Comparison of the PTSD Symptoms, Depression and Anxiety between Bereaved and Non-Bereaved Survivors after Wenchuan Earthquake

Abstract

目的 探討在地震災害發生半年后喪親者與非喪親者創傷后應激障礙、焦慮和抑郁的關系及對比情況.方法 采用一般情況凋查表、創傷后應激障礙(PTSD)檢查表、貝克抑郁量表(BDI)、漢密爾頓焦慮量表(HAMA)在地震半年后對都汀堰災區安置點的人群560人進行調查.結果 10.9%的被調查者在地震中喪失親人.喪親組符合PTSD癥狀診斷的比例(44.4%)顯著高于非喪親組(15.1%)(t=4.737,P<0.05).喪親組中重度抑郁、焦慮和自殺觀念的發生率分別為55.5%、44.4%和44.5%顯著高于非喪親組17.4%、16.7%和14.2%(χ2=46.522,P<0.01).喪親組符合PTSD癥狀診斷者中合并中重度抑郁的占79.2%,合并焦慮或明顯焦慮的占75%;中重度抑郁中合并焦慮或明顯焦慮的占83.4%.抑郁總分、焦慮總分、既往焦慮、噩夢、喪親后感到寂寞為喪親者創傷后應激障礙癥狀的預測因素.結論 地震災區喪親者的抑郁、焦慮、自殺觀念及符合PTSD癥狀診斷的均較非喪親者高.喪親人群的抑郁、焦慮及PTSD癥狀三者共病率高.喪親者PTSD癥狀的預測因素足多方面的. Objective To compare the differences of PTSD symptoms, depression and anxiety between bereaved and non-bereaved survivors, and to explore the risk factors of PTSD among victims of the Sichuan earthquake 2008. Methods To investigate the mental health status among 560 survivors of disaster six-month after the earthquake using post-traumatic stress disorder Checklist, Beck Depression Inventory (BDI), and Hamilton Anxiety Scale (HAMA). Results There were 10.9% of victims who lost their relatives in the earthquake. The rates of PTSD symptoms among bereaved survivors (44.4% ) were significantly higher than non-bereaved group (15.1% ) (P<0.05). The rates of depression, anxiety, and suicidal ideation among bereaved survivors (55.5% , 44.4%, and 44.5% ) were significantly higher than that of the non-bereaved group respectively ( 17.4%, 16.7%, and 14.2% ) (P<0.001). Bereaved survivors with PTSD symptoms reported comorbidity of medium to severe depression (79.2%) and anxiety symptoms (75%). Bereaved survivors with medium to severe depression reported comorbidity of anxiety symptoms (83.4%). Total score of depression and anxiety, previous anxiety, nightmare, and feeling of being lonely could predict the level of PTSD symptoms. Conclusion The rates of depression, anxiety, suicidal ideation, and PTSD symptoms of bereaved survivors were significantly higher than non-bereaved group. There were multi-factors which could predict PTSD in bereaved survivors. Bereaved survivors were high risk victims of PTSD, depression, and anxiety.