芦山地震后3个月教师广泛性焦虑障碍的预测因素

Predictors of Generalized Anxiety Disorder among Teachers in 3 Months aft er the Lushan Earthquake

目的对影响芦山地震震后3个月灾区教师的广泛性焦虑障碍（GAD）的因素进行评估。方法采用前瞻性队列研究方法,分别于地震后14~20天和85~95天对宝兴县教师进行地震后社会心理状况及GAD的诊断性评估。社会心理状况评估采用自编调查表,GAD诊断采用简明国际神经精神访谈（M.I.N.I.）中GAD的症状评估标准,时间标准则采用3个月。完成2次评估后,采用单因素与多因素logistic回归分析GAD的预测因素。结果共319名教师完成了2次评估,教师总体响应率为51.3%。70名教师被诊断为GAD,患病率为21.9%。单因素logistic回归模型显示GAD的预测因素包括：男性、年龄大于35岁、住房不能居住、住在帐篷、入睡困难、容易伤感、躯体不适、食欲下降、感受不到社会支持、不能平静下来工作、感教学困难、观察到学生注意力不集中更明显、想要休假以调节自己情绪或关注身体健康。多因素logistic回归模型结果显示,独立的预测因素包括：男性、住房不能居住、感受不到社会支持、震后感觉教学更困难。结论地震后教师群体存在GAD的可能性较高。特别在地震后早期,应该对缺乏正常居住、缺乏社会支持、教学感觉更困难的男教师给与重点关注。

Objective To evaluate the predictors of generalized anxiety disorder（GAD） among teachers in 3months after Lushan earthquake. Methods A prospective cohort study was conducted to diagnostically evaluate the psychological sequelae and GAD during 14-20 days and 85-95 days after the earthquake. The possible predictive factors of psychological sequelae were assessed by a self-made questionnaire and the GAD was assessed by the GAD symptom criterion of M.I.N.I. in 3 months. The univariate and multivariate logistic regression analysis（ULRA, MLRA） were applied to analyze the predictors of GAD after the two-staged assessments. Results There were a total of 319 teachers completed the two-staged assessments. The total response rate was 51.3%. Seventy teachers were diagnosed as GAD and the prevalence of GAD in 3 months was 21.9%. The predictive factors by ULRA included： male, older than 35 years old,having unlivable house, living in tents, sleeping difficulties, easy to feel sad, physical discomfort, loss of appetite, feeling short of social support, unable to calm down for working, feeling difficult for teaching, observing more inattention of students, and wanting to ask for a leave. The independent predictors by MLRA included： male, having unlivable house,feeling short of social support, and feeling difficult for teaching. Conclusion The teachers have a higher likelihood of GAD after earthquake. It is essential to pay more attention to those male teachers, who feel short of social support and don＇t have a livable house thus to prevent the GAD at the early stage of post-earthquake.