突发群体事件后社区居民创伤后应激障碍及抑郁症的相关因素  

Related factors to post-traumatic stress disorder and major depressive disorder in community residents after a sudden mass incident

作　　者：徐向东[1] 吕淑云[1] 张莉[1] 李月娥[1] 陈亮[1] 买买提热夏提.吐尔逊 马瑞晨[1] 古丽娜尔.阿布都克里木 夏小龙[1] 米尔孜.艾合买提 吐尔洪.库尔班 肖开提.苏力唐 伊力哈木江.克里木阿吉 买力开木.阿布都克里木 

机构地区：[1]新疆精神卫生中心,乌鲁木齐830002

出　　处：《中国心理卫生杂志》2014年第4期241-247,共7页Chinese Mental Health Journal

摘　　要：目的：探讨突发群体事件后社区居民创伤后应激障碍（PTSD）和抑郁症发病的相关因素.方法：乌鲁木齐市某突发群体事件后2个月,对事发地之一沿街社区年龄≥15岁的居民931人进行调查.由精神科医生以美国精神障碍诊断与统计手册第4版修订版（DSM-Ⅳ-TR）轴Ⅰ障碍临床定式检查患者版进行检查,使用DSM-Ⅳ对各类精神障碍进行诊断,计算PTSD和抑郁症的检出率.用创伤后应激障碍筛查表（PTSD7）、艾森克人格问卷（EPQ）和应付方式问卷（CSQ）评估应激症状和人格及应付方式,分析PTSD和抑郁症发病的相关因素.结果：PTSD检出率为13.5％,抑郁症为8.7％,排在所有精神障碍检出率的前两位.将931人按诊断结果分4组,即无病组（n =705）、PTSD组（n=72）、抑郁症组（n=28）和PTSD抑郁症共病组（n=53）.无病组EPQ神经质得分小于其他3组[（5.8＆#177;4.8） vs.（10.6＆#177;5.1）,（10.9＆#177;4.9）,（14.0＆#177;5.2）],PTSD组和抑郁症组小于共病组（均P＜0.01）.无病组的CSQ退避、幻想、自责、合理化4个因子得分均低于其他3组,共病组的自责因子得分高于其他3组,无病组和抑郁症组的求助因子得分高于共病组.Logistic回归分析显示,年龄大、事发时暴露程度高,神经质、掩饰性和自责得分高者更容易出现PTSD（OR=1.03 ～ 3.95）和抑郁症（OR=1.04 ～4.33）.结论：突发群体事件后社区居民PTSD和抑郁症检出率较高,心理创伤后PTSD和抑郁症发病的危险因素有年龄大、事发时暴露程度高,以及较高水平的神经质、掩饰性和自责.Objective： To explore the related factors to post-traumatic stress disorder （PDST） and major de- pressive disorder （MDD） in community residents after a sudden mass incident. Methods： Two months after the sud- den mass incident, 931 residents aged 15 years and older in Urumqi were assessed with Structured Clinical Interview for DSM-IV-TR Axis I Disorders/ Patients （SCID-I/P） and diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition （DSM-IV） criteria to understand the detection rate of PTSD and MDD. Their stress symptoms, personality and coping style were assessed with the 7-items Screening Scale forPTSD, Eysenck Personality Questionnaire （EPQ）, and Coping Style Questionnaire （CSQ） respectively. Results： The detection rates were 13.5% for PTSD and 8.7% for MDD. All subjects were divided into 4 groups according to the diagnosis, including disease-free group （ n = 705）, PTSD group （ n = 72）, MDD group （ n = 28） and PTSD co- morbid with MDD group （n = 53）. The EPQ neuroticism scores were lower in the disease-free group than in the other three groups [（5.8 ± 4.8） vs. （10.6 ± 5.1）,（10.9 ± 4.9）,（14.0 ± 5. 2） , P 〈 0. 05] , lower in the PTSD and MDD groups than in the comorbid group （P 〈 0. 01 ）. The CSQ scores of retreat, fantasy, remorse and rationali- zation factors were lower in the disease-free group than in the other three groups. The score of remorse was higher in the comorbid group than in the other three groups. The scores of calling for help were higher in the disease-free group and MDD group than in the comorbid group. Logistic stepwise regression analysis showed that those with ol- der age, higher degree of exposure, higher scores of neuroticism were more likely to have symptoms of PTSD （ OR = 1.03 - 3.95） and MDD （ OR = 1.04 - 4. 33）. Conclusions： PTSD and MDD are the two commonl mental disor- ders in people after a sudden mass incident. The related factors to MDD after trauma may be

关 键 词：群体事件 社区居民 创伤后应激障碍 抑郁症 现况调查 

分 类 号：R749.5[医药卫生—神经病学与精神病学] R749.4[医药卫生—临床医学]