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从灾难的直接后果中幸存:对2023年土耳其地震后青少年急性应激反应和心理健康需求的初步调查

Surviving the Immediate Aftermath of a Disaster: A Preliminary Investigation of Adolescents' Acute Stress Reactions and Mental Health Needs after the 2023 Turkey Earthquakes.

作者信息

Efendi Gökçe Yağmur, Temeltürk Rahime Duygu, Çakmak Işık Batuhan, Dinçer Mustafa

机构信息

Department of Child and Adolescent Psychiatry, Şanlıurfa Mehmet Akif İnan Training and Research Hospital, Şanlıurfa 63500, Türkiye.

Department of Child and Adolescent Psychiatry, Ankara University, Ankara 06590, Türkiye.

出版信息

Children (Basel). 2023 Aug 31;10(9):1485. doi: 10.3390/children10091485.

DOI:10.3390/children10091485
PMID:37761446
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10527644/
Abstract

On 6 February, southeastern Turkey and parts of Syria were struck by two powerful earthquakes, one measuring a magnitude of 7.8 and the other, nine hours later, at a magnitude of 7.5. These earthquakes have been recorded as some of the deadliest natural disasters worldwide since the 2010 Haiti earthquake, impacting around 14 million people in Turkey. For trauma survivors, the stressors associated with an event can lead to the development of acute stress disorder (ASD) or other psychiatric disorders. Trauma experiences during adolescence can impact development and affect adolescents differently than adults. Although ASD in adults has been addressed in several studies, there is much less information available about how younger populations respond to acute stress. The aim of our study was to assess the occurrence of ASD among individuals seeking help at the Şanlıurfa Mehmet Akif İnan Research and Training Hospital Child and Adolescent Outpatient Clinic following the 2023 Turkey Earthquakes and the factors associated with acute stress reactions. A child and adolescent psychiatry specialist conducted psychiatric interviews with the adolescents, and the individuals were also asked to complete 'The National Stressful Events Survey Acute Stress Disorder Short Scale' (NSESSS) to evaluate acute stress symptoms. ASD diagnoses were established according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria. Results showed that 81.6% of the participants ( = 49) were diagnosed with ASD, and drug treatment was initiated in 61.7% of the cases ( = 37). It was determined that ASD rates did not differ according to gender, and patients without physical injury had higher acute stress symptom scores ( > 0.05). According to the logistic regression models, paternal educational levels and adolescents' own requests for psychiatric assistance were predictors of acute stress disorder (OR 10.1, β = 2.31, = 0.006 and OR 16.9, 95 β = 2.83, = 0.001, respectively). Our findings revealed striking results in demonstrating the need for careful evaluation of adolescents without physical injury in terms of acute stress disorder and the need to pay close attention to the psychiatric complaints of adolescents willing to seek mental health assistance. Moreover, our study suggests that the proportion of adolescents experiencing acute stress symptoms after earthquakes might be higher than previously reported. Estimation of the incidence rate and symptoms of psychiatric distress in the short-term period following a disaster is important for establishing disaster epidemiology and implementing efficient relief efforts in the early stages. The outcomes of this study have the potential to yield novel insights into the realms of disaster mental health and emergency response policies, as well as their pragmatic implementations.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b88/10527644/4105cd4d11ac/children-10-01485-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b88/10527644/4105cd4d11ac/children-10-01485-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b88/10527644/4105cd4d11ac/children-10-01485-g001.jpg
摘要

2月6日,土耳其东南部和叙利亚部分地区遭受了两次强烈地震,一次震级为7.8级,另一次在9小时后发生,震级为7.5级。这些地震被记录为自2010年海地地震以来全球最致命的自然灾害之一,影响了土耳其约1400万人。对于创伤幸存者来说,与事件相关的压力源可能导致急性应激障碍(ASD)或其他精神障碍的发展。青春期的创伤经历会影响发育,对青少年的影响与成年人不同。尽管已有多项研究探讨了成人的急性应激障碍,但关于年轻人群如何应对急性应激的信息要少得多。我们研究的目的是评估2023年土耳其地震后在加济安泰普穆罕默德·阿基夫·伊南研究与培训医院儿童和青少年门诊寻求帮助的个体中急性应激障碍的发生率以及与急性应激反应相关的因素。一名儿童和青少年精神病学专家对青少年进行了精神科访谈,还要求个体完成“国家应激事件调查急性应激障碍短量表”(NSESSS)以评估急性应激症状。根据《精神疾病诊断与统计手册》第五版(DSM-5)标准进行急性应激障碍诊断。结果显示,81.6%的参与者(n = 49)被诊断为急性应激障碍,61.7%的病例(n = 37)开始了药物治疗。确定急性应激障碍发生率在性别上没有差异,无身体损伤的患者急性应激症状评分更高(P > 0.05)。根据逻辑回归模型,父亲的教育水平和青少年自己寻求精神科帮助的请求是急性应激障碍的预测因素(OR分别为10.1,β = + 2.31,P = 0.006和OR为16.9,95%β = 2.83,P = 0.001)。我们的研究结果显示出显著成果,表明需要仔细评估无身体损伤的青少年的急性应激障碍情况,并且需要密切关注愿意寻求心理健康帮助的青少年的精神科主诉。此外,我们的研究表明地震后经历急性应激症状的青少年比例可能高于先前报告的比例。估计灾难后短期内精神痛苦的发病率和症状对于建立灾难流行病学和在早期实施有效的救援工作很重要。这项研究的结果有可能为灾难心理健康和应急响应政策领域以及它们的实际实施带来新的见解。

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