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目的了解“5.12”地震后灾区中学生的创伤后应激障碍(PTSD)的发生率和影响因素,为青少年灾后精神卫生问题预防工作提供依据。方法采用多级整群非随机抽样方法,有效样本为来自地震灾区2个县的3所初中和1所高中的1 253名学生。采用复合性国际诊断问卷(Comprehensive International Diagnostic Interview,CIDI)中PTSD模块内容,采用一对一面谈的方式对所有调查对象进行调查,根据DSM-Ⅳ中PTSD诊断标准进行诊断,并记录一般人口学资料。结果地震后5个月,PTSD的发生率为10.21%。多因素logistic回归分析结果显示,进入方程有统计学意义的变量有少数民族(β=0.62,P=0.00,OR=1.86)、亲属伤亡(β=0.83,P=0.00,OR=2.29)和重度财产损失(β=0.98,P=0.02,OR=2.67),少数民族、有亲属伤亡、存在重度财产损失的个体PTSD危险性高。结论地震发生后5个月中学生中PTSD现患率高,中学生灾难特定相关精神卫生问题应引起足够重视和长期关注,灾后心理重建工作仍应继续加强。
Objective To understand the incidence and influencing factors of secondary post-traumatic stress disorder (PTSD) in disaster-stricken area after the “5.12” earthquake and provide the basis for the prevention of post-disaster mental health problems among adolescents. Methods A multistage cluster non-random sampling method was used. The valid samples were 1 253 students from 3 junior high schools and 1 high school in 2 counties in the earthquake-stricken area. Using the content of the PTSD module in the Comprehensive International Diagnostic Interview (CIDI), all subjects were investigated by one-on-one interviews, diagnosed according to the PTSD diagnostic criteria in DSM-IV, and the general demographic data . Results 5 months after the earthquake, the incidence of PTSD was 10.21%. Multivariate logistic regression analysis showed that there were statistically significant variables (P = 0.62, P = 0.00, OR = 1.86), relatives (β = 0.83, P = 0.00, OR = 2.29) Property loss (β = 0.98, P = 0.02, OR = 2.67), ethnic minorities, relatives of casualties, there is a high risk of PTSD in individuals with heavy property losses. Conclusion The prevalence of PTSD among middle school students is high at 5 months after the earthquake. Specific mental health problems related to secondary school students’ disaster should be given sufficient attention and long-term concerns. Psychological reconstruction after disasters should continue to be strengthened.