Kessler R C, Galea S, Gruber M J, Sampson N A, Ursano R J, Wessely S
Department of Healthcare Policy, Harvard Medical School, Boston, MA 02115, USA.
Mol Psychiatry. 2008 Apr;13(4):374-84. doi: 10.1038/sj.mp.4002119. Epub 2008 Jan 8.
A representative sample of 815 pre-hurricane residents of the areas affected by Hurricane Katrina was interviewed 5-8 months after the hurricane and again 1 year later as the Hurricane Katrina Community Advisory Group (CAG). The follow-up survey was carried out to study patterns-correlates of recovery from hurricane-related post-traumatic stress disorder (PTSD), broader anxiety-mood disorders and suicidality. The Trauma Screening Questionnaire screening scale of PTSD and the K6 screening scale of anxiety-mood disorders were used to generate DSM-IV prevalence estimates. Contrary to results in other disaster studies, where post-disaster mental disorder typically decreases with time, prevalence increased significantly in the CAG for PTSD (20.9 vs 14.9% at baseline), serious mental illness (SMI; 14.0 vs 10.9%), suicidal ideation (6.4 vs 2.8%) and suicide plans (2.5 vs 1.0%). The increases in PTSD-SMI were confined to respondents not from the New Orleans Metropolitan Area, while the increases in suicidal ideation-plans occurred both in the New Orleans sub-sample and in the remainder of the sample. Unresolved hurricane-related stresses accounted for large proportions of the inter-temporal increases in SMI (89.2%), PTSD (31.9%) and suicidality (61.6%). Differential hurricane-related stress did not explain the significantly higher increases among respondents from areas other than New Orleans, though, as this stress was both higher initially and decreased less among respondents from the New Orleans Metropolitan Area than from other areas affected by the hurricane. Outcomes were only weakly related to socio-demographic variables, meaning that high prevalence of hurricane-related mental illness remains widely distributed in the population nearly 2 years after the hurricane.
卡特里娜飓风社区咨询小组（CAG）对815名卡特里娜飓风受灾地区的飓风前居民进行了抽样调查，在飓风过后5至8个月进行了首次访谈，并在1年后再次访谈。后续调查旨在研究与飓风相关的创伤后应激障碍（PTSD）、更广泛的焦虑情绪障碍和自杀倾向的恢复模式及相关因素。使用PTSD的创伤筛查问卷筛查量表和焦虑情绪障碍的K6筛查量表来生成DSM-IV患病率估计值。与其他灾难研究的结果相反，在其他灾难研究中，灾后精神障碍通常会随时间减少，但在CAG中，PTSD（基线时为20.9%，而之前为14.9%）、严重精神疾病（SMI；14.0%对10.9%）、自杀意念（6.4%对2.8%）和自杀计划（2.5%对1.0%）的患病率显著增加。PTSD-SMI的增加仅限于非新奥尔良都会区的受访者，而自杀意念-计划的增加则同时出现在新奥尔良子样本和其余样本中。未解决的与飓风相关的压力在SMI（89.2%）、PTSD（31.9%）和自杀倾向（61.6%）的跨期增加中占很大比例。然而，与飓风相关的差异压力并不能解释新奥尔良以外地区受访者中显著更高的增加率，因为这种压力在最初就更高，而且新奥尔良都会区受访者的压力下降幅度比其他受飓风影响地区的受访者要小。结果与社会人口统计学变量的相关性较弱，这意味着在飓风过后近2年，与飓风相关的精神疾病高患病率在人群中仍然广泛存在。
