汶川地震3年后地震亲历者心理应激状况评估

Assessment of the posttraumatic symptoms among survivors for three years following WenchuanEarthquake

目的 探讨汶川地震3年后地震亲历者心理应激水平及其影响因素。方法 以自制一般情况调查表、创伤后应激障碍筛查量表平时版（PCL-C）为调查工具，采用系统抽样方法，评估870名来自极重灾区北川县（605名）和重灾区江油县（265名）地震亲历者的心理应激水平及其相关影响因素。结果 PCL-C测评结果显示，地震3年后创伤后应激障碍（PTSD）阳性率为8.5%（74/870），其中，北川县为11.2%（68/605），高于江油县[2.3%（6/265）]（P＜0.05）；女性为11.8%（55/465），高于男性[4.7%（19/405）]（P＜0.05）；财产损失重者（≥10 000元）为13.3%（62/466），高于财产损失轻者（＜10 000元）[3.0%（12/404）]（P＜0.05）；有亲属死亡者PTSD阳性率为13.4%（45/336），高于没有亲属死亡者[5.4%（29/534）]（P＜0.05）。PTSD阳性者中反复创伤性体验症状症候群和警觉性过强所致易激惹症状症候群阳性率均为100%（74/74），情感麻木与回避症状症候群阳性率为93%（69/74）。PTSD阳性者以反复创伤性体验症状和警觉性过强所致易激惹症状阳性率最高，均为100%（74/74）。PTSD的17项症状中,以过分的惊吓反应、强烈的心理痛苦和烦恼、强烈的生理反应阳性率最高，依次为96%（71/74）、94%（70/74）和90%（67/74）。logistic回归分析结果显示，女性、财产损失重、有亲属死亡是PTSD发生的危险因素[OR（95%CI）值分别为2.746（1.580～4.772）、3.616（1.871～6.988）、1.805（1.057～3.084）]。结论 汶川地震3年后地震亲历者的心理应激水平不容乐观，女性、受灾程度重、有亲属死亡的亲历者是系统性心理干预和经济社会支持的重点人群。

Objective To investigate the incidence of posttraumatic stress disorder （PTSD） and its influencing factors for three years following the “5.12” Wenchuan Earthquake. Methods A systematic sampling of 870 subjects who came from Beichuan（605 persons） and Jiangyou（265 persons） areas were investigated by adopting subscale of PTSD Checklist-Civilian Version（PCL-C） and Social Demographic Questionnaire. Results The incidence rate of PTSD was 8.5%（74/870）,the incidence rates of PTSD for the area of Beichuan and Jiangyou were 11.2%（68/605） and 2.3%（6/265） respectively. Subjects from Beichuan had higher PTSD incidence rate compared to Jiangyou（P〈0.05）. The prevalence of PTSD for female and male were 11.8%（55/465） and 4.7%（19/405） respectively, female had higher prevalence of PTSD compared to male（P〈0.05）. The incidence rates of PTSD for victims who suffered from major property lost and those who lost less were 13.3%（62/466） and 3.0%（12/404） respectively, victims suffered major property lost had higher incidence rate of PTSD（P〈0.05）. The incidence rates of PTSD for victims who lost family members and those did not were 13.4%（45/336） and 5.4%（29/534） respectively, victims who lost family members had higher incidence rates of PTSD（P〈0.05）.The posttraumatic symptoms for survivors who suffered from PTSD mainly focused on the symptoms of reexpericement and over vigilance, the prevalence rate was 100%（74/74）. Exaggerated startle response, intense psychological distress and physiological reactivity were higher than others in total 17 symptoms, accounting for 96%（71/74）,94%（70/74） and 90%（67/74）.The logistic regression showed that being female, victims who suffered from major property lost, lost family member in this earthquake were the risk factors of PTSD, The value of OR（95%CI） were 2.746（1.580-4.772）,3.616（1.871-6.988） and 1.805（1.057-3.084）, respectively. Conclusion Posttraumatic symptoms were still common among survivors three years after “5.12” Wenchuan Earthquake. Survivors in Beichuan（heavy hit area）, female victims, victims who suffered from major property lost, victims who lost family member need more social and economic support.