汶川地震后6个月安县受灾群众创伤后应激障碍(PTSD)的发生率及相关因素的分析
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摘要
目的:汶川地震震后6个月安县受灾群众创伤后应激障碍(PTSD)发生率、症状分布及其相关因素。方法:应用PTSD调查表、症状自评量表(SCL-90)、焦虑自评量表、抑郁自评量表和标准化评定工具,对地震时在安县地区居住的群众,进行DSM-ⅣPTSD诊断检查及相关量表的测查。结果:完成调查的289人中,PTSD筛查阳性率为11.4%。抑郁症状阳性率为23.4%,8.7%报告有自杀观念。灾后6个月PTSD发生率为11.4%,PTSD组反复更现创伤性体验、持续性警觉性增高、持续的回避等症状较对照组明显。SCL-90总分和躯体化、强迫、人际关系、抑郁、焦虑、敌对、恐怖、偏执、精神及其他因子分、SDS总分和标准分、SAS总分和标准分均显著高于对照组。结论:地震后PTSD的发生率是11.4%(6个月)。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 observe 6 months after wenchuan earthquake post-traumatic stress disorder(PTSD)incidence,symptoms distribution and related factors of victims in an-town.Methods:Apply PTSD questionnaire,symptoms self rating scale(SCL-90),anxiety self rating scale,depression self rating scale and standardization evaluation tool,the examinationin of DSM-Ⅳ PTSD diagnostic tests and related scale for the people living in sichuan region in the earthquake period.Results:Among the 289 surveys which has been completed,PTSD screening positive rate was 11.4%.Depressive symptoms positive rate was 23.4%,8.7% was reported with suicidal ideas.6 months after disasters PTSD incidence was 11.4%.In the PTSD group symptoms such as the repeating appearance of the traumatic experience,the increase of the vigilance and sustainability,persistent withdrawal were more obvious than the control group.SCL-90 overall score and scores of somatization,force,interpersonal relationship,depression,anxiety,hostility,terror,intolerance,spirit,and other factors,SDS overall scores and standard scores,SAS overall scores and standard scores were significantly higher than those in the control group.Conclusion:The incidence of PTSD after earthquake is 11.4%(6 months).Patients of the PTSD cannot get rid of painful memories of the mental wounds.The PTSD seriously impacts the psychosomatic health.of the patients.
Objective:To observe 6 months after wenchuan earthquake post-traumatic stress disorder(PTSD)incidence,symptoms distribution and related factors of victims in an-town.Methods:Apply PTSD questionnaire,symptoms self rating scale(SCL-90),anxiety self rating scale,depression self rating scale and standardization evaluation tool,the examinationin of DSM-Ⅳ PTSD diagnostic tests and related scale for the people living in sichuan region in the earthquake period.Results:Among the 289 surveys which has been completed,PTSD screening positive rate was 11.4%.Depressive symptoms positive rate was 23.4%,8.7% was reported with suicidal ideas.6 months after disasters PTSD incidence was 11.4%.In the PTSD group symptoms such as the repeating appearance of the traumatic experience,the increase of the vigilance and sustainability,persistent withdrawal were more obvious than the control group.SCL-90 overall score and scores of somatization,force,interpersonal relationship,depression,anxiety,hostility,terror,intolerance,spirit,and other factors,SDS overall scores and standard scores,SAS overall scores and standard scores were significantly higher than those in the control group.Conclusion:The incidence of PTSD after earthquake is 11.4%(6 months).Patients of the PTSD cannot get rid of painful memories of the mental wounds.The PTSD seriously impacts the psychosomatic health.of the patients.
引文
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[21]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(J).中华精神科杂志,2000,33(2):111-114.
[22]Kidson MA,Douglas JC,Holwill BJ.Posttraumatic stressddisorder in Australian World War 2veterans attending apsy-chiatric outpatient clinic(J).Med J Aust,1993,158(8):563-566.
[23]Gersons BPR.Diagnostic dilemmas in assessing post-traumaticstress disorder.In Post-traumatic Stress Disorder:Diagnosis,Management and Treatment(M).Edited by Nutt D,DavidsonJRT,Zohar J.London,2000:29-40.
[24]袁茵,毛文君,杨德华.汶川地震丧亲与非丧亲者PTSD、焦虑和抑郁的对比研究(J).中华行为医学与脑科学杂志,2009,18(12):1109-1111.
[25]Goto T,Wilson J.A review of the history of traum aticstressstudies in Japan:From traum atic neurosis to PTSD(J).Trauma Violence Abuse,2003,4:195-209.
[26]Kokai M,Fuji S,Shinfuku N,et al.Natural disaster and men-tal health in Asia(J).Psychiatry clin Neurosci,2004,58:110-116.
[2]Ehlers A,Clark DM,Hackmann A,et al.A randomized con-trolled trial of cognitive therapy,a self-help booklet,and repeat-ed assessments as early interventions for posttraumatic stressdisorder(J).Arch Gen Psychiat,2003,60(10):1024-1032.
[3]Grubaugh AL,Elhai JD,et al.Screening for PTSD in public sector mental health settings:the diagnostic utility of the PTSDchecklist(J).Depression Anxiety,2007,24(2):124-129.
[4]杨晓云,杨宏爱,等.创伤后应激检查量表平民版的效度、信度及影响因素的研究(J).中国健康心理学杂志,2007,15(1):6-9.
[5]张明园,主编.精神卫生评定量表手册(M).长沙:湖南科学技术出版社,1993:16-41.
[6]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(M).第3版.济南:山东科学技术出版社,2001.
[7]Aker AT.1999Marmara earthquakes:a review of epidemiologicfindings and community mental health policies(J).TurkPsikiyatri Derq,2006,17(3):204-212.
[8]Basoglu M,Salciolu E,Livanou M,et al.Traumtic stress re-sponses in earthquake sunrivors in Turkey(J).J TraumaStress,2002,15:269.
[9]樊毫军,侯世科,彭碧波,等.印度海啸后难民心理状况调查(J).中国行为医学科学,2006,15(1):74.
[10]Chou FH,Wu HC,Chou P,et al.Epidemiologic psychiatricstudies on post-disaster impact among Chi-Chi earthquakesurvivors in Yu-Chi.Taiwan(J).Psychiatry Clin Neurosi,2007,61(4):370-378.
[11]Kadri N,Berrada S,Douab S,et al.Post-traumatic stress disor-der in survivors of the Agadir earthquake(Morocco)in 1960(J).Encephale,2006,32(2Pt 1):215-216.
[12]Kuo HW,WU SJ,Ma TC,et al.Pesttraumatic symptoms wereworst among quake victims with injuries following the Chi-chiquake in Taiwan(J).J Psychosom Res,2007,62(4):495-500.
[13]赵丞智,汪向东,高岚.张北尚义地震后创伤后应激障碍随访研究(J).中国心理卫生杂志,2000,14(6):361-363.
[14]侯彩兰,李凌江,张燕.矿难后2个月和10个月刨伤后应激障碍的发生率及相关因素(J).中南大学学报(医学版),2008,33(4):279-283.
[15]李勇,贺丹军,吴玉琴,等.汶川大地震受灾者创伤后应激症状及危险因素(J).中国康复医学杂志,2008,23(10):868-871.
[16]Altindag A,Ozen S,Sir A.One-year follow-up study of post-traumatic stress disorder among earthquake survivors in Tur-key(J).2005,46(5):328-333.
[17]Basoglu M,Kilic C,Salicioglu E,et al.Prevalence of posttrau-matic stress disorder and depression in earthquake survivors inTurkey:an epidemiological study(J).J Trauma Stress,2004,17:133-141.
[18]秦虹云,季建林.PTSD及其危机干预(J).中国心理卫生杂志,2003,17(9):614-616.
[19]张本,王学义.孙识祥.唐山大地震心理创伤后应激障碍的抽样调查研究(J).中华精神科杂志,1999,32(2):106-108.
[20]Galea S,Nandi A,Vlahov D.The epidemidogy of post-trau-matic stress disorder after disasters(J).Epidemiol Rev,2005,27(1):78-91.
[21]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(J).中华精神科杂志,2000,33(2):111-114.
[22]Kidson MA,Douglas JC,Holwill BJ.Posttraumatic stressddisorder in Australian World War 2veterans attending apsy-chiatric outpatient clinic(J).Med J Aust,1993,158(8):563-566.
[23]Gersons BPR.Diagnostic dilemmas in assessing post-traumaticstress disorder.In Post-traumatic Stress Disorder:Diagnosis,Management and Treatment(M).Edited by Nutt D,DavidsonJRT,Zohar J.London,2000:29-40.
[24]袁茵,毛文君,杨德华.汶川地震丧亲与非丧亲者PTSD、焦虑和抑郁的对比研究(J).中华行为医学与脑科学杂志,2009,18(12):1109-1111.
[25]Goto T,Wilson J.A review of the history of traum aticstressstudies in Japan:From traum atic neurosis to PTSD(J).Trauma Violence Abuse,2003,4:195-209.
[26]Kokai M,Fuji S,Shinfuku N,et al.Natural disaster and men-tal health in Asia(J).Psychiatry clin Neurosci,2004,58:110-116.
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