汶川地震后都江堰某中学学生创伤后应激障碍调查
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摘要
目的调查极重灾区某中学学生的创伤后应激障碍(PTSD)症状检出率及影响因素,为进一步开展灾后心理卫生服务提供依据。方法 2008年9月下旬,对汶川地震的极重灾区都江堰某镇中学1 500名同学进行调查,获有效问卷1 498份。采用一般情况调查问卷、儿童事件影响量表(CRIES-13)中文版进行集体施测。结果某镇中学学生灾后4个月PTSD症状检出率29.71%(445/1 498)。经非条件逐步logistic回归筛选PTSD症状的影响因素有:地震时是否受伤(OR=1.995,P=0.000)、性别(OR=1.785,P=0.000)、绝望感(OR=1.597,P=0.000)、是否目睹死亡(OR=1.344,P=0.000)、年龄(OR=1.308,P=0.000)、是否目睹受伤(OR=1.262,P=0.000)、地震时是否被困(OR=1.209,P=0.011)、震后居住地点(OR=1.182,P=0.000)、是否目睹垮塌(OR=1.176,P=0.000)、家人情况(OR=1.104,P=0.000)、地震后是否住院(OR=0.828,P=0.041)12个因素。结论在灾后重建过程中,该中学的学生PTSD症状检出率较高,其与地震时是否受伤、性别、绝望感、是否目睹死亡、年龄、是否目睹受伤、地震时是否被困、震后居住地点、是否目睹垮塌、家人情况、地震后是否住院呈显著相关。
Objective To investigate the incidence rate and related factors of post-traumatic stress disorder(PTSD) among a secondary school students after Wenchuan earthquake,and to provide information for psychological and medical intervention.Methods In the last third part of September 2008,we investigated 1 500 students of a secondary school in Dujiangyan,an area of severe disaster,and attained 1 498 valid questionnaires.General inventory(self-writing) and the Children’s Revised Impact of Event Scale were used in the analysis.Results The diagnosis rate of PTSD was 29.71%(445/1498) among the students 4 months after the earthquake.The result of non-condition gradual logistic regression analysis showed that the influence factors of PTSD symptom included whether hurt or not in the earthquake(OR=1.995,P=0.000),sex(OR=1.785,P=0.000),desperation(OR=1.597,P=0.000),whether having witnessed death or not(OR=1.344,P=0.000),age(OR=1.308,P=0.000),whether having witnessed injures or not(OR=1.262,P=0.000),whether buried or not in the earthquake(OR=1.209,P=0.011),living place after the earthquake(OR=1.182,P=0.000),whether having witnessed collapsing or not(OR=1.176,P=0.000),the condition of family members(OR=1.104,P=0.000),and whether hospitalized after the earthquake(OR=0.828,P=0.041).Conclusion In the post-disaster reconstruction process,the students have a high diagnosis rate of PTSD symptoms,and it is significantly correlated with such factors as whether hurt or not,sex,desperation,whether having witnessed death,age,whether having witnessed injures,whether buried or not,the residing place after the earthquake,whether having witnessed collapsing,the condition of family members,and whether hospitalized or not.
Objective To investigate the incidence rate and related factors of post-traumatic stress disorder(PTSD) among a secondary school students after Wenchuan earthquake,and to provide information for psychological and medical intervention.Methods In the last third part of September 2008,we investigated 1 500 students of a secondary school in Dujiangyan,an area of severe disaster,and attained 1 498 valid questionnaires.General inventory(self-writing) and the Children’s Revised Impact of Event Scale were used in the analysis.Results The diagnosis rate of PTSD was 29.71%(445/1498) among the students 4 months after the earthquake.The result of non-condition gradual logistic regression analysis showed that the influence factors of PTSD symptom included whether hurt or not in the earthquake(OR=1.995,P=0.000),sex(OR=1.785,P=0.000),desperation(OR=1.597,P=0.000),whether having witnessed death or not(OR=1.344,P=0.000),age(OR=1.308,P=0.000),whether having witnessed injures or not(OR=1.262,P=0.000),whether buried or not in the earthquake(OR=1.209,P=0.011),living place after the earthquake(OR=1.182,P=0.000),whether having witnessed collapsing or not(OR=1.176,P=0.000),the condition of family members(OR=1.104,P=0.000),and whether hospitalized after the earthquake(OR=0.828,P=0.041).Conclusion In the post-disaster reconstruction process,the students have a high diagnosis rate of PTSD symptoms,and it is significantly correlated with such factors as whether hurt or not,sex,desperation,whether having witnessed death,age,whether having witnessed injures,whether buried or not,the residing place after the earthquake,whether having witnessed collapsing,the condition of family members,and whether hospitalized or not.
引文
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[10]陈树林,李凌江,卢原,等.火灾灾民创伤后应激障碍的发生及其影响因素[J].中国神经精神疾病杂志,2005,31(3):198-201.
[11]Bromet E,Dew MA.Review of psychiatric epidemiologic researchon disasters[J].Epidemiol Rev,1995,17(1):113-119.
[12]Foa EB,Street GP.women and traumatic events[J].J Chin Psychiatry,2001,62(Suppl 17):29-34.
[13]Breslau N.Epidemiologic studies of trauma posttraumatic stressdisorder and other psychiatric disorders[J].Can J Psychiatry,2002,47(10):923-929.
[14]赵高锋,杨彦春,张强,等.汶川地震极重灾区社区居民创伤后应激障碍发生率及影响因素[J].中国心理卫生杂志,2009,23(7):478-483.
[15]赵丞智,李俊福,王明山,等.地震后17个月受灾青少年PTSD及其相关因素[J].心理卫生杂志,2001,15(3):145-147.
[2]景璐石,陈婷,司徒明镜,等.中文版儿童事件影响量表划界分研究[J].中华行为医学与脑科学杂志,2010,19(8):757-759.
[3]景璐石,陈婷,王丹,等.中文版儿童事件影响量表的信效度研究[J].中华行为医学与脑科学杂志,2010,18(7):654-657.
[4]王相兰,陶炯,温盛霖,等.汶川地震灾民的心理健康状况及影响因素[J].中山大学学报(医学科学版),2008,29(4):367-371.
[5]刘婉婷,况利,陈建梅,等.地震伤员PTSD及其影响因素的研究[J].重庆医科大学学报,2009,34(12):1719-1722.
[6]Wang XD,Gao L,Shinfuku N,et al.Longitudinal study ofearthquake-related PTSD in a randomly selected community samplein north China[J].Am J Psychiatry,2000,157(8):1260-1266.
[7]徐唯,宋瑛,梁爱民,等.特大爆炸事故幸存者创伤后应激障碍的初步研究[J].中国心理卫生杂志,2003,17(9):603-606.
[8]Jehel L,Paterniti S,Brunet A,et al.Prediction of the occurrence andintensity of post-traumatic stress disorder in victims 32 months afterbomb attack[J].Eur Psychiatry,2003,18(4):172-176.
[9]伍志刚,刘爱忠,谭红专,等.洪灾区成人PTSD及其危险因素的研究[J].中国临床心理学杂志,2003,11(3):173-175.
[10]陈树林,李凌江,卢原,等.火灾灾民创伤后应激障碍的发生及其影响因素[J].中国神经精神疾病杂志,2005,31(3):198-201.
[11]Bromet E,Dew MA.Review of psychiatric epidemiologic researchon disasters[J].Epidemiol Rev,1995,17(1):113-119.
[12]Foa EB,Street GP.women and traumatic events[J].J Chin Psychiatry,2001,62(Suppl 17):29-34.
[13]Breslau N.Epidemiologic studies of trauma posttraumatic stressdisorder and other psychiatric disorders[J].Can J Psychiatry,2002,47(10):923-929.
[14]赵高锋,杨彦春,张强,等.汶川地震极重灾区社区居民创伤后应激障碍发生率及影响因素[J].中国心理卫生杂志,2009,23(7):478-483.
[15]赵丞智,李俊福,王明山,等.地震后17个月受灾青少年PTSD及其相关因素[J].心理卫生杂志,2001,15(3):145-147.
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