Psychiatric sequelae in atomic bomb survivors in Hiroshima and Nagasaki two decades after the explosions
Psychiatric sequelae in atomic bomb survivors in Hiroshima and Nagasaki two decades after the explosions
复制标题
DOI：
10.1007/s00127-002-0572-5
复制
发表时间：
2002-09-01
影响因子：
4.4
通讯作者：
Izumi, S
中科院分区：
文献类型：
--
作者：
Yamada, M;Izumi, S
背景原子弹暴露是一件压力极大的事件。尽管对爆炸的精神影响进行的流行病学研究很少，但许多对幸存者的医学描述表明，各种症状增加，暗示着自主神经性共济失调或神经症样障碍。这项研究评估了广岛和长崎原子弹爆炸的精神影响。方法从1962~1965年间完成的9421名知情同意的成人健康研究对象的自填式医学问卷中，选择符合DSM-IV广泛性焦虑症和躯体化障碍诊断标准的问题作为焦虑症状和躯体化症状的指标。分析与年龄、性别、城市(广岛与长崎)、急性辐射症状、接触状况(城市与非城市)、离震源地面距离、病史、家属死亡有关的精神症状的发生率。结果有急性放射症状者焦虑症状(优势比为1.73)和躯体化症状(优势比为1.99)的发生率高于无症状者。爆炸发生时身在城市的人的焦虑症状和躯体化症状的患病率明显高于不在城市的人。在前者中，近距离接触者的患病率低于远端接触者。症状的发生率也受年龄、性别和城市的影响。虽然神经症和溃疡等病史是焦虑症状和躯体化症状的危险因素，但与原子弹暴露相关的焦虑症状和躯体化症状的增加与病史和家庭成员的死亡无关。结论原子弹爆炸幸存者焦虑症状和躯体化症状的发生率在爆炸发生后17~20年仍较高，提示该经历的精神影响具有长期性。精神后遗症独立于生理后遗症。
Background Atomic bomb exposure was an extraordinarily stressful event. Although little epidemiological research has been performed on the psychiatric effects of the bombings, many medical descriptions of the survivors suggest that there was an increase of various symptoms that implied autonomic ataxia or neurosis-like disorders. The psychiatric effects of exposure to the atomic bomb explosions in Hiroshima and Nagasaki were assessed in this study. Method From a self-administered medical questionnaire completed between 1962 and 1965 by 9,421 informed and consenting Adult Health Study subjects, some questions congruent with the DSM-IV diagnostic criteria for generalized anxiety disorder and somatization disorder were selected and used as indicators of anxiety symptoms and somatization symptoms. The prevalence of psychiatric symptoms in relation to age, sex, city (Hiroshima vs. Nagasaki), acute radiation symptoms, exposure status (in city or not in city), ground distance from hypocenter, disease history, and death of family members were analyzed. Results A higher prevalence of anxiety symptoms (odds ratio, 1.73) and somatization symptoms (odds ratio, 1.99) was observed in those with acute radiation symptoms than in those without them. The prevalence of anxiety symptoms and somatization symptoms among people who were in the city at the time of the explosion was significantly higher than among those who were not in the city. Among the former, prevalence was lower among proximally exposed people than among distally exposed people. Symptom prevalences were also affected by age, sex, and city. Although disease history such as neurotic disorder and ulcer were risk factors for anxiety symptoms and somatization symptoms, the increased prevalence of anxiety symptoms and somatization symptoms in association with atomic bomb exposure was independent of disease history and the death of family members. Conclusion The prevalence of anxiety symptoms and somatization symptoms was elevated in atomic bomb survivors even 17-20 years after the bombings had occurred, indicating the long-term nature of the psychiatric effects of the experience. Psychiatric sequelae were independent of physical sequelae.