汶川地震极重灾区780名受灾群众心理状况调查
摘要
目的了解汶川地震受灾群众的受灾情况及心理状况,为进一步开展心理干预提供依据。方法采用横断面调查方法,对成都市2个临时居住点极重灾区受灾群众登记人口学背景、受灾情况及PTSD(Post-traumatic stress disorder)检查量表平民版(PCL-C)评估,依据DSM-Ⅳ的诊断标准,进行急性应激障碍(ASD)临床检查。结果780名受灾群众完成登记评估。在完成登记的资料中729份有效,其中450份PCL-C有效;男女比例为1:1.31。平均年龄36.73±20.82岁;9.5%患有躯体疾病,9.7%生活需人协助,70.7%被动和没有参加社区活动,9.1%严重心理问题。ASD的发生率为30.9%(139/450),PCL-C≥38分有186(41.3%)例,PCL-C≥45分有100(22.2%)例,PCL-C≥50分者有83(18.4%)例,PCL-C≥45分筛查结果与临床诊断结果一致性检验较好(Kappa=0.780,P=0.033)。ASD组和非ASD组性别构成比差异无统计学意义(P>0.05),ASD组与非ASD组年龄差异有统计学意义(P<0.05)。结论来自地震极重灾区的受灾群众较早出现了心理问题。在生命救助的同时,应该尽早关注他们的心理问题。
Objective To evaluate the mental status of survivors after Wenchuan earthquake, so as to provide relevant information for psychological and medical intervention. Methods Demographic data was recorded and the post-traumatic stress disorder (PTSD) Checklist-Civilian Version (PCL-C) was evaluated. The acute stress disorder (ASD) were assessed with the DSM -IV criteria in the survivors from the central earthquake area who are now living in two shelters in Chengdu. Results Among the 780 retrieved questionnaires, 729 baseline registration forms and 450 PCL-C were valid. In the 729 baseline registration forms, male to female ratio was 11.31 and the mean age was 36.73±20.82. 9.5% of subjects suffered from physical diseases, 9.7% needed assistance in daily activities, 70.7% were passive and didn’t participate in community activities, 9.1% suffered from severe psychological problems. In the present study, 30.9% of subjects were found to meet the DSM-IV criteria for ASD. 41.3%, 22.2% and 18.4% of subjects had a PCL-C score ≥38, ≥45 and ≥50, respectively. Consistency check showed there was no significant difference between the screening result of PCL-C score≥45 and clinical diagnosis (Kappa=0.780, P=0.033). There was significant difference in the age of subjects between ASD and non-ASD groups (P<0.05). Conclusion The earthquake survivors suffered from psychological problems after the disaster in the early stage. Thus, in addition to life rescue, we should pay more attention to psychological intervention.
Objective To evaluate the mental status of survivors after Wenchuan earthquake, so as to provide relevant information for psychological and medical intervention. Methods Demographic data was recorded and the post-traumatic stress disorder (PTSD) Checklist-Civilian Version (PCL-C) was evaluated. The acute stress disorder (ASD) were assessed with the DSM -IV criteria in the survivors from the central earthquake area who are now living in two shelters in Chengdu. Results Among the 780 retrieved questionnaires, 729 baseline registration forms and 450 PCL-C were valid. In the 729 baseline registration forms, male to female ratio was 11.31 and the mean age was 36.73±20.82. 9.5% of subjects suffered from physical diseases, 9.7% needed assistance in daily activities, 70.7% were passive and didn’t participate in community activities, 9.1% suffered from severe psychological problems. In the present study, 30.9% of subjects were found to meet the DSM-IV criteria for ASD. 41.3%, 22.2% and 18.4% of subjects had a PCL-C score ≥38, ≥45 and ≥50, respectively. Consistency check showed there was no significant difference between the screening result of PCL-C score≥45 and clinical diagnosis (Kappa=0.780, P=0.033). There was significant difference in the age of subjects between ASD and non-ASD groups (P<0.05). Conclusion The earthquake survivors suffered from psychological problems after the disaster in the early stage. Thus, in addition to life rescue, we should pay more attention to psychological intervention.
引文
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2Goenjian AK,Najarian LM,Pynoos RS,et al.Posttraumatic stress disorder in elderly and younger adults after the1988earthquake in Armenia.Am J Psychiatry,1994,151:895-901.
3David D,Mellman TA,Mendoza LM,et al.Psychiatric morbidity following Hurricane Andrew.J Trauma Stress,1996,9:607-612.
4Madakasira S,O’Brien KF.Acute posttraumatic stress disorder in victims of a natural disaster.J Nerv Ment Dis,1987,175:286-290.
5American Psychiatric Association.Chief Editor.Diagnostic and Statistical Manual of Mental Disorders(DSM-Ⅳ),4th ed.,Washington,DC:American Psychiatric Press,1994:424-429.
6American Psychiatric Association.Chief Editor.Diagnostic and Statistical Manual of Mental Disorders(DSM-Ⅳ),4th ed.,Washington,DC:American Psychiatric Press,1994.
7姜荣环,马弘.急性应激障碍的研究现状.国际精神病学杂志,2007,34(3):147-149.
8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其影响因素.中国心理卫生杂志,1999,13(1):28-30.
9Tang CS.Trajectory of Traumatic Stress Symptom in the Aftermath of Extreme Natural Disaster.J Nerv Ment Dis,2007,195(1):54-59.
10Soldatos CR.Paparrigopoulos TJ,Pappa,DA,et al.Early post-traumatic stress disorder in relation to acute stress reaction:An ICD-10study among help seekers following an earthquake.Psychiatry Res,2006,143:245-253.
11Brauchle G.Incidence and reaction related predictors of the acute and posttraumatic stress disorder in disaster workers.J Z Psychosom Med Psychother,2006,52:52-62.
12Harvey AG,Bryant RA.Acute stress disorder across trauma populations.J Nerv Ment Dis,1999,187:443-446.
13Harvey AG,Bryant RA.Two2year prospective evaluation of the relationship between acute stress disorder and posttraumatic stress disorder following mild traumatic brain injury.Am J Psychiatry,2000,157:626-628.
14Walker EA,Newman E,Dobie DJ,et al.Validation of the PTSD checklist in an HMO sample of women.J Ann Gen Hosp Psychiatry,2002,24(6):375-380.
15Dobie DJ,Kivlahan DR,Maynard C,et al.Posttraumatic stress disorder in female veterans:association with self-reported health problems and functional impairment.Arch Intern Med,2004,164(4):394-400.
16Lang A riel J,Laffaye Charlene,Satz Leslie E,et al.Sensitivity and specificity of the PTSD checklist in detecting PTSD in female veterans in primary care.J Trauma Stress,2003,16(3):257-264.
17Dobie DJ,Kivlahan DR,Maynard C,et al.Screening for post-traumatic stress disorder in female Veteran’s Affairs patients:validation of the PTSD checklist.Gen Hosp Psychiatry,2002,24(6):367-374.
2Goenjian AK,Najarian LM,Pynoos RS,et al.Posttraumatic stress disorder in elderly and younger adults after the1988earthquake in Armenia.Am J Psychiatry,1994,151:895-901.
3David D,Mellman TA,Mendoza LM,et al.Psychiatric morbidity following Hurricane Andrew.J Trauma Stress,1996,9:607-612.
4Madakasira S,O’Brien KF.Acute posttraumatic stress disorder in victims of a natural disaster.J Nerv Ment Dis,1987,175:286-290.
5American Psychiatric Association.Chief Editor.Diagnostic and Statistical Manual of Mental Disorders(DSM-Ⅳ),4th ed.,Washington,DC:American Psychiatric Press,1994:424-429.
6American Psychiatric Association.Chief Editor.Diagnostic and Statistical Manual of Mental Disorders(DSM-Ⅳ),4th ed.,Washington,DC:American Psychiatric Press,1994.
7姜荣环,马弘.急性应激障碍的研究现状.国际精神病学杂志,2007,34(3):147-149.
8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其影响因素.中国心理卫生杂志,1999,13(1):28-30.
9Tang CS.Trajectory of Traumatic Stress Symptom in the Aftermath of Extreme Natural Disaster.J Nerv Ment Dis,2007,195(1):54-59.
10Soldatos CR.Paparrigopoulos TJ,Pappa,DA,et al.Early post-traumatic stress disorder in relation to acute stress reaction:An ICD-10study among help seekers following an earthquake.Psychiatry Res,2006,143:245-253.
11Brauchle G.Incidence and reaction related predictors of the acute and posttraumatic stress disorder in disaster workers.J Z Psychosom Med Psychother,2006,52:52-62.
12Harvey AG,Bryant RA.Acute stress disorder across trauma populations.J Nerv Ment Dis,1999,187:443-446.
13Harvey AG,Bryant RA.Two2year prospective evaluation of the relationship between acute stress disorder and posttraumatic stress disorder following mild traumatic brain injury.Am J Psychiatry,2000,157:626-628.
14Walker EA,Newman E,Dobie DJ,et al.Validation of the PTSD checklist in an HMO sample of women.J Ann Gen Hosp Psychiatry,2002,24(6):375-380.
15Dobie DJ,Kivlahan DR,Maynard C,et al.Posttraumatic stress disorder in female veterans:association with self-reported health problems and functional impairment.Arch Intern Med,2004,164(4):394-400.
16Lang A riel J,Laffaye Charlene,Satz Leslie E,et al.Sensitivity and specificity of the PTSD checklist in detecting PTSD in female veterans in primary care.J Trauma Stress,2003,16(3):257-264.
17Dobie DJ,Kivlahan DR,Maynard C,et al.Screening for post-traumatic stress disorder in female Veteran’s Affairs patients:validation of the PTSD checklist.Gen Hosp Psychiatry,2002,24(6):367-374.
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