【摘要】 目的:探讨汶川地震后1月内脱离/未脱离震区的亲历者创伤后应激障碍(posttraumaticstress disorder,PTSD)筛查阳性的发生及心理健康的影响因素。方法:对什邡地区235人(现场组,称A组)、转入湘雅二医院住院的伤病员44人(伤病员组,称B组)及家属36人(家属组,称C组)采用事件影响量表修订版等进行心理评估。结果:(1)灾后1月内PTSD筛查总阳性率为35.56%,女性明显高于男性(χ2=16.27,P<0.001);A组、B组和C组PTSD筛查阳性率分别为39.15%,31.82%和16.67%,差异有统计学意义(χm2h=5.243,P<0.05);在PTSD筛查阳性者的3组人群中,A组在"麻木/回避"和"过度唤起"症状得分上明显高于B组和C组(均P<0.01)。(2)A组和B组的"焦虑"、"抑郁"和"躯体化"因子得分均明显高于C组(均P<0.05);(3)性别、居住地和是否脱离震区是PTSD症状的影响因素。结论:震后1月内对亲历者的心理影响较大,PTSD症状群、焦虑与抑郁症状是其主要心理问题,尤其是女性群体,应予更多关注。早期脱离震区环境、扩大和强化支持系统是其保护性因素。早期心理干预有助于提高亲历者的心理承受力,有效预防PTSD的发生。更多还原

【Abstract】 Objective To explore posttraumatic stress disorder(PTSD) positive screening and factors influencing the mental state in victims who were evacuated/were not evacuated from Wenchuan earthquake area within 1 month.Methods The 3 groups included 235 victims who were not evacuated from Shifang territory(the incident scene,Group A),44 victims who were evacuated to Second Xiangya Hospital(the wounded,Group B) and 36 relatives(the relatives,Group C).The mental state of all subjects was evaluated by Impact of Event Scale-Revised(IES-R)and other tools.Results(1) One month after the disaster,and the positive rate of PTSD screening in these survivors was 35.56%,the positive rate in women was significantly higher than that in men(χ2=16.27,P<0.001).The positive rate of PTSD screening in Group A,Group B and Group C was 39.15%,31.82%,and 16.67%,respectively,with significant difference(χ2mh=5.243,P<0.05).Among the three groups which met the diagnosis criterion of PTSD symptoms,the scores for "numbness/avoidance symptom" and "excessive arousing symptom" in Group A were significantly higher than those in Group B and C(P<0.01).(2) The scores for "anxiety" and "depression" and "psychosomatic" symptoms in Group A and Group B were significantly higher than those in Group C(P<0.05).(3) Gender,place of residence and evacuating from the earthquake area or not were factors of PTSD symptoms.Conclusion One month after the earthquake,the victims suffered psychologically.PTSD symptoms,anxiety and depression symptoms were their major mental problems,more attention to especially women victims.The protection factors include dispersing victims to the secure place as soon as possible,expanding and strengthening society support.Early psychological interventions will help victims to raise their psychological endurance and prevent PTSD effectively.更多还原