1 School of Psychology, University of New South Wales, Sydney, NSW, Australia.
2 Phoenix Australia, Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia.
Aust N Z J Psychiatry. 2018 Jun;52(6):542-551. doi: 10.1177/0004867417714337. Epub 2017 Jun 12.
To map the changing prevalence and predictors of psychological outcomes in affected communities 5 years following the Black Saturday bushfires in Victoria.
Follow-up assessment of longitudinal cohort study in high, medium and non-affected communities in Victoria, Australia. Participants included 1017 respondents (Wave 1) interviewed via telephone and web-based survey between December 2011 and January 2013, and 735 (76.1%) eligible participants were retested between July and November 2014 (Wave 2). The survey included measures of fire-related and subsequent stressful events, probable posttraumatic stress disorder, major depressive episode, alcohol use and severe distress.
There were reduced rates of fire-related posttraumatic stress disorder (8.7% vs 12.1%), general posttraumatic stress disorder (14.7% vs 18.2%), major depressive episode (9.0% vs 10.9%) and serious mental illness (5.4% vs 7.8%). Rates of resilience increased over time (81.8% vs 77.1%), and problem alcohol use remained high across Wave 1 (22.1%) and Wave 2 (21.4%). The most robust predictor of later development of fire-related posttraumatic stress disorder (odds ratio: 2.11; 95% confidence interval: [1.22, 3.65]), general posttraumatic stress disorder (odds ratio: 3.15; 95% confidence interval: [1.98, 5.02]), major depressive episode (odds ratio: 2.86; 95% confidence interval: [1.74, 4.70]), serious mental illness (odds ratio: 2.67; 95% confidence interval: [0.57, 1.72]) or diminished resilience (odds ratio: 2.01; 95% confidence interval: [1.32, 3.05]) was extent of recent life stressors.
Although rates of mental health problems diminished over time, they remained higher than national levels. Findings suggest that policy-makers need to recognize that the mental health consequences of disasters can persist for many years after the event and need to allocate resources towards those who are most at risk as a result of substantive losses and ongoing life stressors.
绘制维多利亚州“黑色星期六”山火 5 年后受灾社区心理结果变化的流行率及其预测因素。
在澳大利亚维多利亚州高、中、非受灾社区进行纵向队列研究的随访评估。参与者包括 1017 名受访者（第 1 波），他们在 2011 年 12 月至 2013 年 1 月期间通过电话和网络调查进行了访谈，其中 735 名（76.1%）符合条件的参与者在 2014 年 7 月至 11 月期间（第 2 波）进行了重新测试。该调查包括火灾相关和随后的压力事件、可能的创伤后应激障碍、重性抑郁发作、酒精使用和严重痛苦的测量。
火灾相关创伤后应激障碍（8.7%比 12.1%）、一般创伤后应激障碍（14.7%比 18.2%）、重性抑郁发作（9.0%比 10.9%）和严重精神疾病（5.4%比 7.8%）的发生率有所下降。弹性率随时间的推移而增加（81.8%比 77.1%），第 1 波（22.1%）和第 2 波（21.4%）的问题饮酒率仍然很高。后来发生火灾相关创伤后应激障碍（优势比：2.11；95%置信区间：[1.22，3.65]）、一般创伤后应激障碍（优势比：3.15；95%置信区间：[1.98，5.02]）、重性抑郁发作（优势比：2.86；95%置信区间：[1.74，4.70]）、严重精神疾病（优势比：2.67；95%置信区间：[0.57，1.72]）或弹性降低（优势比：2.01；95%置信区间：[1.32，3.05]）的最有力预测因素是近期生活压力源的程度。
尽管心理健康问题的发生率随着时间的推移而下降，但仍高于全国水平。研究结果表明，决策者需要认识到，灾难的心理健康后果可能会在事件发生后持续多年，并且需要向那些由于实质性损失和持续的生活压力源而面临最大风险的人分配资源。
