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尼泊尔2015年地震后创伤后应激障碍及相关因素:一项系统评价和荟萃分析。

Posttraumatic stress disorder and associated factors in the aftermath of the 2015 earthquake in Nepal: A systematic review and meta-analysis.

作者信息

Paudel Prayash, Sah Asutosh, Khanal Anil

机构信息

Institute of Medicine, Bachelor of Medicine and Bachelor of Surgery, Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.

Department of Public Health, Pokhara University School of Health and Allied Sciences, Pokhara, Nepal.

出版信息

PLoS One. 2025 Feb 3;20(2):e0310233. doi: 10.1371/journal.pone.0310233. eCollection 2025.

Abstract

We aimed to estimate the pooled incidence of posttraumatic stress disorder among survivors after the 2015 earthquake in Nepal based on available literature and highlight the psychological effects of natural disasters that can hamper the recovery process in the aftermath of disaster. The study protocol was registered on PROSPERO with reference number CRD42024576444. Electronic databases such as PubMed and Google Scholar were searched for observational studies in English that assessed posttraumatic stress disorder at least 1 month after the earthquake via a validated tool from April 2015 to August 2024. In addition, references to the included studies were thoroughly searched. High-quality articles were included after the risk of bias assessment. The random-effects model was used to calculate the pooled incidence with a 95% confidence interval along with subgroup analysis. An analysis of 25 studies revealed a pooled incidence of 22.6%, ranging from 17.6 to 27.5%. A high degree of heterogeneity (I2 = 97.56%, p<0.001) was observed in the results, with the incidence ranging from 3% to 51%. The subgroup analyses revealed that the incidence of posttraumatic stress disorder after an earthquake varied significantly across studies in terms of the time of assessment, sex, age, marital status, ethnicity, educational level, disease history, bereavement, injury to the body, witnessing death, social support, loss of property and damage to one's house. However, stratified analyses could not fully explain the heterogeneity in the results. Our analysis revealed a high incidence of posttraumatic stress disorder among survivors of the 2015 earthquake in Nepal. Addressing the psychological well-being of these survivors is essential. Psychosocial counseling becomes pivotal in assisting them in coping with the trauma they have experienced since the earthquake.

摘要

我们旨在根据现有文献估计2015年尼泊尔地震后幸存者中创伤后应激障碍的合并发病率,并强调自然灾害可能阻碍灾后恢复进程的心理影响。该研究方案已在国际前瞻性系统评价注册库(PROSPERO)上注册,注册号为CRD42024576444。我们检索了电子数据库,如PubMed和谷歌学术,以查找2015年4月至2024年8月期间发表的英文观察性研究,这些研究使用经过验证的工具,在地震至少1个月后评估创伤后应激障碍。此外,我们还对纳入研究的参考文献进行了全面检索。在进行偏倚风险评估后纳入高质量文章。我们使用随机效应模型计算合并发病率及95%置信区间,并进行亚组分析。对25项研究的分析显示,合并发病率为22.6%,范围在17.6%至27.5%之间。结果中观察到高度异质性(I2 = 97.56%,p<0.001),发病率范围为3%至51%。亚组分析显示,地震后创伤后应激障碍的发病率在不同研究中,在评估时间、性别、年龄、婚姻状况、种族、教育水平、疾病史、丧亲情况、身体损伤、目睹死亡、社会支持、财产损失和房屋损坏等方面存在显著差异。然而,分层分析并不能完全解释结果中的异质性。我们的分析显示,2015年尼泊尔地震幸存者中创伤后应激障碍的发病率很高。关注这些幸存者的心理健康至关重要。心理社会咨询对于帮助他们应对地震以来所经历的创伤至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f564/11790126/b704e577b1b1/pone.0310233.g001.jpg

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