Trends in mental illness and suicidality after Hurricane Katrina
Trends in mental illness and suicidality after Hurricane Katrina
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DOI：
10.1038/sj.mp.4002119
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发表时间：
2008-04-01
影响因子：
11
通讯作者：
Wessely, S.
中科院分区：
文献类型：
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作者：
Kessler, R. C.;Galea, S.;Wessely, S.
对受卡特里娜飓风影响地区的815名飓风前居民的代表性样本在飓风发生5-8个月后进行了访谈，并在1年后作为卡特里娜飓风社区咨询小组再次进行了访谈。这项跟踪调查是为了研究模式-从飓风相关的创伤后应激障碍(PTSD)、更广泛的焦虑情绪障碍和自杀行为中恢复的相关性。使用创伤筛查问卷、创伤后应激障碍筛查量表和焦虑-情绪障碍K6筛查量表生成DSM-IV患病率估计。与其他灾难研究的结果相反，灾后精神障碍通常会随着时间的推移而减少，CAG中PTSD(基线时20.9比14.9%)、严重精神疾病(SMI；14.0比10.9%)、自杀意念(6.4比2.8%)和自杀计划(2.5比1.0%)的患病率显著增加。PTSD-SMI的增加仅限于非新奥尔良大都市区的受访者，而自杀意念计划的增加既发生在新奥尔良的子样本中，也发生在样本的其余部分。未解决的飓风相关压力在SMI(89.2%)、PTSD(31.9%)和自杀(61.6%)的跨期增加中占很大比例。然而，不同的飓风相关压力并不能解释来自新奥尔良以外地区的受访者显著增加的原因，因为新奥尔良大都市区的受访者最初的压力更高，而且与其他受飓风影响的地区相比，下降的幅度更小。结果与社会人口变量只有微弱的关系，这意味着飓风相关精神疾病的高患病率在飓风发生近两年后仍广泛分布在人口中。
A representative sample of 815 pre-hurricane residents of the areas affected by Hurricane Katrina was interviewed 5-8 months after the hurricane and again 1 year later as the Hurricane Katrina Community Advisory Group (CAG). The follow-up survey was carried out to study patterns-correlates of recovery from hurricane-related post-traumatic stress disorder (PTSD), broader anxiety-mood disorders and suicidality. The Trauma Screening Questionnaire screening scale of PTSD and the K6 screening scale of anxiety-mood disorders were used to generate DSM-IV prevalence estimates. Contrary to results in other disaster studies, where post-disaster mental disorder typically decreases with time, prevalence increased significantly in the CAG for PTSD (20.9 vs 14.9% at baseline), serious mental illness (SMI; 14.0 vs 10.9%), suicidal ideation (6.4 vs 2.8%) and suicide plans (2.5 vs 1.0%). The increases in PTSD-SMI were confined to respondents not from the New Orleans Metropolitan Area, while the increases in suicidal ideation-plans occurred both in the New Orleans sub-sample and in the remainder of the sample. Unresolved hurricane-related stresses accounted for large proportions of the inter-temporal increases in SMI (89.2%), PTSD (31.9%) and suicidality (61.6%). Differential hurricane-related stress did not explain the significantly higher increases among respondents from areas other than New Orleans, though, as this stress was both higher initially and decreased less among respondents from the New Orleans Metropolitan Area than from other areas affected by the hurricane. Outcomes were only weakly related to socio-demographic variables, meaning that high prevalence of hurricane-related mental illness remains widely distributed in the population nearly 2 years after the hurricane.