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中国2008年汶川地震8年后成年幸存者中的创伤后应激障碍和抑郁症

Post-traumatic stress disorder and depression among adult survivors 8 years after the 2008 Wenchuan earthquake in China.

作者信息

Guo Jing, He Huan, Qu Zhiyong, Wang Xiaohua, Liu Chengbin

机构信息

School of Sociology, Huazhong University of Science and Technology, Wuhan 430074, PR China.

Department of Public Administration, Southwestern University of Finance and Economics, Chengdou 610074, PR China.

出版信息

J Affect Disord. 2017 Mar 1;210:27-34. doi: 10.1016/j.jad.2016.12.009. Epub 2016 Dec 16.

Abstract

BACKGROUND

The Wenchuan earthquake was China's worst natural disaster of the past three decades. Although the psychological sequelae of disasters can last for many years, the long-term sequelae and their risk factors tend to receive little research attention.

OBJECTIVES

The objectives of the present study were to estimate the prevalences of symptomalogical PTSD and depression among survivors 8 years after the Wenchuan earthquake, and to identify the shared and unshared risk factors associated with PTSD and depression, using data from a cross-sectional survey.

METHODS

1369 participants were recruited from two different sites in the areas that were severely affected by the earthquake. Symptomalogical PTSD was assessed by the Impact of Event Scale-Revised (IES-R). The Chinese edition of the Center for Epidemiologic Studies Depression Scale (CES-D) was used to assess depression. Traumatic exposure to the Wenchuan earthquake was assessed using an exposure checklist designed by this study.

RESULTS

Eight years after the Wenchuan earthquake, 11.8% of the respondents had symptomalogical PTSD, and 24.8% of respondents had probable depression. The results also indicated that female gender, low education, poor perceived health, and traumatic experiences after the earthquake were associated with higher odds of both PTSD and depression among survivors. Direct exposure to the earthquake was associated with comorbid symptomalogical PTSD and depression (OR=1.86; 95% CI=1.42, 2.44). Those having only depression were more likely to be unmarried/divorced/widowed, and to have experienced fear at the time of the earthquake (OR=1.34; 95% CI=1.04, 1.72), while those with only symptomalogical PTSD were likely to be from the township of Yongan as opposed to Guangji (OR=1.86; 95% CI=1.06, 3.31).

LIMITATIONS

This is a cross-sectional study, and thus is insufficient for determining causal relationships with regard to chronic PTSD or depression.

CONCLUSIONS

The results of this study indicate that symptomalogical PTSD and depression persist among many survivors of the Wenchuan earthquake, 8 eight years later. Objective earthquake exposure is associated with symptomalogical PTSD, while subjective exposure is associated with long-term depression.

摘要

背景

汶川地震是中国过去三十年来最严重的自然灾害。尽管灾难的心理后遗症可能持续多年,但长期后遗症及其风险因素往往很少受到研究关注。

目的

本研究的目的是利用横断面调查数据,估计汶川地震8年后幸存者中症状性创伤后应激障碍(PTSD)和抑郁症的患病率,并确定与PTSD和抑郁症相关的共同和非共同风险因素。

方法

从地震重灾区的两个不同地点招募了1369名参与者。使用事件影响量表修订版(IES-R)评估症状性PTSD。采用中文版流行病学研究中心抑郁量表(CES-D)评估抑郁症。使用本研究设计的暴露清单评估对汶川地震的创伤暴露情况。

结果

汶川地震8年后,11.8%的受访者有症状性PTSD,24.8%的受访者可能患有抑郁症。结果还表明,女性、低学历、健康状况差以及地震后的创伤经历与幸存者中PTSD和抑郁症的较高几率相关。直接暴露于地震与症状性PTSD和抑郁症共病相关(OR=1.86;95%CI=1.42,2.44)。仅有抑郁症的人更可能未婚/离婚/丧偶,并且在地震发生时经历过恐惧(OR=1.34;95%CI=1.04,1.72),而仅有症状性PTSD的人可能来自永安镇而非广济镇(OR=1.86;95%CI=1.06,3.31)。

局限性

这是一项横断面研究,因此不足以确定与慢性PTSD或抑郁症的因果关系。

结论

本研究结果表明,汶川地震8年后,许多幸存者中仍存在症状性PTSD和抑郁症。客观的地震暴露与症状性PTSD相关,而主观暴露与长期抑郁症相关。

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