Exposure to hurricane-related stressors and mental illness after Hurricane Katrina
Exposure to hurricane-related stressors and mental illness after Hurricane Katrina
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DOI：
10.1001/archpsyc.64.12.1427
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发表时间：
2007-12-01
影响因子：
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通讯作者：
Kessler, Ronald C.
中科院分区：
文献类型：
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作者：
Galea, Sandro;Brewin, Chris R.;Kessler, Ronald C.
背景：卡特里娜飓风暴露人群中精神障碍的患病率、严重程度和相关因素存在不确定性。目的：评估受卡特里娜飓风影响的新奥尔良大都市区和阿拉巴马州、路易斯安那州和密西西比州其余地区的飓风前居民中，DSM-IV焦虑-情绪障碍和飓风相关压力源的患病率及其相关性。设计：社区调查。背景和参与者：在2006年1月19日至3月31日期间，通过电话调查对1043名说英语的飓风前受卡特里娜飓风影响地区的居民进行了概率抽样。这项调查评估了飓风相关的压力源，并对30天的DSM-IV焦虑情绪障碍进行了筛查。主要结果测量：焦虑情绪障碍的K6筛查量表和创伤后应激障碍（PTSD）的创伤筛查问卷量表，均根据盲法结构化临床重新评估访谈进行校准，以近似DSM-IV障碍的30天患病率。结果：飓风前新奥尔良市区的居民估计有49.1%的任何DSM-IV焦虑情绪障碍的30天患病率（30.3%的PTSD估计患病率），而其余样本的26.4%（12.5%的PTSD）。绝大多数受访者表示，他们暴露在与飓风有关的压力源中。与其他样本相比，压力源暴露程度与新奥尔良市区子样本的结果关系更为密切。与这些结果最密切相关的压力源是新奥尔良市区子样本中的身体疾病/伤害和身体逆境，以及其余样本中的财产损失。社会人口学相关性不能用不同的暴露或对飓风相关压力源的反应来解释。结论：DSM-IV焦虑-情绪障碍的高患病率，飓风相关压力源与这些结果的强烈关联，以及社会人口统计学与压力源的独立性表明，与持续压力源相关的实际问题是普遍存在的，必须加以解决，以减少这一人群中精神障碍的患病率。
Context: Uncertainty exists about the prevalence, severity, and correlates of mental disorders among people exposed to Hurricane Katrina.Objective: To estimate the prevalence and associations between DSM-IV anxiety-mood disorders and hurricane-related stressors separately among prehurricane residents of the New Orleans metropolitan area and the remainder of the areas in Alabama, Louisiana, and Mississippi affected by Katrina.Design: Community survey.Setting and Participants: A probability sample of 1043 English-speaking prehurricane residents of the areas affected by Hurricane Katrina was administered via telephone survey between January 19 and March 31, 2006. The survey assessed hurricane-related stressors and screened for 30-day DSM-IV anxiety-mood disorders.Main Outcome Measures: The K6 screening scale of anxiety-mood disorders and the Trauma Screening Questionnaire scale for posttraumatic stress disorder (PTSD), both calibrated against blinded structured clinical reappraisal interviews to approximate the 30-day prevalence of DSM-IV disorders.Results: Prehurricane residents of the New Orleans metropolitan area were estimated to have a 49.1% 30-day prevalence of any DSM-IV anxiety-mood disorder (30.3% estimated prevalence of PTSD) compared with 26.4% (12.5% PTSD) in the remainder of the sample. The vast majority of respondents reported exposure to hurricane-related stressors. Extent of stressor exposure was more strongly related to the outcomes in the New Orleans metropolitan area subsample than the remainder of the sample. The stressors most strongly related to these outcomes were physical illness/injury and physical adversity in the New Orleans metropolitan area subsample and property loss in the remainder of the sample. Sociodemographic correlates were not explained either by differential exposure or reactivity to hurricane-related stressors.Conclusions: The high prevalence of DSM-IV anxiety-mood disorders, the strong associations of hurricane-related stressors with these outcomes, and the independence of sociodemographics from stressors argue that the practical problems associated with ongoing stressors are widespread and must be addressed to reduce the prevalence of mental disorders in this population.