汶川地震安置点灾民抑郁症状及影响因素分析

An analysis on depression and influence factors of victims of Wenchuan earthquake in temporary settlements

目的评估汶川地震后第2周安置点灾民的抑郁症状及影响因素。方法对江油市太平镇安置点灾民随机抽样后，利用汉密尔顿抑郁量表（HRSD）、斯坦福急性应激反应量表（SASRQ）、应激反应问卷（SRQ）及自编调查问卷进行评估，225名灾民完成调查。结果29．35％的灾民存在抑郁症状，11．11％的灾民有自杀观念。HRSD总分[（15．67±11．12）分]与SASRQ总分（r=0．725，P〈0．01）及SRQ总分呈正相关（r=0．767，P〈0．01）。不同年龄组的HRSD总分、焦虑与躯体化、阻滞、睡眠障碍、绝望感的差异有显著性（F=4．94，P〈0．01），LSD多重检验显示儿童组的HRSD总分[（10．35±9．17）分]与青少年组[（16．86±11．82）分]、中年组[（19．31±11．94）分]、老年前期组[（20．04±11．19）分]的差异有显著性（P〈0．05）。女性灾民的睡眠障碍[（5．27±2．25）分]比男性[（2．59±2．27）分]严重，差异有显著性（1=2．145，P=0．033）。亲人遇难组的HRSD总分[（22．82±13．99）分]高于仅经济损失组[（14．51±10．06）分]，差异有显著性（t=3．308，P=0．002）。以HRSD总分为因变量的线性回归分析结果显示，SRQ、烦扰程度、是否受伤、SASRQ进入回归方程（R=0．870，F=95．307，P〈0．01）。结论灾民在地震发生后第2周存在明显的抑郁症状，与急性应激症状密切相关，儿童的抑郁症状相对较轻，灾后心理干预应关注女性、亲人遇难等特殊人群。

Objective To investigate the symptoms of depression and influence factors of victims of Wen-chuan Earthquake in temporary settlements in the second week. Method A random sample of 225 cases were assessed by using Hamilton Rating Scale for Depression （HRSD）, Stanford Acute Stress Reaction Questionnaire （ SASRQ）, Stress Reaction Questionnaire （SRQ） and a self-designed questionnaire. Result 29.33 % of the victims had symptoms of depression, 11.11% of the victims had suicidal idea. The total score of HRSD（ 15.67±11.12） had positive correlation with SASRQ （r = 0. 725, P 〈 0.01 ） and SRQ （r = 0. 767, P 〈 0.01 ）. There were statistical differences of the total score of HRSD（F = 4.94, P 〈 0. 001 ） , anxiety and somatization, blockade, dyssomnia and feeling of despair among 6 age groups by analysis of variance（ANOVA）. The children had lower score of HRSD（ 10.35±9.17） than the adolescent（ 16.86±11.82）, the middle age（ 19.31±11.94） and the presenium （P 〈 0.05 ）. The dyssomnia of the female victims （ 3.27±2.25 ） was worse than the male （ 2.59±2.27 ） （t = 2. 145, P = 0. 033 ）. The victims who had lost a loved one had higher scores of HRSD （22.82±13.99 ） than those with property loss only（ 14.51±10.06） （t = 3. 308, P= 0.002）. According to regression model, SRQ, disturbing degree, and SASRQ significantly explained HRSD variance. （R = 0. 870, F = 95. 307, P 〈 0. 01 ）. Conclusion The victims had obvious symptoms of depression in the second week after the Wenchuan earthquake. The symptoms of depression had positive correlation with the symptoms of acute stress reaction. The symptoms of depression of children were milder. The female victims and the victims who had lost a loved one in the earthquake should be pay more attention to psychological intervention in the after-disaster.