Jha Arun, Shakya Suraj, Zang Yinyin, Pathak Nishita, Pradhan Prabhat Kiran, Bhatta Khem Raj, Sthapit Sabitri, Niraula Shanta, Nehete Rajesh
Hertfordshire Partnership University NHS Foundation Trust, Hertfordshire, UK.
Department of Psychiatry and Mental Health, TU Teaching Hospital, Kathmandu, Nepal.
Indian J Psychiatry. 2017 Jul-Sep;59(3):320-327. doi: 10.4103/psychiatry.IndianJPsychiatry_236_16.
In April 2015, a major earthquake struck northern regions of Nepal affecting one-third of the population, and many suffered mental health problems.
This study aimed to conduct a preliminary investigation of prevalence and feasibility of brief therapy for posttraumatic stress disorder (PTSD) among earthquake survivors.
This is an exploratory cross-sectional study of prevalence and feasibility of brief trauma-focused therapy for PTSD among survivors 3 and 11 months after the earthquake in affected areas near Kathmandu.
A team of local nonspecialist mental health volunteers was trained to identify survivors with PTSD using the PTSD checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (PCL-5) (cutoff score 38). They were trained to deliver either shortened versions of narrative exposure therapy (NET)-revised or group-based control-focused behavioral treatment (CFBT).
Altogether, 333 survivors were surveyed (130 in July 2015 and 203 in March 2016) with PCL-5 as the screening instrument, using the cutoff score of 38 or more for diagnosing PTSD. A PTSD prevalence of 33% was noted in 2015 and 28.5% in 2016. This drop of 4.5% prevalence in the intervening 8 months suggests that a significant number of survivors are still suffering from PTSD. Most participants were female, aged 40 or above, married, and poorly educated. Compared to the brief (four sessions) individual NET-revised, a group-based CFBT was found more acceptable and affordable.
PTSD is common following earthquake trauma, and if untreated, survivors continue to suffer for a long time. Management of PTSD should be included in future disaster management plans.
2015年4月，尼泊尔北部地区发生大地震，三分之一的人口受到影响，许多人出现心理健康问题。
本研究旨在对地震幸存者中创伤后应激障碍（PTSD）简短治疗的患病率及可行性进行初步调查。
这是一项探索性横断面研究，研究加德满都附近受灾地区地震发生3个月和11个月后，PTSD简短创伤聚焦治疗的患病率及可行性。
一组当地非专业心理健康志愿者接受培训，使用《精神疾病诊断与统计手册》第五版（PCL-5）的PTSD检查表（临界值为38分）来识别PTSD幸存者。他们接受培训，提供叙事暴露疗法（NET）修订版的缩短版本或基于团体的以控制为重点的行为治疗（CFBT）。
共对333名幸存者进行了调查（2015年7月130名，2016年3月203名），以PCL-5作为筛查工具，采用38分及以上的临界值来诊断PTSD。2015年PTSD患病率为33%，2016年为28.5%。在这中间的8个月里患病率下降了约4.5%，这表明仍有相当数量的幸存者患有PTSD。大多数参与者为女性，年龄在40岁及以上，已婚，且受教育程度低。与简短的（四节）个体NET修订版相比，基于团体的CFBT被发现更易接受且成本更低。
地震创伤后PTSD很常见，若不治疗，幸存者会长期受苦。PTSD的管理应纳入未来的灾害管理计划中。
