军校学员创伤后应激障碍的发生率及其相关因素研究

目的研究参加＂5.12＂汶川地震一线救援的军校学员创伤后应激障碍（PTSD）的发生率,分析相关危险因素。方法地震后6个月,对1024名军校学员的救援经历、急性应激状况（采用SRQ-20）进行回顾性调查,完成PTSD症状清单（采用PCL-C）、焦虑自评量表（SAS）、抑郁自评量表（SDS）自评,并对调查结果进行统计学分析。对初筛结果高于划界分者,由精神科医师依据临床定式检查（采用SCID）晤谈确定诊断。结果 35人确诊为PTSD,阳性率为3.42%;PCL-C评分城市籍军人明显高于农村籍军人（P〈0.05）,独生子女明显高于非独生子女（P〈0.05）,大专明显高于本科（P〈0.05）;参加现场搜救任务和处理遗体任务的救援人员PCL-C评分均显著高于未参加者（P〈0.01）;以PCL-C总分为因变量,经线性逐步回归分析,SRQ总分、SAS评分、既往创伤经历、内向性格、文化程度、处理遗体任务进入方程。以PTSD确诊结果为因变量,经二元Logistic回归分析,处理遗体任务、独生子女、文化程度、抑郁进入方程,正确预测率为50%,总的正确判断率为75.3%。结论汶川地震后半年时点,一线救援军校学员PTSD患病率为3.42%,处理遗体经历对发病的负性刺激强度最大,独生子女、文化程度、抑郁状态与PTSD的发生率密切相关,急性应激反应、焦虑、创伤经历、内向性格均为相关危险因素。

Prevalence and correlated factors of PTSD in China rescue cadets after the Wenchuan earthquake

Objective To investigate the detection rates and related risk factors of post-traumatic stress disorder（PTSD）among rescue cadets 6 months after ＂5·12＂ Wenchuan earthquake.Methods All the 1024 rescue cadets were assessed with SRQ-20,PCL-C,SAS and SDS as preliminary screening.The selected ones were given a definite diagnosis by psychiatrists according to SCID after the clinical interview.Results The prevalence of PTSD in this sample was 3.42%.PCL-C score among students from cities or one-child families or with lower degrees was higher than that among the opposite ones（P0.05）.PCL-C score in those who participated in spot-rescue and handled dead bodies was higher than in those who did not（P0.01）.Multi-linear gradual regressive analysis indicated that the number and severity of PTSD symptoms were associated with SRQ score,SAS score,other trauma experiences,introverted personality,lower degrees,and the body-disposing experience.Logistic regression analysis showed that the body-disposing experience,being an only child,lower degrees,and depression occurrence were the risk factors for PTSD.The correct prediction rate was 50%,and the total true judgment rate was 75.3%.Conclusion The prevalence of PTSD in China military rescue cadets 6 months after the earthquake is 3.42%.The body-disposing experience generates the greatest stimulus intensity,which is the important risk factor.The first acute stress level,other trauma experiences,anxiety,and introverted personality are potential risk factors.