目的:探讨5·12 四川汶川大地震对系统性红斑狼疮(SLE)病情活动性的影响,以及因地震造成的停药、感染、居住环境恶劣(长期紫外线照射)和创伤后应激障碍(posttraumatic stress disease,PTSD)与病情活动性的相关性。方法:分析41例重灾区(北川、平武、江油、安县)SLE患者地震前后实验室指标和临床表现变化情况,采用Logistic回归分析地震造成停药、感染、居住环境恶劣和PTSD四种因素对SLE病情活动性的影响。结果:41例SLE患者地震后有18例病情活动,其中有27%患者出现关节痛,24%出现颜面红斑,19.5%出现发热,22%合并狼疮肾炎，震后C3水平显著低于震前。震后6例患者感染,13例患者停药,16例患者长期居住于恶劣环境中,11例患者患PTSD。通过Logistic回归分析发现PTSD、停药、居住条件恶劣与地震后SLE患者病情活动相关。结论:地震可使一部分重灾区SLE患者病情出现活动,PTSD、停药、居住条件恶劣与SLE病情活动具有相关性。
Post-traumatic stress disorder (PTSD) is one of the common chronic diseases in psychiatry. It has a long course of disease which seriously affects patient’s life and work, and has a serious impact on social function. So far, the diagnosis of PTSD is limited to clinical symptom manifestations and physician experience, and no exact pathological substance basis is found, while the pathological substance basis is crucial for accurate diagnosis, selection of effective treatment methods, evaluation of treatment results, and assessment of disability. Head MRI is currently one of the most promising techniques to solve this problem. This paper reviews the progress in MRI research on brain structure changes in PTSD patients, in order to explore the possible future development directions.
Objective To investigate the quality of life (QOL) of Beichuan cadres 1 year after Wenchuan earthquake, so as to provide references for promoting psychological intervention and improving QOL. Methods With the adoption of WHOQOL-BREF, questionnaire survey on basic conditions of cadre victims, and PCL-C scale, cross-section survey was conducted for 2 055 cadres of Beichuan public institutions in aspects of their QOL, social demographic characteristics and psychological trauma. Results a) Compared with domestic norm, although the Beichuan cadres had higher score in social relation domain (14.31 ± 2.59, Plt;0.01), their QOL scores in each dimensions (physical domain score: 14.16 ± 2.43; psychological domain score: 13.79 ± 2.59, environmental domain score: 11.20 ± 2.74) were lower with significant difference (Plt;0.01); b) The group with population under the age of 30 scored higher than other age groups in the psychological and environmental domains; men scored higher than women in the psychological domain; the widowed group scored lower than other groups in all domains; the Han nationality group scored higher than the Qiang nationality group in all domains; the primary education group scored lower than other groups in the social relation domain; the group with relatives, houses and physical loss or damage scored lower than the non-loss group in all domains; and the higher the score in PCL-C, the lower the scores in all domains (all Plt;0.05). Conclusion Beichuan cadres are severely affected in their physical, psychological and environmental domains even one year after Wenchuan earthquake, especially the female, the Qiang nationality, the old, the lost, and the psychological injured cadres are more badly affected with worse QOL, so those population should be concerned in particular with sustainable psychological service and other measures. The finding of social relation domain score being higher than general population suggests that it is important to promote the satisfaction with social relation through the timely effective support from both government and civil society, and the resettlement of sample housing area as well.
目的 利用局部一致性（ReHo）方法探测创伤后应激障碍（PTSD）患者在静息状态下是否存在着大脑功能异常。 方法 2010年5月－7月对18例未经治疗的地震PTSD患者和19例同样经历地震但未患PTSD的对照者进行了静息态功能磁共振成像（Rs-fMRI） 扫描。应用ReHo方法处理Rs-fMRI数据，得出PTSD患者的异常脑区，并将患者存在组间差异的脑区ReHo值与临床用PTSD诊断量表（CAPS）、汉密尔顿抑郁量表（HAMD）和汉密尔顿焦虑量表（HAMA）分别进行相关分析。 结果 ① PTSD组ReHo显著增加的脑区包括右侧颞下回、楔前叶、顶下叶、中扣带回，左侧枕中回以及左/右侧后扣带回；ReHo显著降低的脑区包括左侧海马和左/右侧腹侧前扣带回。② 异常脑区中后扣带回和右侧中扣带回ReHo与HAMD呈负相关（中扣带回r=?0.575，P=0.012；右侧后扣带回：r=?0.507，P=0.032），其余脑区ReHo与临床指标无明显相关性（P＞0.05），左侧海马与CAPS的相关性相对其他脑区较大（r=?0.430，P=0.075）。 结论 PTSD患者在静息状态下即存在着局部脑功能活动的降低和增加，ReHo方法可能有助于研究PTSD患者静息状态脑活动。
目的 调查极重灾区某中学学生的创伤后应激障碍（PTSD）症状检出率及影响因素，为进一步开展灾后心理卫生服务提供依据。 方法 2008年9月下旬，对汶川地震的极重灾区都江堰某镇中学1 500名同学进行调查，获有效问卷1 498份。采用一般情况调查问卷、儿童事件影响量表（CRIES-13）中文版进行集体施测。 结果 某镇中学学生灾后4个月PTSD症状检出率29.71%（445/1 498）。经非条件逐步logistic回归筛选PTSD症状的影响因素有：地震时是否受伤（OR=1.995，P=0.000）、性别（OR=1.785，P=0.000）、绝望感（OR=1.597，P=0.000）、是否目睹死亡（OR=1.344，P=0.000）、年龄（OR=1.308，P=0.000）、是否目睹受伤（OR=1.262，P=0.000）、地震时是否被困（OR=1.209，P=0.011）、震后居住地点（OR=1.182，P=0.000）、是否目睹垮塌（OR=1.176，P=0.000）、家人情况（OR=1.104，P=0.000）、地震后是否住院（OR=0.828，P=0.041）12个因素。 结论 在灾后重建过程中，该中学的学生PTSD症状检出率较高，其与地震时是否受伤、性别、绝望感、是否目睹死亡、年龄、是否目睹受伤、地震时是否被困、震后居住地点、是否目睹垮塌、家人情况、地震后是否住院呈显著相关。
【摘要】 目的 了解和分析玉树地震伤员急性应激期睡眠问题。 方法 2010年4月，对90例玉树地震伤员的急性应激反应采用创伤后应激障碍症状清单平民版(PCL-C)17项量表进行筛查评估，并应用SPSS 17.0软件进行统计学分析。 结果 在PCL-C 17个条目中，提示睡眠障碍的条目2和条目13发生率分别为61.10%、63.30%，分别排列第5位、第3位，其得分分别与PCL-C总得分、闪回症状得分、回避症状得分及高警觉性症状得分均呈正相关(P值均lt;0.01)。 结论 睡眠障碍是地震伤员急性应激反应中的常见问题，需高度重视，并进行积极有效的处理。【Abstract】 Objective To learn and analyze the sleep disorders in acute stress of the wounded persons in Yushu earthquake. Methods The acute stress reaction of 90 wounded persons in Yushu earthquake were screened with post-traumatic stress disorder (PTSD) Checklist-Civilian (PCL-C) version-17 in April 2010. Sleep disorders were statistically analyzed with SPSS 17.0. Results In the 17 items of PCL-C, the incidences of the second and the thirteenth item which were related to sleep disorders were respectively 61.10% ranking at the fifth and 63.30% ranking at the third. Both scores of these two items had significant positive correlation with the total score of PCL-C and the scores of the flashback symptom, the avoidance symptom and the heightened alertness symptom (Plt;0.01). Conclusion Sleep disorder is a common problem in acute stress reaction of wounded persons in earthquakes, which needs high attention to be treated positively.
Post-traumatic stress disorder (PTSD) presents with complex and diverse clinical manifestations, making accurate and objective diagnosis challenging when relying solely on clinical assessments. Therefore, there is an urgent need to develop reliable and objective auxiliary diagnostic models to provide effective diagnosis for PTSD patients. Currently, the application of graph neural networks for representing PTSD is limited by the expressiveness of existing models, which does not yield optimal classification results. To address this, we proposed a multi-graph multi-kernel graph convolutional network (MK-GCN) model for classifying PTSD data. First, we constructed functional connectivity matrices at different scales for the same subjects using different atlases, followed by employing the k-nearest neighbors algorithm to build the graphs. Second, we introduced the MK-GCN methodology to enhance the feature extraction capability of brain structures at different scales for the same subjects. Finally, we classified the extracted features from multiple scales and utilized graph class activation mapping to identify the top 10 brain regions contributing to classification. Experimental results on seismic-induced PTSD data demonstrated that our model achieved an accuracy of 84.75%, a specificity of 84.02%, and an AUC of 85% in the classification task distinguishing between PTSD patients and non-affected subjects. The findings provide robust evidence for the auxiliary diagnosis of PTSD following earthquakes and hold promise for reliably identifying specific brain regions in other PTSD diagnostic contexts, offering valuable references for clinicians.
Objective To evaluate the psychological trauma incurred by the hospitalization survivor of Zhouqu district after the Zhouqu debris flow so as to provide relevant information for psychological and medical interventions. Methods The psychological state of 67 hospitalized survivors of the disaster and other 47 inpatients with similar complaints but not coming from the disaster area was investigated through a mental health self-assessment questionnaire, self-rating anxiety scale (SAS), self-rating depression scale (SDS) and PTSD-SS scale. Results The post-disaster survivors had different levels of psychological problems and post-traumatic stress disorder, and there were significant differences compared to the control group (Plt;0.01, Plt;0.01). The SDS score and the SAS score of the survivor were 48.44+15.648 and 52.92+11.672, respectively, which were all much higher than those of the control group (Plt;0.01, Plt;0.05). Conclusion The debris flow disaster bring serious psychological trauma to the victims. It is necessary to pertinently carry out post-disaster psychological relief including psychological intervention and regulation for the hospitalized survivors, so as to alleviate and reduce their psychological suffering.
Objective To investigate the status and influencing factors of psychosis-related post-traumatic stress disorder (PR-PTSD) in hospitalized patients with schizophrenia. Methods A questionnaire survey was conducted among the hospitalized patients with schizophrenia in three grade Ⅱ or above psychiatric hospitals in Chengdu between March and July, 2022, using the convenient sampling method. Questionnaires included the General Information Questionnaire, Impact of Event Scale-revised (IES-R), Self-rating Depression Scales, Simplified Coping Style Questionnaire, and Intolerance of Uncertainty Scale. If the score showed skewed distribution, it was expressed by the median (lower quartile, upper quartile). According to IES-R score, the patients included were divided into 2 groups. The patients whose score ≥33 were divided into PR-PTSD group, and <33 were divided into non-PR-PTSD group. The general information of the two groups of patients were compared. The correlation between PR-PTSD and depression, coping style and intolerance of uncertainty of the included patients were analyzed. The factors affecting the PR-PTSD of hospitalized patients with schizophrenia were analyzed by multivariate binary logistic regression analysis. Results A total of 388 patients were included. Among them, there were 282 cases in the non-PR-PTSD group and 106 cases in the PR-PTSD group. The IES-R score was 23.00 (15.00, 33.00), the depression score was 45.00 (38.00, 53.00), the negative coping style score was 11.00 (8.00, 14.75), the positive coping style score was 20.00 (16.00, 25.00), and the intolerance of uncertainty score was 28.00 (22.25, 33.00). IES-R was positively correlated with depression (r=0.370, P<0.001), negative coping style (r=0.396, P<0.001), positive coping style (r=0.111, P=0.029) and intolerance of uncertainty (r=0.467, P<0.001). Regression analysis showed that depression [(odds ratio, OR)=1.073, 95% confidence interval (CI) (1.043, 1.105), P<0.001)], negative coping style [OR=1.121, 95%CI (1.040, 1.208), P=0.003], intolerance of uncertainty [OR=1.081, 95%CI (1.045, 1.118), P<0.001] were the influencing factors of PR-PTSD in hospitalized patients with schizophrenia. Conclusions The prevalence of PR-PTSD in hospitalized patients with schizophrenia is high. Depression, negative coping style and intolerance of uncertainty are the risk factors for PR-PTSD in hospitalized schizophrenia patients.