Mental health consequences of the Chernobyl disaster
Mental health consequences of the Chernobyl disaster
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DOI：
10.1088/0952-4746/32/1/n71
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发表时间：
2012-03-01
影响因子：
1.5
通讯作者：
Bromet, Evelyn J.
中科院分区：
文献类型：
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作者：
Bromet, Evelyn J.
人们对灾害的社会心理后果的研究已有100多年的历史。最常见的心理健康后果是抑郁、焦虑、创伤后应激障碍、医学上无法解释的躯体症状和耻辱。灾后第一年的精神疾病发病率约为20%。涉及辐射的灾害特别有害，因为辐射是看不见的，普遍令人恐惧，并可能对健康构成长期威胁。切尔诺贝利灾难发生后，对清理工人（清理人员）和污染地区成年人的研究发现，创伤后应激障碍和其他情绪和焦虑障碍增加了两倍，主观健康评级明显下降。在清算人中，最重要的风险因素是风险的严重性。在一般人口样本中，主要的风险因素是认为受到有害程度的辐射。这些发现与三里岛核电站事故后对原子弹幸存者和人口的研究结果一致。关于儿童，除了缺乏关于辐射或其他畸形照射的直接数据的生态研究和基辅的地方研究的结果外，流行病学证据表明，辐射照射或在事故阴影下成长的压力与情绪障碍、认知功能障碍或学业成绩受损无关。因此，根据对成年人的研究，切尔诺贝利论坛得出结论，精神健康是事故造成的最大公共卫生问题。由于精神健康是残疾、身体疾病和死亡的主要原因，因此在福岛等辐射事故后的健康监测应包括标准的福祉措施。此外，考虑到心理和身体健康的共病，研究结果支持培训非精神科医生识别和治疗福岛患者抑郁症等常见心理健康问题的价值。
The psychosocial consequences of disasters have been studied for more than 100 years. The most common mental health consequences are depression, anxiety, post-traumatic stress disorder, medically unexplained somatic symptoms, and stigma. The excess morbidity rate of psychiatric disorders in the first year after a disaster is in the order of 20%. Disasters involving radiation are particularly pernicious because the exposure is invisible and universally dreaded, and can pose a long-term threat to health. After the Chernobyl disaster, studies of clean-up workers (liquidators) and adults from contaminated areas found a two-fold increase in post-traumatic stress and other mood and anxiety disorders and significantly poorer subjective ratings of health. Among liquidators, the most important risk factor was severity of exposure. In general population samples, the major risk factor was perceived exposure to harmful levels of radiation. These findings are consistent with results from A-bomb survivors and populations studied after the Three Mile Island nuclear power plant accident. With regard to children, apart from findings from ecological studies that lack direct data on radiation or other teratologic exposures and local studies in Kiev, the epidemiologic evidence suggests that neither radiation exposure nor the stress of growing up in the shadow of the accident was associated with emotional disorders, cognitive dysfunction, or impaired academic performance. Thus, based on the studies of adults, the Chernobyl Forum concluded that mental health was the largest public health problem unleashed by the accident. Since mental health is a leading cause of disability, physical morbidity, and mortality, health monitoring after radiation accidents like Fukushima should include standard measures of well-being. Moreover, given the comorbidity of mental and physical health, the findings support the value of training non-psychiatrist physicians in recognizing and treating common mental health problems like depression in Fukushima patients.