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德里市区贫民窟中度灾害后精神健康发病率、模式及预测因素:一项改良队列研究。

Prevalence, pattern and predictors of mental health morbidity following an intermediate disaster in an urban slum in delhi : a modified cohort study.

机构信息

Prof. & Head, Dept. of Psychiatry and Medical Superintendent, Institute of Human Behaviour and Allied Sciences (IHBAS), Dilshad Garden, Delhi 110 095

出版信息

Indian J Psychiatry. 2004 Jan;46(1):39-51.

Abstract

The present study reports on the findings from an ICMR supported Research Project on the mental health consequences and service needs of the population of an urban slum in Delhi affected by an intermediate fire disaster. The study was aimed at examining the prevalence, the pattern and the predictors of mental health morbidity in the disaster affected population. Modified cohort design was used , with a control group, and two stage assessments for the prevalence of psychiatric disorder at two years after the disaster, with GHQ-12 and SCAN based clinical interview with ICD-10-DCR.. The data were analysed using r2 test and independent 't' test for inter group comparison and stepwise logistic regression for finding predictors of psychiatric morbidity and psychological ill health. The prevalence of psychiatric disorders was significantly higher (78/1,000 v/s 22/1,000), and the prevalence of psychological ill health was also higher (232/1000 v/s 50/1000), as compared to the control group. The commonest psychiatric disorders were Depression, Substance Use Disorders, Generalised Anxiety Disorder, and Somatoform Disorders. The commonest symptoms of psychological ill health were suggestive of depression. Age and participation in relief work were found to be strong predictors, and physical injuries were found to be a weak predictor of mental health morbidity. The findings have important implications in the service delivery and research on mental health aspects of disasters, which are highlighted and discussed.

摘要

本研究报告了一项由印度医学研究理事会支持的研究项目的结果,该项目关注德里一个城市贫民窟居民在遭受中度火灾灾害后的心理健康后果和服务需求。该研究旨在检查受灾人群中心理健康发病率的流行率、模式和预测因素。采用改良队列设计,设有对照组,并在灾难发生两年后进行两次阶段评估,使用 GHQ-12 和基于 SCAN 的 ICD-10-DCR 临床访谈评估精神障碍的患病率。使用 r2 检验和独立 't' 检验进行组间比较,使用逐步逻辑回归分析寻找精神疾病发病率和心理不健康的预测因素。与对照组相比,受灾人群的精神障碍患病率(78/1000 与 22/1000)和心理不健康患病率(232/1000 与 50/1000)均显著更高。最常见的精神障碍是抑郁症、物质使用障碍、广泛性焦虑障碍和躯体形式障碍。心理不健康最常见的症状提示存在抑郁。年龄和参与救援工作被发现是强有力的预测因素,而身体损伤被发现是心理健康发病率的一个较弱预测因素。这些发现对灾难心理健康方面的服务提供和研究具有重要意义,本文对此进行了强调和讨论。

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