30年后唐山地震所致孤儿创伤后应激障碍现患率调查

英文篇名：A Cross-sectional Study on the Current Prevalence of Post-traumatic Stress Disorder in Adults Orphaned by Tangshan Earthquake in 1976
中文刊名：中国心理卫生杂志
英文刊名：Chinese Mental Health Journal
作者：张本 ; 张凤阁 ; 王丽萍 ; 于振剑 ; 王长奇 ; 王思臣 ; 郭印川 ; 徐广明 ; 岳玲梅 ; 苗丽玲 ; 马文有 ; 姜涛 ; 张朝新 ; 王馨 ; 牛俊红
英文作者：ZHANG Ben ; ZHANG Feng-Ge ; WANG Li-Ping ; et alKailuan Mental Health Center Affiliated to North China Medical University ; Tangshan 063001
中文关键词：创伤后应激障碍 ; 横断面调查 ; 唐山大地震 ; 地震所致孤儿 ; 危险因素
英文关键词：post-traumatic stress disorder ; cross-sectional study ; Tangshan earthquake ; orphaned survivor ; risk factors
出版日期：2008-06-10
机构：华北煤炭医学院附属开滦精神卫生中心,开滦集团关心下一代委员会,华北煤炭医学院附属开滦精神卫生中心,华北煤炭医学院附属开滦精神卫生中心,华北煤炭医学院附属开滦精神卫生中心,开滦集团关心下一代委员会,开滦集团关心下一代委员会,华北煤炭医学院附属开滦精神卫生中心,华北煤炭医学院附属开滦精神卫生中心,华北煤炭医学院附属开滦精神卫生中心,华北煤炭医学院附属开滦精神卫生中心,华北煤炭医学院附属开滦精神卫生中心,开滦集团关心下一代委员会,华北煤炭医学院附属开滦精神卫生中心,华北煤炭医学院附属开滦精神卫生中心唐山063001,唐山063001,唐山063001,唐山063001,唐山063001,唐山063001,唐山063001,唐山063001,唐山063001,唐山063001,唐山063001
年：2008
期：06
出版单位：中国心理卫生杂志

摘要

目的:调查30年后唐山大地震孤儿创伤后应激障碍(PTSD)的现患率并探讨PTSD的危险因素。方法:应用中国精神障碍分类方案与诊断标准第3版中PTSD诊断标准对260例地震所致孤儿进行诊断;按照有无PTSD分为PTSD组和正常组,比较两组社会人口学资料、地震后急性应激反应、地震后生活状况和目前心理健康状况。用logistic回归分析筛选PTSD的危险因素。结果:260例孤儿中有32例为现患PTSD(12%)。患PTSD的孤儿组SAS(47.8±14.5/40.3±10.3)、SDS(53.0±12.0/45.2±11.7)、SCL-90总分(156.6±65.5/127.9±41.0)高于非PTSD孤儿组(均P<0.05)。Logistic回归分析筛选出6个PTSD的预测因素,分别为经历地震时的年龄、神经质、内外向、地震发生后强烈的精神痛苦、反复出现噩梦和消极应对方式(OR值分别为4.5、0.2、5.5、3.5、5.4、3.9)。结论:灾难后孤儿幸存者30年后仍有较高PTSD现患率,青少年阶段、地震创伤的严重程度、人格倾向性及应对方式与现患PTSD相关。
Objectives:To investigate the current prevalence and risk factors of post-traumatic stress disorder in people orphaned by Tangshan earthquake in 1976.Methods:Two hundreds and sixty adults orphaned by the earthquake were interviewed to determine whether they were suffering from PTSD according to Chinese Classification and Diagnostic Criteria for Mental Disorder,the third Revised Edition(CCMD-3).All the subjects were divided into two groups,PTSD group and normal group.The assessed variables included subjective traumatic experiences during the earthquake,post-traumatic reactions,and current mental health status.Logistic regression analysis was conducted to identify risk factors of PTSD.Results:32(12.00%) cases were diagnosed as PTSD among 260 orphans.In comparison with orphans without PTSD,orphans with PTSD had significantly higher SAS(47.8±14.5/40.3±10.3),SDS(53.0±12.0/45.2±11.7)and SCL-90 total score(156.6±65.5/127.9±41.0),P<0.05.In a stepwise logistic regression model,six risk factors were significantly correlated with the development of PTSD including age at the time of the earthquake(OR=4.5),EPQ-N score(OR=0.2),EPQ-E score(OR=5.5),strong posttraumatic spiritual pain(OR=3.5),recurrent nightmare(OR=5.4),and negative coping style(OR=3.9).Conclusions:30 years later the prevalence of PTSD in those orphaned survivors is still high and PTSD were significantly correlated with adolescence,severity of traumatic events,stressful reaction post earthquake,personality characteristics as well as negative coping style.

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