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目的研究参加“5.12”汶川地震一线救援的军校学员创伤后应激障碍(PTSD)的发生率,分析相关危险因素。方法地震后6个月,对1024名军校学员的救援经历、急性应激状况(采用SRQ-20)进行回顾性调查,完成PTSD症状清单(采用PCL-C)、焦虑自评量表(SAS)、抑郁自评量表(SDS)自评,并对调查结果进行统计学分析。对初筛结果高于划界分者,由精神科医师依据临床定式检查(采用SCID)晤谈确定诊断。结果 35人确诊为PTSD,阳性率为3.42%;PCL-C评分城市籍军人明显高于农村籍军人(P<0.05),独生子女明显高于非独生子女(P<0.05),大专明显高于本科(P<0.05);参加现场搜救任务和处理遗体任务的救援人员PCL-C评分均显著高于未参加者(P<0.01);以PCL-C总分为因变量,经线性逐步回归分析,SRQ总分、SAS评分、既往创伤经历、内向性格、文化程度、处理遗体任务进入方程。以PTSD确诊结果为因变量,经二元Logistic回归分析,处理遗体任务、独生子女、文化程度、抑郁进入方程,正确预测率为50%,总的正确判断率为75.3%。结论汶川地震后半年时点,一线救援军校学员PTSD患病率为3.42%,处理遗体经历对发病的负性刺激强度最大,独生子女、文化程度、抑郁状态与PTSD的发生率密切相关,急性应激反应、焦虑、创伤经历、内向性格均为相关危险因素。
Objective To study the incidence of posttraumatic stress disorder (PTSD) in cadets receiving first aid from “5.12 ” Wenchuan earthquake and analyze the related risk factors. METHODS: Six months after the earthquake, 102 military cadets’ rescue experience and acute stress status (using SRQ-20) were retrospectively reviewed. PTSD symptom checklist (using PCL-C), anxiety self-rating scale (SAS) , Self-rating depression self-rating scale (SDS), and the statistical analysis of the survey results. The screening results are higher than the delimitation of the sub-by the psychiatrist based on clinical examination (SCID) to confirm the diagnosis. Results 35 patients were diagnosed as PTSD, the positive rate was 3.42%. The score of PCL-C was significantly higher in urban-born soldiers than in rural-born soldiers (P <0.05), the only child was significantly higher than that of non-only children (P <0.05) (P <0.05). The PCL-C scores of rescue workers who participated in on-the-spot search and rescue mission and remained in mission were significantly higher than those of non-participants (P <0.01). The PCL-C total score was used as the dependent variable and linear regression analysis , SRQ score, SAS score, previous traumatic experience, introverted personality, educational level, and the task of handling the remains into the equation. The results of PTSD diagnosis as dependent variable, the binary Logistic regression analysis, handling the remains of the task, only child, education level, depression into the equation, the correct prediction rate was 50%, the total correct judgment rate of 75.3%. Conclusions Six months after the Wenchuan earthquake, the prevalence of PTSD in first-line rescue cadets was 3.42%. The negative experience in the treatment of extremities experienced the greatest negative stimulation. The only child, educational level, and depression status were closely related to the incidence of PTSD. Irritability, anxiety, traumatic experience, introverted personality are related risk factors.