Keraite Arune, Sumathipala Athula, Siriwardhana Chesmal, Morgan Craig, Reininghaus Ulrich
Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College, London, UK.
Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire, UK; Institute for Research and Development, Colombo, Sri Lanka.
Schizophr Res. 2016 Mar;171(1-3):79-85. doi: 10.1016/j.schres.2016.01.026. Epub 2016 Jan 24.
Recent research conducted in high-income countries suggests psychotic experiences are common in the general population, but evidence from low- and middle-income countries (LMIC) remains limited. Sri Lanka is a LMIC affected by three decades of civil conflict and, in 2004, a devastating tsunami. This study aimed to investigate the prevalence of psychotic experiences in a general population sample in Sri Lanka and associations with conflict- and tsunami-related trauma. This is a first National Mental Health Survey conducted in Sri Lanka. A cross-sectional, multi-stage, cluster sampling design was used to estimate the prevalence of psychotic symptoms. Data on socio-demographic characteristics, conflict- and tsunami-related trauma, and psychotic experiences were collected using culturally validated measures in a sample of 5927 participants. The weighted prevalence of psychotic symptoms was 9.7%. Exposure to one or more conflict-related events (adj. OR 1.79, 95% CI 1.40-2.31, p<0.001) and loss or injury of a family member or friend through conflict (adj. OR, 1.83, 95% CI 1.42-2.37, p<0.001) were associated with increased odds of reporting psychotic experiences. Psychotic experiences were more common in individuals directly exposed to tsunami disaster (adj. OR, 1.68, 95% CI 1.04-2.73, P=0.035) and in those who had a family member who died or was injured as result of tsunami (adj. OR, 1.42, 95% CI 1.04-1.94, p=0.029). Our findings suggest that psychotic experiences are common in the Sri Lankan population. Exposure to traumatic events in armed conflicts and natural disasters may be important socio-environmental factors in the development of psychotic experiences.
近期在高收入国家开展的研究表明，精神病性体验在普通人群中很常见，但来自低收入和中等收入国家（LMIC）的证据仍然有限。斯里兰卡是一个受三十年内战以及2004年毁灭性海啸影响的低收入和中等收入国家。本研究旨在调查斯里兰卡普通人群样本中精神病性体验的患病率以及与冲突和海啸相关创伤的关联。这是在斯里兰卡进行的首次全国心理健康调查。采用横断面、多阶段、整群抽样设计来估计精神病性症状的患病率。使用经过文化验证的测量方法，在5927名参与者的样本中收集了社会人口学特征、与冲突和海啸相关的创伤以及精神病性体验的数据。精神病性症状的加权患病率为9.7%。经历一次或多次与冲突相关的事件（校正比值比1.79，95%置信区间1.40 - 2.31，p<0.001）以及因冲突导致家庭成员或朋友丧生或受伤（校正比值比1.83，95%置信区间1.42 - 2.37，p<0.001）与报告精神病性体验的几率增加相关。精神病性体验在直接遭受海啸灾难的个体中更为常见（校正比值比1.68，95%置信区间1.04 - 2.73，P = 0.035），在有家庭成员因海啸死亡或受伤的个体中也更为常见（校正比值比1.42，95%置信区间1.04 - 1.94，p = 0.029）。我们的研究结果表明，精神病性体验在斯里兰卡人群中很常见。武装冲突和自然灾害中的创伤事件暴露可能是精神病性体验发展中的重要社会环境因素。
