Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA.
Depress Anxiety. 2013 May;30(5):413-24. doi: 10.1002/da.22007. Epub 2012 Nov 1.
In the first population-based study of psychopathology conducted in Haiti, we documented earthquake-related experiences associated with risk for posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) 2-4 months following the 2010 Haiti earthquake.
A population-based survey was conducted of 1,323 survivors randomly selected from the general nondisplaced community, internally displaced persons camps, and a community clinic. Respondents were from the Nazon area of Port-au-Prince, ∼20 miles from the epicenter.
Respondents (90.5%) reported at least one relative/close friend injured/killed, 93% saw dead bodies, and 20.9% lost their job post-earthquake. The prevalence of PTSD (24.6%) and MDD (28.3%) was high. History of violent trauma was associated with risk of PTSD and MDD (adjusted odds ratio [AOR] 1.4, 95% confidence interval [CI], 1.0-1.9; AOR, 1.7, 95% CI 1.3, 2.2, respectively). Low social support (AOR, 1.7, 95% CI 1.2, 2.3; AOR 1.4, 95% CI 1.0, 1.9, respectively) increased risk of PTSD and MDD among women. Suffering damage to the home increased risk of MDD in males (AOR 2.8, 95% CI 1.5, 5.5). Associations between being trapped in rubble, major damage to house, job loss, and PTSD; and participation in rescue/recovery, friends/family injured/killed, and MDD varied based on prior history of violent trauma.
Addressing mental health in a post-earthquake setting such as Haiti will require focusing resources on screening and treatment of identified vulnerable groups while targeting improvement of post-earthquake living conditions. Investment in sources of social support for women may make help mitigate the vulnerability of women to PTSD and MDD.
在海地进行的首次基于人群的精神病理学研究中,我们记录了 2010 年海地地震后 2-4 个月与创伤后应激障碍(PTSD)和重度抑郁障碍(MDD)相关的地震相关经历。
对来自太子港纳宗地区的 1323 名随机抽取的未流离失所的社区、国内流离失所者营地和社区诊所的幸存者进行了一项基于人群的调查。该地区距离震中约 20 英里。
受访者(90.5%)报告至少有一位亲属/亲密朋友受伤/死亡,93%的人看到了尸体,20.9%的人在地震后失业。PTSD(24.6%)和 MDD(28.3%)的患病率很高。暴力创伤史与 PTSD 和 MDD 的风险相关(调整后的优势比[OR] 1.4,95%置信区间[CI],1.0-1.9;OR,1.7,95%CI 1.3,2.2,分别)。低社会支持(OR,1.7,95%CI 1.2,2.3;OR 1.4,95%CI 1.0,1.9,分别)增加了女性 PTSD 和 MDD 的风险。房屋受损会增加男性患 MDD 的风险(OR 2.8,95%CI 1.5,5.5)。被困在瓦砾中、房屋严重受损、失业与 PTSD 之间的关联;以及参与救援/恢复、朋友/家人受伤/死亡与 MDD 的关联,均基于先前的暴力创伤史。
在海地等地震后环境中解决心理健康问题需要集中资源对确定的弱势群体进行筛查和治疗,同时改善地震后的生活条件。为女性提供社会支持的来源可能有助于减轻女性患 PTSD 和 MDD 的脆弱性。