Ⅰ型糖尿病患儿母亲创伤后应激障碍发病率及影响因素

目的：调查Ⅰ型糖尿病患儿母亲创伤后应激障碍（ PTSD）的发生率及影响因素,识别相关的创伤性压力源。方法：采用自制一般情况调查表、压力源访谈提纲、PTSD平民版筛查问卷（ PCL－C ）、临床用创伤后应激障碍诊断量表（CAPS）,对56例已诊断Ⅰ型糖尿病患儿母亲进行调查评估,依据DSM－IV中PTSD的诊断标准调查PTSD发生率并分析影响因素及压力源情况。结果：用PCL－C筛查PTSD症状阳性率14．29％,CAPS诊断PTSD发病率8．93％。单因素分析显示,母亲婚姻情况、教育程度、患儿性别、病程长短、治疗方式、居住地与PTSD症状发生无关,发现孩子诊断为糖尿病是主要创伤性压力源。结论：Ⅰ型糖尿病患儿母亲存在较高的PTSD发病率,需要早期识别和干预。     

30年后唐山地震所致孤儿创伤后应激障碍现患率调查

目的：调查30年后唐山大地震孤儿创伤后应激障碍（PTSD）的现患率并探讨PTSD的危险因素。方法：应用中国精神障碍分类方案与诊断标准第3版中PTSD诊断标准对260例地震所致孤儿进行诊断;按照有无PTSD分为PTSD组和正常组,比较两组社会人口学资料、地震后急性应激反应、地震后生活状况和目前心理健康状况。用logistic回归分析筛选PTSD的危险因素。结果：260例孤儿中有32例为现患PTSD（12%）。患PTSD的孤儿组SAS（47.8±14.5/40.3±10.3）、SDS（53.0±12.0/45.2±11.7）、SCL-90总分（156.6±65.5/127.9±41.0）高于非PTSD孤儿组（均P〈0.05）。Logistic回归分析筛选出6个PTSD的预测因素,分别为经历地震时的年龄、神经质、内外向、地震发生后强烈的精神痛苦、反复出现噩梦和消极应对方式（OR值分别为4.5、0.2、5.5、3.5、5.4、3.9）。结论：灾难后孤儿幸存者30年后仍有较高PTSD现患率,青少年阶段、地震创伤的严重程度、人格倾向性及应对方式与现患PTSD相关。     

汶川地震灾后半年及1年都江堰安置点432例群众心理状况对照研究

目的探讨汶川地震半年及1年后,都江堰地震灾区群众的心理健康状况及其变化情况,并探索其心理健康状况变化的可能影响因素。方法采用创伤后应激障碍检查量表平民版（PCP-C）、贝克抑郁自评量表（BDI）、汉密尔顿焦虑量表（HAMA）分别在震后半年和1年对都江堰安置点受灾群众的创伤后应激障碍（PTSD）症状、焦虑及抑郁情绪进行评估,并实施相关的灾后心理健康教育。结果地震灾区群众震后半年及1年的PTSD症状发生率分别为18.3%、6%;抑郁症状发生率为21.6%、8.4%;焦虑症状发生率为19.7%、5.6%。结论震后1年较之震后半年灾区群众PTSD、抑郁及焦虑症状发生率明显降低,该结果可能对研究对象开展心理健康教育及政府、社会、家庭的支持等有关。     

新生儿窒息复苏存在的问题与经验总结

目的探究新生儿窒息复苏存在的问题及解决方案和注意事项。方法选取我院新生儿病房自2008年1月～2013年1月由于新生儿窒息进行复苏的患儿500例。根据Apar评分系统，评价患儿的窒息情况和复苏是否有效，比较在进行复苏前后患儿的状况。结果根据Apar评分标准，500例患儿生后5min后，重度窒息者为268例（53.6%），轻度窒息者为230例（46.0%），正常者为2例（0.4%）。在进行复苏5min后，重度窒息者为10例（2.0%），轻度窒息者为240例（48.0%），正常者为250例（50.0%）。P＞0.05，差异具有统计学意义。结论由于窒息时间过长，患儿肺部存在问题等因素的存在，往往会造成在复苏后患儿体温、呼吸、血压不稳定，以至于患儿在复苏后，窒息症状仍未改善。     

地震后17个月受灾青少年PTSD及其相关因素

目的：研究地震后17个月受灾青少年创伤后应激障碍（PTSD）的发生率,症状分布及其相关因素。方法：在张北地震震中一所中学随机抽取205名中学生,进行DSM－IV PTSD诊断检查及相关量表的调查。结果：灾后17个月PTSD发生率为9．4％,女性明显高于男性,PTSD症状出现频率较高的有：似乎事件重现的动作或感受（74．5％）,警觉性过高（68．8％）,强烈的生理反应（66．7％）,强烈的心理痛苦和烦恼（63．0％）,及反复闯入的痛苦加忆（60．9％）,出现较少的症状是情感范围有所限制（10．4％）,脱离或觉得他人陌生的感觉（13．5％）。与PTSD发生相关的因素有心理痛苦水平,感受到生命危险程度,受伤程度及女性。结论：地震后青少年PTSD的发生率是9．4％（17个月）,而且PTSD的发生具有可预测性。     

富商的家庭环境与心理健康

目的：了解富裕个体户的家庭环境及心理健康状况。方法：采用症状自评量表（SCL－90）、精神健康测验（PHI）、家庭环境量表（FES－CV）对义鸟市42例富商家庭及33例普通家庭进行测评和对比分析。结果：富商家庭（男性：66．7％／39．1％，妻子61．9％／42．4％，子女34．1％／13．6％）较普通家庭存在较多的心理问题，表现在男性的敏感多疑、好与人争执、行为控制能力差；女性的焦虑紧张、脱离现实及对心理挫折常常采取躯体化的心理防御机制；子女则为过分压抑、敏感和孤独性。结论：富商家庭较普通家庭存在较多心理问题，应针对性的进行心理咨询和心理治疗。     

家庭干预对农村首发精神分裂症患者亲属心理健康影响

目的：观察家庭干预对农村首发精神分裂症患者主要亲属心理健康状况的影响。方法：对符合中国精神疾病分类方案与诊断标准第二版修订本（ＣＣＭＤ２Ｒ）精神分裂症诊断标准的５０例农村首发病人的主要亲属（Ａ组）进行住院８周的积极家庭干预及出院后维持干预,并与５０例条件相仿的农村首发精神分裂症病人主要亲属（Ｂ组）对照,用症状自评量表（ＳＣＬ９０）于病人入院时,入院第４和第８周末,出院后每隔１～３月随诊时分别评定其同一主要亲属的心理健康状况,用简明精神病量表（ＢＰＲＳ）评定病情严重程度,并进行２年随访。结果：Ａ组心理健康状况的改善明显好于Ｂ组,多在入院４周时即显示较好效果。随访期间复发病人亲属的ＳＣＬ９０增分Ａ组显著少于Ｂ组（Ｐ＜００１）,家庭干预对亲属为女性,受教育高者效果好。结论：家庭干预能显著改善农村首发精神分裂症患者亲属的心理健康状况。     

脑电图背景活动在新生儿缺氧缺血性脑病早期诊断和预后评估意义

目的对新生儿缺氧缺血性脑病（UIE）生后一周内脑电图背景活动变化及其在HIE早期诊断和神经学预后评估的价值进行初步探讨。方法对2005年9月-2007年3月在我院新生儿病房住院的45例HIE患儿在生后一周内进行脑电图描记,并将EGG监测结果与HIE患儿临床分度在生后1、3、6、9、12及18个月时的神经学预后进行相关性分析,分析脑电图背景活动在HIE早期诊断和神经学预后预测中的价值。结果45例窒息儿其中轻度窒息32例,重度窒息13例,并据胎龄分为足月儿和早产儿组。脑电图异常率分别为足月儿组36．8％和早产儿组57．7％。脑电图重度异常发生率两组分别为5．3％和11．5％。轻度窒息组脑电图异常43．8％,重度窒息组61．5％。脑电图重度异常发生率分别为3．1％和23．1％。研究表明早产儿脑电图重度异常率高于足月儿组（P〈0．05）,差异有统计学意义。重度窒息组脑电图重度异常发生率高于轻度窒息组（P〈0．05）,差异有统计学意义。结论对HIE新生儿生后一周内进行脑电图背景活动分析能早期预测HIE病情轻重程度并预测其神经学预后,对早期干预提供指导。     

新生儿Apgar评分与窒息关系的探讨

目的：探讨Apgar评分与窒息的关系，以便能对Apgar评分有正确认识和应用。方法：回顾性分析已明确诊断缺氧缺血性脑病（HIE）的96例患儿和40例正常儿Imin,5min Apgar评分和出生时脐动脉血血气。比较两种方法对诊断缺氧窒息的敏感度与特异度。结果：（1）1min Apgar评分对诊断HIE的敏感度为72．92％，特异率为90％；5min Apgar评分法的敏感度75％，特异度95％。（2）除外某些影响因素，采用Apgar评分诊断HIE的敏感度低于特异度。（3）脐动脉血气分析法敏感度83．33％，特异率为80％。（4）5min钟评分的准确性高于1min评分（P＜0．05）。（5）脐动脉血pH值判断新生儿有否窒息、缺氧时，具有较高的敏感度，而特异度相对降低不明显。结论：Apgar评分低并不等于缺氧窒息，对新生儿窒息应进行综合评估。     

模式翻转视觉诱发电位和眶部CT检查在外伤性视神经病变中的应用价值

目的：探讨模式翻转视觉诱发电位（PRVEP）和眶部CT检查在外伤性视神经病变（TON）中的应用价值。方法：选择55例我院眼科病房2013年4～10月期间单眼外伤合并视神经病变的患者进行PRVEP和眶部CT检查,统计两项检查的异常结果情况,并比较外伤患者眼与正常眼的PRVEP结果。结果：TON患者的PRVEP结果异常者55例（占100％）,其中轻度25例（占45％）,中度19例（占35％）,重度11例（占20％）。TON患者PRVEP的外伤眼的眶部CT结果异常者为41例,异常率为75％,其中轻度23例（占42％）,中度12例（占22％）,重度6例（占11％）。外伤眼P100波幅较正常眼明显降低（P＜0．01）,潜伏期明显延长（P＜0．01）。结论：PRVEP和眶部CT检查具有客观、无创性的优点,对于头面部外伤尤其是存在视物不清的患者应常规进行检查,有助于外伤性视神经病变的早期诊断,避免漏诊。     

Predicting post-traumatic stress disorder: validation of the Trauma Screening Questionnaire in victims of assault

BACKGROUND: No accurate means of determining which individuals will develop post-traumatic stress disorder (PTSD) following a traumatic event has yet been identified. This study aimed to determine the validity of the Trauma Screening Questionnaire (TSQ) in predicting the development of PTSD following assault. METHOD: Five hundred and sixty-two individuals who presented to an emergency unit following assault completed the TSQ between 1 and 3 weeks later. The Davidson Trauma Scale (DTS) was completed by the same individuals at 1 month and 6 months following assault to determine the presence of PTSD. The predictive power of the TSQ was determined by statistical tests. RESULTS: The TSQ was an effective means of predicting future PTSD, with a sensitivity of 0.85, specificity 0.89, negative predictive value (NPV) 0.98 and efficiency 0.90. The positive predictive value (PPV) was lower (0.48), probably as a result of the relatively low prevalence of PTSD at 1 month (11%) and 6 months (8%) following the assault. CONCLUSIONS: This study suggests that the TSQ can be used between 1 and 3 weeks after assault to help identify individuals who will develop PTSD.     

A randomized controlled study of single-session behavioural treatment of earthquake-related post-traumatic stress disorder using an earthquake simulator

BACKGROUND: Brief interventions are needed in dealing with traumatic stress problems in large survivor populations after devastating earthquakes. The present study examined the effectiveness of a single session of exposure to simulated tremors in an earthquake simulator and self-exposure instructions in reducing post-traumatic stress disorder (PTSD). METHOD: Participants were consecutively recruited from among survivors screened during field surveys in the disaster region in Turkey. Thirty-one earthquake survivors with PTSD were assigned either to a single session of behavioural treatment (n=16) or to repeated assessments (RA; n=15). Assessments in the treatment group were at 4, 8, 12, 24 weeks and 1-2 years post-treatment. The RA cases were assessed at baseline and 4 and 8 weeks after trial entry, after which they received the same treatment and were followed up at 4, 12, 24 weeks and 1-2 years. RESULTS: Between-group treatment effects at week 8 were significant on measures of fear, PTSD and self- and assessor-rated global improvement. Improvement rates were 40% at week 4, 72% at week 12, 80% at week 24, and 80% at 1-2-years' follow-up, with large effect sizes on fear and PTSD measures. Post-session reduction in fear of earthquakes and increased sense of control over fear at follow-up related to improvement in PTSD. CONCLUSION: The study provided further evidence of the effectiveness of a single session of behavioural treatment in reducing fear and PTSD in earthquake survivors. Future research needs to examine the usefulness of earthquake simulators in increasing psychological preparedness for earthquakes.     

Consequences of Untreated Posttraumatic Stress Disorder Following War in Former Yugoslavia: Morbidity,Subjective Quality of Life,and Care Costs

Aim

To assess long-term mental health outcomes in people who suffer from war-related posttraumatic stress disorder (PTSD) but do not receive appropriate treatment.

Methods

We interviewed 264 subjects from former Yugoslavia, who lived in Croatia, Serbia, Germany, and the United Kingdom. All of them had suffered from PTSD at some point following the war, but never received psychiatric or psychological treatment. The interviews took place on average 10.7 ± 3.0 years after the war-related trauma. Outcomes were current PTSD on the Clinician Administered PTSD Scale for Diagnostic and Statistical Manual of Mental Disorders-IV, subjective quality of life (SQOL) on the Manchester Short Assessment of Quality of Life, and care costs. Socio-demographic characteristics, the level of traumatic war-events, and aspects of the post-war situation were tested for association with outcomes.

Results

Current PTSD was diagnosed in 83.7% of participants, the mean SQOL score was 4.0 ± 0.9, and mean care costs in the last 3 months exceeded €1100 in each center. Older age, more traumatic war-events, lower education, and living in post-conflict countries were associated with higher rates of current PTSD. Older age, combat experience, more traumatic war-events, being unemployed, living alone, being housed in collective accommodation, and current PTSD were independently associated with lower SQOL. Older age and living in Germany were linked to higher costs of formal care.

Conclusion

People with untreated war-related PTSD have a high risk of still having PTSD a decade after the traumatic event. Their SQOL is relatively low, and they generate considerable care costs. Factors that have been reported as influencing the occurrence of PTSD also appear relevant for recovery from PTSD. Current PTSD may impair SQOL independently of social factors.Posttraumatic stress disorder (PTSD) is one of the most frequently reported mental health consequences of exposure to war experience, although studies on both refugees and war veterans yielded inconsistent findings on the exact prevalence rates (1-5). Some evidence suggests that a higher degree of exposure to both war-related traumatic events and the pressures of the post-migration environment can lead to higher rates of PTSD over many years (6-9). Evidence based treatments for PTSD exist and are – at least to some extent – available in most post conflict contexts in the Western world. In such contexts, it can be assumed that a significant number of people with war-related PTSD receive treatment from psychiatrists or psychologists or are prescribed anti-depressants by their general practitioner.For various reasons, however, many people with serious and distressing levels of PTSD following war do not receive psychiatric or psychological treatment (10), and not much is known about their long term outcomes. It is not clear whether most of them recover from PTSD without treatment or the symptoms are likely to take a persistent course. Another question is what their subjective quality of life (SQOL) is, and what costs of formal and informal care they generate. Finally, it is not clear what factors are associated with more or less favorable outcomes in such populations, and whether current PTSD is associated with poorer SQOL.The present study addressed these questions and assessed long term outcomes in people who suffered from PTSD at some point of time following the war in former Yugoslavia in the 1990s, but never received psychiatric or psychological treatment in either primary or secondary care. Current PTSD, SQOL, and care costs were assessed as outcomes in refugees in Western Europe and in people who stayed in the area of conflict. Socio-demographic characteristics, the level of exposure to war stressors, and aspects of the post-war situation were tested for their association with more or less favorable outcomes.     

Associations of pre-trauma attributes and trauma exposure with screening positive for PTSD: analysis of a community-based study of 2,085 young adults

BACKGROUND: While pre-trauma personality and mental health measures are risk factors for post-traumatic stress disorder (PTSD), such information is usually obtained following the trauma and can be influenced by post-trauma distress. We used data collected from a community-based survey of young adults before and after a major natural disaster to examine the extent to which participants' traumatic experiences, demographic and pre-trauma risk factors were associated with their screening positive for PTSD when re-interviewed. METHOD: A representative selection of 2,085 young adults from the Australian Capital Territory and environs, interviewed in 1999 as part of a longitudinal community-based survey, were re-interviewed 3-18 months after a major bushfire had occurred in the region. When re-interviewed, they were asked about their experiences of trauma threat, uncontrollable and controllable traumatic experiences and their reaction to the fire. They were also screened for symptoms of fire-related PTSD experienced in the week prior to interview. RESULTS: Four-fifths of participants were exposed to the trauma with around 50% reporting having experienced uncontrollable traumatic events. Reporting PTSD symptoms was associated with being female, having less education, poorer mental health and higher levels of neuroticism prior to the trauma. Particular fire experiences, including being evacuated and feeling very distressed during the disaster, were more strongly associated with PTSD symptoms compared with pre-trauma measures. CONCLUSIONS: While demographic and pre-trauma mental health increased the likelihood of reporting PTSD symptoms, exposure to trauma threat and reaction to the trauma made greater contributions in explaining such symptoms as a result of this disaster.     

Post‐traumatic stress disorder and illness perceptions over time following myocardial infarction and subarachnoid haemorrhage

Objectives. This study investigated post‐traumatic stress disorder (PTSD) symptoms and illness perceptions in people who suffered the acute medical trauma of a myocardial infarction (MI) or a subarachnoid haemorrhage (SAH). The study tested hypotheses regarding changes in PTSD symptoms and illness perceptions over time, associations between PTSD and illness perceptions and cognitive predictors of PTSD. Design and method. The study employed a longitudinal design and measured the illness perceptions and PTSD symptoms of an MI group (N = 17) and a SAH group (N = 27). Data were collected within 2 weeks of admission (T1), 6 weeks after admission (T2) and 3 months after admission (T3). Statistical analysis was undertaken to examine associations between illness perceptions and PTSD and to examine cognitive predictors of PTSD. Results. The prevalence of PTSD within the total acute medical trauma sample was 16% at 2 weeks, 35% at 6 weeks and 16% at 3 months. Illness perception factors of identity, timeline (acute/chronic), consequences and emotional representation were strongly correlated with PTSD at all three time points. PTSD symptoms and illness perceptions were shown to have changed over time. The results also showed that several illness perception factors are significant predictors of PTSD. Conclusions. Both PTSD symptoms and illness perceptions changed significantly over time following an MI or SAH. Illness perception factors are significant predictors of PTSD.     

坠楼自杀事件目击者创伤性应激障碍

目的:调查某高校自杀坠楼事件目击者急性应激障碍(ASD)和创伤后应激障碍(PTSD)状况。方法:使用一般情况及事件主观体验问卷和创伤性应激障碍临床访谈问卷,对58名事件现场目击者,分别在事件发生后第三周和第五周进行调查。结果:在事件发生后第三周,符合DSM-Ⅳ诊断标准的ASD检出率为6.9%,符合PTSD症状标准和社会功能损害标准的目击受害者共6人,检出率为10.3%。事件后三周受害人出现创伤性应激症状和功能损害的比例较高,分别为强烈恐惧害怕65.5%、创伤性分离51.0%、警觉性增高53.4%、再体验84.5%、回避70.7%、和社会功能障碍25.9%。创伤性事件发生后第三周出现分离症状的目击者比没有出现分离症状的目击者在事件后第五周时表现出了更加严重的ASD和PTSD的各组症状(如分离症状严重程度17.9vs29.7,U=128.5,P=0.001)。结论:1、创伤性事件发生后早期,受害人心理应激反应具有一定的普遍性,其中一部分受害人出现社会功能变化。2、提示对事件后早期那些不符合ASD诊断标准,但符合PTSD症状标准和社会功能变化标准的受害者应该给与心理干预。3、创伤时分离症状可能是预测受害人出现远期严重应激障碍的一个因素。     

Evidence of early neurobiological alternations in adolescents with posttraumatic stress disorder: a functional MRI study

Neuroimaging studies of patients with posttraumatic stress disorder (PTSD) have largely been performed in adult populations. The purpose of the current study was to investigate neural correlates of PTSD in adolescents. Specifically, this study investigates whether a differential brain response was present during the visual perception and imaginary recollection of traumatic reminders in adolescents who developed PTSD versus those who did not after experiencing earthquake. Eleven Taiwanese adolescents (age range: 12-14 years) with traumatic experience of earthquake were enrolled. Five subjects fulfilled PTSD criteria, while the other six served as non-PTSD controls. Brain activation was measured by functional magnetic resonance image (fMRI) during visual perception and imagery recall of earthquake and neutral pictures at 14 months after earthquake. During earthquake imagery (as compared with neutral imagery), PTSD group demonstrated activation in the bilateral visual cortex, bilateral cerebellum and left parahippocampal gyrus, while control group did not. During earthquake perception (as compared with neutral perception), the control group showed activation over anterior cingulate, but the PTSD group did not. Intergroup comparison confirmed above discrepancies was significant. We concluded that neurobiological alternation of PTSD in adolescent was similar to those in adult and might have developed within 14 months after trauma exposure.     

Delayed-onset PTSD: a prospective study of injury survivors

BACKGROUND: Recent studies have indicated that delayed-onset posttraumatic stress disorder (PTSD) (i.e., the development of PTSD more than 6 months posttrauma) is generally characterised by subsyndromal diagnoses within the first 6 months. This study sought to examine the relationship between sub-clinical levels of PTSD symptoms at 3 months posttrauma and delayed onset PTSD at 12 months in a large sample of traumatic injury survivors. METHODS: Three hundred and one consecutively admitted injury survivors were assessed at 3 and 12 months posttrauma. PTSD was diagnosed according to DSM-IV criteria, while partial and subsyndromal diagnoses were based on recent definitions developed by Mylle and Maes [Mylle, J., Maes, M., 2004. Partial posttraumatic stress disorder revisited. J. Affect. Disord. 78, 37-48]. RESULTS: Eight percent of participants was diagnosed with 3-month PTSD while 10% was diagnosed with 12-month PTSD. Nearly half (47%) of 12-month PTSD cases were of delayed onset. The majority of those with delayed-onset were diagnosed with partial or subsyndromal PTSD at 3 months. Ten percent of delayed onset cases did not meet partial or subsyndromal criteria. LIMITATIONS: As symptoms were not assessed at 6 months (the DSM cut-off for delayed PTSD), it could not be conclusively determined that delayed-onset cases had not developed PTSD between 3 and 6 months posttrauma. CONCLUSION: A considerable proportion of 12-month PTSD diagnoses was delayed in onset. While most demonstrated 3-month morbidity in the form of partial and subsyndromal diagnoses, a minority did not. Thus, clinicians should consider subthreshold diagnoses as potential risk factors for delayed-onset PTSD. Future research is required to identify factors that may predict delayed-onset PTSD in trauma survivors without evidence of prior PTSD pathology.     

Impact of posttraumatic stress disorder and injury severity on recovery in children with traumatic brain injury

The adverse impact on recovery of posttraumatic stress disorder (PTSD) in mild traumatic brain injury (TBI) has been demonstrated in returned veterans. The study assessed this effect in children's health outcomes following TBI and extended previous work by including a full range of TBI severity, and improved assessment of PTSD within a longitudinal design. There were 205 children and adolescents (6 to 15 years of age) who experienced a TBI that were assessed at 2, 3, 6, 12, and 18 months following the TBI. Severity of TBI was classified as mild, moderate, or severe. After controlling for the impact of the severity of TBI, premorbid behavioral and emotional problems and executive function, children with TBI and PTSD did not experience as much psychosocial recovery as those without PTSD. Furthermore the level of psychosocial function was no better than that experienced by children with a severe TBI. In contrast, severe TBI was predictive of a poorer physical recovery in the first 6 months, after which recovery was equivalent across all severity levels.     

特大爆炸事故幸存者创伤后应激障碍的初步研究

目的 :了解特大意外爆炸事故对幸存者心理健康水平、PTSD的发生、PTSD的临床特征及其相关因素的影响。方法 :在爆炸事故后 3 -5个月期间 ,调查事故幸存者 ( 2 8例 ,研究组 )的一般情况、创伤经历、受伤程度及对善后处理的满意程度 ,采用创伤后应激反应症状清单、事件影响量表 (IES)、SCL -90、康奈尔医学指数 (CMI)、SDS、SAS评定 ,并与对照 ( 3 0例 )进行比较 ,分析PTSD诊断的相关因素。结果 :研究组IES、SDS、SAS、CMI、总分、CMIMR和SCL -90各统计指标与对照组的差异极其显著 (P <0 0 1)。诊断为PTSD者 78 6% ,PTSD的诊断与IES总分、现场暴露程度和对善后处理的满意程度相关。结论 :特大爆炸事故可导致暴露者出现不同程度的心理痛苦 ,PTSD的发生与创伤事件的暴露程度和对善后处理的满意程度相关。