Post-Graduate Program in Psychiatry and Behavior Sciences, Universidade Federal Do Rio Grande Do Sul (UFRGS), Porto Alegre, RS, Brazil; Pulmonary Service, Hospital Universitário de Santa Maria (HUSM), Santa Maria, RS, Brazil.
Pulmonary Service, Hospital Universitário de Santa Maria (HUSM), Santa Maria, RS, Brazil.
Public Health. 2022 Aug;209:4-13. doi: 10.1016/j.puhe.2022.05.002. Epub 2022 Jun 21.
This survey was conducted to evaluate the prevalence of post-traumatic stress disorder (PTSD) and the sleep quality in victims and rescue team of the third deadliest nightclub fire in the world.
A cross-sectional study.
Participants were victims and rescue workers exposed to a fire at a nightclub, which occurred in January 2013 in Southern Brazil. The Pittsburgh Sleep Quality Index (PSQI), composed of seven subjective sleep variables (including daytime dysfunction), and PTSD Checklist - Civilian version (PCL-C) were applied to all people who sought medical attention at the local reference center in the first year after the event. Comprehensive information was obtained concerning sociodemographic factors, health status, and sleep complaints.
A total of 370 individuals, 190 victims and 180 rescue workers, were included. Participants were 70% male, with an average age of 29 years. The prevalence of PTSD was 31.9%, ranging from 24.4% for rescue workers to 38.9% for victims. The prevalence of poor sleep quality was 65.9%, ranging from 56.1% for rescue workers to 75.3% for victims. Most of the participants with PTSD (91.5%) had PSQI scores >5 (poor sleepers), against 54.0% of the non-PTSD individuals. All seven PSQI subscores showed significant differences between PTSD and non-PTSD individuals, especially daytime dysfunction. Sex, shift work, previous psychiatric disease, and sleep quality remained associated with PTSD in adjusted models, with a prevalence ratio (95% CI) of 1.76 (1.28-2.43) in females, 1.73 (1.17-2.55) in shift workers, 1.36 (1.03-1.80) in individuals with psychiatric disease history, and 5.42 (2.55-11.52) in poor sleepers.
The presence of daytime dysfunction increased by at least tenfold the prevalence of PTSD in this sample. Considering that daytime dysfunction was shown to be strongly associated with PTSD, sleep-related issues should be addressed in the assessment of individuals exposed to traumatic events, both victims and rescuers. Factors like shift work and female sex were also associated with PTSD, especially among victims.
本调查旨在评估世界上第三次最致命的夜总会火灾的受害者和救援人员中创伤后应激障碍（PTSD）的患病率和睡眠质量。
横断面研究。
参与者为 2013 年 1 月在巴西南部一家夜总会发生火灾时暴露于火灾的受害者和救援人员。匹兹堡睡眠质量指数（PSQI）由七个主观睡眠变量（包括日间功能障碍）和民用 PTSD 检查表（PCL-C）组成，适用于所有在事件发生后第一年在当地参考中心寻求医疗的人。全面收集社会人口统计学因素、健康状况和睡眠投诉信息。
共纳入 370 人，其中 190 名受害者和 180 名救援人员，参与者中 70%为男性，平均年龄 29 岁。PTSD 的患病率为 31.9%，范围为救援人员 24.4%至受害者 38.9%。睡眠质量差的患病率为 65.9%，范围为救援人员 56.1%至受害者 75.3%。大多数 PTSD 患者（91.5%）的 PSQI 评分>5（睡眠不佳），而非 PTSD 患者为 54.0%。在 PTSD 和非 PTSD 个体之间，所有七个 PSQI 子量表的得分均存在显著差异，尤其是日间功能障碍。在调整模型中，性别、轮班工作、既往精神疾病和睡眠质量与 PTSD 相关，女性的患病率比（95%CI）为 1.76（1.28-2.43），轮班工人为 1.73（1.17-2.55），有精神疾病史的个体为 1.36（1.03-1.80），睡眠不佳的个体为 5.42（2.55-11.52）。
在该样本中，日间功能障碍的存在使 PTSD 的患病率至少增加了十倍。考虑到日间功能障碍与 PTSD 密切相关，因此应在对暴露于创伤性事件的个体（包括受害者和救援人员）进行评估时，考虑与睡眠相关的问题。轮班工作和女性等因素也与 PTSD 相关，尤其是在受害者中。
