Impact of Ebola experiences and risk perceptions on mental health in Sierra Leone, July 2015.
Impact of Ebola experiences and risk perceptions on mental health in Sierra Leone, July 2015.
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DOI：
10.1136/bmjgh-2017-000471
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发表时间：
2018
影响因子：
8.1
通讯作者：
Redd JT
中科院分区：
文献类型：
--
作者：
Jalloh MF;Li W;Bunnell RE;Ethier KA;O'Leary A;Hageman KM;Sengeh P;Jalloh MB;Morgan O;Hersey S;Marston BJ;Dafae F;Redd JT
2014-2016年埃博拉疫情对幸存者、家庭成员和卫生保健工作者的心理健康影响已经有所描述，但对其对受影响国家一般人口的影响知之甚少。经过一年多的疫情应对，我们评估了塞拉利昂普通人群的焦虑、抑郁和创伤后应激障碍（PTSD）症状。2015年7月，我们通过多阶段整群抽样对3564名自愿参与者进行了横断面调查。采用《患者健康问卷-4》测量焦虑和抑郁症状。创伤后应激障碍症状由事件影响量表修订后的六个项目测量。通过二元logistic回归检验埃博拉经历、感知埃博拉威胁与心理健康症状之间的关系。任何焦虑抑郁症状的患病率为48% (95% CI 46.8%至50.0%)，任何PTSD症状的患病率为76% （95% CI 75.0%至77.8%）。此外，6% （95% CI 5.4%至7.0%）的患者符合焦虑抑郁的临床临界值，27% （95% CI 25.8%至28.8%）的患者符合PTSD的临床关注水平，16% （95% CI 14.7%至17.1%）的患者符合可能的PTSD诊断水平。在双变量分析中，与任何症状报告率较高相关的因素包括居住地、埃博拉经历和感知到的埃博拉威胁。知道某人因埃博拉而被隔离与焦虑抑郁（调整后的OR （AOR）为2.3,95% CI为1.7至2.9）和创伤后应激障碍（AOR为2.095% CI为1.5至2.8）症状独立相关。将埃博拉视为威胁与焦虑-抑郁（AOR 1.69 95% CI 1.44 - 1.98）和创伤后应激障碍（AOR 1.86 95% CI 1.56 - 2.21）症状独立相关。在埃博拉反应一年后，PTSD和焦虑抑郁症状很常见；有埃博拉相关经历的人可能需要心理社会支持。预防、发现和应对精神卫生状况应成为全球卫生安全努力的重要组成部分。
The mental health impact of the 2014–2016 Ebola epidemic has been described among survivors, family members and healthcare workers, but little is known about its impact on the general population of affected countries. We assessed symptoms of anxiety, depression and post-traumatic stress disorder (PTSD) in the general population in Sierra Leone after over a year of outbreak response. We administered a cross-sectional survey in July 2015 to a national sample of 3564 consenting participants selected through multistaged cluster sampling. Symptoms of anxiety and depression were measured by Patient Health Questionnaire-4. PTSD symptoms were measured by six items from the Impact of Events Scale-revised. Relationships among Ebola experience, perceived Ebola threat and mental health symptoms were examined through binary logistic regression. Prevalence of any anxiety-depression symptom was 48% (95% CI 46.8% to 50.0%), and of any PTSD symptom 76% (95% CI 75.0% to 77.8%). In addition, 6% (95% CI 5.4% to 7.0%) met the clinical cut-off for anxiety-depression, 27% (95% CI 25.8% to 28.8%) met levels of clinical concern for PTSD and 16% (95% CI 14.7% to 17.1%) met levels of probable PTSD diagnosis. Factors associated with higher reporting of any symptoms in bivariate analysis included region of residence, experiences with Ebola and perceived Ebola threat. Knowing someone quarantined for Ebola was independently associated with anxiety-depression (adjusted OR (AOR) 2.3, 95% CI 1.7 to 2.9) and PTSD (AOR 2.095% CI 1.5 to 2.8) symptoms. Perceiving Ebola as a threat was independently associated with anxiety-depression (AOR 1.69 95% CI 1.44 to 1.98) and PTSD (AOR 1.86 95% CI 1.56 to 2.21) symptoms. Symptoms of PTSD and anxiety-depression were common after one year of Ebola response; psychosocial support may be needed for people with Ebola-related experiences. Preventing, detecting, and responding to mental health conditions should be an important component of global health security efforts.
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