四川地震灾民灾后心理健康状况及综合干预模式探讨

目的：了解地震后灾民的心理健康状况，探索有效的综合干预模式。方法：对四川省江油市223名灾民进行应激反应问卷（stress—reaction questionnaire，SRQ）评定。再对SRQ检测结果存在心理问题的灾民进行汉密顿抑郁量表（Hamilton depression scale，HAMD）、创伤后应激障碍症状清单平民版（post taumatic stress disorder checklist-civilian version，PCL—C）评定，并对其进行医疗服务、支持性心理治疗、集体心理治疗、药物治疗和随访等的综合干预，比较综合干预前与干预14d后灾民心理健康情况。结果：SRQ结果示121名（54．3％）存在明显的心理问题。HAMD结果示上述121名中可能有抑郁56名（46．3％），有轻度或中度抑郁57名（47．1％），有重度抑郁8名（6．6％）。PCL-C结果示创伤后应激障碍症状阳性27名（22．3％），阴性94名（77．7％）。经综合干预后，灾民的抑郁症状减轻，心理健康状况有所改善。结论：相当一部分地震灾民存在心理问题。医疗服务、支持性心理治疗、集体心理治疗、药物治疗和随访等的综合干预模式能有效改善灾民的心理健康状况。

Study on psychological health status of the victims in Sichuan earthquake and exploration of comprehensive intervention mode

Objective ： To study the psychological health status of the victims in earthquake and to explore effective ways of comprehensive intervention mode. Methods： 223 Victims in Jiangyou city of Sichuang province were assessed for psychological health by using stress-reaction questionnaire （SRQ）. The victims with severe psychological disorder by SRQ result were assessed in mental health by using Hamilton depression scale （HAMD） and post traumatic stress disorder checklist-civilian version （PCL-C） , and underwent comprehensive intervention mode including medical service, supportive psychotherapy, group psychotherapy, medication and following visit. Psychological health status of these victims before and after 14 days comprehensive intervention were compared. Results： Results of SRQ found that 121 victims （54. 3% ） showed mental problem. Results of HAMD found there were 56 victims （46.3%） with possible depression, 57 victims （47. 1%） with moderate depression and 8 victims （6. 6% ） with severe depression. Results of PCL-C found that 27 victims （22. 3% ） were positive and 94 victims （77.7%） were negative. Depression level of victims was reduced and psychological health state improved following comprehensive intervention. Conclusion： Considerable proportion of the victims in earthquake have psychological problems. Comprehensive intervention mode including medical service, supportive psychotherapy, group psychotherapy, medication and following visit can improve psychological health of the victims.