Bromet Evelyn J, Clouston Sean, Gonzalez Adam, Kotov Roman, Guerrera Kathryn M, Luft Benjamin J
Department of Psychiatry, Stony Brook University, Stony Brook, New York, USA.
Program in Public Health, Department of Preventive Medicine, Stony Brook University, Stony Brook, New York, USA.
J Trauma Stress. 2017 Apr;30(2):107-114. doi: 10.1002/jts.22178. Epub 2017 Apr 3.
The psychological consequences of a second disaster on populations exposed to an earlier disaster have rarely been studied prospectively. Using a pre- and postdesign, we examined the effects of Hurricane Sandy on possible World Trade Center (WTC) related posttraumatic stress disorder (PTSD Checklist score of ≥ 50) and overall depression (major depressive disorder [MDD]; Patient Health Questionnaire depression score of ≥ 10) among 870 WTC responders with a follow-up monitoring visit at the Long Island WTC Health Program during the 6 months post-Hurricane Sandy. The Hurricane Sandy exposures evaluated were damage to home (8.3%) and to possessions (7.8%), gasoline shortage (24.1%), prolonged power outage (42.7%), and filing a Federal Emergency Management Agency claim (11.3%). A composite exposure score also was constructed. In unadjusted analyses, Hurricane Sandy exposures were associated with 1.77 to 5.38 increased likelihood of PTSD and 1.58 to 4.13 likelihood of MDD; odds ratios for ≥ 3 exposures were 6.47 for PTSD and 6.45 for MDD. After adjusting for demographic characteristics, WTC exposure, pre-Hurricane Sandy mental health status, and time between assessments, reporting ≥ 3 Hurricane Sandy exposures was associated with a 3.29 and 3.71 increased likelihood of PTSD and MDD, respectively. These findings underscore the importance of assessing the impact of a subsequent disaster in ongoing responder health surveillance programs.
第二次灾难对曾遭受过早期灾难的人群产生的心理影响，此前很少有前瞻性研究。我们采用前后设计，在飓风桑迪过后6个月内，对870名世贸中心应急响应人员进行了随访监测，考察了飓风桑迪对可能出现的与世贸中心相关的创伤后应激障碍（创伤后应激障碍检查表得分≥50）和总体抑郁（重度抑郁症[MDD]；患者健康问卷抑郁得分≥10）的影响。评估的飓风桑迪暴露情况包括房屋受损（8.3%）、财产受损（7.8%）、汽油短缺（24.1%）、长时间停电（42.7%）以及提交联邦紧急事务管理局索赔申请（11.3%）。还构建了一个综合暴露得分。在未经调整的分析中，飓风桑迪暴露与创伤后应激障碍发生可能性增加1.77至5.38倍以及重度抑郁症发生可能性增加1.58至4.13倍相关；暴露≥3次的创伤后应激障碍和重度抑郁症的比值比分别为6.47和6.45。在对人口统计学特征、世贸中心暴露情况、飓风桑迪前心理健康状况以及评估间隔时间进行调整后，报告飓风桑迪暴露≥3次分别与创伤后应激障碍和重度抑郁症发生可能性增加3.29倍和3.71倍相关。这些发现强调了在持续的应急响应人员健康监测项目中评估后续灾难影响的重要性。
