地震后6月灾区创伤后应激障碍中学生伴发焦虑及抑郁分析

目的 对汶川地震后6月都江堰地区青少年创伤后应激障碍(PTSD)伴发焦虑及抑郁症状的状况进行分析.方法 整群分层抽取都江堰地区中学生49个班级,利用儿童创伤后应激障碍自评量表(PTSD-SS)、儿童焦虑性情绪筛查量表(SCARED)、儿童抑郁障碍自评量表(DSRSC)进行评估,共1925人完成调查.结果 PTSD的检出率为15.9%,焦虑症状的检出率为40.8%,抑郁症状的检出率为24.4%.其中,PTSD与焦虑症状的共患率为13.6%,PTSD与抑郁症状的共患率为8.5%,PTSD与抑郁、焦虑症状的共患率为8.1%.PTSD总分与DSRSC抑郁指数(r=0.475,P<0.01)、SCARED焦虑总分(r=0.650、P<0.01)呈正相关.在检出PTSD的青少年中,有85%检出焦虑症状(χ~2=295.160,P<0.01),53.4%检出抑郁症状(χ~2=166.504,P<0.01).在检出PTSD的女性青少年中,有88%检出伴发焦虑症状,高于男性(χ~2=4.010,P<0.05).逻辑回归分析发现,女性、生活在农村、亲人伤亡严重、财产损失大、主观支持少、对支持的利用度低、消极应对方式是PTSD伴发焦虑的危险因素;女性、非独生子女、生活在农村、亲人伤亡严重、社会支持少、对支持的利用度低、消极应对方式是PTSD伴发抑郁的危险因素.结论 地震后6个月,青少年PTSD伴发焦虑及抑郁症状的发生率高,女性PTSD伴发焦虑症状的发生率高于男性.

Analysis of comorbidities of PTSD and anxiety, depression among juvenile victims in Dujiangyan six months after Wenchuan earthquake

Objective To explore the comorbidities status of PTSD and anxiety, depression among juvenile victims of the Wenchuan earthquake in Dujiangyan region six months post-disaster. Methods The middle school students of 49 classes in Dujiangyan region were evaluated by using Post-traumatic Stress Disorder Self-rating Scale (PTSD-SS) ,the Screen for Child Anxiety Related Emotional Disorders (SCARED) , Depression Self-rating Scale for Children (DSRSC). About 1925 victims accomplished the survey. Results The rate of PTSD was 15.9% , anxiety was 40. 8% , and depression was 24. 4%. The rate of comorbidity of PTSD and anxiety was 13. 6% ,cormorbidity of PTSD and depression was 8.5%, and cormorbidity of PTSD , depression and anxiety was 8. 1 % . The total score of PTSD had positive correlation with DSRSC depression index (r = 0. 475 , P < 0. 01 ) and the total score of SCARED (r = 0.650, P < 0. 01) . Among the juvenile victims with PTSD, the rate of anxiety was 85% (χ~2 =295.160, P<0.01) , and depression was 53.4% (χ~2 =166.504, P<0.01), which was much higher than those without PTSD. Among female juvenile victims with PTSD, the rate of comorbidity of PTSD and anxiety was 88% .which was much higher than that among male juvenile victims with PTSD(χ~2 =4.010, P<0. 05). According to logistic regression model, female, living in rural areas, bereavement, loss of property, lower subjective support, lower availability of support, negative coping style significantly explained the variance of comorbidity of PTSD and anxiety. Female, not the only child, living in rural areas, bereavement, lower social support, lower a-vailability of support, negative coping style significantly explained the variance of comorbidity of PTSD and depression. Conclusions The incidence rates of PTSD and comorbid anxiety, depression among juvenile victims of the earthquake were significantly higher than the normal population six months post-disaster. The rates of comorbidities in female was higher than that in male. Psychological reconstruction post-disaster should focus on the female, rural population with bereavement.