Zhang H D, Zeng F H, Wang H
Chongqing Center for Disease Control and Prevention, Chongqing 400707, China.
College of Safety Science and Engineering, Chongqing University of Science and Technology, Chongqing 401331, China.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2025 Apr 20;43(4):288-293. doi: 10.3760/cma.j.cn121094-20240330-00132.
To analyze the epidemiological characteristics of comorbidity of post-traumatic stress disorder and depression symptoms among active firefighters, and explore its influencing factors. In November 2021, a cross-sectional study was conducted using a combination of convenience sampling and cluster sampling. Active firefighters were selected as the research subjects for a questionnaire survey. 1100 questionnaires were distributed, 1032 were collected, and 1021 were valid, with an effective response rate of 98.93%. The PTSD prevalence and characteristics of firefighters were assessed by using the PTSD Checklist Civilian Version (PCL-C) . The degree of depression was assessed by the Patient Health Questionnaire (PHQ-9) . The coping style was assessed by the Trait Coping Style Questionnaire, and the Social Support Rate Scale was used to investigate the degree of social support. Combined with the general information, the influencing factors of comorbidity of PTSD and symptoms of depression in firefighters were analyzed with binary logistic regression based on single factor analysis. Among 1021 firefighters, 379 had a PHQ-9 score of ≥5, and the prevalence rate of depression was 37.1% (379/1 021) . The prevalence rate of PTSD is 4.6% for 47 individuals with a total PCL-C score of ≥38, and the comorbidity rate of depressive symptoms among PTSD patients is 100%. Logistic regression analysis showed that injuries in the past six months, average/poor self-rated health status, and negative coping were all promoting factors for both the simple depression symptom group and the comorbidity group, while social support was the hindering factor (<0.05) . Two sets of values show that negative coping and social support have roughly the same degree of impact in both groups. The (95%) values of the two factors of being injured in the past six months and self-rated as average/poor health status have significantly increased in the comorbidity group. The (95%) values of being injured in the past six months has increased from 2.20 (1.24, 3.93) in the simple depression symptom group to 3.44 (1.30, 9.09) in the comorbidity group, and that of the self-rated as average and poor health status has increased from 4.91 (3.01, 8.00) to 6.56 (1.97, 21.87) and from 7.96 (2.25, 28.25) to 19.17 (4.75, 77.31) separately (<0.05) . The results indicate that firefighters with PTSD generally have comorbidity with depressive symptoms. The common influencing factor of being injured in the past six months is consistent with the pattern of PTSD symptoms triggered by depressive symptoms.
分析在职消防员创伤后应激障碍与抑郁症状共病的流行病学特征，并探讨其影响因素。2021年11月，采用便利抽样与整群抽样相结合的方法进行横断面研究。选取在职消防员作为研究对象进行问卷调查。共发放问卷1100份，回收1032份，有效问卷1021份，有效回收率为98.93%。采用创伤后应激障碍检查表平民版（PCL-C）评估消防员创伤后应激障碍的患病率及特征。采用患者健康问卷（PHQ-9）评估抑郁程度。采用特质应对方式问卷评估应对方式，并用社会支持评定量表调查社会支持程度。结合一般资料，在单因素分析的基础上，采用二元logistic回归分析消防员创伤后应激障碍与抑郁症状共病的影响因素。在1021名消防员中，PHQ-9评分≥5分者379例，抑郁患病率为37.1%（379/1021）。PCL-C总分≥38分的47例患者创伤后应激障碍患病率为4.6%，创伤后应激障碍患者中抑郁症状的共病率为100%。logistic回归分析显示，过去6个月内受伤、自我评定健康状况一般/较差以及消极应对是单纯抑郁症状组和共病组的共同促进因素，而社会支持是阻碍因素（<0.05）。两组数据表明，消极应对和社会支持在两组中的影响程度大致相同。过去6个月内受伤和自我评定健康状况一般/较差这两个因素在共病组中的（95%）值显著升高。过去6个月内受伤的（95%）值从单纯抑郁症状组的2.20（1.24，3.93）升高到共病组的3.44（1.30，9.09），自我评定健康状况一般和较差的（95%）值分别从4.91（3.01，8.00）升高到6.56（1.97，21.87）以及从7.96（2.25，28.25）升高到19.17（4.75，77.31）（<0.05）。结果表明，患有创伤后应激障碍的消防员普遍合并抑郁症状。过去6个月内受伤这一共同影响因素与抑郁症状引发的创伤后应激障碍症状模式一致。
