摘要
目的评估汶川地震后第2周灾民中的创伤后应激障碍（PTSD）症状，探讨PTSD症状清单平民版（PCL—C）的最佳筛查界值。方法利用PCL—C对223名转移安置点灾民进行评估，然后根据DSM—IV PTSD症状标准进行症状学分析，以此结果为状态变量，以PCL-C量表总分为检测变量得到ROC曲线，以曲线上约登指数最大点为PCL—C最佳筛查界值。结果灾民中26．0％符合PTSD症状学诊断标准，77．6％存在至少一项症状，最常见症状为创伤性提示导致痛苦体验（65．0％）、闯入性回忆（63．2％）和过度警觉（51．6％），最少见症状为易激惹／愤怒（7．2％）和心因性遗忘（4．5％）。ROC曲线下面积为0．966±0．011（95％CI：0．945～0．988，P〈0．01）。以PCL—C总分41分为界值时约登指数最大（0．815），筛查灵敏度为0．948，特异度为0．867。结论汶川地震后第2周灾民中PTSD症状常见，41分可能是PCL-C的最佳筛查阳性界值。
Objective To early assess post-traumatic stress disorder （PTSD） symptoms and study the optimal cutoff Value of PCL-C for screening PTSD among victims of Wenchuan earthquake. Methods By random selection strategy, 223 victims were measured by PTSD Checklist-Civilian Version （PCL-C）. Then data were ana- lyzed according to symptom criteria of DSM-IV PTSD, and the result of symptomatology analysis was taken as actual state variable of ROC curve and total score of PCL-C as the test variable. The point on ROC curve having the highest Youden Index was considered as the optimal cutoff value. Results Twenty-six percent of victims met symptom criteria of DSM-IV PTSD and 77.6% had at least one PTSD symptom. The most common three symptoms were upset when reminded （65.0%）, intrusive recollection（63.2% ）, and hypervigilance（51.6% ）. The rarest two symptoms were irritability/anger （7.2%） and psychogenic amenesia（4.5% ）. Area under the curve （AUC） of ROC was 0. 966 ± 0.011 （95% CI：0. 945 - 0. 988, P 〈 0.01）. The point of 41 had the highest Youden Index of 0.815, and had a sensitivity of 0. 948 and specificity of 0.867. Conclusion PTSD symptoms are common among victims in temporary settlements till the second week after Wenchuan earthquake, and 41 may be the optimal cutoff value of PCL-C for screening PTSD symptoms.
出处
《中华行为医学与脑科学杂志》
CAS
CSCD
北大核心
2009年第10期933-935,共3页
Chinese Journal of Behavioral Medicine and Brain Science
