Symptoms of posttraumatic stress disorder and depression among children in tsunami-affected areas in southern Thailand
Symptoms of posttraumatic stress disorder and depression among children in tsunami-affected areas in southern Thailand
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DOI：
10.1001/jama.296.5.549
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发表时间：
2006-08-02
影响因子：
120.7
通讯作者：
van Griensven, Frits
中科院分区：
文献类型：
--
作者：
Thienkrua, Warunee;Lopes Cardozo, Barbara;van Griensven, Frits
2004年12月26日，印度尼西亚苏门答腊岛西北海岸发生海底地震。随后发生的海啸严重影响了泰国所有6个西南省份，约2万名儿童受到直接影响。目的了解泰国南部受海啸影响省份儿童的创伤经历及创伤后应激障碍（PTSD）和抑郁症状的患病率。设计、环境和参与者于2005年2月15日至22日（海啸后2个月）和2005年9月7日至12日（海啸后9个月）在邦牙、普吉和甲米省对7至14岁儿童进行了基于人群的心理健康调查。主要结果测量创伤经历和创伤后应激障碍和抑郁症的症状，测量方法为海啸修正版的PsySTART快速分类系统、UCLA创伤后应激障碍反应指数和Birleson抑郁自评量表。结果共有371名儿童参加了第一次调查，其中167名儿童流离失所并生活在难民营，99名儿童未从海啸受灾村庄流离失所，105名儿童未从未受海啸影响的村庄流离失所。创伤后应激障碍症状的患病率在难民营儿童中为13%，在受影响村庄儿童中为11%，在未受影响村庄儿童中为6%（难民营与未受影响村庄，P= 0.25）；抑郁症状的患病率分别为11%、5%和8% （P= 0.39）。在第一次评估的多变量分析中，延迟撤离、感觉自己或家人的生命处于危险之中、感到极度恐慌或恐惧与创伤后应激障碍症状显著相关。年龄较大和感到自己或家庭成员的生命处于危险之中与抑郁症状显著相关。在随访调查中，72%（151/210）的攀牙儿童参与了调查。在这些儿童中，PTSD和抑郁症状的患病率并没有随着时间的推移而显著降低。本评估记录了泰国南部受海啸影响省份儿童在海啸后2个月和9个月的心理健康问题的普遍程度。海啸期间经历的创伤性事件与创伤后应激障碍和抑郁症的症状显著相关。这些数据可能有助于为儿童提供有针对性的心理健康服务，并可能为这些干预措施的设计提供信息。
Context On December 26, 2004, an undersea earthquake occurred off the northwestern coast of Sumatra, Indonesia. The tsunami that followed severely impacted all 6 southwestern provinces of Thailand, where approximately 20 000 children were directly affected.Objective To assess trauma experiences and the prevalence of symptoms of posttraumatic stress disorder (PTSD) and depression among children in tsunami-affected provinces in southern Thailand.Design, Setting, and Participants Population-based mental health surveys were conducted among children aged 7 to 14 years in Phang Nga, Phuket, and Krabi provinces from February 15-22, 2005 (2 months posttsunami), and September 7-12, 2005 (9 months posttsunami).Main Outcome Measures Trauma experiences and symptoms of PTSD and depression as measured by a tsunami-modified version of the PsySTART Rapid Triage System, the UCLA PTSD Reaction Index, and the Birleson Depression Self-Rating Scale.Results A total of 371 children (167 displaced and living in camps, 99 not displaced from villages affected by the tsunami, and 105 not displaced from unaffected villages) participated in the first survey. The prevalence rates of PTSD symptoms were 13% among children living in camps, 11% among children from affected villages, and 6% among children from unaffected villages (camps vs unaffected villages, P=.25); for depression symptoms, the prevalence rates were 11%, 5 %, and 8 %, respectively (P=.39). In multivariate analysis of the first assessment, having had a delayed evacuation, having felt one's own or a family member's life to have been in danger, and having felt extreme panic or fear were significantly associated with PTSD symptoms. Older age and having felt that their own or a family member's life had been in danger were significantly associated with depression symptoms. in the follow-up survey, 72% (151/210) of children from Phang Nga participated. Prevalence rates of symptoms of PTSD and depression among these children did not decrease significantly over time.Conclusions This assessment documents the prevalence of mental health problems among children in tsunami-affected provinces in southern Thailand at 2 and 9 months posttsunami. Traumatic events experienced during the tsunami were significantly associated with symptoms of PTSD and depression. These data may be useful to target mental health services for children and may inform the design of these interventions.