飓风“艾克”影响下的老年人创伤后应激障碍、抑郁和心理护理需求。
Posttraumatic stress disorder, depression, and perceived needs for psychological care in older persons affected by Hurricane Ike.
机构信息
National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA.
出版信息
J Affect Disord. 2012 Apr;138(1-2):96-103. doi: 10.1016/j.jad.2011.12.018. Epub 2012 Jan 28.
OBJECTIVE
To examine the prevalence and correlates of disaster-related posttraumatic stress disorder (PTSD), depression, and needs for psychological care in older persons affected by Hurricane Ike.
METHOD
A total of 193 adults aged 60 or older who resided in the Galveston Bay area were interviewed 2-5 months following Hurricane Ike. Pre-, peri-, and post-disaster variables hypothesized to be related to PTSD and depressive symptoms, and perceived needs for psychological care were assessed.
RESULTS
Weighted prevalences of past-month Ike-related PTSD and depression were 7.6% and 8.6%, respectively. Risk factors for Ike-related PTSD symptoms were predominantly peri-disaster in nature, with greater hurricane exposure, and peri-event dissociative and autonomic activation symptoms associated positively with these symptoms. Risk factors for depressive symptoms were predominantly pre-disaster in nature, with being married/living with partner associated negatively, and prior disaster exposure and pre-disaster PTSD or depression associated positively with these symptoms. 27.2% of the sample endorsed at least one of the perceived needs for psychological care assessed. A history of PTSD or depression, greater peri-event autonomic activation, and Ike-related PTSD and depressive symptoms were associated with greater need for psychological care.
LIMITATIONS
This study is limited by its cross-sectional design and employment of psychiatric screening instruments.
CONCLUSIONS
A substantial proportion of older adults may have PTSD and depression, as well as perceived needs for psychological care, after a disaster. Assessment of disaster exposures, and peri-event dissociative and autonomic symptoms may help identify older adults at risk for disaster-related psychopathology. Older adults with a history of PTSD or depression, and greater peri-event autonomic activation and PTSD symptoms may be more likely to have needs for psychological care.
目的
调查受艾克飓风影响的老年人中与灾害相关的创伤后应激障碍（PTSD）、抑郁和心理护理需求的发生率和相关因素。
方法
在艾克飓风后 2-5 个月，对居住在加尔维斯顿湾地区的 193 名 60 岁或以上的成年人进行了访谈。评估了与 PTSD 和抑郁症状以及心理护理需求相关的假设的灾前、灾中和灾后变量。
结果
过去一个月中与艾克飓风相关的 PTSD 和抑郁的加权发生率分别为 7.6%和 8.6%。与艾克相关 PTSD 症状相关的风险因素主要是灾中性质，飓风暴露程度越高，事件前分离和自主激活症状与这些症状呈正相关。与抑郁症状相关的风险因素主要是灾前性质，与已婚/与伴侣同住呈负相关，而先前的灾难暴露、灾前 PTSD 或抑郁与这些症状呈正相关。样本中 27.2%的人至少有一项评估的心理护理需求。有 PTSD 或抑郁史、更大的事件前自主激活以及与艾克相关的 PTSD 和抑郁症状与对心理护理的更大需求相关。
局限性
本研究受到其横断面设计和使用精神科筛查工具的限制。
结论
相当一部分老年人在灾难后可能会出现 PTSD 和抑郁，以及对心理护理的需求。对灾难暴露的评估，以及事件前的分离和自主症状可能有助于识别有患与灾难相关的精神病理学风险的老年人。有 PTSD 或抑郁史、更大的事件前自主激活和 PTSD 症状的老年人可能更需要心理护理。
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