A randomizedcontrolled trial of cognitive therapy,a self-help booklet,and repeated assessments as early interventions forposttraumatic stress disorder[J].Arch Gen Psychiat,2003,60(10):1024-1032.
Blanchard EB,Jones-alexander J,Buckley TC,et al.Psychometric properties of the PTSD checklist(PCL)[J].Behav Res Ther,1996,34(8):669-673.
Dobie DJ,Kivlahan DR,Maynard C,et al.Screeningfor post-traumatic stress disorder in female Veteran′sAffairs patients:validation of the PTSD checklist[J].Gen Hosp Psychiatry,2002,24(6):367-374.
Kuo HW,Wu SJ,Ma TC,et al.Posttraumaticsymptoms were worst among quake victims with injuriesfollowing the Chi-chi quake in Taiwan[J].J PsychosomRes,2007,62(4):495-500.
赵丞智,汪向东,高岚,等.张北尚义地震后创伤后应激障碍随访研究[J].中国心理卫生杂志,2000,14(6):361-363.
侯彩兰,李凌江,张燕,等.矿难后2个月和10个月创伤后应激障碍的发生率及相关因素[J].中南大学学报:医学版,2008,33(4):279-283.
Calderoni ME,Alderman EM,Silver EJ,et al.Themental health impact of9/11on inner-city high schoolstudents20miles north of ground zero[J].J AdolescHealth,2006,39(1):57-65.
Chen CC,Yeh TL,YangYK,et al.Psychiatric morbidityand post-traumatic symptoms among survivors in theearly stage following the1999earthquake in Taiwan[J].Psychiatry Res,2001,105(1-2):13-22.
Green BL,Lindy JD,Grace MC.Posttraumatic stressdisorder.toward DSM-IV[J].J Nerv Ment Dis,1985,173(7):406-411.
Rhoads J,Mitchell FA,Rick S.Posttraumatic stressdisorder after hurricane Katrina[J].J Nurse Pract,2006,2(1):18-26.
Yilmaz V,Cangur S,Clik HE.Sex difference andearthquake experience effects on earthquake victims[J].Pers Individ Dif,2005,39(2):341-348.
关念红,王昆,魏钦令,等.汶川地震异地治疗伤员创伤后应激症状及影响因素分析[J].中山大学学报:医学科学版,2008,29(4):361-366.
版权所有：© 2023 中国地质图书馆 中国地质调查局地学文献中心