[1992年法国沃克吕兹洪水发生五年后创伤后应激症状的风险因素]

[Risk factors for post traumatic stress symptoms five years after the 1992 flood in the Vaucluse (France)].

作者信息

Verger P, Hunault C, Rotily M, Baruffol E

机构信息

Institut de Protection et de Sûreté Nucléaire, Département de Protection de la santé de l'Homme et de Dosimétrie, Service d'Evaluation et de Gestion des Risques, Laboratoire d'Epidémiologie. B.P.6, F 92 265, Fontenay-aux-Roses Cedex.

出版信息

Rev Epidemiol Sante Publique. 2000 Aug;48 Suppl 2:2S44-53.

PMID:10992109

Abstract

BACKGROUND

Natural disasters may induce post-traumatic stress disorder (PTSD), a severe and longlasting psychopathology, in exposed populations. In France, several natural disasters occurred in the past, but epidemiological data on their psychological consequences are scarce. In September 1992, a flood affected 63 municipalities in the Vaucluse, South of France, and resulted in 38 deaths. An epidemiological study was carried out in 1997 to evaluate the potential association between the degree of exposure to the flood and PTSD symptoms as well as PTSD risk factors.

METHODS

A telephone survey was carried out in Bédarrides (5000 inhabitants), one of the most affected municipalities. Subjects residing in Bédarrides and older than 18 years at the time of the disaster were included in the study. Symptoms of PTSD were assessed using a structured questionnaire based on DSM-IV criteria and a PTSD score was calculated. Individual exposure was retrospectively assessed by questionnaire. To take into account the exposure level, an indicator of cumulated exposure was established. Multiple regression analyses were performed to explain the PTSD score.

RESULTS

Five hundred individuals were interviewed with a 79% response rate. A significantly higher PTSD score was observed for females, subjects older than 35 years, subjects with a monthly income lower than 9000 FF, subjects with a history of psychological disorders or life-threatening traumatic event. A significant exposure-effect relationship was observed between the level of exposure to the flood and the PTSD score which was multiplied by 3.4 in most severely exposed individuals. An increased PTSD score was also observed in subjects residing in the flooded area and in those who benefited from psychological care at the time of the flood.

CONCLUSION

These results, compatible with published results, suggest a long term psychological impact of the 1992 flood on the Bédarrides population.

摘要

背景

自然灾害可能会在受灾人群中诱发创伤后应激障碍（PTSD），这是一种严重且持久的精神病理学疾病。在法国，过去曾发生过几次自然灾害，但关于其心理后果的流行病学数据却很匮乏。1992年9月，一场洪水侵袭了法国南部沃克吕兹省的63个市镇，造成38人死亡。1997年开展了一项流行病学研究，以评估洪水暴露程度与PTSD症状以及PTSD风险因素之间的潜在关联。

方法

在受灾最严重的市镇之一贝达里德（有5000名居民）进行了一项电话调查。研究纳入了在灾难发生时居住在贝达里德且年龄超过18岁的受试者。使用基于《精神疾病诊断与统计手册》第四版（DSM-IV）标准的结构化问卷评估PTSD症状，并计算PTSD评分。通过问卷对个体暴露情况进行回顾性评估。为考虑暴露水平，建立了累积暴露指标。进行多元回归分析以解释PTSD评分。

结果

共访谈了500人，应答率为79%。女性、35岁以上的受试者、月收入低于9000法郎（FF）的受试者、有心理障碍或危及生命的创伤事件史的受试者的PTSD评分显著更高。在洪水暴露水平与PTSD评分之间观察到显著的暴露-效应关系，在暴露最严重的个体中，PTSD评分增加了3.4倍。居住在洪水泛滥地区的受试者以及在洪水发生时接受过心理护理的受试者的PTSD评分也有所增加。