5·12汶川大地震灾民创伤后应激障碍的特点分析

Characteristic of post-traumatic stress disorder in 5·12 Wenchuan earthquake victims

目的了解5.12汶川大地震3月后北川灾民的心理健康状况以及创伤后应激障碍的特点。方法对义诊接待的140名灾民利用90项症状清单(SCL-90)和创伤后应激障碍(PTSD)简易筛查量表(SPAN)进行评分。结果86例(61.4%)发生PTSD,SCL-90总分PTSD组为(225.37±41.32)分,非PTSD组为(198.78±43.12)分,均显著高于全国常模(P<0.01);两组躯体化、抑郁、焦虑、惊恐因子分也显著高于全国常模;PTSD组躯体化、强迫、抑郁、焦虑、恐怖、偏执、精神病性因子得分与全国常模差异有显著性意义(P<0.01),躯体化、抑郁、偏执、精神病性因子得分与非PTSD组差异有显著性意义(P<0.05)。结论在PTSD灾民中,抑郁和躯体化是两个突出的表现,抑郁存在自杀的风险,应给予足够的重视;躯体症状常掩盖了情绪障碍,临床医生在对灾民的诊治过程中,应注意到躯体症状背后可能隐藏着的情绪问题。

Objective To investigate the mental health status and the characteristic of posttraumatic stress disorder （PTSD） in victims of Wenchuan earthquake in Beichuan county. Methods 140 victims were surveyed using the Symptom Checklist 90 （ SCL-90 ） and PTSD screening scale （ SPAN scale） in our hospital. Results 86 （ 61.4 % ） cases were diagnosed as PTSD. Total scores of SCL-90 in PTSD group and non-PTSD group were 225.37 ± 41.32 and 198. 78 ± 43.12 respectively. They were significantly higher than the national norm（P 〈 0.01 ）. The scores of somatization, obsession, depression, anxiety, fear, paranoid, psychosis in PTSD group were significantly different as compared with the national norm （P 〈 0. 01 ）. The scores of somatization , depression, paranoid, psychosis in PTSD group were significantly different as compared with non-PTSD group （ P 〈 0. 05 or 0. 01 ）. Conclusion In the victims with PTSD, depression and somzatization are outstanding performance. Depression should be given enough care due to the risk of suicide. Clinicians should be sensitive to note that the emotional problem hidden behind the body symptoms during the diagnosis and treatment of victims.