芦山地震受灾人群创伤后应激障碍的流行病学调查

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目的 调查芦山地震受灾人群PTSD的患病率及其影响因素.方法 采用横断面调查,在四川省雅安市芦山县、宝兴县两地分层随机抽取1110名成年被调查者,使用自编问卷采集一般人口学资料、芦山地震受灾情况以及芦山地震、汶川地震对被调查者影响的比较等,PTSD筛查量表平民版(PTSD Check List-Civilian Version,PCL-C)筛查被调查者对芦山地震的应激反应程度,MINI-自杀风险评估其自杀风险.PCL-C>38分者由精神科医师采用MINI中文版中的PTSD章节诊断其是否患有PTSD.采用线性回归分析方法对PTSD的影响因素进行相关分析.结果 998名被调查者纳入分析,其中男372名(37.27%,372/998),女626名(62.73%,626/998).PCL-C>38分者251名(25.15%,251/998),PTSD患者24例,PTSD患病率2.40%(24/998).自杀高风险者11名(1.10%,11/998).回归分析显示,PCL-C总分与女性(β=-2.041)、家庭低收入(β=-3.870)、地震中亲属遇难(β=0.164)、朋友遇难(β=-0.059)、地震中被掩埋(β=-14.335)、受伤(β=0.495)等因素相关(均P<0.05).女性(OR=4.304)、地震中被掩埋(OR=15.688)是罹患PTSD的危险因素(均P<0.05).家庭低收入(OR=3.147)、罹患PTSD (OR=25.101)是自杀高风险的危险因素(均P<0.05).结论 5年内连续2次遭受地震创伤的受灾人群中PTSD的患病率并不高,女性及在地震中自身生命受威胁是罹患PTSD的危险因素,应有针对性地进行干预.“,”Objective To investigate the prevalence and influence factors of post-traumatic stress disorder (PTSD) in people experiencing the Lushan 4.20 earthquake in 2013.Methods By stratified random sampling,a cross-sectional survey was conducted among 1 110 adult victims from the county of Lushan and Baoxing three months after the earthquake.Self-made questionnaire was adopted to collect the demographic data and the general situation of the disaster and compare with the situation of Wenchuan 5.12 earthquake.The scale of PTSD Check List-Civilian Version (PCL-C) was applied to scan the high risky individuals.Mini-Suicide was used to assess the suicide risk.The psychiatric doctor used the Mini-PTSD to diagnose the individuals with the PCL-C total score>38.Linear regression analysis was used for correlation analysis the influence factors of PTSD.Results 998 efficient questionnaires were collected,and male 372 (37.27%,372/998),female 626(62.73%,626/998).Among them,251 subjects(25.15%,251/998) had high scores of PCL-C (total score>38),24 subjects were diagnosed PTSD (2.40%,24/998) and 11 subjects(1.10%,11/998) had high risk of suicide committing.The factors of female(β =-2.041),poor economic condition (B=-3.870),losing relatives(β=0.164),losing friends(B=-0.059),being buried(β=-14.335),and being injured (β=0.495) were found related with higher total score of PCL-C(all P<0.05).The factors of female(OR=4.304) and being buried(OR=15.688) were found to be the risky factors of PTSD(both P<0.05).The factors of lower income(OR=3.147) and being diagnosed with PTSD(OR=25.101) were found to be the risky factors of suicide (both P<0.05).Conclusions Twice earthquake experience during 5 years may increase the morbidity of PTSD,and female and life-threatening in the earthquake are the high risk factors of PTSD.
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