汶川地震極重災區780名受災群眾心理狀況調查_《中國循證醫學雜志》

作者：

趙高鋒 ¹ , 楊彥春 ¹ , 張樹森 ¹ ,  鄧紅 ¹ , 朱燕 ² , 任正伽 ¹ , 張偉 ¹ , 孫學禮 ¹ , 李海民 ¹ , 劉傳新 ³ , 王梅 ⁴ , 岳莉莉 ¹ , 劉善明 ¹ , 張倬秋 ¹ , 陶慶蘭 ¹ , 陳穎 ¹ , 徐加軍 ¹ , 畢建強 ¹ , 何瑩瑩 ¹

1. 四川大學華西醫院心理衛生中心（成都 610041）；2. 成都市第四人民醫院（成都 610036）；3. 濟寧醫學院（濟寧 272013）；4. 成都市鐵路局（成都 610081）;

關鍵詞：

汶川地震心理狀況急性應激障礙 PTSD檢查量表平民版

DOI：

10.7507/1672-2531.20080182

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目的　了解汶川地震受災群眾的受災情況及心理狀況，為進一步開展心理干預提供依據。
方法　采用橫斷面調查方法，對成都市2個臨時居住點極重災區受災群眾登記人口學背景、受災情況及PTSD（Post-traumaticstress disorder）檢查量表平民版（PCL-C）評估，依據DSM-Ⅳ的診斷標準，進行急性應激障礙（ASD）臨床檢查。
結果　 780名受災群眾完成登記評估。在完成登記的資料中729份有效，其中450份PCL-C有效；男女比例為1:1.31。平均年齡36.73±20.82 歲；9.5% 患有軀體疾病，9.7% 生活需人協助，70.7%被動和沒有參加社區活動，9.1%嚴重心理問題。ASD的發生率為30.9%（139/450），PCL-C ≥ 38 分有186（41.3%）例，PCL-C ≥ 45 分有100（22.2%）例，PCL-C ≥ 50 分者有83(18.4%) 例，PCL-C ≥ 45 分篩查結果與臨床診斷結果一致性檢驗較好（Kappa=0.780，P=0.033）。ASD 組和非ASD 組性別構成比差異無統計學意義（P gt;0.05），ASD組與非ASD組年齡差異有統計學意義（P lt;0.05）。
結論　來自地震極重災區的受災群眾較早出現了心理問題。在生命救助的同時，應該盡早關注他們的心理問題。

引用本文： 趙高鋒,楊彥春,張樹森,鄧紅,朱燕,任正伽,張偉,孫學禮,李海民,劉傳新,王梅,岳莉莉,劉善明,張倬秋,陶慶蘭,陳穎,徐加軍,畢建強,何瑩瑩. 汶川地震極重災區780名受災群眾心理狀況調查. 中國循證醫學雜志, 2008, 08(10): 815-819. doi: 10.7507/1672-2531.20080182 復制

1.	Kessler RC, Sonnega A, Bromer E, et al. Posttraumatic stressdisorder in the national comorbidity survey. Arch Gen Psychiatry, 1995, 52(12): 1048-1060.
2.	Goenjian AK, Najarian LM, Pynoos RS, et al. Posttraumatic stressdisorder in elderly and younger adults after the 1988 earthquake inArmenia. Am J Psychiatry, 1994, 151: 895-901.
3.	David D, Mellman TA, Mendoza LM, et al. Psychiatric morbidityfollowing Hurricane Andrew. J Trauma Stress, 1996, 9: 607-612.
4.	Madakasira S, O’Brien KF. Acute posttraumatic stress disorder invictims of a natural disaster. J Nerv Ment Dis, 1987, 175: 286-290.
5.	American Psychiatric Association. Chief Editor. Diagnosticand Statistical Manual of Mental Disorders (DSM-Ⅳ), 4th ed., Washington, DC: American Psychiatric Press, 1994: 424-429.
6.	American Psychiatric Association.Chief Editor. Diagnosticand Statistical Manual of Mental Disorders(DSM-Ⅳ), 4th ed., Washington, DC: American Psychiatric Press, 1994.
7.	姜榮環, 馬弘. 急性應激障礙的研究現狀. 國際精神病學雜志, 2007, 34(3): 147-149.
8.	汪向東, 趙丞智, 新福尚隆, 等. 地震后創傷性應激障礙的發生率及其影響因素. 中國心理衛生雜志, 1999, 13(1): 28-30.
9.	Tang CS. Trajectory of Traumatic Stress Symptom in the Aftermathof Extreme Natural Disaster. J Nerv Ment Dis, 2007, 195(1): 54-59.
10.	Soldatos CR. Paparrigopoulos TJ, Pappa, DA, et al. Early posttraumaticstress disorder in relation to acute stress reaction: An ICD-10 study among help seekers following an earthquake. Psychiatry Res, 2006, 143: 245-253.
11.	Brauchle G. Incidence and reaction related predictors of the acuteand posttraumatic stress disorder in disaster workers. J Z PsychosomMed Psychother, 2006, 52: 52-62.
12.	Harvey AG, Bryant RA. Acute stress disorder across traumapopulations. J Nerv Ment Dis, 1999, 187: 443-446.
13.	Harvey AG, Bryant RA. Two 2 year prospective evaluation of therelationship between acute stress disorder and posttraumatic stressdisorder following mild traumatic brain injury. Am J Psychiatry, 2000, 157: 626-628.
14.	Walker EA, Newman E, Dobie DJ, et al. Validation of the PTSDchecklist in an HMO sample of women. J Ann Gen Hosp Psychiatry, 2002, 24(6): 375-380.
15.	Dobie DJ, Kivlahan DR, Maynard C, et al. Posttraumatic stressdisorder in female veterans: association with self-reported healthproblems and functional impairment. Arch Intern Med, 2004, 164(4): 394-400.
16.	Lang A riel J, Laffaye Charlene, Satz Leslie E, et al. Sensitivity andspecificity of the PTSD checklist in detecting PTSD in femaleveterans in primary care. J Trauma Stress, 2003, 16(3): 257-264.
17.	Dobie DJ, Kivlahan DR, Maynard C, et al. Screening for posttraumaticstress disorder in female Veteran’s Affairs patients: validation of the PTSD checklist. Gen Hosp Psychiatry, 2002, 24(6):367-374.

1. Kessler RC, Sonnega A, Bromer E, et al. Posttraumatic stressdisorder in the national comorbidity survey. Arch Gen Psychiatry, 1995, 52(12): 1048-1060.
2. Goenjian AK, Najarian LM, Pynoos RS, et al. Posttraumatic stressdisorder in elderly and younger adults after the 1988 earthquake inArmenia. Am J Psychiatry, 1994, 151: 895-901.
3. David D, Mellman TA, Mendoza LM, et al. Psychiatric morbidityfollowing Hurricane Andrew. J Trauma Stress, 1996, 9: 607-612.
4. Madakasira S, O’Brien KF. Acute posttraumatic stress disorder invictims of a natural disaster. J Nerv Ment Dis, 1987, 175: 286-290.
5. American Psychiatric Association. Chief Editor. Diagnosticand Statistical Manual of Mental Disorders (DSM-Ⅳ), 4th ed., Washington, DC: American Psychiatric Press, 1994: 424-429.
6. American Psychiatric Association.Chief Editor. Diagnosticand Statistical Manual of Mental Disorders(DSM-Ⅳ), 4th ed., Washington, DC: American Psychiatric Press, 1994.
7. 姜榮環, 馬弘. 急性應激障礙的研究現狀. 國際精神病學雜志, 2007, 34(3): 147-149.
8. 汪向東, 趙丞智, 新福尚隆, 等. 地震后創傷性應激障礙的發生率及其影響因素. 中國心理衛生雜志, 1999, 13(1): 28-30.
9. Tang CS. Trajectory of Traumatic Stress Symptom in the Aftermathof Extreme Natural Disaster. J Nerv Ment Dis, 2007, 195(1): 54-59.
10. Soldatos CR. Paparrigopoulos TJ, Pappa, DA, et al. Early posttraumaticstress disorder in relation to acute stress reaction: An ICD-10 study among help seekers following an earthquake. Psychiatry Res, 2006, 143: 245-253.
11. Brauchle G. Incidence and reaction related predictors of the acuteand posttraumatic stress disorder in disaster workers. J Z PsychosomMed Psychother, 2006, 52: 52-62.
12. Harvey AG, Bryant RA. Acute stress disorder across traumapopulations. J Nerv Ment Dis, 1999, 187: 443-446.
13. Harvey AG, Bryant RA. Two 2 year prospective evaluation of therelationship between acute stress disorder and posttraumatic stressdisorder following mild traumatic brain injury. Am J Psychiatry, 2000, 157: 626-628.
14. Walker EA, Newman E, Dobie DJ, et al. Validation of the PTSDchecklist in an HMO sample of women. J Ann Gen Hosp Psychiatry, 2002, 24(6): 375-380.
15. Dobie DJ, Kivlahan DR, Maynard C, et al. Posttraumatic stressdisorder in female veterans: association with self-reported healthproblems and functional impairment. Arch Intern Med, 2004, 164(4): 394-400.
16. Lang A riel J, Laffaye Charlene, Satz Leslie E, et al. Sensitivity andspecificity of the PTSD checklist in detecting PTSD in femaleveterans in primary care. J Trauma Stress, 2003, 16(3): 257-264.
17. Dobie DJ, Kivlahan DR, Maynard C, et al. Screening for posttraumaticstress disorder in female Veteran’s Affairs patients: validation of the PTSD checklist. Gen Hosp Psychiatry, 2002, 24(6):367-374.

《中國循證醫學雜志》

汶川地震極重災區780名受災群眾心理狀況調查

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《中國循證醫學雜志》

汶川地震極重災區780名受災群眾心理狀況調查

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