汶川地震1年后北川干部创伤后应激症状及其与焦虑抑郁的关系
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摘要
目的探讨汶川地震1年后北川干部创伤后应激症状及其与焦虑抑郁状况的关系。方法采用焦虑自评量表、抑郁自评量表、PCL-C对北川县事业单位的2055名干部进行调查。结果①1341人(65.3%)再体验症状阳性,780人(38.0%)回避/麻木症状阳性,1076人(52.4%)警觉性增高症状阳性,695人(33.8%)三大症状均呈阳性。②北川干部SAS总粗分(37.22±9.20)高于中国常模(29.78±10.07),有差异显著性(P<0.001);③SDS总粗分(41.97±8.30)与标准分(52.47±10.37)均高于国内常模(33.46±8.55,41.88±10.57),有差异显著性(P<0.001);④PCL、SDS、SAS得分在受教育程度、亲人遇难、房屋倒塌、身体受伤方面均存在差异显著性;⑤PCL-C总分及各分量表得分与SDS标准分、SAS标准分均显著正相关(P<0.001)。结论汶川地震发生1年后,北川干部创伤后应激症状、焦虑症状、抑郁症状仍广泛存在,其中丧失明显者更为显著,而且创伤后应激症状常共病抑郁等其他心理问题。提示,在干预创伤后应激症状时,应同时改善合病的抑郁等状况。
Objective To study the psychological state and the relationship between psychological state and anxiety depression in Beichuan cadres 1 year after the earthquake. Methods 2055 cadres were investigated in Beichuan county institutions by self-rating anxiety scale,self-rating depression scale and PCL-C. Results 1341 people(65.3%)re-experience symptoms positive,780(38.0%)avoidance/numbing symptoms positive,1076(52.4%) increased awareness of the symptoms positive,695(33.8%)were positive three symptoms.Beichuan cadres SAS total coarse points(37.22±9.20) was higher than the Chinese norm(29.78±10.07),there were significant differences(P<0.001);SDS total coarse points(41.97±8.30) and standard scores(52.47±10.37)were higher than the national norm(33.46±8.55,41.88±10.57),there were significant differences(P<0.001);PCL,SDS,SAS score were significant differences in education,their loved killed,houses collapsed,physical injury;PCL-C total score and subscale scores with SDS standard score,SAS standard scores were significantly positive correlated(P<0.001). Conclusion 1 year after the earthquake in Wenchuan,post-traumatic stress symptoms,anxiety symptoms,depressive symptoms were still widespread.With obvious loss of which is more significant and post-traumatic stress symptoms often co-morbid depression and other psychological problems post-traumatic stress symptoms in the intervention,the co-depressive illness and other illness should also be improve.
Objective To study the psychological state and the relationship between psychological state and anxiety depression in Beichuan cadres 1 year after the earthquake. Methods 2055 cadres were investigated in Beichuan county institutions by self-rating anxiety scale,self-rating depression scale and PCL-C. Results 1341 people(65.3%)re-experience symptoms positive,780(38.0%)avoidance/numbing symptoms positive,1076(52.4%) increased awareness of the symptoms positive,695(33.8%)were positive three symptoms.Beichuan cadres SAS total coarse points(37.22±9.20) was higher than the Chinese norm(29.78±10.07),there were significant differences(P<0.001);SDS total coarse points(41.97±8.30) and standard scores(52.47±10.37)were higher than the national norm(33.46±8.55,41.88±10.57),there were significant differences(P<0.001);PCL,SDS,SAS score were significant differences in education,their loved killed,houses collapsed,physical injury;PCL-C total score and subscale scores with SDS standard score,SAS standard scores were significantly positive correlated(P<0.001). Conclusion 1 year after the earthquake in Wenchuan,post-traumatic stress symptoms,anxiety symptoms,depressive symptoms were still widespread.With obvious loss of which is more significant and post-traumatic stress symptoms often co-morbid depression and other psychological problems post-traumatic stress symptoms in the intervention,the co-depressive illness and other illness should also be improve.
引文
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7 Nixon RD,Resick PA,Nishith P.An exploration of comorbid de-pression among female victims of intimate partner violence withposttraumatic stress disorder[J].J Affect Disord,2004,82(2):315～320.
8 Vranceanu AM,Hobfoll SE,Johnson RJ.Child multi-type mal-treatment and associated depression and PTSD symptoms:the roleof social support and stress[J].Child Abuse Negl,2007,31(1):71～84.
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10 Brady SS.Lifetime family violence exposure is associated with cur-rent symptoms of eating disorders among both young men andwomen[J].J Trauma Stress,2008,21(3):347～351.
2汪向东,王希林,马弘,等.心理卫生评定量表手册[J].中国心理卫生杂志社,1999(增刊):15～85.
3 Kuo H W,Wu SJ,Ma TC,et al.Posttraumatic symptoms were worstamong quake victims with injuries following the Chi-chi quake inTaiwan[J].J Psychosom Res,2007,62(4):495～500.
4王相兰,孙先广,韩自力,等.早期创伤后应激障碍症状清单平民版最佳筛查界值ROC分析[J].中华行为医学与脑科学杂志,2009,17(10):933～935.
5 Charuvastra A,Cloitre M.Social bonds and posttraumat-ic stressdisorder[J].Annu Rev Psychol,2008,10(3):301～328.
6 Davis JL,Petretic-Jackson PA,Ting L.Intimacy dysfunction andtrauma symptomatology:Long-term correlates of different types ofchild abuse[J].J Trauma Stress,2001,14(1):63～79.
7 Nixon RD,Resick PA,Nishith P.An exploration of comorbid de-pression among female victims of intimate partner violence withposttraumatic stress disorder[J].J Affect Disord,2004,82(2):315～320.
8 Vranceanu AM,Hobfoll SE,Johnson RJ.Child multi-type mal-treatment and associated depression and PTSD symptoms:the roleof social support and stress[J].Child Abuse Negl,2007,31(1):71～84.
9 Binder EB,Salyakina D,Lichtner P,et al.Polymorphisms in FK-BP5 are associated with increased recurrence of depressive episodesand rapid response to antidepressant treatment[J].Nat Genet,2004,36(12):1319～1325.
10 Brady SS.Lifetime family violence exposure is associated with cur-rent symptoms of eating disorders among both young men andwomen[J].J Trauma Stress,2008,21(3):347～351.
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