Shih Hsin-I, Chao Tzu-Yuan, Huang Yi-Ting, Tu Yi-Fang, Wang Jung-Der, Chang Chia-Ming
Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; School of Medicine, College of Medicine, National Cheng Kung University Hospital, Tainan, Taiwan; Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Department of Urban Planning, National Cheng Kung University, Tainan, Taiwan.
J Formos Med Assoc. 2021 Jan;120(1 Pt 2):337-345. doi: 10.1016/j.jfma.2020.05.016. Epub 2020 Jun 3.
BACKGROUND/PURPOSE: Typhoon Morakot in August 2009 caused significant damages and health and socio-economic impacts in Taiwan. Therefore, we evaluated the mental health status of adult and patients who lived in the affected area after the disaster.
An observational, prospective population-based study was conducted. Adults living in the affected area were selected as the affected population in the National Health Insurance Database from January 2008 to December 2011. Prevalence and incidence of stress-associated illnesses, such as insomnia, anxiety, depressive, adjustment and mood disorders, post-traumatic stress disorder (PTSD) in the psychiatry department were analysed after the disaster.
A total of 897,689 adult patients were studied. Of the affected population without pre-existing chronic mental health illness, the monthly visits for stress-associated illnesses, such as insomnia, anxiety, depressive disorders and PTSD increased about twice after the disaster in elderly and non-elderly groups. Comparing to the non-elderly group, the elderly group has more increased in the incidence of insomnia (356% vs. 318% increase) and depressive disorders (308% vs. 245%) but was affected to a lesser extent increase in the anxiety (269% vs. 307%), PTSD, episodic mood disorders (82% vs. 158%), and adjustment reaction (160% vs. 202%).
The mental health statuses of patients who experienced a major natural disaster deteriorated in the elderly population after the disaster. However, we still need pay more attentions on the elderly of the affected population to decrease the risk for insomnia and depressive disorders after the disaster.
背景/目的：2009年8月的莫拉克台风给台湾造成了重大破坏以及健康和社会经济影响。因此，我们评估了受灾地区成年居民和患者灾后的心理健康状况。
开展了一项基于人群的前瞻性观察性研究。从2008年1月至2011年12月的国民健康保险数据库中选取居住在受灾地区的成年人作为受灾人群。分析灾后精神科压力相关疾病的患病率和发病率，如失眠、焦虑、抑郁、适应和情绪障碍、创伤后应激障碍（PTSD）。
共研究了897,689名成年患者。在无既往慢性心理健康疾病的受灾人群中，老年组和非老年组因压力相关疾病（如失眠、焦虑、抑郁障碍和PTSD）的月就诊量在灾后增加了约两倍。与非老年组相比，老年组失眠发病率的增幅更大（分别增加356%和318%）以及抑郁障碍发病率的增幅更大（分别增加308%和245%），但焦虑发病率的增幅较小（分别增加269%和307%）、PTSD、发作性情绪障碍（分别增加82%和158%）以及适应反应（分别增加160%和202%）。
经历重大自然灾害的患者的心理健康状况在灾后老年人群中恶化。然而，我们仍需更加关注受灾人群中的老年人，以降低灾后失眠和抑郁障碍的风险。
