“5.12”汶川地震后应急障碍的流行病学研究进展
摘要
目的:对汶川"5,12"地震后PTSD、ASD的流行病学研究现状进行总结,以期找出研究中存在的共性,以便为我国学者从事进一步的研究提供参考。方法:收集"5.12"汶川地震后应急障碍的流行病学研究,并对其进行总结归纳。结果:"5.12"汶川地震后1月内ASD的发生率为5.88%～78.3%。"5.12"汶川地震后1月～3月急性PTSD的发生率为9.4%～76.8%。"5.12"汶川地震后3月及以后慢性PTSD的发生率为7.6%～61.14%。结论:有关"5.12"汶川地震后PTSD流行病学的研究的质量和结论存在着较大差异。这可能与研究者采用的方法、使用的诊断及测评工具,以及受调查人群的年龄、性别、文化程度、获得支持的程度、受灾程度、居住地、是否脱离震区等多因素相关。使用的诊断标准及测评工具有待统一、规范。
Objective:To summarize the research progress on acute stress disorder (ASD) and posttraumatic stress disorder (PTSD)after 5.12 Wenchuan Earthquake.Methods:To summarize and conclude studies on epidemiology of stress disorder after 5.12 Wenchuan Earthquake.Results: Occurrence rate of ASD in one month after the earthquake is 5.88%~78.3%. From one month to three months after the earthquake the occurrence of PTSD is 9.4%~76.8%. Occurrence of PTSD after three month after the earthquake is 7.6%~61.14%.Conclusion:Results of studies on epidemiology of stress disorder after 5.12 Wenchuan Earthquake have big differences. These may be caused by the differences on methods, diagnosis standards, evaluation criterions and the differences on subject's age, sex, education, degree of obtained support, damage, residence, whether away from seismic region and so on. The standards of diagnosis and evaluation criterions should be unified in the future.
Objective:To summarize the research progress on acute stress disorder (ASD) and posttraumatic stress disorder (PTSD)after 5.12 Wenchuan Earthquake.Methods:To summarize and conclude studies on epidemiology of stress disorder after 5.12 Wenchuan Earthquake.Results: Occurrence rate of ASD in one month after the earthquake is 5.88%~78.3%. From one month to three months after the earthquake the occurrence of PTSD is 9.4%~76.8%. Occurrence of PTSD after three month after the earthquake is 7.6%~61.14%.Conclusion:Results of studies on epidemiology of stress disorder after 5.12 Wenchuan Earthquake have big differences. These may be caused by the differences on methods, diagnosis standards, evaluation criterions and the differences on subject's age, sex, education, degree of obtained support, damage, residence, whether away from seismic region and so on. The standards of diagnosis and evaluation criterions should be unified in the future.
引文
[1] 尹智,王东明,卢杰.震后灾难心理及其救援对策研究[J].防灾科 技学院学报,2007,9(3) :13-6．
[2] Koopman C, Classen C, Cardena E, et al. When Disaster Strikes,Acute Stress Disorder May Follow[J]. J Traunu Stress,1995,8:29-46．
[3] American Phychiatric Association. Diagnostic and statistic manual of mental disorders [M], 4thed (DSM-IV ).Washington DC:APA,1994,424-9．
[4] 中华医学会精神科分会.中国精神障碍分类与诊断标准[M],济南:山东科学技术出版社,2001:97-8．
[5] Harris EC, Barraclough B.Suicide as an outcome for me.ntal disorders[J].A meta-analysis. Br J Psychiatry,1997,170:205-28．
[6] Davidson JR.Recognition and treatment of posttraumatic stress disorder[J].JAMA,2001,286(5) :584-8．
[7] 赵国秋,汪永光,王义强,等.汶川地震后急性应激障碍发生率及影响因素[J].中华预防医学杂志,2008,42(11) :802-5．
[8] 杨帆,白祥军,刘开俊,等.汶川地震创伤患者急性应激障碍分析[J].重庆医学,2008,37 (24) :2772-6
[9] 邓燕华,周伯荣,苏秀芳,等.社会心理支持与急性应激障碍发生发展的相关性研究[J].国际医药卫生导报,2009,15(9) :92-4．
[10] 魏宁,周韦华,胡健波,等.汶川地震外转伤员心理创伤状况调查分析[J].中华预防医学杂志,2009,43(5) :376-9．
[11] 赵高锋,杨彦春,张树森,等.汶川地震极重灾区780名受灾群众心理状况调查[J].中国循证医学杂志,2008,8(10) :815-9．
[12] 姚一民,陈华,唐佩福,等.地震骨科伤员72例创伤后应激障碍调查[J].军医进修学院学报,2008,29(5) :429．
[13] 高雪屏,罗兴伟.汶川地震后1月内脱离/未脱离震区的亲历者PTSD筛查阳性的发生及心理影响因素[J].中南大学学报(医学版),2009,34(6) :504-9．
[14] 蔡兴林,杨远波.汶川地震创伤后应激障碍(PISD)的发生调查及体育干预方式研究[J].中国体育科技,2009,45(5) :107-110．
[15] 刘潇霞,熊国钰,马道川,等.汶川地震灾区中学生地震创伤后应 激障碍与领悟社会支持的关系[J].中华流行病学杂志,2009,30(10) :1017-20．
[16] 范一鸣,孙源泉,宫瑞莹,等.异地复学震区中小学生PTSD及心理健康状况的调查[J].心理科学进展,2009,17(3) :527-31．
[17] 郭阳,陈爱敏,林浩春,等.“5． 12”汶川大地震伤员心理应激状况调查[J].南方医科大学学报,2008,28(7) :1114-22．
[18] 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．
[19] 陶炯,温盛霖,王相兰,等.汶川地震安置点灾民急性应激障碍及影响因素分析[J].中国神经精神疾病杂志,2008,34(10) :618-20．
[20] 李洁,郭建雄,徐文军,等.四川汶川地震伤员的心理卫生状况调查[J].中国神经精神疾病杂志,2008,340) :523-4．
[21] 范惠民,孙梅芹,肖欣荣,等.汶川地震后成都军区总医院住院高龄老干部创伤后应激障碍调查[J].职业卫生与病伤,200924(6) :337-9．
[22] 徒明镜,张毅,邹可,等.汶川大地震后灾区儿童青少年心理健康状况调查[J].四川大学学报(医学版),2009,400) :712-5．
[23] 赵玉芳,胡丽,汤永隆,等.汶川震后一个月受灾者心理应激状况[J].中国健康教育,2009,25(5) :356-8．
[24] 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) :1719-22．
[25] 游永恒,张皓,刘晓.四川地震灾后中小学教师心理创伤评估报告[J].心理科学进展,2009,17(3) :524-6．
[26] 闫永平,王波,王安辉,等.汶川“5712”大地震后受灾人群急性应激障碍的调查[J].中华流行病学杂志,2008,29(11) :1169-70．
[27] Kun P,Chen X,Han S,et al.Prevalence of post-traumatic stress disorder in Sichuan Province,China after the 2008 Wenchuan earthquake[J].Public Health,2009,123(11) :703-7．
[28] Wang L,Zhang Y,Shi Z,et al.Symptoms of posttraumatic stress disorder among adult survivors two months after the Wenchuan earthquake[J].Psychol Rep,2009． 109(3 Pt 1) :879-85．
[29] 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].应激与心理健康,2009． 23(7) :478-83．
[30] Li Wang,Yuqing Zhang,Wenzhong Wang, et al.Symptoms of posttraumatic stress disorder among adult survivors three months after the Sichuan earthquake in China[J].J Trauma Stress 2009,22(5) :444-50．
[31] .周波,周东,肖军,等.5． 12汶川大地震灾民创伤后应激障碍的特点分析[J].实用医院临床杂志,2009,6(1) :32-4．
[32] 傅璟,赵铀,宋豪,等.汶川大地震妇女创伤后应激障碍的抽样调查研究[J].实用妇科杂志,2008,24(12) :744-6．
[33] Kun P,Han S,Chen X,et al.Prevalence and risk factors for posttraumatic stress disorder: a cross-sectional study among survivors of the Wenehuan 2008 earthquake in China[J].Depress Anxiety 2009,26(12) :1134-40．
[34] 陆琳,胡丽娜,李燕华,等.汶川大地震后女性应激反应的调查[J].实用妇科杂志,2008,24(12) :747-9
[35] Liu X,Yang Y,Yuan P, et al.A study of the relationship between mental health and menstrual abnormalities in female middle school students from postearthquake Wenchuan[J].Biosei Trends.2010,4(1) :4-8．
[36] Jia Z,Tian W,Liu W,et al.Are the elderly more vulnerable to psychological impact of natural disaster? A population-based survey of adult survivors of the 2008 Sichuan earthquake [J].BMC Public Health.,2010,10(1) :172
[37] 王志阳,汤月芬,施慎逊.创伤后应激障碍国内研究现状[J].上海精神医学,2006,18(6) :372-4．
[38] 汪向东,赵丞智,新福尚隆,等.地震后创伤性应激障碍的发生率及影响因素[J].中国心理卫生杂志,1999,13(1) :28-30．
[39] 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) :173-5．
[40] 汪向东,赵丞智,新福尚隆,等.地震后创伤后应激障碍的发生率及影响因素[J].中国心理卫生杂志,1999,13(1) :28-30
[41] 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[J]中华精神科杂志,1999,32(2) :106-8．
[2] Koopman C, Classen C, Cardena E, et al. When Disaster Strikes,Acute Stress Disorder May Follow[J]. J Traunu Stress,1995,8:29-46．
[3] American Phychiatric Association. Diagnostic and statistic manual of mental disorders [M], 4thed (DSM-IV ).Washington DC:APA,1994,424-9．
[4] 中华医学会精神科分会.中国精神障碍分类与诊断标准[M],济南:山东科学技术出版社,2001:97-8．
[5] Harris EC, Barraclough B.Suicide as an outcome for me.ntal disorders[J].A meta-analysis. Br J Psychiatry,1997,170:205-28．
[6] Davidson JR.Recognition and treatment of posttraumatic stress disorder[J].JAMA,2001,286(5) :584-8．
[7] 赵国秋,汪永光,王义强,等.汶川地震后急性应激障碍发生率及影响因素[J].中华预防医学杂志,2008,42(11) :802-5．
[8] 杨帆,白祥军,刘开俊,等.汶川地震创伤患者急性应激障碍分析[J].重庆医学,2008,37 (24) :2772-6
[9] 邓燕华,周伯荣,苏秀芳,等.社会心理支持与急性应激障碍发生发展的相关性研究[J].国际医药卫生导报,2009,15(9) :92-4．
[10] 魏宁,周韦华,胡健波,等.汶川地震外转伤员心理创伤状况调查分析[J].中华预防医学杂志,2009,43(5) :376-9．
[11] 赵高锋,杨彦春,张树森,等.汶川地震极重灾区780名受灾群众心理状况调查[J].中国循证医学杂志,2008,8(10) :815-9．
[12] 姚一民,陈华,唐佩福,等.地震骨科伤员72例创伤后应激障碍调查[J].军医进修学院学报,2008,29(5) :429．
[13] 高雪屏,罗兴伟.汶川地震后1月内脱离/未脱离震区的亲历者PTSD筛查阳性的发生及心理影响因素[J].中南大学学报(医学版),2009,34(6) :504-9．
[14] 蔡兴林,杨远波.汶川地震创伤后应激障碍(PISD)的发生调查及体育干预方式研究[J].中国体育科技,2009,45(5) :107-110．
[15] 刘潇霞,熊国钰,马道川,等.汶川地震灾区中学生地震创伤后应 激障碍与领悟社会支持的关系[J].中华流行病学杂志,2009,30(10) :1017-20．
[16] 范一鸣,孙源泉,宫瑞莹,等.异地复学震区中小学生PTSD及心理健康状况的调查[J].心理科学进展,2009,17(3) :527-31．
[17] 郭阳,陈爱敏,林浩春,等.“5． 12”汶川大地震伤员心理应激状况调查[J].南方医科大学学报,2008,28(7) :1114-22．
[18] 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．
[19] 陶炯,温盛霖,王相兰,等.汶川地震安置点灾民急性应激障碍及影响因素分析[J].中国神经精神疾病杂志,2008,34(10) :618-20．
[20] 李洁,郭建雄,徐文军,等.四川汶川地震伤员的心理卫生状况调查[J].中国神经精神疾病杂志,2008,340) :523-4．
[21] 范惠民,孙梅芹,肖欣荣,等.汶川地震后成都军区总医院住院高龄老干部创伤后应激障碍调查[J].职业卫生与病伤,200924(6) :337-9．
[22] 徒明镜,张毅,邹可,等.汶川大地震后灾区儿童青少年心理健康状况调查[J].四川大学学报(医学版),2009,400) :712-5．
[23] 赵玉芳,胡丽,汤永隆,等.汶川震后一个月受灾者心理应激状况[J].中国健康教育,2009,25(5) :356-8．
[24] 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) :1719-22．
[25] 游永恒,张皓,刘晓.四川地震灾后中小学教师心理创伤评估报告[J].心理科学进展,2009,17(3) :524-6．
[26] 闫永平,王波,王安辉,等.汶川“5712”大地震后受灾人群急性应激障碍的调查[J].中华流行病学杂志,2008,29(11) :1169-70．
[27] Kun P,Chen X,Han S,et al.Prevalence of post-traumatic stress disorder in Sichuan Province,China after the 2008 Wenchuan earthquake[J].Public Health,2009,123(11) :703-7．
[28] Wang L,Zhang Y,Shi Z,et al.Symptoms of posttraumatic stress disorder among adult survivors two months after the Wenchuan earthquake[J].Psychol Rep,2009． 109(3 Pt 1) :879-85．
[29] 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].应激与心理健康,2009． 23(7) :478-83．
[30] Li Wang,Yuqing Zhang,Wenzhong Wang, et al.Symptoms of posttraumatic stress disorder among adult survivors three months after the Sichuan earthquake in China[J].J Trauma Stress 2009,22(5) :444-50．
[31] .周波,周东,肖军,等.5． 12汶川大地震灾民创伤后应激障碍的特点分析[J].实用医院临床杂志,2009,6(1) :32-4．
[32] 傅璟,赵铀,宋豪,等.汶川大地震妇女创伤后应激障碍的抽样调查研究[J].实用妇科杂志,2008,24(12) :744-6．
[33] Kun P,Han S,Chen X,et al.Prevalence and risk factors for posttraumatic stress disorder: a cross-sectional study among survivors of the Wenehuan 2008 earthquake in China[J].Depress Anxiety 2009,26(12) :1134-40．
[34] 陆琳,胡丽娜,李燕华,等.汶川大地震后女性应激反应的调查[J].实用妇科杂志,2008,24(12) :747-9
[35] Liu X,Yang Y,Yuan P, et al.A study of the relationship between mental health and menstrual abnormalities in female middle school students from postearthquake Wenchuan[J].Biosei Trends.2010,4(1) :4-8．
[36] Jia Z,Tian W,Liu W,et al.Are the elderly more vulnerable to psychological impact of natural disaster? A population-based survey of adult survivors of the 2008 Sichuan earthquake [J].BMC Public Health.,2010,10(1) :172
[37] 王志阳,汤月芬,施慎逊.创伤后应激障碍国内研究现状[J].上海精神医学,2006,18(6) :372-4．
[38] 汪向东,赵丞智,新福尚隆,等.地震后创伤性应激障碍的发生率及影响因素[J].中国心理卫生杂志,1999,13(1) :28-30．
[39] 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) :173-5．
[40] 汪向东,赵丞智,新福尚隆,等.地震后创伤后应激障碍的发生率及影响因素[J].中国心理卫生杂志,1999,13(1) :28-30
[41] 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[J]中华精神科杂志,1999,32(2) :106-8．
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