Epidemiological Investigation Of Post Traumatic Stress Disorder In Chinese Military Rescuers After The Wenchuan Earthquake

On May 12, 2008 an earthquake measuring 8.0 on the Richter scale devastated the Sichuan province in southwest China. It was one of the deadliest and most destructive natural disasters on Earth in recorded history. 13 million PLA officers and soldiers rushed to the front line for earthquake relief from all over the country. In the disaster area, rescuers went through the traumatic experience of witnessing and touching the bodies of the dead and wounded. They were under extreme physical and mental stress. Some military rescuers showed signs of sleep disorders, depression, anxiety, re-experiencing of rescue experience (flashbacks), avoidance and reaction numbness and increased arousal. The physical and mental health of the military rescuers was seriously affected.Being ready to participate in local wars or major disaster relief, counter-terrorism, peacekeeping and other non-war military operations, the military are at relatively high-risk for PTSD. It was valuable to study the prevalence, comorbidity rates, turnover, relevant impact factors and prevention strategies of PTSD in the wenchuan military rescuers. The data can be used in the future to help treat PTSD in military diversification operations.Objective and Methods3010 soldiers including the Army, Air Force, Navy, Marine Brigade, the armed police were randomized sampleing, 2921 questionnaires were valid, which 1811(62.0%)military rescuers served as the study group while 1110 (38.0%)soldiers who did not participate in rescue were used as the control group.1. Preliminary screening. All the 2921 military rescuers were randomly assessed with SRQ-20,PCL-C, SAS ,REQ and SDS as preliminary screening.2. Clinical Interview. The selected ones were given an original diagnosis by psychiatrists according with SCID-I/P after the Clinical Interview.3. Final diagnosis. The chief physician was made to a final diagnosis according to the diagnostic record.Results1. The prevalence of PTSD among military rescuers was higher than in normal time. The prevalence of PTSD in rescue group was 4.25% and the prevalence was 0.27% in control group. There were significant differences between the both groups. The prevalence of PTSD in rescue group was higher than that of military(0.48%) and civilians(0.35%)in peace, while it was lower than that of people who were devastated in wenchuan earthquake(8.91～62.8%).2. The course of PTSD was relatively long. The prevalence of PTSD was 3.42% at 6 months and 2.13% at 24 months after earthquake. 56.23% of the original PTSD subjects were identified as PTSD at the two-year follow up. If they had not received effective treatment, they would suffer from PTSD indefinitely. We offered counseling to those who were in a state of shock. The diagnosis and treatment of some serious cases were advised to the local doctors after the interview.3. Impact factors of PTSD. Logistic regression analysis suggest that ASD is the most important impact factors for PTSD. Rescuers may suffer from PTSD if they are not properly treated for ASD. Rescue missions were also an impact factor for PTSD. The more demanding the rescue mission, the higher the chances were of developing PTSD. Also, PTSD tended to be worse in subjects who had a more traumatic experience. This was not, however, the only factor which determined the likelihood and severity of PTSD-the various impact factors interrelated and influence each other.4. Comorbidity with PTSD. 73% of PTSD patients comorbid with other mental disorders. 53.2% of the PTSD patients suffered from depression and 42.9% of PTSD patients from anxiety disorders. The pure PTSD was only 27%. Some comorbid with somatoform disorders, substance dependence. The high rate of PTSD comorbidity reflect the complexity of the disorder. Patients with comorbidity had a more serious case of PTSD and their recovery was worse. ConclusionThe military rescuers were obviously damaged both physically and mentally. The prevalence of PTSD among military rescuers was far higher than that of military and civilians in normal time. PTSD symptoms were long-lasting and the comorbidity rate was high. The impact factors of PTSD were ASD, anxiety disorder, depression disorder, rescue mission intensity, adaptability, and whether or not the individual had previously participated in rescue missions. It's important to use the data collected from the Wenchuan earthquake military rescuers to devise new and better methods to aid in the prevention and treatment of PTSD in future disasters and military diversification operations.