汶川大地震受灾者创伤后应激症状及危险因素
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摘要
目的:探讨大地震受灾者的心理健康状况、创伤后应激障碍(PTSD)症状及其影响因素,为心理救助及康复提供依据。方法:2008年四川汶川大地震1个月后,采用事件影响量表(IES)、症状自评量表(SCL-90)和受灾情况表对57例受灾者进行创伤后应激障碍症状、情绪障碍及人口学资料调查,根据诊断分为PTSD组与非PTSD组进行对照比较,并与60例医院健康体检人群进行对照比较。结果:①地震受灾组的IES总分、闯入因子、回避因子、警觉性因子、躯体化、抑郁、焦虑和其他项目因子分均高于正常对照组,差异有显著性意义(P<0.01),地震受灾组的SCL-90总分和抑郁因子分高于正常对照组,差异有显著性意义(P<0.05);②PTSD组的教育程度在小学及以下的比例、被困比例和伤残比例均高于非PTSD组,差异有显著性意义(P<0.05),PTSD组的一级亲属死亡比例、无家人支持比例均高于非PTSD组,差异有显著性意义(P<0.01)。结论:地震受灾者灾后1个月存在明显创伤后应激症状、躯体化、抑郁、焦虑、眠差等表现,心理救助和康复较为必要,应重点关注导致伤残、教育程度低、有被困经历、丧失亲人、缺少家庭支持的地震受灾个体。
Objective: To describe the characteristic of post -traumatic stress disorder (PTSD) among earthquake survivors in Wenchuan Sichuan and to explore the risk factors associated with PTSD following earthquake. Method: In 2008, 1 month after the major earthquake in Wenchuan Sichuan, 57 survivors and 60 health control subjects were surveyed to examine the background factors of demographics and to exposure the stress symptoms and mental disorders that were associated with PTSD. The characteristic of PTSD was assessed using Impact of Event Scale (IES) and SCL -90. Result: Compared with control subjects, earthquake survivors group had more IES scores, significant severe post-traumatic stress symptoms, physical fatigue, depression and anxiety. The prevalence rate of PTSD (n=25) was 43%. The PTSD group significantly different from non-PTSD on variables, with greater likelihood on low school education, disability, death of first-class relative, no family support. Conclusion: Earthquake survivors had more symptoms of PTSD, physical fatigue and emotion problems. Low school education, disability, death of first-class relative and less family support were the risk factors associated with PTSD following earthquake.
Objective: To describe the characteristic of post -traumatic stress disorder (PTSD) among earthquake survivors in Wenchuan Sichuan and to explore the risk factors associated with PTSD following earthquake. Method: In 2008, 1 month after the major earthquake in Wenchuan Sichuan, 57 survivors and 60 health control subjects were surveyed to examine the background factors of demographics and to exposure the stress symptoms and mental disorders that were associated with PTSD. The characteristic of PTSD was assessed using Impact of Event Scale (IES) and SCL -90. Result: Compared with control subjects, earthquake survivors group had more IES scores, significant severe post-traumatic stress symptoms, physical fatigue, depression and anxiety. The prevalence rate of PTSD (n=25) was 43%. The PTSD group significantly different from non-PTSD on variables, with greater likelihood on low school education, disability, death of first-class relative, no family support. Conclusion: Earthquake survivors had more symptoms of PTSD, physical fatigue and emotion problems. Low school education, disability, death of first-class relative and less family support were the risk factors associated with PTSD following earthquake.
引文
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[13]张本,王学义,孙贺祥.唐山大地震心理创伤后应激障碍的抽样调查研究[J].中华精神科杂志,1999,32(2):106—108.
[2]Goenjian AK,Steinberg AM,Najarian LM,et al.Prospective study of post-traumatic stress,anxiety,and depressive reactions after earthquake and political violence[J].Am J Psychiatry,2000,157(6):911—916.
[3]Altindag A,Ozen S,Sir A.One-year follow-up study of post-traumatic stress disorder among earthquake survivors in Turkey[J].2005,46(5):328—333.
[4]Basoglu M,Kilic C,Salcioglu E,et al.Prevalence of posttrau-matic stress disorder and depression in earthquake survivors in Turkey:an epidemiological study[J].J Trauma Stress,2004,17:133—141.
[5]American Psychiatric Association.Diagnostic and statistical manual of mental disorders[M].4th ed.Washington,DC:APA:1994.
[6]Sundin EC,Horowitz MJ.Impact of Event Scale:psychometric properties[J].Br J Psychiatry,2002,180:205—209.
[7]Giannopoulou I,Strouthos M,Smith P,et al.Post-traumatic stress reactions of children and adolescents exposed to the Athens1999earthquake[J].Eur Psychiatry,2006,21(3):160—166.
[8]秦虹云,季建林.PTSD及其危机干预[J].中国心理卫生杂志,2003,17(9):614—616.
[9]Chen CC,Yeh TL,Yang YK,et al.Psychiatric morbidity and post-traumatic symptoms among survivors in the early stage following the1999earthquake in Taiwan[J].Psychiatry Res,2001,105(1):13—22.
[10]熊亚敏,施琪嘉.创伤后应激障碍的脑磁共振及波谱研究[J].中国康复医学杂志,2006,21(3):283—285.
[11]Zhang W,Lee LC,Connor KM,et al.Symptoms of neurasthenia following earthquake trauma:re-examination of a discarded syndrome[J].Psychiatry Research,2007,153(2):171—177.
[12]王丽萍,张本,姜涛.唐山大地震所致慢性创伤后应激障碍临床研究[J].中国心理卫生杂志,2005,9(8):517—520.
[13]张本,王学义,孙贺祥.唐山大地震心理创伤后应激障碍的抽样调查研究[J].中华精神科杂志,1999,32(2):106—108.
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