Marshall Grant N, Schell Terry L, Elliott Marc N, Rayburn Nadine R, Jaycox Lisa H
RAND Corporation, 1776 Main St., Santa Monica, CA 90407, USA.
Psychiatr Serv. 2007 Apr;58(4):509-14. doi: 10.1176/ps.2007.58.4.509.
This study estimated the prevalence of psychopathology at a three-month follow-up among persons seeking emergency relief services after a wildfire and identified a practical screener for use in these disaster assistance settings to aid early identification of persons at risk of subsequent psychopathology.
During the October 2003 California firestorm that occurred at the wildland-urban interface, 357 persons who were seeking assistance from adjacent American Red Cross and government relief centers were recruited for this study. Within days of mandatory evacuation, participants completed baseline self-administered questionnaires assessing demographic characteristics, initial subjective reactions, and degree of fire exposure. At the three-month follow-up, symptoms of posttraumatic stress disorder (PTSD) and major depression were measured via a mailed survey.
At follow-up 33% showed evidence of probable major depression; 24% exhibited probable PTSD. On a bivariate basis, seven initial reaction and fire exposure items were significantly associated with subsequent psychopathology. Best-subsets logistic regression analyses revealed that property damage and physical injury were the best multivariate predictors of psychopathology at follow-up. No additional items provided a significant incremental improvement in prediction.
Individuals seeking immediate emergency assistance related to the wildland-urban interface fire were at elevated risk of psychopathology in the weeks after the fire. A short, easily administered, two-item screener, composed of items assessing fire exposure severity, appears to hold promise for aiding early identification of persons at risk of postfire psychopathology. These findings may also have implications for other mass disasters.
本研究估计了野火后寻求紧急救援服务的人群在三个月随访时精神病理学的患病率，并确定了一种实用的筛查工具，用于这些灾难援助环境，以帮助早期识别有后续精神病理学风险的人群。
在2003年10月发生在城乡交界处的加利福尼亚州火灾风暴期间，招募了357名从相邻的美国红十字会和政府救援中心寻求援助的人员参与本研究。在强制疏散后的几天内，参与者完成了基线自我管理问卷，评估人口统计学特征、初始主观反应和火灾暴露程度。在三个月随访时，通过邮寄调查测量创伤后应激障碍（PTSD）和重度抑郁症的症状。
随访时，33%的人有可能患重度抑郁症的证据；24%的人表现出可能患创伤后应激障碍。在双变量分析中，七个初始反应和火灾暴露项目与随后的精神病理学显著相关。最佳子集逻辑回归分析显示，财产损失和身体伤害是随访时精神病理学的最佳多变量预测因素。没有其他项目在预测方面提供显著的增量改善。
与城乡交界处火灾相关寻求即时紧急援助的个体在火灾后的几周内有更高的精神病理学风险。一个简短、易于管理的两项筛查工具，由评估火灾暴露严重程度的项目组成，似乎有望帮助早期识别有火灾后精神病理学风险的人群。这些发现也可能对其他大规模灾难有启示意义。
