Effect of evacuation and displacement on the association between flooding and mental health outcomes: a cross-sectional analysis of UK survey data.
Effect of evacuation and displacement on the association between flooding and mental health outcomes: a cross-sectional analysis of UK survey data.
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DOI：
10.1016/s2542-5196(17)30047-5
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发表时间：
2017-07
期刊：
影响因子：
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通讯作者：
English National Study of Flooding and Health Study Group
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文献类型：
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作者：
Munro A;Kovats RS;Rubin GJ;Waite TD;Bone A;Armstrong B;English National Study of Flooding and Health Study Group
2013 - 2014年冬季，英格兰发生了大面积的洪水。先前的研究表明，洪水会影响心理健康。使用2013-14年英国公共卫生国家洪水与健康研究的数据，我们比较了因洪水流离失所的参与者和洪水但未流离失所的参与者在洪水发生1年后抑郁、焦虑和创伤后应激障碍症状的患病率。在这个多变量有序回归分析中，我们收集了一项横断面调查的数据，该调查是在洪水事件发生一年后从英国五个县的受洪水影响的邮政编码中收集的。分析仅限于房屋被洪水淹没的个人（n=622），以分析洪水造成的流离失所。主要结果测量是抑郁（由PHQ-2抑郁量表测量）和焦虑（由两项广泛性焦虑障碍[GAD]-2焦虑量表测量），以及创伤后应激障碍（由创伤后应激障碍检查表[PCL]-6量表测量）。我们调整了对记录的潜在混杂因素的分析。我们还分析了流离失所的持续时间和收到的警告数量。背井离乡的人更有可能在每个量表上获得更高的分数；抑郁症的比值比（OR）为1.95 (95% CI为1.30 - 2.93)，焦虑症的比值比为1.66 (95% CI为1.12 - 2.46)，创伤后应激障碍的比值比为1.70 （95% CI为1.17 - 2.48）。即使在调整了洪水的严重程度后，抑郁症的风险也显著增加。没有收到警告的流离失所者的抑郁和创伤后应激障碍得分高于在洪水发生前12小时收到警告的人（抑郁p= 0.04，创伤后应激障碍p= 0.01），尽管焦虑得分差异不显著。洪水后流离失所与洪水后1年较高的抑郁、焦虑和创伤后应激障碍症状相关。收到的警告数量显示出对所研究的三种精神疾病的症状有保护作用，洪水的严重程度可能是导致两组之间差异的部分原因，但不是全部原因。伦敦国王学院的应急准备和反应健康保护研究单位，伦敦卫生和热带医学学院的环境变化与健康，以及英国公共卫生部布里斯托尔大学的干预措施评估。
Extensive flooding occurred during the winter of 2013–14 in England. Previous studies have shown that flooding affects mental health. Using data from the 2013–14 Public Health England National Study of Flooding and Health, we compared the prevalence of symptoms of depression, anxiety, and post-traumatic stress disorder between participants displaced by flooding and those flooded, but not displaced, 1 year after flooding. In this multivariable ordinal regression analysis, we collected data from a cross-sectional survey collected 1 year after the flooding event from flood-affected postcodes in five counties in England. The analysis was restricted to individuals whose homes were flooded (n=622) to analyse displacement due to flooding. The primary outcome measures were depression (measured by the PHQ-2 depression scale) and anxiety (measured by the two-item Generalised Anxiety Disorder [GAD]-2 anxiety scale), and post-traumatic stress disorder (measured by the Post-Traumatic Stress Disorder Checklist [PCL]-6 scale). We adjusted analyses for recorded potential confounders. We also analysed duration of displacement and amount of warning received. People who were displaced from their homes were significantly more likely to have higher scores on each scale; odds ratio (OR) for depression 1·95 (95% CI 1·30–2·93), for anxiety 1·66 (1·12–2·46), and for post-traumatic stress disorder 1·70 (1·17–2·48) than people who were not displaced. The increased risk of depression was significant even after adjustment for severity of flooding. Scores for depression and post-traumatic stress disorder were higher in people who were displaced and reported receiving no warning than those who had received a warning more than 12 h in advance of flooding (p=0·04 for depression, p=0·01 for post-traumatic stress disorder), although the difference in anxiety scores was not significant. Displacement after flooding was associated with higher reported symptoms of depression, anxiety, and post-traumatic stress disorder 1 year after flooding. The amount of warning received showed evidence of being protective against symptoms of the three mental illnesses studied, and the severity of flooding might be the reason for some, but not all, of the differences between the groups. National Institute for Health Research Health Protection Research Units (HPRU) in Emergency Preparedness and Response at King's College London, Environmental Change and Health at the London School of Hygiene and Tropical Medicine, and Evaluation of Interventions at the University of Bristol, Public Health England.