Kraemer Bernd, Wittmann Lutz, Jenewein Josef, Schnyder Ulrich
Department of Psychiatry, University Hospital Zurich, Culmannstrasse 8, Zurich CH-8091, Switzerland.
Aust N Z J Psychiatry. 2009 May;43(5):420-5. doi: 10.1080/00048670902817653.
Most of the data on psychological outcome and the mental health treatment available following natural disasters originate from the indigenous population of the region destroyed. Examining tourists returning from the area affected by the 2004 tsunami presents an opportunity of studying the impact of natural disasters on psychological outcome and mental health treatment in their countries of origin. The aim of the present study was to extend the current knowledge on psychiatric morbidity and potential positive outcomes, as well as subsequent mental health treatment following a natural disaster, based on the results from a sample of home-coming Swiss tourists.
Tourists who had been potentially affected by the 2004 tsunami were assessed using the Post-traumatic Diagnostic Scale, the Hospital Anxiety and Depression Scale, and the Post-traumatic Growth Inventory. Outcome variables were related to the degree of tsunami exposure. In addition, mental health treatment before and after the tsunami was assessed.
Of the 342 respondents, 55 (16.8%) fulfilled the criteria of post-traumatic stress disorder (PTSD). Evidence of anxiety or depressive disorder was found in 17.8% and 8.0%, respectively. The tsunami victims who had been directly affected showed significantly more symptoms of anxiety, depression and PTSD, as well as post-traumatic personal growth, than tourists who were indirectly affected or unaffected. A total of 12.3% of untreated respondents fulfilled the criteria for PTSD and 38% of respondents who had received psychiatric treatment were still fulfilling PTSD criteria 2(1/2) years after the tsunami.
A marked percentage of respondents reported symptoms of PTSD but they remained untreated or were treated insufficiently. We recommend that tourists returning from regions affected by natural disasters be informed about PTSD and that careful screening be given to those found to be at risk of PTSD. An open-door policy of mental health services is particularly needed for tourists returning home who have been affected by large-scale disasters.
关于自然灾害后心理结果和心理健康治疗的大多数数据来自受灾地区的本地居民。研究从2004年海啸受灾地区返回的游客，为研究自然灾害对其原籍国心理结果和心理健康治疗的影响提供了一个机会。本研究的目的是基于一组回国瑞士游客的样本结果，扩展当前关于自然灾害后精神疾病发病率、潜在积极结果以及后续心理健康治疗的知识。
使用创伤后诊断量表、医院焦虑抑郁量表和创伤后成长量表对可能受2004年海啸影响的游客进行评估。结果变量与海啸暴露程度相关。此外，还评估了海啸前后的心理健康治疗情况。
在342名受访者中，55人（16.8%）符合创伤后应激障碍（PTSD）的标准。分别有17.8%和8.0%的人有焦虑或抑郁障碍的迹象。与间接受影响或未受影响的游客相比，直接受影响的海啸受害者表现出明显更多的焦虑、抑郁和PTSD症状，以及创伤后个人成长。在未经治疗的受访者中，共有12.3%符合PTSD标准，在海啸发生2年半后，38%接受过精神治疗的受访者仍符合PTSD标准。
相当比例的受访者报告有PTSD症状，但他们未得到治疗或治疗不足。我们建议，应告知从自然灾害受灾地区返回的游客有关PTSD的信息，并对那些被发现有PTSD风险的人进行仔细筛查。对于受大规模灾害影响回国的游客，尤其需要心理健康服务的开放政策。
