汶川地震救援官兵中PTSD患者负性情绪表达及相关因素分析
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摘要
目的调查汶川地震6个月后救援官兵创伤后应激障碍(posttraumatic stress disorder,PTSD)患者的焦虑和抑郁状态,并探讨其相关因素。方法按整群分层抽样原则对1125名一线救援官兵进行调查,采用Davidson创伤量表(DTS)确定诊断PTSD组(DTS≥40分)和非PTSD组,分析两组Beck焦虑量表(BAI)、Beck抑郁量表-Ⅱ(BDI-Ⅱ)的测评结果,采用简单直线相关法进行相关性分析。结果①实查1056人,共检出PTSD 69例(6.5﹪);②PTSD组焦虑发生率、抑郁发生率均显著高于非PTSD组(P<0.01);③PTSD组BAI/BDI-Ⅱ各单项症状发生率及评分、总分均显著高于非PTSD组(P<0.05或P<0.01);④军龄、独生子女、饮酒、吸烟、兵源、心理干预、地震经历总分与PTSD患者负性情绪表达均无明显相关(P>0.05)。结论汶川地震救援官兵PTSD患者较非PTSD者具有更显著的焦虑、抑郁情绪,其症状发生率高、程度重,应及时进行有针对性地干预与治疗。
Objective To investigate the anxiety and depression status in military rescuers with posttraumatic stress disorder(PTSD) 6 months after Wen Chuan earthquake,and analyze the related factors.Methods A sample of 1125 military rescuers was obtained by cluster sampling method.The PTSD were examined with the Davidson Trauma Scale(DTS),and according to the DTS score of ≥40 or <40,all subjects were divided into PTSD group and non-PTSD group.The scores of Beck Anxiety Inventory(BAI) and Beck Depression Inventory-Ⅱ(BDI-Ⅱ) in the two groups were compared.Linear correlation analysis was used to study the effects of related factors on anxiety and depression scores in PTSD group.Results ①The final analysis was carried out on 1056 military rescuers.The prevalence of PTSD was 6.5%(69 cases);②The occurrence rate of anxiety and depression were higher in PTSD group than that in non-PTSD group(P<0.01);③The BAI/BDI-Ⅱ total scores,the score and frequency of each anxiety/depression symptom were higher in PTSD group than those in non-PTSD group(P<0.05 or P<0.01);④ Whether the only child,whether smoking,whether drinking et al were not correlated with BAI and BDI-Ⅱscores(P>0.05).Conclusion The military rescuers with PTSD after the earthquake have higher anxiety and depression levels,and have more frequent and prominent anxiety and depression symptoms.They should be given a timely and targeted psychological intervention or treatment.
Objective To investigate the anxiety and depression status in military rescuers with posttraumatic stress disorder(PTSD) 6 months after Wen Chuan earthquake,and analyze the related factors.Methods A sample of 1125 military rescuers was obtained by cluster sampling method.The PTSD were examined with the Davidson Trauma Scale(DTS),and according to the DTS score of ≥40 or <40,all subjects were divided into PTSD group and non-PTSD group.The scores of Beck Anxiety Inventory(BAI) and Beck Depression Inventory-Ⅱ(BDI-Ⅱ) in the two groups were compared.Linear correlation analysis was used to study the effects of related factors on anxiety and depression scores in PTSD group.Results ①The final analysis was carried out on 1056 military rescuers.The prevalence of PTSD was 6.5%(69 cases);②The occurrence rate of anxiety and depression were higher in PTSD group than that in non-PTSD group(P<0.01);③The BAI/BDI-Ⅱ total scores,the score and frequency of each anxiety/depression symptom were higher in PTSD group than those in non-PTSD group(P<0.05 or P<0.01);④ Whether the only child,whether smoking,whether drinking et al were not correlated with BAI and BDI-Ⅱscores(P>0.05).Conclusion The military rescuers with PTSD after the earthquake have higher anxiety and depression levels,and have more frequent and prominent anxiety and depression symptoms.They should be given a timely and targeted psychological intervention or treatment.
引文
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[11]Gersons BPR.Diagnostic dilemmas in assessing posttraumatic stress disorder[M].Posttraumaitc stress disorder diagnosis management and treatment edited by Nutt D,Davidson JRT,Zohar J.London,2000:29-40.
[12]Breslau N.Epidemiologic studies of trauma,posttraumatic stress disorder,and other psychiatric disorders[J].Can J Psychiatry,2002,47(10):923-929.
[13]Tural U,Onder E,Aker T.Effect of depression on recovery from PTSD[J].Community Ment Health J,2012,48(2):161-166.
[2]马宁,何鸣,梁光明,等.震后9个月部分受灾群众精神痛苦现况调查[J].中国心理卫生杂志,2010,24(7):509-513.
[3]顾克胜,宋端铱,邵水聪,等.汶川地震一线救援人员灾后应激相关障碍状况分析[J].军事医学科学院院刊,2010,34(5):476-479.
[4]Huanlin WANG,Hua JIN,Sarah E,et al.Identification of posttrau-matic stress disorder and risk factors in military first responders 6months after Wenchuan earthquake in China[J].J Affect Disord,2011,130(1):213-219.
[5]王焕林,过伟,Hua Jin,等.中国汶川地震现场救援军人创伤后应激障碍及相关因素的调查研究[J].中华精神科杂志,2010,43(2):97-101.
[6]Chen CH,Lin SK,Tang HS,et al.The Chinese version of the da-vidson trauma scale:a practice test for validation[J].PsychiatryClin Neurosci,2001,55(5):493-499.
[7]汪向东,王希林,马弘,等.心理卫生评定量表手册(增订版)[M].北京:中国心理卫生杂志社,1999:191-194,251-253.
[8]Vogt DS,Proctor SP,King DW,et al.Validation of scales from thedeployment risk and resilience inventory in a sample of operationIraq freedom veterans[J].Assessment,2008,15(4):391-403.
[9]Mase M,Mylle J,Delmeire L,et al.Psychiatric morbidity and co-morbidity following accidental man-made traumatic events:inci-dence and risk factors[J].Eur Arch Psychiatry Clin Neurosci,2000,250(3):156-162.
[10]Brady KT,Killeen TK,Breserton T,et al.Comorbidity of psychiat-ric disorders and posttraumatic stress disorder[J].J Clin Psychia-try,2000,61(suppl7):22-32.
[11]Gersons BPR.Diagnostic dilemmas in assessing posttraumatic stress disorder[M].Posttraumaitc stress disorder diagnosis management and treatment edited by Nutt D,Davidson JRT,Zohar J.London,2000:29-40.
[12]Breslau N.Epidemiologic studies of trauma,posttraumatic stress disorder,and other psychiatric disorders[J].Can J Psychiatry,2002,47(10):923-929.
[13]Tural U,Onder E,Aker T.Effect of depression on recovery from PTSD[J].Community Ment Health J,2012,48(2):161-166.
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