CAJ | 학술논문

目的对汶川地震后6月都江堰地区青少年创伤后应激障碍(PTSD)伴发焦虑及抑郁症状的状况进行分析.方法整群分层抽取都江堰地区中学生49个班级,利用儿童创伤后应激障碍自评量表(PTSD-SS)、儿童焦虑性情绪筛查量表(SCARED)、儿童抑郁障碍自评量表(DSRSC)进行评估,共1925人完成调查.结果 PTSD的检出率为15.9%,焦虑症状的检出率为40.8%,抑郁症状的检出率为24.4%.其中,PTSD与焦虑症状的共患率为13.6%,PTSD与抑郁症状的共患率为8.5%,PTSD与抑郁、焦虑症状的共患率为8.1%.PTSD总分与DSRSC抑郁指数(r=0.475,P<0.01)、SCARED焦虑总分(r=0.650、P<0.01)呈正相关.在检出PTSD的青少年中,有85%检出焦虑症状(χ~2=295.160,P<0.01),53.4%检出抑郁症状(χ~2=166.504,P<0.01).在检出PTSD的女性青少年中,有88%检出伴发焦虑症状,高于男性(χ~2=4.010,P<0.05).逻辑回归分析发现,女性、生活在农村、亲人伤亡严重、财产损失大、主观支持少、对支持的利用度低、消极应对方式是PTSD伴发焦虑的危险因素;女性、非独生子女、生活在农村、亲人伤亡严重、社会支持少、对支持的利用度低、消极应对方式是PTSD伴发抑郁的危险因素.结论地震后6个月,青少年PTSD伴发焦虑及抑郁症状的发生率高,女性PTSD伴发焦虑症状的发生率高于男性.
목적 대문천지진후6월도강언지구청소년창상후응격장애(PTSD)반발초필급억욱증상적상황진행분석.방법 정군분층추취도강언지구중학생49개반급,이용인동창상후응격장애자평량표(PTSD-SS)、인동초필성정서사사량표(SCARED)、인동억욱장애자평량표(DSRSC)진행평고,공1925인완성조사.결과 PTSD적검출솔위15.9%,초필증상적검출솔위40.8%,억욱증상적검출솔위24.4%.기중,PTSD여초필증상적공환솔위13.6%,PTSD여억욱증상적공환솔위8.5%,PTSD여억욱、초필증상적공환솔위8.1%.PTSD총분여DSRSC억욱지수(r=0.475,P<0.01)、SCARED초필총분(r=0.650、P<0.01)정정상관.재검출PTSD적청소년중,유85%검출초필증상(χ~2=295.160,P<0.01),53.4%검출억욱증상(χ~2=166.504,P<0.01).재검출PTSD적녀성청소년중,유88%검출반발초필증상,고우남성(χ~2=4.010,P<0.05).라집회귀분석발현,녀성、생활재농촌、친인상망엄중、재산손실대、주관지지소、대지지적이용도저、소겁응대방식시PTSD반발초필적위험인소;녀성、비독생자녀、생활재농촌、친인상망엄중、사회지지소、대지지적이용도저、소겁응대방식시PTSD반발억욱적위험인소.결론 지진후6개월,청소년PTSD반발초필급억욱증상적발생솔고,녀성PTSD반발초필증상적발생솔고우남성.
Objective To explore the comorbidities status of PTSD and anxiety, depression among juvenile victims of the Wenchuan earthquake in Dujiangyan region six months post-disaster. Methods The middle school students of 49 classes in Dujiangyan region were evaluated by using Post-traumatic Stress Disorder Self-rating Scale (PTSD-SS) ,the Screen for Child Anxiety Related Emotional Disorders (SCARED) , Depression Self-rating Scale for Children (DSRSC). About 1925 victims accomplished the survey. Results The rate of PTSD was 15.9% , anxiety was 40. 8% , and depression was 24. 4%. The rate of comorbidity of PTSD and anxiety was 13. 6% ,cormorbidity of PTSD and depression was 8.5%, and cormorbidity of PTSD , depression and anxiety was 8. 1 % . The total score of PTSD had positive correlation with DSRSC depression index (r = 0. 475 , P < 0. 01 ) and the total score of SCARED (r = 0.650, P < 0. 01) . Among the juvenile victims with PTSD, the rate of anxiety was 85% (χ~2 =295.160, P<0.01) , and depression was 53.4% (χ~2 =166.504, P<0.01), which was much higher than those without PTSD. Among female juvenile victims with PTSD, the rate of comorbidity of PTSD and anxiety was 88% .which was much higher than that among male juvenile victims with PTSD(χ~2 =4.010, P<0. 05). According to logistic regression model, female, living in rural areas, bereavement, loss of property, lower subjective support, lower availability of support, negative coping style significantly explained the variance of comorbidity of PTSD and anxiety. Female, not the only child, living in rural areas, bereavement, lower social support, lower a-vailability of support, negative coping style significantly explained the variance of comorbidity of PTSD and depression. Conclusions The incidence rates of PTSD and comorbid anxiety, depression among juvenile victims of the earthquake were significantly higher than the normal population six months post-disaster. The rates of comorbidities in female was higher than that in male. Psychological reconstruction post-disaster should focus on the female, rural population with bereavement.