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  

Prevalence and Related factors for PTSD in Community Residents after the Wenchuan Earthquake

作　　者：赵高锋[1] 杨彦春[1] 张强[2] 张树森[1] 邓红[1] 朱燕[3] 任正伽[1] 兰科[4] 刘传新[5] 陶庆兰[1] 王梅 刘善明[1] 张倬秋[1] 陈颖[1] 李海民[1] 耿婷[1] 刘宇[1] 张伟[1] 孙学礼[1] 

机构地区：[1]四川大学华西医院心理卫生中心,成都610041 [2]四川大学华西公共卫生学院,成都610041 [3]成都市第四人民医院,成都610036 [4]四川大学华西医院西藏成办分院,成都610041 [5]济宁医学院,济宁272013 [6]成都市铁路局,成都610081

出　　处：《中国心理卫生杂志》2009年第7期478-483,共6页Chinese Mental Health Journal

摘　　要：目的：调查汶川地震后，极重灾区社区居民创伤后应激障碍发生率及影响因素，为进一步开展灾后心理卫生服务提供依据。方法：采用整群随机抽样的方法，从安县京安小区、什邡红白镇两个临时安置点社区居民2685人中，随机抽取820名社区居民登记人口学背景、受灾状况，并使用PTSD检查量表平民版（PTSD Checklist—Civilian Version，PCL—C）和领悟社会支持量表（Perceived Social Support Scale，PSSS）进行评估，依据DSM-Ⅳ中PTSD的诊断标准确诊PTSD患者。结果：在完成的820份调查评估资料中，785份PCL—C和PSSS问卷有效。男女比例为1：1．41；平均年龄（43±18）岁；26．0％患有躯体疾病，28．4％有地震前饮酒习惯，23．6％有震后饮酒行为。不同年龄居民PSSS总分及2因子分差异均无统计学意义（P〉0．05）。PTSD的临床检出率为12．4％（97／785），女性PTSD发生率高于男性（15．3％vs．8．3％，P=0．003），地震中有曾被掩埋经历者PTSD发生率高于无被掩埋经历者（26．3％vs．11．6％，P=0．018），有丧亲者的FFSD发生率高于无丧亲者（18．7％vs．11．1％，P=0．015）。以PTSD诊断是否成立为因变量，一般资料为自变量进行Logistic回归分析显示：女性（OR=2．070，95％CI：1．274—3．365）、有曾被掩埋经历者（OR=2．806，95％CI：1．249～6．306）、亲人丧失（OR=1．537，95％CI：1．087—2．173）及PSSS评分偏低（OR=0．960，95％CI：0．941～0．979）是PTSD发生的危险因素。结论：在灾后社区重建过程中，临时安置点社区居民存在较高的创伤后应激障碍的发生率，女性、有曾被掩埋经历、亲人丧失及个人感受到的社会支持偏低是PTSD发生的危险因素。Objective： To investigate the prevalence and related factors of post-traumatic stress disorder （PTSD） among community residents after the Wenchuan Earthquake, and to provide the information for the psychological and medical intervention. Methods ： A total of 820 community residents aged 12 years or older were randomly selected from 2 large communities in Anxian and Shifang cities. The demographic situation and health state were collected the subjects were assessed with the PTSD Checklist-Civilian Version （PCL-C） and Perceived Social Support Scale （PSSS） . The diagnosis of PTSD were made with the Diagnostic and Statistical Mental Disorders （ IV Edition ） criteria. Results： Among the 820 retrieved questionnaires, 785 were valid. In the 785 questionnaires, male to female ratio was 1 ： 1.41, and the mean age was （43 ± 18） years; 26. 0% of subjects suffered from phys- ical diseases, 28.4% had drinking habits before the earthquake, and 23.6% had drinking behavior after earthquake. The mean score of PSSS was （61.05 ± 10. 54）, and there were no significant differences in PSSS score between different age groups. The prevalence of PTSD in this sample was 12.4% （97/785） . Logistic regression analysis showed that female （ OR = 2. 070, 95% CI： 1. 274±3. 365 ） , experience of being buried （ OR = 2. 806, 95 % CI： 1. 249 ± 6. 306 ）, losing relatives （ OR = 1. 537, 95 % CI： 1. 087± 2. 173 ）, and low PSSS score [ OR = 0. 961, 95 % CI： 0. 941 ± 0. 979 ） were the risk factors for PTSD. Conclusion： In the post-disaster reconstruction process, the community residents suffer from the psychological problems after the earthquake. Female, experience of being buried, losing relatives, and low PSSS score may be the risk factors for PTSD and should be paid more attention.

关 键 词：地震 创伤后应激障碍 PTSD检查量表平民版 发生率 影响因素 

分 类 号：R749.5[医药卫生—神经病学与精神病学] B845.67[医药卫生—临床医学]