삼풍사고 생존자들에서의 급성 외상후스트레스장애： 발생빈도, 예측인자, 증상 변화에 대한 예비적 연구

Acute PTSD in Survivors of a Building Collapse Accident in Seoul：A Preliminary Study on Incidence, Predictors and Pattern of Symptom Changes

Objective：This is a prospective clinical study on survivors of the collapse accident of a major department store building occurred in Seoul in June 1995 to investigate the incidence of acute PTSD, to identify risk factors affecting the severity of PTSD symptoms, and to evaluate the pattern of symptom changes over time. Method：Thirty-two victims were interviewed with modified Korean version of the PTSD-I (DSM-III-R) to determine the severity of symptoms and diagnosis of PTSD. Degrees of anxiety and depression were measured with Hamilton’s Anxiety Scale(HAS) and Depression Scales(HDS) respectively. Subjects were assessed in series at one month(time point 1) and three month(time point 2) from the time the accident occurred. Results：The incidence of PTSD in the subjects over the 3 months was 41% using by full criteria and 48% by partial criteria. Regression analysis at the time point 1, the HDS score, which was partially related with death of accompanied persons(friends/relatives/colleagues), contributed significantly to the PTSD-I variances. At the time point 2, loss of consciousness contributed significantly to the variance of the PTSD-I, HDS and HAS scores. Between time point 1 and time point 2, the overall severity of PTSD symptoms for all the subjects has remained almost unchanged. However, reexperience and hyperarousal symptoms were improved in comparison with avoidance symptoms, although not statistically significant. Conclusions：This study results show a high risk of developing PTSD and partial PTSD among the building collapse victims. The death of accompanied person, severity of depression and loss of consciousness are all regarded as major factors affecting the severity of PTSD. Of PTSD symptom clusters, avoidance symptoms are likely to be less changeable than reexperience and hyperarousal symptoms over time.