胎儿期经历唐山大地震的青少年心理状况

Psychological status in adolescents who experienced Tangshan earthquake during fetal period

目的:通过胎儿期经历唐山大地震的青少年症状自评量表评分研究,探讨胎儿期经历大地震对青少年心理状况的远期影响。方法:1994/1995对唐山市14所学校年满18周岁的高中三年级学生,进行90项症状自评量表测评。其中①胎儿期经历过唐山大地震,出生时间为1976-07-29/1977-04-28,测评时年龄满18周岁的高三学生611例为实验组,男295例,女316例。将实验组分为3个亚组:1976-07-29/1976-10-28出生的为早孕组(地震时母亲已怀孕7～9个月);1976-10-29/1977-01-28出生的为中孕组(地震时已怀孕4～6个月),1977-01-29/1977-04-28出生的为晚孕组(地震时已怀孕1～3个月)。②胎儿期未经历过唐山大地震,出生地点为唐山市地震中心。出生时间为1977-07-29/1978-04-28,测评时年龄满18周岁高三学生601例为对照组,男250例,女351例。将对照组也分为3个亚组:1977-07-29/1977-10-28出生的为早孕组(地震后4～6个月母亲怀孕);1977-10-29/1978-01-28出生的为中孕组(地震后7～9个月怀孕);1978-01-29/1978-04-28出生的为晚孕组(地震后10～12个月怀孕)。两组调查评估均在开滦精神卫生中心心理测验室完成。结果:1212例研究对象均进入结果分析。①实验组与对照组的90项症状自评量表总分比较差异无显著性意义,其中对照组恐怖因子分明显高于实验组(1.57±0.53,1.50±0.49,t=-2.389,P<0.01),其他因子分两组比较差异无显著性意义(P>0.05)。②对照早孕组总评分和躯体化、强迫、焦虑、敌对、恐怖、精神病因子分均高于实验早孕组[166.64±39.29,154.96±35.88;1.57±0.49,1.46±0.40;2.37±1.37,2.11±0.54;1.84±0.52,1.69±0.48;2.00±0.63,1.85±0.58;1.65±0.58,1.48±0.46;1.73±0.45,1.63±0.40,(P<0.05-0.01)];实验晚孕组的总分和强迫、焦虑、偏执、精神病和其他因子评分明显高于对照晚孕组[153.55±38.33,145.09±38.05;2.05±0.58,1.90±0.54;1.68±0.50,1.57±0.50;1.86±0.64,1.68±0.58;1.62±0.48,1.53±0.43;1.59±0.49,1.49±0.44,(P<0.05-0.01)]。③对照组三个孕期间比较,早孕组和中孕组的总评分和各因子分均高于晚孕组(P<0.01);早孕组总分和强迫、抑郁、焦虑因子分高于中孕组[166.64±39.29,158.39±36.70;2.37±1.37,2.10±0.54;1.81±0.58,1.69±0.53;1.84±0.52,1.74±0.46,(P<0.05～0.01)]。实验组三个孕期组间的比较差异无显著性意义(P>0.05)。结论:唐山大地震对孕妇的强烈应激影响到其子女的远期心身健康水平。

AIM： To study the long-term effect of the psychological status on adolescents who experienced Tangshan earthquake during their fetal period by comparing their Symptom Checklist 90 （SCL-90）. METHODS： Totally 14 students aged 18 years in grade three in high schools of Tangshan were evaluated with SCL-90 for their mental status between 1994 and 1995. ① Totally 611 senior three students who experienced Tangshan earthquake during their fetal period were regarded as the experimental group （bern between July 29, 1976 and April 28,1977）, with 295 male and 316 female. All cases in the experimental group were divided into 3 subgroups： early-pregnant group who were bern between October 29, 1976 and October 28, 1977 （fetus 7-9 months）; middle-pregnant group who were born between January 29, 1977 and April 28, 1977 （fetus 4-6 months）, and late-pregnant group who were born between July 29, 1,977 and April 28, 1978 （fetus 1-3 months）.② Totally 601 senior three students aged 18 years who did not experience Tangshan earthquake but born in the earthquake center during their fetal period were regarded as the control group （bern between July 29, 1977 and April 28, 1978） with 250 male and 351 female. All cases in the control group were divided into 3 subgroups： early-pregnant group who were born between July 29, 1977 and October 28, 1977 （mother-pregnant fetus 4-6 months after earthquake）, middle-pregnant group who were born between October 29, 1977 and January 28, 1978 （mother-pregnant fetus 7-9 months after earthquake） and late-pregnant group who were born between January 29, 1978 and April 28, 1978 （mother-pregnant fetus 10-12 months after earthquake）. The evaluations of both groups were made in the psychological testing laboratory in Kailuan Mental Health Center. RESULTS： Totally 1 212 objects of the study were all included in the results analysis, ①The total score of SCL-90 in both groups were not significant difference, but score of phobic anxiety in control group was higher than that in experimental group （1.57±0.53, 1.50±0.49, t= -0.239, P 〈 0.01）, and other factors in both two groups were not significant difference （P 〉 0.05）. ② The total score and the scores of somatization, obsessive-compulsive, anxiety, hostility, phobic anxiety and psychoticism in early-pregnant control group was notably higher than those in earlypregnant experimental group （166.64±39.29, 154.96±35.88; 1.57±0.49, 1.46±0.40; 237±1.37, 2.11±0.54; 1.84±10.52, 1.69±0.48; 2.00±0.63, 1.85±0.58;1.65±0.58, 1.48±0.46; 1.73±0.45, 1.63±0.40, P 〈 0.05-0.01）; the total score and the scores of obsessive-compulsive, anxiety, paranoid ideation, psychoticism and other factors in late-pregnant experimentalogroup was higher than those in late-pregnant control group （153.55±38.33, 145.09±38.05; 2.05±0.58, 1.90±0.54; 1.68±0.50, 1.57±0.50; 1.86±0.64, 1.68±0.58; 1.62±0.48, 1.53±0.43; 1.59±0.49, 1.49±0.44, P 〈 0.05-0.01）. ③ As compared scores in three pregnant periods, total score and scores of factors in early-pregnant and middle-pregnant control group were higher than those in late-pregnant control group （P 〈 0.01）. The total score and scores of obsessivecompulsive, depression and anxiety in early-pregnant group were higher than those in middle-pregnant group （166.64±39.29, 158.39±36.70; 2.37±1.37, 2.10±0.54; 1.81±0.58, 1.69±0.53; 1.84±0.52, 1.74±0.46, P 〈 0.05-0.01）. There was no significant difference among the three pregnant periods in experimental group （P 〉 0.05）. CONCLUSION： The drastic stress caused by Tangshan Earthquake on the pregnant woman has a long-term effect on psychosomatic health of their children.