汶川地震后18个月都江堰地区青少年睡眠问题共患PTSD、抑郁、焦虑状况
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摘要
目的:考查汶川地震后18个月青少年睡眠问题共患PTSD、抑郁、焦虑状况及其影响因素。方法:采用便利取样,抽取都江堰地区青少年1287人,应用匹兹堡睡眠质量指数、创伤后应激障碍自评量表、儿童抑郁障碍自评量表、儿童焦虑性情绪障碍自评量表、青少年自评生活事件量表、儿童青少年社会支持评定量表等对其进行评估。结果:采用PSQI总分8作为划界分,震后18个月都江堰地区青少年睡眠问题的检出率为28.2%;睡眠问题共患PTSD、抑郁、焦虑的检出率分别为7.5%、15.6%、17.9%。睡眠质量总分与PTSD(r=0.397)、抑郁(r=0.504)、焦虑总分(r=0.463)显著正相关。在检出有睡眠问题的青少年中,有26.4%检出PTSD,有55.4%检出抑郁,有63.4%检出焦虑。多元Lo-gistic回归表明地震中有亲人伤亡、对支持的利用度低、震后较多负性生活事件是睡眠问题共患PTSD的危险性因素;女性、客观支持少、主观支持少、对支持的利用度低和震后较多负性生活事件是睡眠问题共患抑郁的危险性因素;女性、主观支持低、对支持的利用度低和震后较多继发负性生活事件是睡眠问题共患焦虑的危险性因素。结论:震后18个月睡眠问题共患PTSD、抑郁、焦虑较高,评估及干预青少年的睡眠问题对预防精神健康问题有重要意义。
Objective: To examine the association between sleep quality and PTSD,anxiety and depressive symptoms among juvenile victims 18 months post 2008 Wenchuan earthquake,China.Methods: A total of 1287 adolescents were sampled from Dujiangyan district,20 kilometers away from the epicenter.Participants were asked to complete the Pittsburgh Sleep Quality Index,Self-Rating Scale for Posttraumatic Stress Disorder,the Depression Self-Rating Scale for Children,the Screen for Child Anxiety and Related Emotional Disorders,Adolescent Self-rating Life Event Checklist,Social Support Rating Scale for Children and Adolescents.Results: The total PSQI score of 8 was used as cutoff;the prevalence of poor sleep was 28.2%.The comorbidity of poor sleep with PTSD,depression,and anxiety were 7.5%,15.6%,and 17.9% respectively.The total PSQI score was significantly related to PTSD(r=0.397),depression(r=0.504) and anxiety score(r=0.463).Among adolescents with poor sleep quality,the prevalence of PTSD,depression,and anxiety were 26.4%,55.4%,63.4% respectively.According to multiple logistic regressions,experiences of death,missing,and/or injury of family members,lower utilization of social supports,and more negative life events significantly explained the variance of comorbidity of poor sleep and PTSD.For female,lower objective social supports,lower subjective social supports,lower utilization of social supports and more negative life events significantly explained the variance of co-morbidity of poor sleep and depression.For female,lower subjective social supports,lower utilization of social supports and more negative life events significantly explained the variance of co-morbidity of poor sleep and anxiety.Conclusion: Poor sleep quality is associated with PTSD,anxiety,and depressive symptoms among adolescent survivors after earthquake.
Objective: To examine the association between sleep quality and PTSD,anxiety and depressive symptoms among juvenile victims 18 months post 2008 Wenchuan earthquake,China.Methods: A total of 1287 adolescents were sampled from Dujiangyan district,20 kilometers away from the epicenter.Participants were asked to complete the Pittsburgh Sleep Quality Index,Self-Rating Scale for Posttraumatic Stress Disorder,the Depression Self-Rating Scale for Children,the Screen for Child Anxiety and Related Emotional Disorders,Adolescent Self-rating Life Event Checklist,Social Support Rating Scale for Children and Adolescents.Results: The total PSQI score of 8 was used as cutoff;the prevalence of poor sleep was 28.2%.The comorbidity of poor sleep with PTSD,depression,and anxiety were 7.5%,15.6%,and 17.9% respectively.The total PSQI score was significantly related to PTSD(r=0.397),depression(r=0.504) and anxiety score(r=0.463).Among adolescents with poor sleep quality,the prevalence of PTSD,depression,and anxiety were 26.4%,55.4%,63.4% respectively.According to multiple logistic regressions,experiences of death,missing,and/or injury of family members,lower utilization of social supports,and more negative life events significantly explained the variance of comorbidity of poor sleep and PTSD.For female,lower objective social supports,lower subjective social supports,lower utilization of social supports and more negative life events significantly explained the variance of co-morbidity of poor sleep and depression.For female,lower subjective social supports,lower utilization of social supports and more negative life events significantly explained the variance of co-morbidity of poor sleep and anxiety.Conclusion: Poor sleep quality is associated with PTSD,anxiety,and depressive symptoms among adolescent survivors after earthquake.
引文
1 North CS,Nixon S,Shariat S,et al.Psychiatric disordersamong survivors of the Oklahoma City bombing.Journal ofthe American Medical Association,1999,282(8):755-762
2王震宇,沙维伟,顾小扬,等.四川汶川地震灾区伤员和伤员家属心理状况调查研究.精神医学杂志,2009,22(3):193-194
3 Fran HN,Matthew JF,Patricia JW,et al.60,000 disastervictims speak:part I.an empirical review of the empiricalliterature,1981-2001.Psychiatry,2002,65(3):207-239
4陶炯,范方,杨肖嫦,等.地震后6月灾区创伤后应激障碍中学生共患焦虑及抑郁分析.中华行为医学与脑科学杂志,2009,18(11):991-993
5 American psychiatry association diagnostic and statisticalmanual of mental disorders,fourth edition(DSM-Ⅳ).Wash-ington,DC.American Psychiatric Association,1994.424-429
6 Krakow B,Hollifield M,Johnston L,et al.Imagery rehearsaltherapy for chronic nightmares in sexual assault survivorswith posttraumatic stress disorder a randomized controlledtrial.Journal of the American Medical Association,2001,286(5):537-545
7 Swanson LM,Favorite TK,Horin E,et al.A combined grouptreatment for nightmares and insomnia in combat veterans:A pilot study.Journal of Traumatic Stress,2009,22(6):639-642
8 Taylor DJ,Lichstein KL,Durrence HH,et al.Epidemiologyof insomnia,depression,and anxiety.SLEEP,2005,28(11):1457-1464
9 Ford DE,Kamerow DB.Epidemiologic study of sleep distur-bances and an opportunity for prevention?Journal of theAmerican Medical Association,1989,262(11):1479-1484
10 Kar N.Psychological impact of disasters on children:Re-view of assessment and interventions.World Journal of Pe-diatr,2009,5(1):5-11
11 Carr VJ,Lewin TJ,Webster RA,et al.A synthesis of thefindings from the quake impact study:A two-year investig-ation of the psychosocial sequelae of the 1989 Newcastleearthquake.Social Psychiatry and Psychiatr Epidemiology,1997,32(3):123-36
12汪向东,王希林,马弘.心理卫生评定量表手册.增订版.北京:中国心理卫生杂志社,1999.375-378
13刘贤臣,马登岱,刘连启,等.心理创伤后应激障碍自评量表的编制和信度效度研究.中国行为医学科学,1998,7(2):93-96
14苏林雁,王凯,朱焱,等.儿童抑郁障碍自评量表的中国城市常模.中国心理卫生杂志,2003,17(8):547-549
15王凯,苏林雁,朱焱,等.儿童焦虑性障碍筛查表的中国城市常模.中国心理卫生杂志,2003,7(8):547-549
16刘贤臣,刘连启,杨杰,等.青少年生活事件量表的编制与信效度测试.山东精神医学,1997,10(1):15-19
17汪向东,王希林,马弘.心理卫生评定量表手册.增订版.北京:中国心理卫生杂志社,1999.127-130
18范方,柳武妹,郑裕鸿,等.震后6个月都江堰地区青少年心理问题及影响因素.中国临床心理学杂志,2010,18(1):56-59
19 Thomas AM,Daniella D,Renee KB,et al.sleep disturbanceand its relationship to psychiatric morbidity after HurricaneAndrew.American Journal of Psychiatry,1995,152(11):1659-1663
2王震宇,沙维伟,顾小扬,等.四川汶川地震灾区伤员和伤员家属心理状况调查研究.精神医学杂志,2009,22(3):193-194
3 Fran HN,Matthew JF,Patricia JW,et al.60,000 disastervictims speak:part I.an empirical review of the empiricalliterature,1981-2001.Psychiatry,2002,65(3):207-239
4陶炯,范方,杨肖嫦,等.地震后6月灾区创伤后应激障碍中学生共患焦虑及抑郁分析.中华行为医学与脑科学杂志,2009,18(11):991-993
5 American psychiatry association diagnostic and statisticalmanual of mental disorders,fourth edition(DSM-Ⅳ).Wash-ington,DC.American Psychiatric Association,1994.424-429
6 Krakow B,Hollifield M,Johnston L,et al.Imagery rehearsaltherapy for chronic nightmares in sexual assault survivorswith posttraumatic stress disorder a randomized controlledtrial.Journal of the American Medical Association,2001,286(5):537-545
7 Swanson LM,Favorite TK,Horin E,et al.A combined grouptreatment for nightmares and insomnia in combat veterans:A pilot study.Journal of Traumatic Stress,2009,22(6):639-642
8 Taylor DJ,Lichstein KL,Durrence HH,et al.Epidemiologyof insomnia,depression,and anxiety.SLEEP,2005,28(11):1457-1464
9 Ford DE,Kamerow DB.Epidemiologic study of sleep distur-bances and an opportunity for prevention?Journal of theAmerican Medical Association,1989,262(11):1479-1484
10 Kar N.Psychological impact of disasters on children:Re-view of assessment and interventions.World Journal of Pe-diatr,2009,5(1):5-11
11 Carr VJ,Lewin TJ,Webster RA,et al.A synthesis of thefindings from the quake impact study:A two-year investig-ation of the psychosocial sequelae of the 1989 Newcastleearthquake.Social Psychiatry and Psychiatr Epidemiology,1997,32(3):123-36
12汪向东,王希林,马弘.心理卫生评定量表手册.增订版.北京:中国心理卫生杂志社,1999.375-378
13刘贤臣,马登岱,刘连启,等.心理创伤后应激障碍自评量表的编制和信度效度研究.中国行为医学科学,1998,7(2):93-96
14苏林雁,王凯,朱焱,等.儿童抑郁障碍自评量表的中国城市常模.中国心理卫生杂志,2003,17(8):547-549
15王凯,苏林雁,朱焱,等.儿童焦虑性障碍筛查表的中国城市常模.中国心理卫生杂志,2003,7(8):547-549
16刘贤臣,刘连启,杨杰,等.青少年生活事件量表的编制与信效度测试.山东精神医学,1997,10(1):15-19
17汪向东,王希林,马弘.心理卫生评定量表手册.增订版.北京:中国心理卫生杂志社,1999.127-130
18范方,柳武妹,郑裕鸿,等.震后6个月都江堰地区青少年心理问题及影响因素.中国临床心理学杂志,2010,18(1):56-59
19 Thomas AM,Daniella D,Renee KB,et al.sleep disturbanceand its relationship to psychiatric morbidity after HurricaneAndrew.American Journal of Psychiatry,1995,152(11):1659-1663
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