Mental illness and suicidality after Hurricane Katrina
Mental illness and suicidality after Hurricane Katrina
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DOI：
10.2471/blt.06.033019
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发表时间：
2006-12-01
期刊：
影响因子：
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通讯作者：
Parker, Holly A.
中科院分区：
文献类型：
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作者：
Kessler, Ronald C.;Galea, Sandro;Parker, Holly A.
Objective.通过比较卡特里娜飓风后的调查结果与早期调查结果，估计卡特里娜飓风对精神疾病和自杀行为的影响。方法。2001年2月至2003年2月进行的科摩罗全国重复调查访问了后来受到卡特里娜飓风影响的人口普查区的826名成年人。卡特里娜飓风后的调查采访了飓风前居住在同一地区的1043名成年人。同样的问题被问到了精神疾病和自杀倾向。卡特里娜飓风后的调查还评估了创伤导致的个人成长的几个方面（例如，与亲人的亲密关系增加，宗教信仰增加）。结果的措施是K6筛选规模的严重精神疾病和轻中度精神疾病和问题的自杀意念，计划和自杀。卡特里娜飓风后调查的受访者严重精神疾病的估计患病率明显高于早期调查的受访者（卡特里娜飓风后为11.3%，卡特里娜飓风前为6.1%;卡方（2）（1）= 10.9; P < 0.001）和轻中度精神疾病（卡特里娜飓风后19.9%对前9.7%;卡方（2）（1）= 22.5;P < 0.001）。然而，在卡特里娜飓风后的调查中，估计患有精神疾病的受访者中，自杀意念和计划的流行率明显降低（Katrina后自杀意念0.7%，Katrina前8.4%;卡方（2）（1）= 13.1; P < 0.001; Katrina后自杀计划0.4%，Katrina前3.6%;卡方（2）（1）= 6.0; P = 0.014）。这种较低的自杀倾向的条件患病率与创伤后个人成长的两个维度（对自己重建生活能力的信心和内心力量的实现）密切相关，没有这两个维度，自杀倾向的调查间差异就不显著。尽管卡特里娜飓风过后，精神疾病的患病率估计翻了一番，但自杀的患病率却出乎意料地低。创伤后个人成长在改善创伤相关精神疾病对自杀倾向的影响中的作用值得进一步研究。
Objective. To estimate the impact of Hurricane Katrina on mental illness and suicidality by comparing results of a post-Katrina survey with those of an earlier survey.Methods. The National Comorbidity Survey-Replication, conducted between February 2001 and February 2003, interviewed 826 adults in the Census Divisions later affected by Hurricane Katrina. The post-Katrina survey interviewed a new sample of 1043 adults who lived in the same area before the hurricane. Identical questions were asked about mental illness and suicidality. The post-Katrina survey also assessed several dimensions of personal growth that resulted from the trauma (for example, increased closeness to a loved one, increased religiosity). Outcome measures used were the K6 screening scale of serious mental illness and mild-moderate mental illness and questions about suicidal ideation, plans and attempts.Findings. Respondents to the post-Katrina survey had a significantly higher estimated prevalence of serious mental illness than respondents to the earlier survey (11.3% after Katrina versus 6.1% before; chi(2)(1) = 10.9; P < 0.001) and mild-moderate mental illness (19.9% after Katrina versus 9.7% before; chi(2)(1) = 22.5;P < 0.001). Among respondents estimated to have mental illness, though, the prevalence of suicidal ideation and plans was significantly lower in the post-Katrina survey (suicidal ideation 0.7% after Katrina versus 8.4% before; chi(2)(1) = 13.1; P < 0.001; plans for suicide 0.4% after Katrina versus 3.6% before; chi(2)(1) = 6.0; P = 0,014). This lower conditional prevalence of suicidality was strongly related to two dimensions of personal growth after the trauma (faith in one's own ability to rebuild one's life, and realization of inner strength), without which between-survey differences in suicidality were insignificant.Conclusion. Despite the estimated prevalence of mental illness doubling after Hurricane Katrina, the prevalence of suicidality was 11 unexpectedly low. The role of post-traumatic personal growth in ameliorating the effects of trauma-related mental illness on suicidality warrants further investigation.