波斯尼亚和黑塞哥维那不同寄养及家庭环境中受过战争创伤儿童的心理障碍
Psychological disturbances of war-traumatized children from different foster and family settings in Bosnia and Herzegovina.
作者信息
Hasanović Melvudin, Sinanović Osman, Selimbasić Zihnet, Pajević Izet, Avdibegović Esmina
机构信息
Department of Psychiatry, Tuzla University Clinical Center, Tuzla, Bosnia and Herzegovina.
出版信息
Croat Med J. 2006 Feb;47(1):85-94.
AIM
To assess the psychological health of war-traumatized children in different foster settings and compare them with children living with one or both parents, 7 years after the 1992-1995 war in Bosnia and Herzegovina.
METHOD
The study was carried out in Tuzla, Bosnia and Herzegovina, in March 2002. We assessed 186 (93 girls and 93 boys) elementary school children aged 12.7-/+1.8 years for war trauma, presence of posttraumatic stress disorder (PTSD), and depression. There were 38 (14 girls) children from the government orphanage, 48 (24 girls) children from the non-governmental organization (NGO) SOS Children's Village, 50 (24 girls) children who lost a parent in the war but lived with the surviving parent, and 50 (31 girls) children who lived with both parents. For data collection, we used Children's Posttraumatic Stress Reaction Index and Children's Depression Inventory. Basic sociodemographic data were also collected.
RESULTS
Of 186 children, 90 (48.4%) had been forced into refuge because of the war. Loss of a family member was most frequent among children in the SOS Children's Village, who also experienced the highest number of other types of trauma. PTSD was present in 51.6% of 186 children, with the highest prevalence among children in the SOS Children's Village (39/48). PTSD prevalence was higher among children who lost a parent but lived with the surviving parent (29/50) then among children in the orphanage (15/38) or children living with both parents (13/50) (chi(2)(3)=33.075, P<0.001). Depression was present in 42 of 186 (22.6%) children, but with no statistical difference among the groups (chi(2)(3)=6.337, P=0.096). The prevalence of PTSD and depression was similar in boys and girls. Loss of a parent was associated with higher frequency of PTSD and depression. The loss of both parents was associated with high prevalence of PTSD, but not depression. Prevalence of PTSD was positively correlated with the prevalence of depression (Spearman's rho=0.188; P=0.01).
CONCLUSIONS
All children experienced war trauma and many had psychological consequences. The highest prevalence of PTSD, often comorbid with depression, was found among children who lost one or both parents. The children with the lowest rate of psychological disturbances were those living with both parents.
目的
评估波斯尼亚和黑塞哥维那1992 - 1995年战争结束7年后，处于不同寄养环境下受战争创伤儿童的心理健康状况，并与和父母一方或双方共同生活的儿童进行比较。
方法
2002年3月在波斯尼亚和黑塞哥维那的图兹拉开展了此项研究。我们评估了186名（93名女孩和93名男孩）年龄在12.7±1.8岁的小学生的战争创伤情况、创伤后应激障碍（PTSD）及抑郁症状。其中有38名（14名女孩）来自政府孤儿院的儿童，48名（24名女孩）来自非政府组织“救助儿童村”的儿童，50名（24名女孩）在战争中失去了一位家长但与幸存家长生活在一起的儿童，以及50名（31名女孩）与父母双方共同生活的儿童。为收集数据，我们使用了儿童创伤后应激反应指数和儿童抑郁量表。同时还收集了基本的社会人口统计学数据。
结果
在186名儿童中，90名（48.4%）曾因战争被迫避难。家庭成员死亡在“救助儿童村”的儿童中最为常见，他们还经历了最多其他类型的创伤。186名儿童中有51.6%患有PTSD，其中“救助儿童村”的儿童患病率最高（39/48）。在失去一位家长但与幸存家长生活在一起的儿童中PTSD患病率较高（29/50），高于孤儿院儿童（15/38）或与父母双方共同生活的儿童（13/50）（χ²(3)=33.075，P<0.001）。186名儿童中有42名（22.6%）患有抑郁，但各组间无统计学差异（χ²(3)=6.337，P=0.096）。PTSD和抑郁在男孩和女孩中的患病率相似。失去一位家长与PTSD和抑郁的较高发生率相关。失去双亲与PTSD的高患病率相关，但与抑郁无关。PTSD患病率与抑郁患病率呈正相关（斯皮尔曼相关系数ρ=0.188；P=0.01）。
结论
所有儿童都经历了战争创伤，许多儿童出现了心理问题。在失去一位或双亲的儿童中，PTSD患病率最高，且常与抑郁共病。心理障碍发生率最低的是与父母双方共同生活的儿童。
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