目的：探討大地震後罹難者家屬的急性精神疾病，並檢測創傷後壓力疾患（以下 簡稱PTSD）篩檢工具PTSS-10的效度。方法：本研究在靠近921地震震央的國姓鄉，以80戶罹 難者直系親屬為目標族群進行研究。使用PTSS-10自填量表進行評估，且由受過訓練的精神 科醫師使用標準診斷工具MINI，以半結構式會談作精神疾病診斷。結果：共有34位男性，20 位女性完成評估，反應率為62.5%（50/80戶），訪視日距離地震發生為42.9±11.7日，且一 等親佔88.9%。PTSS-10的最佳切換點為4/5，敏感度為75.0%，特異度為67.6%。精神疾病盛 行率依序為創傷後壓力疾患（29.6%）、重鬱症（16.7%）、適應性疾患（14.8%）、酒精使 用疾患（7.4%）等，女性罹患精神疾病的比率明顯高於男性。具PTSD者，有不少具有愧咎（ 44%）及憂鬱（100%）等症狀。有半數災民接受過民俗治療，但也有10%曾因身體問題向醫療 院所求診。結論：本研究顯示地震後罹難者家屬有高比例的精神疾病罹病率，這群高危險群 宜有適當的精神醫療介入，使之儘早恢復健康。

　　　　　Objective: This study investigated acute psychiatic disorders manifested in survivors who had lost relatives as a result of a severe earthquake, and validated a screening instrument (PTSS-10) for post-traumatic stress disorder (PTSD). Methods: Eighty lineal families from Guo-Xing township, near the epicenter of the earthquake that struck Taiwan on September 21, 1999, that had lost family members were included in this study. The PTSS-10 was used for PTSD screening, and trained psychiatrists made the assessment with the aid of a semi-structured intreview using the MINI as the standardized diagnostic tool. Results: The interview was completed by 34 males and 20 females, with an acceptable response rate of 62.5% and average elapsed time (SD) from the earthquake of 42.9 (11.7) days. Most of the subjects had lost first-order family members (88.8%). The optimal cutoff point for PTSS-10 was 4/5 with satifactory performance (sensitivity=75.0%, specificity=67.6%). In descending order, the prevalence for psychiatric disorders was PTSD (29.6%), the major depression (16.7%), adjustment disorder (14.8%) and alcohol use disorder (7.4%). Females revealed higher morbidity rates than males. Depression was determined for all of the subjects diagnosed with PTSD (100%) and many had guilt feelings (44%). The majority of victims had only ever taken folk medicine, with only 10% calling at the primary care facility. Conclusion: The results of this study revealed that bereaved survivors of a major natural disaster presented with higher psychiatric morbidity, and this high-risk subpopulation required more intervention to prevent excerbation and persistence of psychic dysfunction. (Full Text in Chiness)