中学生地震创伤后应激障碍发生情况及其影响因素分析
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摘要
目的了解"5.12"地震后灾区中学生的创伤后应激障碍(PTSD)的发生率和影响因素,为青少年灾后精神卫生问题预防工作提供依据。方法采用多级整群非随机抽样方法,有效样本为来自地震灾区2个县的3所初中和1所高中的1 253名学生。采用复合性国际诊断问卷(Comprehensive International Diagnostic Interview,CIDI)中PTSD模块内容,采用一对一面谈的方式对所有调查对象进行调查,根据DSM-Ⅳ中PTSD诊断标准进行诊断,并记录一般人口学资料。结果地震后5个月,PTSD的发生率为10.21%。多因素logistic回归分析结果显示,进入方程有统计学意义的变量有少数民族(β=0.62,P=0.00,OR=1.86)、亲属伤亡(β=0.83,P=0.00,OR=2.29)和重度财产损失(β=0.98,P=0.02,OR=2.67),少数民族、有亲属伤亡、存在重度财产损失的个体PTSD危险性高。结论地震发生后5个月中学生中PTSD现患率高,中学生灾难特定相关精神卫生问题应引起足够重视和长期关注,灾后心理重建工作仍应继续加强。
Objective To investigate the prevalence and predictors of post-traumatic stress disorder(PTSD) in the middle school students affected by Wenchuan earthquake.Methods Totally 1 253 students of 33 classes were chosen from three junior high and one senior high school of two counties suffered the earthquake directly according to multi-stage cluster non-random sampling method.All the information was collected by face-to-face interview.The interview was designed to include socio-demographic data,characteristic feature,family history of mental disorder,variables about the events and PTSD(Post-Traumatic Stress Disorder)diagnostic interview based on Comprehensive International diagnostic Interview(CIDI).Results Five months after the earthquake,the prevalence of PTSD in the past month was 10.21%.Logistic regression indicated that the ASD diagnosis was predicted by minority(β= 0.62,P=0.00,OR=1.86),the condition of casualties of family members(β= 0.83,P=0.00,OR=2.29),and the condition of sharp properties loss(β= 0.98,P=0.02,OR=2.67).ConclusionFive months after the earthquake,the prevalence of PTSD among middle school students expose the Wenchuan earthquake is quite high.Much more attention should be paid to the mental health problems in the middle school students after disasters.
Objective To investigate the prevalence and predictors of post-traumatic stress disorder(PTSD) in the middle school students affected by Wenchuan earthquake.Methods Totally 1 253 students of 33 classes were chosen from three junior high and one senior high school of two counties suffered the earthquake directly according to multi-stage cluster non-random sampling method.All the information was collected by face-to-face interview.The interview was designed to include socio-demographic data,characteristic feature,family history of mental disorder,variables about the events and PTSD(Post-Traumatic Stress Disorder)diagnostic interview based on Comprehensive International diagnostic Interview(CIDI).Results Five months after the earthquake,the prevalence of PTSD in the past month was 10.21%.Logistic regression indicated that the ASD diagnosis was predicted by minority(β= 0.62,P=0.00,OR=1.86),the condition of casualties of family members(β= 0.83,P=0.00,OR=2.29),and the condition of sharp properties loss(β= 0.98,P=0.02,OR=2.67).ConclusionFive months after the earthquake,the prevalence of PTSD among middle school students expose the Wenchuan earthquake is quite high.Much more attention should be paid to the mental health problems in the middle school students after disasters.
引文
[1]GOENJIAN AK,PYNOOS RS,STEINBERG AM,et al.Psychiatriccomorbidity in children after the 1988 earthquake in Armenia.J AmAcad Child Adoles Psychi,1995,34(9):1174-1184.
[2]DONNELLY CL,AMAYA-JACKSONL.Post-traumatic stress dis-order in children and adolescents:epidemiology,diagnosis and treat-ment options.Paediatr Drugs,2002,4(3):159-170.
[3]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.中国心理卫生杂志,2002,14:361-363.
[4]SALCIOGLUF,BASOGLUM.Psychological effects of earthquakes inchildren:prospects for brief behavioral treatment.World J Pediatr,2008,4(3):165-172.
[5]赵国秋,汪永光,王义强,等.汶川地震后急性应激障碍发生率及影响因素.中华预防医学杂志,2008,11:802-805.
[6]SAHIN NH,BATIG N AD,,YILMAZ B.Psychological symptoms ofTurkish children and adolescents after the 1999 earthquake:exposure,gender,location,and time duration.J Traum Stress.2007,20(3):335-345.
[7]GOENJIAN AK,PYNOOS RS,STEINBERG AM,et al.Psychiatriccomorbidity in children after the 1988 earthquake in Armenia.J AmAcad Child Adoles Psychi,1995,34(9):1174-1184.
[8]PYNOOS RS,GOENJIAN A,TASHJIAN M,et al.Post-traumaticstress reactions in children after the 1988 Armenian earthquake.B JPsychi,1993,163(2):239-247.
[9]GALEA S,NANDI A,VLAHOV D.The epidemiology of post-trau-matic stress disorder after disasters.Epidemiol Revi,2005,27,78-91.
[10]CLARK DB,KIRISCI L.Posttraumatic stress disorder,depression,alcohol use disorders and quality of life in adolescents.Anxiety,1996,2(5):226-233.
[11]易华云,刘爱忠,孙晓花.创伤后应激障碍的流行病学研究进展.中华创伤杂志,2006,22(5):396-398.
[12]GARRISONCZ,BRYANTES,ADDYCL,et al.Posttraumatic stressdisorder in adolescents after Hurricane Andrew.J Am Acade ChildAdoles,1995,34(9):1193-1201.
[13]汪向东,姜经纬.创伤后应激障碍的流行病学特点及危险因素.中华流行病学杂志,2002,23(5):334-337.
[14]张本,张凤阁,王丽萍.30年后唐山地震所致孤儿创伤后应激障碍现患率调查.中国心理卫生杂志,2008,22(6):469-473.
[15]KAMINER D,SEEDAT S,STEIN DJ,et al.Post-traumatic stressdisorder in children.World Psychi,2005,4(2):121-125.
[2]DONNELLY CL,AMAYA-JACKSONL.Post-traumatic stress dis-order in children and adolescents:epidemiology,diagnosis and treat-ment options.Paediatr Drugs,2002,4(3):159-170.
[3]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.中国心理卫生杂志,2002,14:361-363.
[4]SALCIOGLUF,BASOGLUM.Psychological effects of earthquakes inchildren:prospects for brief behavioral treatment.World J Pediatr,2008,4(3):165-172.
[5]赵国秋,汪永光,王义强,等.汶川地震后急性应激障碍发生率及影响因素.中华预防医学杂志,2008,11:802-805.
[6]SAHIN NH,BATIG N AD,,YILMAZ B.Psychological symptoms ofTurkish children and adolescents after the 1999 earthquake:exposure,gender,location,and time duration.J Traum Stress.2007,20(3):335-345.
[7]GOENJIAN AK,PYNOOS RS,STEINBERG AM,et al.Psychiatriccomorbidity in children after the 1988 earthquake in Armenia.J AmAcad Child Adoles Psychi,1995,34(9):1174-1184.
[8]PYNOOS RS,GOENJIAN A,TASHJIAN M,et al.Post-traumaticstress reactions in children after the 1988 Armenian earthquake.B JPsychi,1993,163(2):239-247.
[9]GALEA S,NANDI A,VLAHOV D.The epidemiology of post-trau-matic stress disorder after disasters.Epidemiol Revi,2005,27,78-91.
[10]CLARK DB,KIRISCI L.Posttraumatic stress disorder,depression,alcohol use disorders and quality of life in adolescents.Anxiety,1996,2(5):226-233.
[11]易华云,刘爱忠,孙晓花.创伤后应激障碍的流行病学研究进展.中华创伤杂志,2006,22(5):396-398.
[12]GARRISONCZ,BRYANTES,ADDYCL,et al.Posttraumatic stressdisorder in adolescents after Hurricane Andrew.J Am Acade ChildAdoles,1995,34(9):1193-1201.
[13]汪向东,姜经纬.创伤后应激障碍的流行病学特点及危险因素.中华流行病学杂志,2002,23(5):334-337.
[14]张本,张凤阁,王丽萍.30年后唐山地震所致孤儿创伤后应激障碍现患率调查.中国心理卫生杂志,2008,22(6):469-473.
[15]KAMINER D,SEEDAT S,STEIN DJ,et al.Post-traumatic stressdisorder in children.World Psychi,2005,4(2):121-125.
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