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格鲁吉亚境内流离失所者和回归者中的精神障碍及其与残疾的关联。

Mental disorders and their association with disability among internally displaced persons and returnees in Georgia.

作者信息

Makhashvili Nino, Chikovani Ivdity, McKee Martin, Bisson Jonathan, Patel Vikram, Roberts Bayard

机构信息

Global Initiative on Psychiatry-Tbilisi, Tbilisi, Georgia; Ilia State University, Tbilisi, Georgia.

出版信息

J Trauma Stress. 2014 Oct;27(5):509-18. doi: 10.1002/jts.21949.

Abstract

There remains limited evidence on comorbidity of mental disorders among conflict-affected civilians, particularly internally displaced persons (IDPs) and former IDPs who have returned to their home areas (returnees). The study aim was to compare patterns of mental disorders and their influence on disability between IDPs and returnees in the Republic of Georgia. A cross-sectional household survey was conducted with adult IDPs from the conflicts in the 1990s, the 2008 conflict, and returnees. Posttraumatic stress disorder (PTSD), depression, anxiety, and disability were measured using cut scores on Trauma Screening Questionnaire, Patient Health Questionnaire 9, Generalised Anxiety Disorder 7, and the WHO Disability Assessment Schedule 2.0. Among the 3,025 respondents, the probable prevalence of PTSD, depression, anxiety, and comorbidity (>1 condition) was 23.3%, 14.0%, 10.4%, 12.4%, respectively. Pearson correlation coefficients (p < .001) were .40 (PTSD with depression), .38 (PTSD with anxiety), and .52 (depression with anxiety). Characteristics associated with mental disorders in regression analyses included displacement (particularly longer-term), cumulative trauma exposure, female gender, older age, poor community conditions, and bad household economic situation; coefficients ranged from 1.50 to 3.79. PTSD, depression, anxiety, and comorbidity were associated with increases in disability of 6.4%, 9.7%, 6.3%, and 15.9%, respectively. A high burden of psychiatric symptoms and disability persist among conflict-affected persons in Georgia.

摘要

关于受冲突影响的平民,尤其是境内流离失所者(IDP)以及返回原居地的前境内流离失所者(回归者)中精神障碍共病的证据仍然有限。本研究旨在比较格鲁吉亚共和国境内流离失所者与回归者的精神障碍模式及其对残疾的影响。对经历过20世纪90年代冲突、2008年冲突的成年境内流离失所者以及回归者进行了横断面家庭调查。使用创伤筛查问卷、患者健康问卷9、广泛性焦虑障碍7和世界卫生组织残疾评估量表2.0的临界值来测量创伤后应激障碍(PTSD)、抑郁症、焦虑症和残疾情况。在3025名受访者中,PTSD、抑郁症、焦虑症和共病(>1种情况)的可能患病率分别为23.3%、14.0%、10.4%、12.4%。Pearson相关系数(p <.001)分别为0.40(PTSD与抑郁症)、0.38(PTSD与焦虑症)和0.52(抑郁症与焦虑症)。回归分析中与精神障碍相关的特征包括流离失所(尤其是长期流离失所)、累积创伤暴露、女性、年龄较大、社区条件差和家庭经济状况不佳;系数范围为1.50至3.79。PTSD、抑郁症、焦虑症和共病分别与残疾增加6.4%、9.7%、6.3%和15.9%相关。格鲁吉亚受冲突影响人群中持续存在着高负担的精神症状和残疾情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a155/4496794/9d393327a896/jts0027-0509-f1.jpg

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