Long-term mental health outcomes following the 2004 Asian tsunami disaster: A comparative study on direct and indirect exposure.
Long-term mental health outcomes following the 2004 Asian tsunami disaster: A comparative study on direct and indirect exposure.
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DOI：
10.4161/dish.24705
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发表时间：
2014-01-01
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影响因子：
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通讯作者：
Rameshraj, Kavitha
中科院分区：
文献类型：
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作者：
Kar, Nilamadhab;Krishnaraaj, Rameshraj;Rameshraj, Kavitha
关于低收入和中等收入国家灾民的长期心理健康结果的信息不足。对于间接遭受灾害的绝大多数受害者来说，情况尤其如此。为了解决这一认识上的差距，我们调查了2004年印度亚洲海啸受害者的精神疾病发病率，特别是焦虑、抑郁和创伤后应激障碍(PTSD)，这是灾难发生4.5年后的情况。它还旨在比较直接暴露于海啸水域的受害者和间接暴露于海啸灾难中的受害者(居住在海边的人，他们逃离海啸水域，但目睹了灾难并遭受各种损失)的心理健康结果。在一项横断面流行病学研究中，随机选择了南印度666名受害者，通过自我报告问卷(SRQ)、Zung抑郁自评量表、Zung焦虑自评量表、创伤后应激障碍自评量表(SRS-PTSD)和自杀筛查来评估精神疾病的发病率。还评估了灾害经历、生活质量和社会人口概况。基于SRQ的精神疾病患病率为77.6%，焦虑症状(23.1%)、抑郁(33.6%)、创伤后应激障碍(70.9%)和共病(44.7%)的估计患病率暗示了海啸灾民精神疾病的性质和程度。根据SRQ、焦虑症状和自杀企图，直接暴露组的精神疾病发病率明显更高。预测精神疾病发病率的因素是：缺乏正规教育、认为灾难压力大、家庭受损以及生计和牲畜的损失。总之，在灾难发生4.5年后，观察到很大比例的亚洲海啸受害者仍有精神健康问题，这突出表明需要为受灾社区提供精神服务。
There is inadequate information on the long-term mental health outcomes among disaster victims in low and middle income countries. It is especially so for the vast majority of victims who are indirectly exposed to disasters. To address this gap in knowledge we examined the prevalence of psychiatric morbidity, particularly anxiety, depression and post-traumatic stress disorder (PTSD) in the 2004 Asian tsunami victims in India, 4.5 y after the disaster. It was also intended to compare the mental health outcomes of the victims with direct exposure to tsunami waters and those who were indirectly exposed to tsunami disaster (people living near the sea who escaped tsunami waters but witnessed the disaster and suffered various losses). In a cross-sectional epidemiological study, 666 randomly selected victims in South India were assessed for psychiatric morbidity through the Self-Reporting questionnaire (SRQ), Zung Self-Rating Depression Scale, Zung Self-Rating Anxiety Scale, Self-Rating Scale for PTSD (SRS-PTSD) and suicidality screening. The disaster experience, quality of life and socio-demographic profile were also assessed. Psychiatric morbidity based on SRQ was 77.6% and estimated prevalence of anxiety symptoms (23.1%), depression (33.6%), PTSD (70.9%) and comorbidity (44.7%) suggested nature and extent of the psychiatric morbidity in the tsunami victims. The direct exposure group had a significantly greater proportion of psychiatric morbidity based on SRQ, anxiety symptoms and suicide attempts. Factors which predicted psychiatric morbidity were: lack of formal education, perception of disaster as highly stressful, damage to home and loss of livelihood and livestock. In conclusion, a large proportion of Asian tsunami victims were observed to have continuing mental health problems 4.5 y after the disaster, which highlighted the need for psychiatric services for the affected communities.