Office of the President, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Hospital of Chengdu, University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
J Evid Based Med. 2023 Dec;16(4):455-464. doi: 10.1111/jebm.12557. Epub 2023 Oct 5.
Post-traumatic stress disorder (PTSD) is a prevalent condition characterized by prolonged psychological distress following traumatic events encompassing serious health threats, domestic abuse, and natural disasters. The onset and persistence of PTSD can be attributed to advanced age. This study aimed to explore the occurrence and influencing factors of enduring post-traumatic stress disorder (PTSD) in survivors aged 60 years and over in the main area of the 2008 Wenchuan earthquake 10 years after the disaster.
Data were collected using a multistage sampling method from individuals aged 60 years and older living in the main impacted areas of Wenchuan 10 years after the Wenchuan earthquake. The PTSD Checklist-Civilian Version (PCL-C) was used to evaluate PTSD symptoms. We evaluated participants based on their PTSD symptoms: those exhibiting and those without. The latter group was four times the size of the former and was matched based on gender and age (within ± 2 years). Conditional logistic regression was used to discern the risk factors.
Out of the total, 56 participants were recognized as having probable PTSD as per the PCL-C checklist, leading to a rate of 9.4% (56/588). The univariate conditional logistic regression values showed that playing Mahjong/poker (odds ratio (OR) = 0.394, 95% confidence interval (CI) = 0.171-0.911) and displacement (OR = 0.446, 95% CI = 0.220-0.907) were protective factors for the long-term mental health of survivors in the hard-hit areas, while the presence of a 2-week illness (OR = 3.605, 95% CI = 1.751-7.424), possessing insurance (OR = 0.250, 95% CI = 0.072-0.864), suffering from a chronic ailment (OR = 3.132, 95% CI = 1.2-8.174), and having an injured family member (OR = 2.26, 95% CI = 1.136-4.496) emerged as risk factors for PTSD symptoms. Multivariate analysis indicated that the absence of insurance and prevalence of 2-week illness correlated with increased PTSD symptoms.
Ten years after the Wenchuan earthquake, the prevalence of probable PTSD remained significantly high in the elderly population. The major risk factors were the absence of insurance and the occurrence of a 2-week illness. Policymakers should incorporate these findings when devising strategies for aging societies.
创伤后应激障碍（PTSD）是一种常见的疾病，其特征是在经历严重的健康威胁、家庭暴力和自然灾害等创伤事件后，出现长期的心理困扰。PTSD 的发生和持续与年龄增长有关。本研究旨在探讨震后 10 年，在汶川地震主震区 60 岁及以上幸存者中，持久的创伤后应激障碍（PTSD）的发生和影响因素。
采用多阶段抽样方法，从震后 10 年居住在汶川主震区的 60 岁及以上老年人中收集数据。使用平民版创伤后应激障碍检查表（PCL-C）评估 PTSD 症状。我们根据 PTSD 症状对参与者进行评估：有 PTSD 症状的和没有 PTSD 症状的。后者的人数是前者的四倍，按照性别和年龄（±2 岁）进行匹配。采用条件逻辑回归分析来识别风险因素。
共有 56 名参与者被认为符合 PCL-C 检查表中的 PTSD 标准，患病率为 9.4%（56/588）。单因素条件逻辑回归值显示，打麻将/扑克（比值比（OR）=0.394，95%置信区间（CI）=0.171-0.911）和流离失所（OR=0.446，95%CI=0.220-0.907）是重灾区幸存者心理健康的保护因素，而两周内患病（OR=3.605，95%CI=1.751-7.424）、有保险（OR=0.250，95%CI=0.072-0.864）、患有慢性病（OR=3.132，95%CI=1.2-8.174）和有受伤的家庭成员（OR=2.26，95%CI=1.136-4.496）是 PTSD 症状的风险因素。多因素分析表明，无保险和两周内患病与 PTSD 症状增加相关。
震后 10 年，老年人中创伤后应激障碍的患病率仍显著较高。主要危险因素是无保险和两周内患病。决策者在制定老龄化社会政策时应考虑这些发现。
