Department of Epidemiology, Harvard Chan School of Public Health, Harvard University.
Department of Psychiatry, School of Medicine, Boston University.
Psychol Trauma. 2021 Sep;13(6):684-693. doi: 10.1037/tra0001006. Epub 2021 Feb 4.
Traumatic events and ensuing stress are not widely studied in individuals with severe mental illness (SMI) despite their increased vulnerability to both. Far less is known about traumatic events and posttrauma reactions in people with SMI in low-resourced settings.
To address this gap in knowledge, our study focused on trauma and its effects for individuals with SMI and their caregivers in rural Ethiopia. Study aims were to identify events that were considered traumatic by stakeholders; characterize the mental health effects of such events; and discern events and posttrauma symptoms most relevant for SMI.
Qualitative interviews were gathered from 48 participants in Ethiopia who included individuals with SMI, their caregivers, health care providers, and community and religious leaders.
Based on a combined emic and etic approach, major traumatic events included those commonly experienced in rural Ethiopia (e.g., lost property, forced marriage) and endorsed by individuals with SMI (e.g., restraining or chaining, SMI illness in a low-resourced setting). In addition, traumatic events were identified consistent with Western medical criteria (e.g., physical assault, sexual assault). Posttrauma symptoms that were commonly reported included emotions like anger and sadness; thinking too much; crying; and somatic (e.g., burning sensation) and physiological (e.g., shortness of breath) symptoms. As for symptoms consistent with the Diagnostic and Statistical Manual, we found the presence of all four symptom clusters.
Overall, results point to the common occurrence of traumatic events and trauma-linked symptoms for individuals with SMI and their caregivers, including as a result of SMI. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
尽管严重精神疾病 (SMI) 患者更容易受到创伤事件和随之而来的压力的影响，但对他们的创伤事件和创伤后反应的研究并不广泛。在资源匮乏的环境中，人们对 SMI 患者的创伤事件和创伤后反应知之甚少。
为了弥补这一知识空白，我们的研究专注于农村埃塞俄比亚的 SMI 患者及其照顾者的创伤及其影响。研究目的是确定利益相关者认为具有创伤性的事件；描述这些事件对心理健康的影响；并确定与 SMI 最相关的事件和创伤后症状。
从埃塞俄比亚的 48 名参与者中收集了定性访谈，参与者包括 SMI 患者、他们的照顾者、医疗保健提供者以及社区和宗教领袖。
基于综合的内在和外在方法，主要的创伤性事件包括在农村埃塞俄比亚常见的事件（例如，财产损失、强迫婚姻）以及 SMI 患者认可的事件（例如，限制或锁链、资源匮乏环境中的 SMI 疾病）。此外，还确定了符合西方医学标准的创伤性事件（例如，身体攻击、性侵犯）。常见的创伤后症状包括愤怒和悲伤等情绪；过度思考；哭泣；以及躯体（例如烧灼感）和生理（例如呼吸急促）症状。至于与《诊断和统计手册》一致的症状，我们发现所有四个症状群都存在。
总的来说，结果表明 SMI 患者及其照顾者经常发生创伤事件和与创伤相关的症状，包括 SMI 引起的症状。（美国心理协会，2022 年）。
