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东日本大地震后宫城县孕期的心理困扰:日本环境与儿童研究

Psychological distress during pregnancy in Miyagi after the Great East Japan Earthquake: The Japan Environment and Children's Study.

作者信息

Watanabe Zen, Iwama Noriyuki, Nishigori Hidekazu, Nishigori Toshie, Mizuno Satoshi, Sakurai Kasumi, Ishikuro Mami, Obara Taku, Tatsuta Nozomi, Nishijima Ichiko, Fujiwara Ikuma, Nakai Kunihiko, Arima Takahiro, Takeda Takashi, Sugawara Junichi, Kuriyama Shinichi, Metoki Hirohito, Yaegashi Nobuo

机构信息

Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan.

Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan; Environment and Genome Research Center, Tohoku University Graduate School of Medicine, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan.

出版信息

J Affect Disord. 2016 Jan 15;190:341-348. doi: 10.1016/j.jad.2015.10.024. Epub 2015 Oct 28.

Abstract

OBJECTIVE

To examine psychological distress among pregnant women in Miyagi prefecture which was directly affected by the Great East Japan Earthquake and tsunami and compare other areas of Japan that were less damaged.

METHODS

This study was conducted in conjunction with the Japan Environment and Children's Study (JECS). We examined 10,129 Japanese women using the primary fixed data of the JECS. The Kessler 6-item psychological distress scale (K6) was administered to 7473 eligible women including 998 in Miyagi unit center ('Miyagi UC') and 6475 in the other unit centers ('13UCs'). We compared the prevalence and the risk of distress (K6 ≥ 13) during pregnancy in 'Miyagi UC' and '13UCs'.

RESULTS

More women in 'Miyagi UC' (4.9%) suffered psychological distress, compared with '13UCs' (3.1%) (p<0.001). A significantly higher prevalence of women in 'Miyagi UC' (55.5%) had experienced negative life events, whereas '13UCs' showed 42.7% (p<0.0001). In multivariable logistic analyses adjusted for baseline characteristics, there was a significant regional difference of psychological distress (adjusted odds ratio; aOR in Miyagi UC=1.488; 95%CI, 1.059-2.090). After further adjusting for negative life events, the association was diminished (aOR=1.338; 95%CI, 0.949-1.884).

LIMITATIONS

The JECS had no data before the earthquake and the extent of damage was not investigated. Possible regional representativeness is also a limitation.

CONCLUSION

After the Great East Japan Earthquake, the prevalence of pregnant women with psychological distress (K6 ≥ 13) were high in Miyagi prefecture. Especially in the coastal area directly affected by tsunami, it is high with or without negative life events experienced.

摘要

目的

调查受东日本大地震和海啸直接影响的宫城县孕妇的心理困扰情况,并与日本其他受灾较轻地区进行比较。

方法

本研究与日本环境与儿童研究(JECS)联合开展。我们使用JECS的主要固定数据对10129名日本女性进行了调查。对7473名符合条件的女性施行了凯斯勒6项心理困扰量表(K6),其中包括宫城单元中心(“宫城UC”)的998名女性和其他单元中心(“13个UC”)的6475名女性。我们比较了“宫城UC”和“13个UC”孕期心理困扰(K6≥13)的患病率和风险。

结果

“宫城UC”中遭受心理困扰的女性(4.9%)多于“13个UC”(3.1%)(p<0.001)。“宫城UC”中经历负面生活事件的女性患病率(55.5%)显著更高,而“13个UC”为42.7%(p<0.0001)。在根据基线特征进行调整的多变量逻辑分析中,心理困扰存在显著的地区差异(调整后的优势比;宫城UC的aOR=1.488;95%CI,1.059-2.090)。在进一步对负面生活事件进行调整后,这种关联减弱(aOR=1.338;95%CI,0.949-1.884)。

局限性

JECS没有地震前的数据,且未调查受损程度。可能的地区代表性也是一个局限性。

结论

东日本大地震后,宫城县心理困扰(K6≥13)的孕妇患病率较高。尤其是在直接受海啸影响的沿海地区,无论是否经历负面生活事件,患病率都很高。

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