Shahed University, Tehran, Iran.
Health Qual Life Outcomes. 2012 Apr 12;10:36. doi: 10.1186/1477-7525-10-36.
Sulfur mustard (SM) has been used as a chemical warfare agent since the early twentieth century. Despite the large number of studies that have investigated SM induced ocular injuries, few of those studies have also focused on the psychological health status of victims. This study has evaluated the most prominent influences on the psychological health status of patients with severe SM induced ocular injuries.
This descriptive study was conducted on 149 Iranian war veterans with severe SM induced eye injuries. The psychological health status of all patients was assessed using the Iranian standardized Symptom Check List 90-Revised (SCL90-R) questionnaire. The results of patients' Global Severity Index (GSI) were compared with the optimal cut-off point of 0.4 that has previously been calculated for GSI in Iranian community. The Mann-Whitney U test, T tests and effect sizes (using Cohen's d) were employed as statistical methods. Data were analyzed using SPSS software.
The mean age of patients was 44.86 (SD=8.7) and mean duration of disease was 21.58 (SD=1.20) years. Rate of exposure was once in 99 (66.4%) cases. The mean GSI (1.46) of the study group was higher compared to standardized cut off point (0.4) of the Iranian community. The results of this study showed that the mean of total GSI score was higher in participants with lower educational levels (effect size=0.507), unemployment (effect size=0.464) and having more than 3 children (effect size=0.62). Among the participants, 87 (58.4%) cases had a positive psychological history for hospitalization or receiving outpatient cares previously and 62 (41.6%) cases had a negative psychological history. In addition, the mean of GSI in participants with negative psychological history was lower than those with positive psychological history (Mean Change Difference=-0.621 with SD=0.120). There was a significant difference between positive and negative psychological history with respect to GSI (P<0.001).
The study showed that severe ophthalmologic complications in chemical survivors are accompanied with destructive effects on psychological health status. Appropriate management may improve psychological health status in these patients.
自 20 世纪初以来，芥子气（SM）一直被用作化学战剂。尽管有大量研究调查了 SM 引起的眼部损伤，但很少有研究关注受害者的心理健康状况。本研究评估了对严重 SM 引起的眼部损伤患者心理健康状况影响最大的因素。
本描述性研究纳入了 149 名患有严重 SM 眼部损伤的伊朗退伍军人。使用伊朗标准化症状检查表 90 修订版（SCL90-R）问卷评估所有患者的心理健康状况。将患者的总体严重度指数（GSI）的结果与先前为伊朗社区计算的最佳截断点 0.4 进行比较。采用 Mann-Whitney U 检验、T 检验和效应量（使用 Cohen 的 d）作为统计学方法。使用 SPSS 软件进行数据分析。
患者的平均年龄为 44.86（SD=8.7）岁，疾病平均持续时间为 21.58（SD=1.20）年。99 例（66.4%）患者仅暴露 1 次。研究组的平均 GSI（1.46）高于伊朗社区标准化截断点（0.4）。本研究结果表明，教育程度较低（效应量=0.507）、失业（效应量=0.464）和子女超过 3 人（效应量=0.62）的参与者的总 GSI 评分均值较高。在参与者中，87 例（58.4%）有住院或门诊治疗的阳性心理史，62 例（41.6%）有阴性心理史。此外，有阳性心理史的参与者的 GSI 均值低于有阴性心理史的参与者（均值变化差值=-0.621，标准差=0.120）。阳性和阴性心理史与 GSI 之间存在显著差异（P<0.001）。
研究表明，化学幸存者的严重眼部并发症伴有对心理健康状况的破坏性影响。适当的管理可能会改善这些患者的心理健康状况。
