汶川地震后2～3年灾区儿童创伤后应激障碍及抑郁症状的对照研究

Comparative study on the symptoms of PTSD and depression of the children exposed to the Wenchuan earthquake 2 and 3 years after it

目的探讨汶川地震2年及3年后灾区儿童的心理健康状况及其变化情况。方法使用一般情况调查表、创伤应激量表儿童版（CRIES一13）、儿童抑郁障碍自评量表（DSRSC）分别于震后2年及3年调查了同一批来自于彭州灾区的儿童的心理健康状况及其影响因素。结果震后3年CRIES一13及DSRSC量表总分比震后2年均有所降低（z=-8．772，P=0．00；z=-2．870，P=0．00）。震后3年与创伤后应激障碍症状相关的危险因素为性别（OR=1．069，P=0．00）、家人伤亡程度（OR=1．141，P=0．02）、震后安全时间（OR=1．416，P=0．03）、是否目睹垮塌（OR=1．014，P=0．01）。震后3年与抑郁症状相关的危险因素为性别（OR=1．367，P=0．00）、年龄（OR=1．035，P=0．04）、绝望感（OR：2．490，P=0．01）。结论震后灾区儿童的创伤后应激障碍症状及抑郁症状在时隔1年后有所下降。灾区儿童心理健康状况受到性别、年龄、震后被转移至安全地点的时间、家人伤亡程度、是否目睹垮塌、绝望感等的影响。

Objective To examine the mental health status and its changes among children exposed to the Wenchuan earthquake 2 and 3 years after it has passed, and evaluate the possible influencing factors of mental health. Methods The General questionnaire,the self-reported Children＇s revised impact of event scale（CRIES） and the Depression self-rating scale for children （ DSRSC ） were administered to the same children from the earth-quake affected areas 2,3 years after the earthquake. Results Both of the CRIES scores and DSRSC scores had decreased over the 2,3 years periods after the earthquake （ z=-8. 772, P = 0.00; z = -2. 870, P = 0.00）. The risk factors associated with PTSD 3 years after the earthquake were ： gender （ OR = 1. 069, P = 0.00 ）, the severity of their familyg injury（ OR = 1. 141, P.= 0.02）, the length of living in transferred safe places （OR = 1. 416, P = 0.03 ）, and whether or not witnessed collapse（ OR = 1. 014, P = 0.01 ）. The risk factors associated with depression 3 years after the earthquake were ： gender（ OR = 1. 367, P = 0.00） , age （ OR = 1. 035, P = 0.04）, and despair （ OR = 2. 490, P = 0.01 ）. Conclusion Both of the symptoms of PTSD and depression among the children from earth-quake affected areas have decreased over the 2,3 years periods after the earthquake. The mental health status of the children from the earthquake affected areas are influenced by their gender, age, the length of living in transferred safe places, the severity of their family＇s injury, whether or not witnessed collapse and despair. These factors should be taken into considerations when the long-term post-traumatic psychological interventions are planned.