Predictors of Generalized Anxiety Disorder among Teachers in 3 Months after the Lushan Earthquake_Chinese Journal of Evidence-Based Medicine

Authors：

 CHENDe-chao ¹ , ZHUShen-yue ² , TIANYu-lian ³ ,  ZHANGJun ¹ , LIHai-ming ¹ , CHENRan ¹ , GONGYao ¹ , YANGJun-hai ¹

1. Mental Health Center, West China Hospital, Sichuan University, Chengdu 610041, China;
2. Education Bureau of Baoxin County of Ya'an City, Ya'an 625700, China;
3. The People's Hospital of Baoxin County of Ya'an City, Ya'an 625700, China;

Corresponding author：

ZHANGJun, Email: zh2000jun2000@163.com

Keywords：

Earthquake; Teacher; Generalized anxiety disorder; Predictor; Multivariate logistic regression analysis

DOI：

10.7507/1672-2531.20150186

Video：

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Objective To evaluate the predictors of generalized anxiety disorder (GAD) among teachers in 3 months after Lushan earthquake. Methods A prospective cohort study was conducted to diagnostically evaluate the psychological sequelae and GAD during 14-20 days and 85-95 days after the earthquake. The possible predictive factors of psychological sequelae were assessed by a self-made questionnaire and the GAD was assessed by the GAD symptom criterion of M.I.N.I. in 3 months. The univariate and multivariate logistic regression analysis (ULRA, MLRA) were applied to analyze the predictors of GAD after the two-staged assessments. Results There were a total of 319 teachers completed the two-staged assessments. The total response rate was 51.3%. Seventy teachers were diagnosed as GAD and the prevalence of GAD in 3 months was 21.9%. The predictive factors by ULRA included:male, older than 35 years old, having unlivable house, living in tents, sleeping difficulties, easy to feel sad, physical discomfort, loss of appetite, feeling short of social support, unable to calm down for working, feeling difficult for teaching, observing more inattention of students, and wanting to ask for a leave. The independent predictors by MLRA included:male, having unlivable house, feeling short of social support, and feeling difficult for teaching. Conclusion The teachers have a higher likelihood of GAD after earthquake. It is essential to pay more attention to those male teachers, who feel short of social support and don't have a livable house thus to prevent the GAD at the early stage of post-earthquake.

Citation： CHENDe-chao, ZHUShen-yue, TIANYu-lian, ZHANGJun, LIHai-ming, CHENRan, GONGYao, YANGJun-hai. Predictors of Generalized Anxiety Disorder among Teachers in 3 Months after the Lushan Earthquake. Chinese Journal of Evidence-Based Medicine, 2015, 15(10): 1121-1126. doi: 10.7507/1672-2531.20150186 Copy

1.	Andrews G, Hobbs MJ, Borkovec TD, et al. Generalized worry disorder:a review of DSM-IV generalized anxiety disorder and options for DSM-V. Depress Anxiety, 2010, 27(2):134-147.
2.	Shen YC, Zhang MY, Huang YQ, et al. Twelve-month prevalence, severity, and unmet need for treatment of mental disorders in metropolitan China. Psychol Med, 2006, 36(2):257-267.
3.	Lee S, Tsang A, Ruscio AM, et al. Implications of modifying the duration requirement of generalized anxiety disorder in developed and developing countries. Psychol Med, 2009, 39(7):1163-1176.
4.	Kendler KS, Neale MC, Kessler RC, et al. Clinical characteristics of familial generalized anxiety disorder. Anxiety, 1994, 1(4):186-191.
5.	Bienvenu OJ, Nestadt G, Eaton WW. Characterizing generalized anxiety:temporal and symptomatic thresholds. J Nerv Ment Dis, 1998, 186(1):51-56.
6.	Maier W, Gansicke M, Freyberger HJ, et al. Generalized anxiety disorder (ICD-10) in primary care from a cross-cultural perspective:a valid diagnostic entity? Acta Psychiatr Scand, 2000, 101(1):29-36.
7.	Hettema JM, Prescott CA, Kendler KS. A population-based twin study of generalized anxiety disorder in men and women. J Nerv Ment Dis, 2001, 189(7):413-420.
8.	Kessler RC, Brandenburg N, Lane M, et al. Rethinking the duration requirement for generalized anxiety disorder:evidence from the National Comorbidity Survey Replication. Psychol Med, 2005, 35(7):1073-1082.
9.	Angst J, Gamma A, Joseph Bienvenu O, et al. Varying temporal criteria for generalized anxiety disorder:prevalence and clinical characteristics in a young age cohort. Psychol Med, 2006, 36(9):1283-1292.
10.	Craske MG, Rapee RM, Jackel L, et al. Qualitative dimensions of worry in DSM-Ⅲ-R generalized anxiety disorder subjects and nonanxious controls. Behav Res Ther, 1989, 27(4):397-402.
11.	Weems CF, Silverman WK, La Greca AM. What do youth referred for anxiety problems worry about? Worry and its relation to anxiety and anxiety disorders in children and adolescents. J Abnorm Child Psychol, 2000, 28(1):63-72.
12.	Hoyer J, Becker ES, Roth WT. Characteristics of worry in GAD patients, social phobics, and controls. Depress Anxiety, 2001, 13(2):89-96.
13.	Kar N, Bastia BK. Post-traumatic stress disorder, depression and generalised anxiety disorder in adolescents after a natural disaster:a study of comorbidity. Clin Pract Epidemiol Ment Health, 2006, 2:17.
14.	Neria Y, Olfson M, Gameroff MJ, et al. The mental health consequences of disaster-related loss:findings from primary care one year after the 9/11 terrorist attacks. Psychiatry, 2008, 71(4):339-348.
15.	司天梅, 舒良, 党卫民, 等. 简明国际神经精神访谈中文版的临床信效度. 中国心理卫生杂志, 2009, 4(7):493-503.
16.	Neria Y, Nandi A, Galea S. Post-traumatic stress disorder following disasters:a systematic review. Psychol Med, 2008, 38(4):467-480.
17.	Thormar SB, Gersons BP, Juen B, et al. The mental health impact of volunteering in a disaster setting:a review. J Nerv Ment Dis, 2010, 198(8):529-538.
18.	Bromet EJ, Havenaar JM. Psychological and perceived health effects of the Chernobyl disaster:a 20-year review. Health Phys, 2007, 93(5):516-521.
19.	Neria Y, DiGrande L, Adams BG. Posttraumatic stress disorder following the September 11, 2001, terrorist attacks:a review of the literature among highly exposed populations. Am Psychol, 2011, 66(6):429-446.
20.	Anwar J, Mpofu E, Matthews LR, et al. Reproductive health and access to healthcare facilities:risk factors for depression and anxiety in women with an earthquake experience. BMC Public Health, 2011, 11:523.
21.	Xu J, Wei Y. Social support as a moderator of the relationship between anxiety and depression:an empirical study with adult survivors of Wenchuan earthquake. PloS ONE, 2013, 8(10):e79045.
22.	胡永东, 汪卫东, 刘艳骄, 等. 对地震后德阳、绵竹地区部分群体的心理卫生状况调查. 中国民康医学, 2009, 5(23):2963-2968.
23.	Zhou X, Kang L, Sun X, et al. Risk factors of mental illness among adult survivors after the Wenchuan earthquake. Soc Psychiatry Psychiatr Epidemiol, 2013, 48(6):907-915.
24.	Zhang Z, Shi Z, Wang L, et al. Post-traumatic stress disorder, anxiety and depression among the elderly:a survey of the hard-hit areas a year after the Wenchuan earthquake. Stress Health, 2012, 28(1):61-68.
25.	刘瑶霞, 陈树, 陈平, 等. 汶川地震后2年重灾区群众焦虑、抑郁情绪调查. 实用医院临床杂志, 2012, 9(5):103-105.
26.	Fan F, Zhang Y, Yang Y, et al. Symptoms of posttraumatic stress disorder, depression, and anxiety among adolescents following the 2008 Wenchuan earthquake in China. J Trauma Stress, 2011, 24(1):44-53.
27.	王鸣. 汶川地震灾后居民安置点焦虑状况及影响因素调查. 中华流行病学杂志, 2008, 29(9):887-890.
28.	Ehring T, Razik S, Emmelkamp PM. Prevalence and predictors of posttraumatic stress disorder, anxiety, depression, and burnout in Pakistani earthquake recovery workers. Psychiatry Res, 2011, 185(1-2):161-166.

1. Andrews G, Hobbs MJ, Borkovec TD, et al. Generalized worry disorder:a review of DSM-IV generalized anxiety disorder and options for DSM-V. Depress Anxiety, 2010, 27(2):134-147.
2. Shen YC, Zhang MY, Huang YQ, et al. Twelve-month prevalence, severity, and unmet need for treatment of mental disorders in metropolitan China. Psychol Med, 2006, 36(2):257-267.
3. Lee S, Tsang A, Ruscio AM, et al. Implications of modifying the duration requirement of generalized anxiety disorder in developed and developing countries. Psychol Med, 2009, 39(7):1163-1176.
4. Kendler KS, Neale MC, Kessler RC, et al. Clinical characteristics of familial generalized anxiety disorder. Anxiety, 1994, 1(4):186-191.
5. Bienvenu OJ, Nestadt G, Eaton WW. Characterizing generalized anxiety:temporal and symptomatic thresholds. J Nerv Ment Dis, 1998, 186(1):51-56.
6. Maier W, Gansicke M, Freyberger HJ, et al. Generalized anxiety disorder (ICD-10) in primary care from a cross-cultural perspective:a valid diagnostic entity? Acta Psychiatr Scand, 2000, 101(1):29-36.
7. Hettema JM, Prescott CA, Kendler KS. A population-based twin study of generalized anxiety disorder in men and women. J Nerv Ment Dis, 2001, 189(7):413-420.
8. Kessler RC, Brandenburg N, Lane M, et al. Rethinking the duration requirement for generalized anxiety disorder:evidence from the National Comorbidity Survey Replication. Psychol Med, 2005, 35(7):1073-1082.
9. Angst J, Gamma A, Joseph Bienvenu O, et al. Varying temporal criteria for generalized anxiety disorder:prevalence and clinical characteristics in a young age cohort. Psychol Med, 2006, 36(9):1283-1292.
10. Craske MG, Rapee RM, Jackel L, et al. Qualitative dimensions of worry in DSM-Ⅲ-R generalized anxiety disorder subjects and nonanxious controls. Behav Res Ther, 1989, 27(4):397-402.
11. Weems CF, Silverman WK, La Greca AM. What do youth referred for anxiety problems worry about? Worry and its relation to anxiety and anxiety disorders in children and adolescents. J Abnorm Child Psychol, 2000, 28(1):63-72.
12. Hoyer J, Becker ES, Roth WT. Characteristics of worry in GAD patients, social phobics, and controls. Depress Anxiety, 2001, 13(2):89-96.
13. Kar N, Bastia BK. Post-traumatic stress disorder, depression and generalised anxiety disorder in adolescents after a natural disaster:a study of comorbidity. Clin Pract Epidemiol Ment Health, 2006, 2:17.
14. Neria Y, Olfson M, Gameroff MJ, et al. The mental health consequences of disaster-related loss:findings from primary care one year after the 9/11 terrorist attacks. Psychiatry, 2008, 71(4):339-348.
15. 司天梅, 舒良, 党卫民, 等. 简明国际神经精神访谈中文版的临床信效度. 中国心理卫生杂志, 2009, 4(7):493-503.
16. Neria Y, Nandi A, Galea S. Post-traumatic stress disorder following disasters:a systematic review. Psychol Med, 2008, 38(4):467-480.
17. Thormar SB, Gersons BP, Juen B, et al. The mental health impact of volunteering in a disaster setting:a review. J Nerv Ment Dis, 2010, 198(8):529-538.
18. Bromet EJ, Havenaar JM. Psychological and perceived health effects of the Chernobyl disaster:a 20-year review. Health Phys, 2007, 93(5):516-521.
19. Neria Y, DiGrande L, Adams BG. Posttraumatic stress disorder following the September 11, 2001, terrorist attacks:a review of the literature among highly exposed populations. Am Psychol, 2011, 66(6):429-446.
20. Anwar J, Mpofu E, Matthews LR, et al. Reproductive health and access to healthcare facilities:risk factors for depression and anxiety in women with an earthquake experience. BMC Public Health, 2011, 11:523.
21. Xu J, Wei Y. Social support as a moderator of the relationship between anxiety and depression:an empirical study with adult survivors of Wenchuan earthquake. PloS ONE, 2013, 8(10):e79045.
22. 胡永东, 汪卫东, 刘艳骄, 等. 对地震后德阳、绵竹地区部分群体的心理卫生状况调查. 中国民康医学, 2009, 5(23):2963-2968.
23. Zhou X, Kang L, Sun X, et al. Risk factors of mental illness among adult survivors after the Wenchuan earthquake. Soc Psychiatry Psychiatr Epidemiol, 2013, 48(6):907-915.
24. Zhang Z, Shi Z, Wang L, et al. Post-traumatic stress disorder, anxiety and depression among the elderly:a survey of the hard-hit areas a year after the Wenchuan earthquake. Stress Health, 2012, 28(1):61-68.
25. 刘瑶霞, 陈树, 陈平, 等. 汶川地震后2年重灾区群众焦虑、抑郁情绪调查. 实用医院临床杂志, 2012, 9(5):103-105.
26. Fan F, Zhang Y, Yang Y, et al. Symptoms of posttraumatic stress disorder, depression, and anxiety among adolescents following the 2008 Wenchuan earthquake in China. J Trauma Stress, 2011, 24(1):44-53.
27. 王鸣. 汶川地震灾后居民安置点焦虑状况及影响因素调查. 中华流行病学杂志, 2008, 29(9):887-890.
28. Ehring T, Razik S, Emmelkamp PM. Prevalence and predictors of posttraumatic stress disorder, anxiety, depression, and burnout in Pakistani earthquake recovery workers. Psychiatry Res, 2011, 185(1-2):161-166.

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Predictors of Generalized Anxiety Disorder among Teachers in 3 Months after the Lushan Earthquake

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