唐山大地震所致慢性创伤后应激障碍临床研究
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摘要
目的:研究唐山大地震所致慢性创伤后应激障碍(PTSD)患者临床特征和心身健康状况。方法: 35例唐山大地震所致慢性PTSD 患者(PTSD 组)和33例经历过唐山大地震的非PTSD 患者(对照组)接受了PTSD 症状频度和心身健康问卷的评定。结果:PTSD 组不由自主地回想受打击的经历、反复出现有创伤性内容的恶梦、反复出现触景生情的精神痛苦并产生生理反应、入睡困难或睡眠不深、过分地担惊受怕、极力不去想有关创伤性经历的人和事、避免参加能引起痛苦回忆的活动或避免到会引起痛苦回忆的地方、不愿与人交往对亲人变得冷漠、兴趣爱好范围变窄、对未来失去希望和信心的症状较对照组明显。SCL-90总分和躯体化、强迫、人际关系、抑郁、焦虑、恐惧、其它因子分、SDS 总分和标准分、SAS 总分和标准分均显著高于对照组。结论: PTSD 患者无法摆脱精神创伤的痛苦记忆,PTSD 严重影响了患者的心身健康。
Objective:To study the clinic feature and psychosomatic symptoms of the patients with Posttrau- matic Stress Disorder(PTSD)caused by Tangshan violent earthquake.Methods:35 patients(PTSD group)with PTSD caused by Tangshan earthquake and 33 controls were assessed by PTSD symptoms frequency questionnaires and psychosomatic health questionnaires.Results:Symptoms of the patients with PTSD were more obvious than those of the controls such as involuntary recall of the experience of being attacked,repeated manifestation of night- mare with traumatic content,repeatedly feel affiliation when the scene retakes place in memories and cause marked physiological reaction,difficulty of falling sleep or unreality of sleep,excessively feeling alarmed,trying not to think people and events related to traumatic experience,avoiding activities or places that may agony recall,unwilling to contact and becoming cold on relatives,narrowing of range of interests,loss of longing for future.Patients with PTSD have higher total,somatic,obsessive,interpersonal sensitivity,depression,anxiety,phobia and other factorial scores of SCL-90 than controls.Conclusion:Patients with PTSD can't be divorced from the distressing recollections.PTSD seriously affects the patients'psychosomatic health.
Objective:To study the clinic feature and psychosomatic symptoms of the patients with Posttrau- matic Stress Disorder(PTSD)caused by Tangshan violent earthquake.Methods:35 patients(PTSD group)with PTSD caused by Tangshan earthquake and 33 controls were assessed by PTSD symptoms frequency questionnaires and psychosomatic health questionnaires.Results:Symptoms of the patients with PTSD were more obvious than those of the controls such as involuntary recall of the experience of being attacked,repeated manifestation of night- mare with traumatic content,repeatedly feel affiliation when the scene retakes place in memories and cause marked physiological reaction,difficulty of falling sleep or unreality of sleep,excessively feeling alarmed,trying not to think people and events related to traumatic experience,avoiding activities or places that may agony recall,unwilling to contact and becoming cold on relatives,narrowing of range of interests,loss of longing for future.Patients with PTSD have higher total,somatic,obsessive,interpersonal sensitivity,depression,anxiety,phobia and other factorial scores of SCL-90 than controls.Conclusion:Patients with PTSD can't be divorced from the distressing recollections.PTSD seriously affects the patients'psychosomatic health.
引文
1 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研究．中华精神科杂志，1999，32(2)：106-108．
2 张本，王学义，孙贺祥，等．唐山大地震所致孤儿心理创伤后应激障碍的调查．中华精神科杂志，2000，33(2)：111-114．
3 Kidson MA,Douglas JC,Holwill BJ.Posttmumatic stress disorder in Australian World War 2 veterans attending a psychiatric outpatiem clinic.Med J Aust,1993,158(8):563-566.
4 中华医学会精神科分会编．CCMD-3中国精神障碍分类与诊断标准．第3版．济南：山东科学技术出版社，2001，
5 张明园，主编．精神卫生评定量表手册．长沙：湖南科学技术出版社，1993．16-41．
6 明尼苏达多相个性调查表(中文版)．北京：中国科学院心理研究所，1989．1-17．
7 Zohar J,Sasson Y,Amital D,et al.Current diagnostic issues and epidemiological in sights in PTSD.Inter J Neuropsychiattic Med,1998,(suppl 2):12-41.
8 Yehuda R,McFarlane AC.Conflict between Current Knowledge about posttraumctic Stress disorder and its Original Conceptual basts.Am J psychiatry,1995,152(12):1705-1713.
9 Gersons BPR.Diagnostic dilemmas in assessing post-traumatic stress disorder.Post-traumatic Stress Disorder Diagnosis Management and Treatment Edited by Nutt D,Davidson JRT,Zohar J.London 2000.29-40.
2 张本，王学义，孙贺祥，等．唐山大地震所致孤儿心理创伤后应激障碍的调查．中华精神科杂志，2000，33(2)：111-114．
3 Kidson MA,Douglas JC,Holwill BJ.Posttmumatic stress disorder in Australian World War 2 veterans attending a psychiatric outpatiem clinic.Med J Aust,1993,158(8):563-566.
4 中华医学会精神科分会编．CCMD-3中国精神障碍分类与诊断标准．第3版．济南：山东科学技术出版社，2001，
5 张明园，主编．精神卫生评定量表手册．长沙：湖南科学技术出版社，1993．16-41．
6 明尼苏达多相个性调查表(中文版)．北京：中国科学院心理研究所，1989．1-17．
7 Zohar J,Sasson Y,Amital D,et al.Current diagnostic issues and epidemiological in sights in PTSD.Inter J Neuropsychiattic Med,1998,(suppl 2):12-41.
8 Yehuda R,McFarlane AC.Conflict between Current Knowledge about posttraumctic Stress disorder and its Original Conceptual basts.Am J psychiatry,1995,152(12):1705-1713.
9 Gersons BPR.Diagnostic dilemmas in assessing post-traumatic stress disorder.Post-traumatic Stress Disorder Diagnosis Management and Treatment Edited by Nutt D,Davidson JRT,Zohar J.London 2000.29-40.
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