The Altshuler Center for Education & Research at Metrocare Services and Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, USA.
Department of Psychiatry, Keck School of Medicine, Los Angeles, CA, USA.
J Psychiatr Res. 2018 Jul;102:96-101. doi: 10.1016/j.jpsychires.2017.12.013. Epub 2017 Dec 25.
The objective of this study was to examine predictors of postdisaster major depression in two separate datasets of survivors of various disasters. Postdisaster major depression was examined in two disaster databases using consistent research methodology, permitting combination of databases into a combined dataset including 1181 survivors of 11 disasters representing all major disaster typologies with full diagnostic assessment using structured diagnostic interviews from two databases. The first database includes 808 directly-exposed survivors of 10 disasters. The second includes 373 survivors of the September 11, 2001 attacks on New York City's World Trade Center, recruited from employees of eight organizations affected by the disaster. This rich dataset permitted comparison of predictors of postdisaster major depression between databases and across survivors of different disasters. Identical models applied to both databases found postdisaster major depression to be independently associated with pre-existing major depression, indirect exposure to disaster trauma through family/friends, and disaster-related PTSD. In a final model limited to directly-exposed disaster across both databases, postdisaster major depression was independently associated with terrorism in addition to the 3 variables that predicted postdisaster major depression in the two separate databases. Replication of findings from one model to the next across different types of disasters and populations in this study suggests that these three variables could potentially provide a powerful tool for estimating likelihood of postdisaster major depression.
这项研究的目的是在两个独立的灾难幸存者数据库中，研究灾难后重度抑郁症的预测因素。在两个灾难数据库中，使用一致的研究方法检查了灾难后重度抑郁症，允许将数据库合并为一个包含 11 个灾难的 1181 名幸存者的综合数据集，这些灾难代表了所有主要的灾难类型，使用来自两个数据库的结构化诊断访谈进行了全面的诊断评估。第一个数据库包括 10 个灾难中的 808 名直接受灾幸存者。第二个数据库包括 373 名 2001 年 9 月 11 日纽约世界贸易中心袭击事件的幸存者，这些幸存者是从受灾难影响的八个组织的员工中招募的。这个丰富的数据集允许比较不同数据库和不同灾难幸存者的灾难后重度抑郁症的预测因素。相同的模型适用于两个数据库，发现灾难后重度抑郁症与先前存在的重度抑郁症、通过家人/朋友间接接触灾难创伤以及与灾难相关的 PTSD 独立相关。在一个仅限于两个数据库中直接暴露于灾难的最终模型中，除了在两个独立数据库中预测灾难后重度抑郁症的 3 个变量外，灾难后重度抑郁症与恐怖主义独立相关。在这项研究中，从一个模型到另一个模型在不同类型的灾难和人群中复制发现，这三个变量可能为估计灾难后重度抑郁症的可能性提供一个有力的工具。
