九寨沟地震后1周伤员急性应激障碍的发生率及相关心理状况

Incidence of acute stress disorder and psychologic status in the wounded one week after 8·8 Jiuzhaigou earthquake

目的调查"8·8"九寨沟地震1周后47名伤员急性应激障碍(ASD)发生情况,为合理分配卫生资源、及时有效的心理干预提供参考。方法于2017年8月筛选绵阳市某三级甲等医院收治的47名九寨沟地震伤员,依据《精神障碍诊断与统计手册(第5版)》(DSM-5)分为急性应激障碍组(ASD组)与非急性应激障碍组(非ASD组)。采用汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表24项版(HAMD-24)、自杀风险评估量表(MINI自杀量表)、事件影响量表修订版(IES-R)对伤员进行评定。结果在47名地震伤员中,ASD组8例(17.02%),非ASD组39例(82.98%)。两组性别、年龄比较差异无统计学意义(P均>0.05);ASD组IES-R总评分[(53.38±23.43)分]、HAMA评分[(27.38±13.46)分]、HAMD-24评分[(21.12±11.85)分]和MINI自杀量表评分[(3.75±6.63)分]均高于非ASD组[(15.62±15.49)分、(6.56±6.72)分、(4.69±4.65)分、0],差异均有统计学意义(P均<0.01)。IES-R总评分与HAMA、HAMD-24评分均呈正相关(r=0.81、0.84,P均<0.01)。结论九寨沟地震后1周伤员ASD发生率较高;伤员的创伤后应激症状越严重,越易出现焦虑、抑郁症状,自杀风险越高。

Objective To investigate the condition of Acute Stress Disorder（ ASD） among the wounded in Jiuzhaigou earthquake and to provide references for rational allocation of health resources and effective psychological intervention. Methods Totally47 subjects in Jiuzhaigou earthquake were surveyed. According to the Diagnostic and Statistical Manual of Mental Disorders,fifth edition（ DSM-5）,the wounded were divided into two groups： ASD group and non-ASD group. They were assessed with Hamilton Anxiety Scale（ HAMA）,Hamilton Depression Scale-24 item（ HAMD-24）,Suicide Risk Assessment Scale（ MINI suicide scale）and Impact of Event Scale-Revised（ IES-R）. Results Among the 47 wounded,8 cases（ 17. 02%） were ASD（ 17. 02%） and 39 cases（ 82. 98%） were not. There was no significant difference in gender and age between the two groups（ P 0. 05）. The total scores of IES-R（ 53. 38 ± 23. 43）,HAMA（ 27. 38 ± 13. 46）,HAMD-24（ 21. 12 ± 11. 85） and MINI suicide scale（ 3. 75 ± 6. 63） of ASD group were higher than those of non-ASD group [（ 15. 62 ± 15. 49）,（ 6. 56 ± 6. 72）,（ 4. 69 ± 4. 65）,0,P 0. 01]. The total score of IES-R was positively correlated with the scores of HAMA and HAMD-24（ r = 0. 81,0. 84,P 0. 01）. Conclusion The incidence of ASD after one week of Jiuzhaigou earthquake is high. People who has more severe PTSD symptoms shows more anxiety and depression as well as higher the risk of suicide.