Department of Psychiatry, VA North Texas Health Care System, University of Texas Southwestern Medical Center, Dallas, TX 75390-8828, USA.
Soc Psychiatry Psychiatr Epidemiol. 2013 Feb;48(2):195-203. doi: 10.1007/s00127-012-0535-4. Epub 2012 Jun 21.
While disasters are common in Africa, disaster studies in Africa are underrepresented in the published literature. This study prospectively examined the longitudinal course of psychopathology, coping, and functioning among 128 directly exposed Kenyan civilian survivors of the 1998 US Embassy bombing in Nairobi.
The Diagnostic Interview Schedule/Disaster Supplement assessed predisaster and postdisaster psychiatric disorders and variables related to coping, functioning, safety, and religion near the end of the first and third postdisaster years.
Total postdisaster prevalence of posttraumatic stress disorder (PTSD) at the 3-year follow-up was 49; 28% of the sample still had active PTSD. Delayed-onset PTSD was not observed. Posttraumatic symptoms decayed more slowly in individuals with than those without PTSD. PTSD was more prevalent and chronic than major depression. Those with current PTSD or major depression reported more functioning problems than those without. The length of hospitalization for injuries after the bombing predicted major depression remission, but no predictors of PTSD remission were found.
Despite differences in coping and social variables, longitudinal psychopathology in the Nairobi terrorism survivors appeared broadly similar to results in Western disaster populations. These findings contribute to the understanding of disaster mental health in Africa and may have implications for generalizability of psychiatric effects of terrorist attacks around the globe.
虽然灾难在非洲很常见，但有关非洲灾难的研究在已发表的文献中却很少有涉及。本研究前瞻性地考察了 1998 年美国驻内罗毕大使馆爆炸事件中 128 名直接受影响的肯尼亚平民幸存者在灾难后的心理病理、应对方式和功能的纵向变化过程。
在灾难发生后的第一年和第三年接近尾声时，使用诊断访谈表/灾难补充问卷评估了发病前和发病后的精神障碍以及与应对方式、功能、安全和宗教相关的变量。
在 3 年的随访中，创伤后应激障碍（PTSD）的总发病后患病率为 49%；有 28%的样本仍患有活动性 PTSD。未观察到延迟发作的 PTSD。与没有 PTSD 的个体相比，PTSD 患者的创伤后症状消退得更慢。PTSD 的患病率和慢性程度均高于重度抑郁症。当前患有 PTSD 或重度抑郁症的个体报告的功能问题比没有的个体更多。爆炸后住院治疗的时间长短可以预测重度抑郁症的缓解，但未发现 PTSD 缓解的预测因素。
尽管在应对和社会变量方面存在差异，但内罗毕恐怖主义幸存者的纵向心理病理表现与西方灾难人群的结果大致相似。这些发现有助于理解非洲的灾难心理健康问题，并且可能对全球恐怖袭击的精神影响的普遍性具有启示意义。
