汶川地震后四个月平武县部分灾民的精神健康状况
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摘要
目的了解汶川地震灾后4个月时灾民的精神健康状况。方法以四川省平武县地震重灾区灾民点的1164名灾民为调查对象,采用心理健康自评问卷(SRQ)为本次调查的筛选工具,以DSM-Ⅳ轴Ⅰ障碍定式临床检查病人版(SCID-I/P)中有关抑郁和焦虑障碍的章节为本次调查的诊断工具,以SRQ总分≥7分为高危人群,<7分为低危人群,对部分高、低危人群进行SCID-I/P检查;采用匹兹堡睡眠质量指数(PSQI)中国修订版对灾民的睡眠质量进行评定。结果SRQ的平均分为(8.20±5.57)分,SRQ总分<7分者517人(44.4%),SRQ总分≥7分者647人(55.6%),灾民存在明显的焦虑、抑郁及躯体症状,且女性明显多于男性。灾民的睡眠质量较低,有亲人死亡的灾民睡眠问题更加突出。震后4个月,与地震有关的焦虑抑郁障碍发生率为37.5%。结论地震所致的创伤后应激障碍、抑郁焦虑障碍发生率高,应根据不同情况给予药物和心理干预。
Objective To describe the mental health condition of parts of victims in Pingwu County,Sichuan Province four months after the Wenchuan earthquake.Methods Totally 1 164 heavy victims from Pingwu County were screened by self-reporting questionnair(SRQ),then a structured depression and anxiety examination in SCID-I/P of Diagnostic and Statistical Manual of Mental Disorder(Fourth edition DSM-Ⅳ) was used for their diagnosis.The subjects whose SRQ was ≥7 were classified as high risk group and those whose SRQ was <7 as low risk group.SCID-I/P examination was conducted for parts of the high and low risk subjects,and the sleep quality was assessed by Pittsburgh Sleep Quality Index Revised for Chinese (C-PSQI).Results The average SRQ scores was (8.20±5.57),There were 517 subjects with SRQ<7 (44.4%),and 647 with SRQ≥7 (55.6%).The victims suffered from apparent anxiety,depression and somatic symptoms,and there were more females than males.The victims' sleep quality was lower,especially serious for those with death of their relatives.Four months after earthquake the prevalence of mental disorders relevant to disaster was 37.5%.Conclusion The prevalence of post-traumatic stress,depression and anxiety is higher in victims.Medication and psychological interventions should be given according to the different conditions.
Objective To describe the mental health condition of parts of victims in Pingwu County,Sichuan Province four months after the Wenchuan earthquake.Methods Totally 1 164 heavy victims from Pingwu County were screened by self-reporting questionnair(SRQ),then a structured depression and anxiety examination in SCID-I/P of Diagnostic and Statistical Manual of Mental Disorder(Fourth edition DSM-Ⅳ) was used for their diagnosis.The subjects whose SRQ was ≥7 were classified as high risk group and those whose SRQ was <7 as low risk group.SCID-I/P examination was conducted for parts of the high and low risk subjects,and the sleep quality was assessed by Pittsburgh Sleep Quality Index Revised for Chinese (C-PSQI).Results The average SRQ scores was (8.20±5.57),There were 517 subjects with SRQ<7 (44.4%),and 647 with SRQ≥7 (55.6%).The victims suffered from apparent anxiety,depression and somatic symptoms,and there were more females than males.The victims' sleep quality was lower,especially serious for those with death of their relatives.Four months after earthquake the prevalence of mental disorders relevant to disaster was 37.5%.Conclusion The prevalence of post-traumatic stress,depression and anxiety is higher in victims.Medication and psychological interventions should be given according to the different conditions.
引文
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4栗克清,崔泽,崔利军,等.河北省精神障碍的现况调查[J].中华精神科杂志,2007,40(3):36-41.
5Kessler RC,Sonnega A,Bromet E,et al.Posttraumatic stress disorder in the National Comorbidity Survey[J].Archives of General Psychia-try,1995,52(12):1048-1060.
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7Goenjian AK,Najarian LM,Pynoos RS,et al.Posttraumatic stress dis-order in elderly and younger adults after the1988earthquake in Armania[J].Am J Psychiatry,1994,151(10):895-901.
8赵丞智,李俊福,王明山,等.地震后17个月受灾青少年创伤后应激障碍及其相关因素[J].中国心理卫生杂志,2001,15(3):145-147.
9Olff M,Olangeland W,Draijer N,et al.Gender differences in postt-raumatic stress disorder[J].Psychological Bulletin,2007,133(2):183-204.
10崔利军,栗克清,江琴普,等.河北省2004—2005年抑郁症现况调查[J].中华精神科杂志,2007,40(3):140-143.
11张本,王学义,孙贺祥,等.唐山大地震心理创伤后应激障碍的抽样调查[J].中华精神科杂志,1999,32(2):106-108.
12崔利军,栗克清,孙秀丽,等.多种精神障碍患者的睡眠质量调查[J].中华精神科杂志,2008,41(3):172-175.
13张本.心理应激与精神医学[M].赤峰:内蒙古科学技术出版社,2007:86.
2Michael B,Robert L,Miriam Gibbon,et al.Structured Clinical Inter-viewfor DSM-ⅣAxis I Disorders[M].Biometrics Research Depart-ment New York State Psychiatric Institute.2002.
3刘贤臣.匹兹堡睡眠质量指数(PSQI)[J].中国心理卫生杂志,1999,增刊:375-378.
4栗克清,崔泽,崔利军,等.河北省精神障碍的现况调查[J].中华精神科杂志,2007,40(3):36-41.
5Kessler RC,Sonnega A,Bromet E,et al.Posttraumatic stress disorder in the National Comorbidity Survey[J].Archives of General Psychia-try,1995,52(12):1048-1060.
6汪向东,赵丞智,新福尚隆,等.地震后创伤性应激障碍的发生率及影响因素[J].中国心理卫生杂志,1999,13(1):28-30.
7Goenjian AK,Najarian LM,Pynoos RS,et al.Posttraumatic stress dis-order in elderly and younger adults after the1988earthquake in Armania[J].Am J Psychiatry,1994,151(10):895-901.
8赵丞智,李俊福,王明山,等.地震后17个月受灾青少年创伤后应激障碍及其相关因素[J].中国心理卫生杂志,2001,15(3):145-147.
9Olff M,Olangeland W,Draijer N,et al.Gender differences in postt-raumatic stress disorder[J].Psychological Bulletin,2007,133(2):183-204.
10崔利军,栗克清,江琴普,等.河北省2004—2005年抑郁症现况调查[J].中华精神科杂志,2007,40(3):140-143.
11张本,王学义,孙贺祥,等.唐山大地震心理创伤后应激障碍的抽样调查[J].中华精神科杂志,1999,32(2):106-108.
12崔利军,栗克清,孙秀丽,等.多种精神障碍患者的睡眠质量调查[J].中华精神科杂志,2008,41(3):172-175.
13张本.心理应激与精神医学[M].赤峰:内蒙古科学技术出版社,2007:86.
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