Pérez-Olmos Isabel, Fernández-Piñeres Patricia E, Rodado-Fuentes Sonia
Facultad de Medicina, Universidad del Rosario, Bogotá, Colombia.
Rev Salud Publica (Bogota). 2005 Sep-Dec;7(3):268-80. doi: 10.1590/s0124-00642005000300003.
Determining the prevalence of post-traumatic stress disorder (PTSD) related to the type of war exposure and associated factors in school-aged children from three Colombian towns.
Cross-sectional epidemiological study. Representative randomised sample of 493 children aged 5-14. The children were evaluated during 2002 using semi-structured psychiatric interviews and the clinician administered PTSD scale. 167 children were evaluated in La Palma who had been chronically exposed to war, 164 in Arbeláez who had had recent war-exposure and 162 in Sopó who had not been exposed to war. War-related PTSD prevalence was calculated in each municipality. Odds ratio (OR) and chi-square were used for evaluating the association between exposure to war and PTSD and the related risk. Multivariate analysis used the logistic regression model. The affected children required specialised mental health counselling.
The prevalence of PTSD resulting from war was 16,8 % in La Palma, 23,2 % in Arbeláez and 1.2% in Sopó. A 19.9 OR (CI 4.7, 119.2), 30,5 Chi-square and p = 0.000 revealed war-related PTSD association and risk for children when comparing the exposed towns to Sopó. The logistic regression showed that geographical closeness to war zone and intense emotional reaction to war increased the probability of war-related PTSD. Vulnerability factors were predominant in war-exposed towns. Poverty, parents' low educational level and child abuse predominated in La Palma. Attention-deficit and psychosomatic disorders were more prevalent in Arbeláez.
War affects children's mental health; the children from the exposed towns had 19 times greater probability of war-related PTSD than those from a non-exposed town. Early therapeutic intervention is a public health priority. The results are useful for countries suffering from war, internal conflict and/or terrorism.
确定哥伦比亚三个城镇学龄儿童与战争暴露类型相关的创伤后应激障碍(PTSD)患病率及相关因素。
横断面流行病学研究。对493名5 - 14岁儿童进行代表性随机抽样。2002年期间,使用半结构化精神科访谈和临床医生管理的PTSD量表对儿童进行评估。在长期遭受战争影响的拉帕尔马对167名儿童进行了评估,在近期遭受战争影响的阿韦莱兹对164名儿童进行了评估,在未遭受战争影响的索波对162名儿童进行了评估。计算每个城市与战争相关的PTSD患病率。采用优势比(OR)和卡方检验评估战争暴露与PTSD之间的关联及相关风险。多变量分析使用逻辑回归模型。受影响的儿童需要专业的心理健康咨询。
拉帕尔马因战争导致的PTSD患病率为16.8%,阿韦莱兹为23.2%,索波为1.2%。与索波相比,在比较遭受战争影响的城镇时,OR为19.9(CI 4.7,119.2),卡方值为30.5,p = 0.000,表明与战争相关的PTSD存在关联及儿童患病风险。逻辑回归显示,与战区的地理距离近以及对战争的强烈情绪反应会增加与战争相关的PTSD发生概率。在遭受战争影响的城镇,脆弱因素占主导。在拉帕尔马,贫困、父母教育水平低和儿童虐待情况较为突出。注意力缺陷和身心障碍在阿韦莱兹更为普遍。
战争影响儿童心理健康;遭受战争影响城镇的儿童患与战争相关PTSD的可能性比未受影响城镇的儿童高19倍。早期治疗干预是公共卫生的优先事项。这些结果对遭受战争、内部冲突和/或恐怖主义的国家有用。