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目的:考查汶川地震后18个月青少年睡眠问题共患PTSD、抑郁、焦虑状况及其影响因素。方法:采用便利取样,抽取都江堰地区青少年1287人,应用匹兹堡睡眠质量指数、创伤后应激障碍自评量表、儿童抑郁障碍自评量表、儿童焦虑性情绪障碍自评量表、青少年自评生活事件量表、儿童青少年社会支持评定量表等对其进行评估。结果:采用PSQI总分8作为划界分,震后18个月都江堰地区青少年睡眠问题的检出率为28.2%;睡眠问题共患PTSD、抑郁、焦虑的检出率分别为7.5%、15.6%、17.9%。睡眠质量总分与PTSD(r=0.397)、抑郁(r=0.504)、焦虑总分(r=0.463)显著正相关。在检出有睡眠问题的青少年中,有26.4%检出PTSD,有55.4%检出抑郁,有63.4%检出焦虑。多元Lo-gistic回归表明地震中有亲人伤亡、对支持的利用度低、震后较多负性生活事件是睡眠问题共患PTSD的危险性因素;女性、客观支持少、主观支持少、对支持的利用度低和震后较多负性生活事件是睡眠问题共患抑郁的危险性因素;女性、主观支持低、对支持的利用度低和震后较多继发负性生活事件是睡眠问题共患焦虑的危险性因素。结论:震后18个月睡眠问题共患PTSD、抑郁、焦虑较高,评估及干预青少年的睡眠问题对预防精神健康问题有重要意义。
Objective: To investigate the PTSD, depression, anxiety and their influencing factors in adolescent sleep problems 18 months after Wenchuan earthquake. Methods: A total of 1,287 adolescents in Dujiangyan area were sampled with convenience. Pittsburgh Sleep Quality Index, Post-traumatic Stress Disorder Self-rating Scale, Self-rating Depression Scale for Children, Self-rating Scale for Children Anxiety Disorder, Life event scale, children and adolescents social support rating scale to assess it. Results: The total score of PSQI 8 was used as the demarcation point. The detection rate of juvenile sleep problems in Dujiangyan area was 28.2% at 18 months after earthquake. The prevalence of PTSD, depression and anxiety in patients with sleep problems was 7.5% and 15.6% , 17.9%. The total score of sleep quality was positively correlated with PTSD (r = 0.397), depression (r = 0.504) and anxiety total score (r = 0.463). Of the adolescents with sleep problems detected, 26.4% detected PTSD, 55.4% detected depression, and 63.4% detected anxiety. Multivariate Lo-gistic regression showed that there were relatives casualties in the earthquake, low utilization of support, and more negative life events after earthquake were risk factors of PTSD with sleep problems; women with less objective support and less subjective support, Low utilization and more post-quake negative life events are risk factors for sleep-depressive coexisting depression; women, with low subjective support, low support for support, and more post-quake negative negative life events are sleep problems Common risk factors for anxiety. Conclusion: PTSD, depression and anxiety are common in sleep problems 18 months after earthquake. It is of great significance to evaluate and intervene the sleep problems of adolescents to prevent mental health problems.