唐山大地震远期神经症抽样调查和病因学探讨
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摘要
目的 了解唐山大地震远期神经症患病率,并探讨重大精神创伤和神经症发病之间的关系。方法抽样调查了亲身经历唐山大地震的幸存者1 807人,全部抽样样本完成了自行编制的唐山大地震调查表和标准化评定工具的调查、评定和诊断。结果 1 807人中诊断神经症114例、神经症现患病率为62.87‰,男性现患病率43.74‰、女性现患病率为78.79‰。神经症组在大地震中遭受的精神创伤严重度显著高于非神经症组。结论 本调查显示神经症高患病率与精神创伤持续性影响效应有关。精神创伤的严重程度和神经症发生之间存在着密切的联系。应对遭受重大精神创伤的群体和个体实施神经症防治工作。
Objective To investigate the morbidity of neurosis long time after the violent earthquake in Tangshan, and to clarify the relationship between heavy psychic trauma and the onset of neurosis. Methods 1 807 survivals who lived in Tangshan city and experienced the earthquake were investigated, assessed diagnosed with the self- made Tangshan earthquake questionnaires and the standard assessment instruments. Results 114 (8.283%) survivals were diagnosed as neurosis (62. 87‰), The morbidity of male and females were 43.74‰(36 cases) and 78.79‰(78 cases) respectively. The degree of mental trauma in the survivals with neurosis was much heavier than that in that in the survivals without neurosis in the Tangshan earthquake. Conclusions Our study showed that the higher morbidity of neurosis were correlated with the long - time effects of mental trauma on survival. The degree of severity of mental trauma was significantly correlated with the onset of neurosis. Neurosis should be prevented and treated after heavy psychic trauma.
Objective To investigate the morbidity of neurosis long time after the violent earthquake in Tangshan, and to clarify the relationship between heavy psychic trauma and the onset of neurosis. Methods 1 807 survivals who lived in Tangshan city and experienced the earthquake were investigated, assessed diagnosed with the self- made Tangshan earthquake questionnaires and the standard assessment instruments. Results 114 (8.283%) survivals were diagnosed as neurosis (62. 87‰), The morbidity of male and females were 43.74‰(36 cases) and 78.79‰(78 cases) respectively. The degree of mental trauma in the survivals with neurosis was much heavier than that in that in the survivals without neurosis in the Tangshan earthquake. Conclusions Our study showed that the higher morbidity of neurosis were correlated with the long - time effects of mental trauma on survival. The degree of severity of mental trauma was significantly correlated with the onset of neurosis. Neurosis should be prevented and treated after heavy psychic trauma.
引文
1 12地区精神疾病流行学调查协作组.向孟泽执笔.12地区神经症 流行学调查.中华神经精神科杂志.1986． 19(2) :87-91
2 陈复平.神经症的流行学调查.中华神经精神科杂志,1 986． 1 9(5) :301～305
3 王宝珠,赵振声.云南大理白族自治州神经症病人抽样调查.临床精神医学杂志,1997,7(2) :88-89．
4 郭红利.朱振华,黄良珩.90年代首都精神卫生问题的现状与前瞻.临床精神医学杂志,1 994． 4(3) :131～134．
5 李淑然,沈渔(?),张维熙.等.中国七个地区神经症流行病学调查.中华精神科杂志,1998,31(2) :80
6 王子平主编.瞬间与十年.唐山地震始末.北京:地震出版社.1986． 49
7 沈渔(?)主编.精神病学.第3版.北京:人民卫生出版社,1993． 312-313．
8 中华医学会精神科学会.中国精神疾病分类方案与诊断标准.第2版.修订本.南京:东南大学出版社,1995． 74～86．
9 刘志中译.神经症的流行学和病因学.国外医学精神病学分册,1983,10(1) :1～6
10 刘铁榜,杨德森.从流行学特征及患者就医现状看当前农村神经症的防治策略.中国心理卫生杂志,1991,5(1) :1～5．
11 张亚林.神经症.见:杨德森主编.行为医学.长沙:湖南科学技术出版社,1989． 2-4．
12 Lima BR.Pai S,Santacruz H,et al.Psychiatric disorders amongpoor victims following a major disaster:Armero,Colombia,J NewMent Dis.1991． 179:420～427．
13 张本,王学义,孙贺祥,等.唐山大地震对人类心身健康的远期影响.中国心理卫生杂志,1998,12(4) :200～202．
14 张本,王学义,孙贺祥,等.唐山大地震中丧偶再婚者远期心身健康调查.中国心理卫生杂志,1998,12(1) :43～44
15 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．
16 张本,张均正,王学义,等.经历大地震的开滦矿离退休干部心身健康状况调查.健康心理学杂志,1999,7(1) :51～54．
17 张本,王学义,孙贺祥,等.唐山大地震孤儿远期心身健康的调查研究.中国心理卫生杂志,2000,14(1) :17～19．
18 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．
19 韩岭,杨德森.神经症患者个性特征的性别差异.中国心理卫生杂志,1991,5(1) :9～10．
2 陈复平.神经症的流行学调查.中华神经精神科杂志,1 986． 1 9(5) :301～305
3 王宝珠,赵振声.云南大理白族自治州神经症病人抽样调查.临床精神医学杂志,1997,7(2) :88-89．
4 郭红利.朱振华,黄良珩.90年代首都精神卫生问题的现状与前瞻.临床精神医学杂志,1 994． 4(3) :131～134．
5 李淑然,沈渔(?),张维熙.等.中国七个地区神经症流行病学调查.中华精神科杂志,1998,31(2) :80
6 王子平主编.瞬间与十年.唐山地震始末.北京:地震出版社.1986． 49
7 沈渔(?)主编.精神病学.第3版.北京:人民卫生出版社,1993． 312-313．
8 中华医学会精神科学会.中国精神疾病分类方案与诊断标准.第2版.修订本.南京:东南大学出版社,1995． 74～86．
9 刘志中译.神经症的流行学和病因学.国外医学精神病学分册,1983,10(1) :1～6
10 刘铁榜,杨德森.从流行学特征及患者就医现状看当前农村神经症的防治策略.中国心理卫生杂志,1991,5(1) :1～5．
11 张亚林.神经症.见:杨德森主编.行为医学.长沙:湖南科学技术出版社,1989． 2-4．
12 Lima BR.Pai S,Santacruz H,et al.Psychiatric disorders amongpoor victims following a major disaster:Armero,Colombia,J NewMent Dis.1991． 179:420～427．
13 张本,王学义,孙贺祥,等.唐山大地震对人类心身健康的远期影响.中国心理卫生杂志,1998,12(4) :200～202．
14 张本,王学义,孙贺祥,等.唐山大地震中丧偶再婚者远期心身健康调查.中国心理卫生杂志,1998,12(1) :43～44
15 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．
16 张本,张均正,王学义,等.经历大地震的开滦矿离退休干部心身健康状况调查.健康心理学杂志,1999,7(1) :51～54．
17 张本,王学义,孙贺祥,等.唐山大地震孤儿远期心身健康的调查研究.中国心理卫生杂志,2000,14(1) :17～19．
18 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．
19 韩岭,杨德森.神经症患者个性特征的性别差异.中国心理卫生杂志,1991,5(1) :9～10．
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