Psychiatric disorders and functional impairment among disaster victims after exposure to a natural disaster: A population based study

Norwegian Centre for Violence and Traumatic Stress Studies, Kirkeveien 166, N-0407 Oslo, Norway.
Journal of Affective Disorders (Impact Factor: 3.71). 01/2011; 128(1-2):135-41. DOI: 10.1016/j.jad.2010.06.018
Source: PubMed

ABSTRACT We aimed to examine psychiatric morbidity and functional impairment after a natural disaster.
Norwegian tourists who survived the 2004 tsunami in Khao Lak (n = 63), a severely affected area in Thailand, were interviewed in person 2.5 years after the disaster. The examination included the Mini International Neuropsychiatric Interview, the PTSD module of the Structured Clinical Interview for DSM-IV Axis I disorders, the Work and Social Adjustment Scale (WSAS), the Global Assessment of Functioning function score (GAF-F), and questions covering background characteristics and disaster exposure.
The most prevalent disorders were specific phobia (30.2%), agoraphobia (17.5%), social anxiety disorder (11.1%), PTSD (11.1%), major depressive disorder (MDD, 11.1%), and dysthymic disorder (DD, 11.1%). In 24 of the 40 respondents with a current psychiatric disorder, symptoms had originated after the tsunami. The post-tsunami 2.5 year incidence of PTSD and MDD was 36.5% and 28.6%, respectively. Multivariable regression analysis showed that the depressive disorders (MDD and DD) and PTSD were associated with self-reported functional impairment (WSAS), and the depressive disorders were associated with clinician assessed functional impairment (GAF-F).
Small sample size and high education may limit the generalizability of the results.
Depression and anxiety disorders were common among disaster victims 2.5 years after the 2004 tsunami. Psychiatric disorders other than PTSD, especially depressive disorders, are of clinical importance when considering long-term mental health effect of disasters.

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Available from: Trond Heir, May 23, 2014
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    • "We focus on the above disorders because they are among the most prevalent of the primary anxiety disorders as defined by the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5); specific phobia was excluded due to its relatively low levels of impairment (e.g. Hussain et al. 2011) and because it has heterogeneous subtypes that complicate latent variable modeling (see below for our approach). For descriptive purposes, we quantify mean impairment for individuals with a principal diagnosis of one of these three disorders, assessing overall impairment as well as impairment across five life domains (i.e. "
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    ABSTRACT: Anxiety disorders are highly prevalent disorders associated with substantial psychosocial impairment, but few studies have examined impairment within specific anxiety disorders. Furthermore, it is unclear how change in different types of anxiety has an impact on change in impairment, particularly given high rates of co-morbidity. The current study assessed the temporal associations of impairment and symptoms of three common anxiety disorders in a large, diagnostically heterogeneous clinical sample. Method Data were collected from 606 treatment-seeking individuals at an anxiety clinic, most of whom subsequently enrolled in cognitive-behavioral therapy. Symptoms of panic, social anxiety and generalized anxiety disorder (GAD), as well as levels of impairment, were assessed three times over 2 years. In addition to examining levels of impairment across diagnostic groups, latent growth modeling was used to evaluate the longitudinal associations of anxiety symptoms and impairment. Those with a principal diagnosis of GAD reported higher levels of impairment in some domains at baseline; however, at follow-up assessments individuals with social anxiety disorder reported greater impairment than those with panic disorder. Anxiety symptoms and impairment both declined over time. Change in all three anxiety symptoms was closely associated with change in impairment, but only GAD remained a significant (positive) predictor of change in impairment after accounting for co-morbidity. Impairment and all three anxiety disorders were closely associated, both cross-sectionally and longitudinally. Because change in GAD was most specifically related to change in impairment, treatment for those with multiple anxiety disorders could focus on treating GAD symptoms first or treating transdiagnostic processes.
    Psychological Medicine 06/2014; 44:1691-1700. DOI:10.1017/S0033291713001967 · 5.43 Impact Factor
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    • "The prevalence of MDD after Hurricane Katrina in this study is greater than what has been reported in the general population (6.6%; Kessler et al., 2003) but is similar to reports after other natural disasters (11.1%; Hussain et al., 2011; 11.7%; Onder et al., 2006). However, the prevalence of current MDD in this study (9.1%) is significantly greater than what has been documented in the general population (2.2%; Regier et al., 1993) and after other natural disasters (4.9%; Tracy et al., 2011). "
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    ABSTRACT: The current study examined demographic and psychosocial factors that predict major depressive disorder (MDD) and comorbid MDD/posttraumatic stress disorder (MDD/PTSD) diagnostic status after Hurricane Katrina, one of the deadliest and costliest hurricanes in the history of the United States. This study expanded on the findings published in the article by Galea, Tracy, Norris, and Coffey (J Trauma Stress 21:357-368, 2008), which examined the same predictors for PTSD, to better understand related and unique predictors of MDD, PTSD, and MDD/PTSD comorbidity. A total of 810 individuals representative of adult residents living in the 23 southernmost counties of Mississippi before Hurricane Katrina were interviewed. Ongoing hurricane-related stressors, low social support, and hurricane-related financial loss were common predictors of MDD, PTSD, and MDD/PTSD, whereas educational and marital status emerged as unique predictors of MDD. Implications for postdisaster relief efforts that address the risk for both MDD and PTSD are discussed.
    The Journal of nervous and mental disease 10/2013; 201(10):841-847. DOI:10.1097/NMD.0b013e3182a430a0 · 1.81 Impact Factor
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    • "Evidence also suggests that tourist survivors are at risk of developing mental health problems following exposure to a natural disaster (Johannesson et al., 2009; Kraemer et al., 2009; Hussain et al., 2011). Hussain et al. reported high levels of PTSD (36.5%) and major mood disorders (28.5%), 2.5 years following exposure to the disaster in Norwegian survivors of the 2004 tsunami. "
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    Asia-Pacific Psychiatry 06/2012; 4(2). DOI:10.1111/j.1758-5872.2012.00196.x · 0.42 Impact Factor
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