汶川地震后儿童青少年创伤后应激障碍和抑郁症状及影响因素
문천지진후인동청소년창상후응격장애화억욱증상급영향인소
Influence factors of post-traumatic stress disorder(PTSD)and depression symptoms in children and adolescents after Wenchuan earthquake in China
  • 万方数据
    中华预防医学杂志 중화예방의학잡지
    CHINESE JOURNAL OF
    2011年 6期 531-536 ,共6页

    朱翠珍%司徒明镜%张毅%方慧%景璐石%王丹%闫敬%黄颐

    주취진%사도명경%장의%방혜%경로석%왕단%염경%황이

    自然灾害%儿童%青少年%创伤后应激障碍%抑郁障碍 自然災害%兒童%青少年%創傷後應激障礙%抑鬱障礙
    자연재해%인동%청소년%창상후응격장애%억욱장애
    Natural disasters%Child%Adolescent%Post-traumatic stress disorder
    目的 研究汶川地震对儿童青少年心理问题造成影响的相关因素.方法 样本来自成都、都江堰、北川、汶川等地,分别选取受地震影响严重的12所中、小学,采用自编的一般情况调查表、儿童事件影响量表(CRIES-13)、儿童抑郁障碍自评量表(DSRC),调查上述学校儿童青少年在震后3、6、24个月后的心理卫生状况.3、6、24个月调查有效的学生人数分别为:7341名、7387名、7395名.采用多因素logistic回归模型分析创伤后应激障碍(PTSD)和抑郁障碍的危险因素.结果 震后3、6、24个月CRIES-13量表总分分别为(27.51±12.26)、(23.54 4-12.79)、(21.35±12.59)分(F=28.842,P≤0.05);DSRSC量表总分分别为(11.79±5.73)、(10.94±5.50)、(10.75 ±5.27)分(F=17.084,P≤0.05).震后3、6、24个月时与DSRSC得分相关的危险因素是女性(OR值分别为2.14、2.72、2.31,95%CI/值分别为1.01～3.03、1.10～5.01、1.02～4.58),年龄小于12岁(OR值分别为1.97、2.22、1.93,95%CI值分别为1.43～3.17、1.02～3.54、1.32～3.27),家人伤亡(OR值分别为2.19、2.45、2.35,95%CI值分别为1.04～2.89、1.16～2.08、1.02～2.79),绝望感(OR值分别为2.24、2.09、2.16,95%CI值分别为1.00～2.54、1.70～2.58、1.00～4.56);震后3、6、24个月时与CRIES-13得分均相关的危险因素为女性(OR值分别为2.16、2.94、1.96,95%CI值分别为1.36～2.53、1.36～2.53、1.06～3.92),年龄小于12岁(OR值分别为3.51、2.62、1.92,95%CI值分别为1.22～5.40、1.14～4.93、1.08～3.35),同学老师伤亡(OR值分别为2.32、2.48、2.36,95%CI值分别为1.17～2.48、1.30～2.72、1.02～2.85),家人伤亡(OR值分别为2.73、2.21、1.85,95%CI值分别为1.67～3.61、1.04～3.15、1.05～2.38),目睹受伤(OR值分别为2.17、2.36、2.34,95%CI值分别为1.15～3.65、1.17～2.67、1.02～3.67),目睹死亡(OR值分别为1.98、2.39、1.71,95%CI值分别为1.10～2.56、1.14～3.70、1.57～3.88),绝望感(OR值分别为2.02、1.94、2.02,95%CI值分别为1.67～2.35、1.66～2.27、1.82～2.26).结论 汶川地震灾区儿童青少年幸存者PTSD及抑郁症状随时间的推移逐渐减少,年龄小于12岁、女性、家人有伤亡和震时绝望感等是影响灾后儿童青少年心理健康的主要危险因素.
    목적 연구문천지진대인동청소년심리문제조성영향적상관인소.방법 양본래자성도、도강언、북천、문천등지,분별선취수지진영향엄중적12소중、소학,채용자편적일반정황조사표、인동사건영향량표(CRIES-13)、인동억욱장애자평량표(DSRC),조사상술학교인동청소년재진후3、6、24개월후적심리위생상황.3、6、24개월조사유효적학생인수분별위:7341명、7387명、7395명.채용다인소logistic회귀모형분석창상후응격장애(PTSD)화억욱장애적위험인소.결과 진후3、6、24개월CRIES-13량표총분분별위(27.51±12.26)、(23.54 4-12.79)、(21.35±12.59)분(F=28.842,P≤0.05);DSRSC량표총분분별위(11.79±5.73)、(10.94±5.50)、(10.75 ±5.27)분(F=17.084,P≤0.05).진후3、6、24개월시여DSRSC득분상관적위험인소시녀성(OR치분별위2.14、2.72、2.31,95%CI/치분별위1.01～3.03、1.10～5.01、1.02～4.58),년령소우12세(OR치분별위1.97、2.22、1.93,95%CI치분별위1.43～3.17、1.02～3.54、1.32～3.27),가인상망(OR치분별위2.19、2.45、2.35,95%CI치분별위1.04～2.89、1.16～2.08、1.02～2.79),절망감(OR치분별위2.24、2.09、2.16,95%CI치분별위1.00～2.54、1.70～2.58、1.00～4.56);진후3、6、24개월시여CRIES-13득분균상관적위험인소위녀성(OR치분별위2.16、2.94、1.96,95%CI치분별위1.36～2.53、1.36～2.53、1.06～3.92),년령소우12세(OR치분별위3.51、2.62、1.92,95%CI치분별위1.22～5.40、1.14～4.93、1.08～3.35),동학로사상망(OR치분별위2.32、2.48、2.36,95%CI치분별위1.17～2.48、1.30～2.72、1.02～2.85),가인상망(OR치분별위2.73、2.21、1.85,95%CI치분별위1.67～3.61、1.04～3.15、1.05～2.38),목도수상(OR치분별위2.17、2.36、2.34,95%CI치분별위1.15～3.65、1.17～2.67、1.02～3.67),목도사망(OR치분별위1.98、2.39、1.71,95%CI치분별위1.10～2.56、1.14～3.70、1.57～3.88),절망감(OR치분별위2.02、1.94、2.02,95%CI치분별위1.67～2.35、1.66～2.27、1.82～2.26).결론 문천지진재구인동청소년행존자PTSD급억욱증상수시간적추이축점감소,년령소우12세、녀성、가인유상망화진시절망감등시영향재후인동청소년심리건강적주요위험인소.
    Objective This study was to analyze the mental health status of the children and adolescents from the areas struck by Wenchuan earthquake and to understand the factors that may have impact on their mental health after exposing to the earthquake.Methods Subjects of this survey were tudents(8-16 years old)from Chendu,Dujiangyan,Beichuan and Wenchuan districts which were the most severely affected areas in the earthquake.We analyzed the subjects'mental health conditions after Wenchuan earthquake by using a general questionnaire that was composed of the Children's Revised Impact of Event Scale(CRIES-13)and Depression Self-rating Scale for Children(DSRSC).Students are investigated 7341 case,7387 case,7395 case after 3,6,24 months.The data were analyzed with logistic regression model.Results The CRIES-13 scores were(27.51±12.26),(23.54±12.79)and(21.35±12.59)(F=28.842,P≤0.05)and the DSRSC scores were(11.79±5.73),(10.94±5.50)and(10.75±5.27)(F=17.084,P≤0.05)3,6 and 24 months after the earthquake,respectively.The risk factors associated with depression 3,6,24 months after the earthquake were gender(female)(OR values were 2.14,2.72,2.31：95％CI values were 1.01-3.03,1.10-5.01,1.02-4.58),age(less than 12 years old)(OR values were 1.97,2.22,1.93;95％CI values were 1.43-3.17,1.02-3.54,1.32-3.27),having family member iniury and death(OR values ware 2.19,2.45,2.35;95％CI valves were 1.04-2.89,1.16-2.08,1.02-2.79),desperation(OR values were 2.24,2.09,2.16;95％CI values were 1.00-2.54,1.70-2.58,1.00-4.56).The risk factors associated with PTSD 3,6.24 months after the earthquake were gender(OR values were 2.16,2.94,1.96;95％CI values were 1.36-2.53,1.36-2.53,1.06-3.92),age(less than 12 years old)(OR values were 3.51,2.62,1.92;95％CI values were 1.22-5.40,1.14-4.93,1.08-3.35),having teachers and schoolmates injury and death(OR values were 2.32,2.48,2.36;95％CI values were 1.17-2.48,1.30-2.72,1.02-2.85),having family member injury and death(OR values were 2.73,2.21,1.85;95％CI valties were 1.67-3.61,1.04-3.15,1.05-2.38),witnessing injury(OR values were 2.17,2.36,2.34;95％CI values were 1.15-3.65,1.17-2.67,1.02-3.67),witnessing death(OR values were 1.98,2.39,1.71;95％CI values were 1.10-2.56,1.14-3.70,1.57-3.88),desperation(OR values were 2.02,1.94,2.02;95％CI values were 1.67-2.35,1.66-2.27,1.82-2.26).Conclusion The symotoms of PTSD and depression of young survivors from the earthquake-struck areas had gradually alleviated 3,6,24 months after the earthquake.Age(less than 12 years old),gender (female),having family member injury and death,witnessing injury and death,and desperation were the main risk factors that affected the children and adolescents mental health.
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