玉树地震伤员急性应激反应调查
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摘要
目的早期(灾后67h内)筛查玉树地震伤员的急性应激反应,以及时指导有效的心理干预工作。方法选取四川大学华西医院收治的符合纳入、排除标准的90名玉树地震伤员,采用创伤后应激障碍症状清单平民版(PTSD Checklist-Civilian Version,PCL-C),由藏族大学生志愿者翻译,在征得伤员同意后,完成资料收集。结果震后伤员PCL-C总分为18～74分,平均为(43.00±13.89)分;筛查PTSD阳性28例,占31.11%,阴性62人,占68.89%;最常见的是再体验症状,发生率为87.78%(79/90);其次是高警觉症状,发生率为67.77%(61/90);回避麻木症状发生率为33.33%(30/90);PCL-C总分的性别、年龄、民族差异均无统计学意义,丧亲情况差异有统计学意义(P<0.05)。结论玉树地震伤员早期急性应激反应的发生率较高,应及时采取有效的心理干预措施。
Objective To examine acute stress reaction among the injured persons after Yushu earthquake for early and effective psychological intervention.Methods A face-to-face interview was carried out among 90 injured persons with the Post-Traumatic Stress Disorder Symptoms Civilian Version(PCL-C) within three days after Yushu earthquake in 2010.Results The total score of PCL-C ranged from 18 to 74 among the injuries with an average score of 43±13.89.A total of 28 injuries(31.11%) were positive for PTSD and 62(68.89%) were negative.The most common symptom was re-experience(87.78%),followed by high alert(67.77%),and avoiding numbness(33.33%).Conclusion There was a high incidence of acute stress reaction among the injuries of Yushu earthquake and it is important to take timely and effective psychological intervention.
Objective To examine acute stress reaction among the injured persons after Yushu earthquake for early and effective psychological intervention.Methods A face-to-face interview was carried out among 90 injured persons with the Post-Traumatic Stress Disorder Symptoms Civilian Version(PCL-C) within three days after Yushu earthquake in 2010.Results The total score of PCL-C ranged from 18 to 74 among the injuries with an average score of 43±13.89.A total of 28 injuries(31.11%) were positive for PTSD and 62(68.89%) were negative.The most common symptom was re-experience(87.78%),followed by high alert(67.77%),and avoiding numbness(33.33%).Conclusion There was a high incidence of acute stress reaction among the injuries of Yushu earthquake and it is important to take timely and effective psychological intervention.
引文
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[18]姜佐宁.现代精神病学[M].北京:科学出版社,2004:455-461.
[2]美国精神科学会(编)庞天鉴(译).DSM-分类与诊断标准[J].杨森文库-精神医学分册(增),2001:68-75.
[3]McKibben JB,Bresnick MG,Wiechman Askay SA,et al.Acutestress disorder and posttraumatic stress disorder:a prospective studyof prevalence,course,and predictors in a sample with major burninjuries[J].Burn Care Res,2008,29(1):22-35.
[4]何树德.地震灾区大学生创伤后应激障碍及其共病[J].中国公共卫生,2010,26(6):719-720.
[5]Blanchard EB,Jones-alexander J,Buckley TC,et al.Psychometricproperties of the PTSD checklist(PCL)[J].Behav Res Ther,1996,34(8):669-673.
[6]孙玉芹.老年人保健与护理[M].天津:科学技术出版社,2008:2-3.
[7]Demir T,Demir DE,Alkas L.Some clinical characteristics of chil-dren who survived the Marmara earthquakes[J].Eur Child AdolescPsychiatry,2009(1):12-16.
[8]Staab JP,Grieger TA,Fullerton CS,et al.Acute stress disorder,subsequent posttraumatic stress disorder and depression after a se-ries of typhoons[J].Anxiety,1996,2(5):219-225.
[9]温盛霖,陶炯,王相兰.四川地震灾民灾后心理健康状况及综合干预模式探讨[J].新医学,2009,40(8):505-508.
[10]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.
[11]向莹君,熊国玉,董毅强.汶川地震灾区1960名中学生创伤后应激障碍症状调查[J].中国心理卫生杂志,2010,24(1):17-20.
[12]Vehid HE,Alyanak B,Eksia KS.Suicide ideation after the 1999earthquake in Marmara,Turkey[J].Tohoku J ExpMed,2006,208(1):19-24.
[13]王湘兰,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.
[14]Bryant RA,Mastrodomenico J,Felmingham KL,et al.Treatment ofacute stress disorder:a randomized controlled trial[J].Arch GenPsychiatry,2008,65(6):659.
[15]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):106-108.
[16]吴景芬,肖军,陈祥慧.四川江油太平镇安置点北川、平武地震灾民1周后心理症状分析[J].实用医院临床杂志,2009,6(1):25-26.
[17]温盛霖,王相兰,陶炯,等.四川汶川地震安置点灾民急性和创伤应激症状及相关因素分析[J].中国神经精神疾病杂志,2008,34(9):525-527.
[18]姜佐宁.现代精神病学[M].北京:科学出版社,2004:455-461.
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