Mental Illness and Suicidality after Hurricane Katrina

Department of Health Care Policy, Harvard Medical School, Boston, MA 02115, USA.
Bulletin of the World Health Organisation (Impact Factor: 5.09). 12/2006; 84(12):930-9. DOI: 10.1590/S0042-96862006001200008
Source: PubMed


To estimate the impact of Hurricane Katrina on mental illness and suicidality by comparing results of a post-Katrina survey with those of an earlier survey.
The National Comorbidity Survey-Replication, conducted between February 2001 and February 2003, interviewed 826 adults in the Census Divisions later affected by Hurricane Katrina. The post-Katrina survey interviewed a new sample of 1043 adults who lived in the same area before the hurricane. Identical questions were asked about mental illness and suicidality. The post-Katrina survey also assessed several dimensions of personal growth that resulted from the trauma (for example, increased closeness to a loved one, increased religiosity). Outcome measures used were the K6 screening scale of serious mental illness and mild-moderate mental illness and questions about suicidal ideation, plans and attempts.
Respondents to the post-Katrina survey had a significantly higher estimated prevalence of serious mental illness than respondents to the earlier survey (11.3% after Katrina versus 6.1% before; chi(2)1= 10.9; P < 0.001) and mild-moderate mental illness (19.9% after Katrina versus 9.7% before; chi(2)1 = 22.5; P < 0.001). Among respondents estimated to have mental illness, though, the prevalence of suicidal ideation and plans was significantly lower in the post-Katrina survey (suicidal ideation 0.7% after Katrina versus 8.4% before; chi(2)1 = 13.1; P < 0.001; plans for suicide 0.4% after Katrina versus 3.6% before; chi(2)1 = 6.0; P = 0.014). This lower conditional prevalence of suicidality was strongly related to two dimensions of personal growth after the trauma (faith in one's own ability to rebuild one's life, and realization of inner strength), without which between-survey differences in suicidality were insignificant.
Despite the estimated prevalence of mental illness doubling after Hurricane Katrina, the prevalence of suicidality was unexpectedly low. The role of post-traumatic personal growth in ameliorating the effects of trauma-related mental illness on suicidality warrants further investigation.

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Available from: Russell T Jones, Oct 05, 2015
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    • "In this study, Cronbach’s α coefficients were 0.88. Based on previous research on K6 in Japan, the respondents were classified into having a serious mental health problem (SMHP) (the score of 13+), moderate mental health problem (MMHP) (5–12), and no mental health problem (0–4) [3], [20]–[22]. "
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    ABSTRACT: Mental health is one of the most important issues facing disaster survivors. The purpose of this study is to determine the prevalence and correlates of mental health problems in survivors of the Great East Japan Earthquake and Tsunami at 6-11 months after the disaster. The questionnaire and notification were sent to the survivors in three municipalities in the Tohoku area of the Northern part of Honshu, Japan's largest island, between September 2011 and February 2012. Questionnaires were sent to 12,772, 11,411, and 18,648 residents in the Yamada, Otsuchi, and Rikuzentakata municipalities, respectively. Residents were asked to bring the completed questionnaires to their health check-ups. A total of 11,124 or (26.0%) of them underwent health check-ups, and 10,198 were enrolled. We excluded 179 for whom a K6 score was missing and two who were both 17 years of age, which left 10,025 study participants (3,934 male and 6,091 female, mean age 61.0 years). K6 was used to measure mental health problems. The respondents were classified into moderate (5-12 of K6) and serious mental health problems (13+). A total of 42.6% of the respondents had moderate or serious mental health problems. Multivariate analysis showed that women were significantly associated with mental health problems. Other variables associated with mental health problems were: younger male, health complaints, severe economic status, relocations, and lack of a social network. An interaction effect of sex and economic status on severe mental health problems was statistically significant. Our findings suggest that mental health problems were prevalent in survivors of the Great East Japan Earthquake and Tsunami. For men and women, health complaints, severe economic status, relocations, and lack of social network may be important risk factors of poor mental health. For men, interventions focusing on economic support may be particularly useful in reducing mental health problems after the disaster.
    PLoS ONE 07/2014; 9(7):e102497. DOI:10.1371/journal.pone.0102497 · 3.23 Impact Factor
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    • "In addition, this hurricane led to significant displacement and chronic stressors for a significant amount of individuals. High levels of psychopathology have already been documented after this disaster (Galea et al., 2008; Kessler et al., 2006). For example, depressive symptoms increased 1 month after Hurricane Katrina made landfall as compared with 1 month before in an outpatient psychiatric clinic (McLeish and Del Ben, 2008). "
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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 · 1.69 Impact Factor
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    • "PD was high before the hurricane (24% with K6>7.) This rate exceeds the 16% found for a representative sample of Gulf Coast residents from the National Co-morbidity Survey who were assessed before Hurricane Katrina (Kessler et al., 2006). This difference may reflect the characteristics of our sample. "
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    ABSTRACT: Hurricane Katrina, which struck the Gulf Coast of the United States in August 2005, exposed area residents to trauma and extensive property loss. However, little is known about the long-run effects of the hurricane on the mental health of those who were exposed. This study documents long-run changes in mental health among a particularly vulnerable group-low income mothers-from before to after the hurricane, and identifies factors that are associated with different recovery trajectories. Longitudinal surveys of 532 low-income mothers from New Orleans were conducted approximately one year before, 7-19 months after, and 43-54 months after Hurricane Katrina. The surveys collected information on mental health, social support, earnings and hurricane experiences. We document changes in post-traumatic stress symptoms (PTSS), as measured by the Impact of Event Scale-Revised, and symptoms of psychological distress (PD), as measured by the K6 scale. We find that although PTSS has declined over time after the hurricane, it remained high 43-54 months later. PD also declined, but did not return to pre-hurricane levels. At both time periods, psychological distress before the hurricane, hurricane-related home damage, and exposure to traumatic events were associated with PTSS that co-occurred with PD. Hurricane-related home damage and traumatic events were associated with PTSS without PD. Home damage was an especially important predictor of chronic PTSS, with and without PD. Most hurricane stressors did not have strong associations with PD alone over the short or long run. Over the long run, higher earnings were protective against PD, and greater social support was protective against PTSS. These results indicate that mental health problems, particularly PTSS alone or in co-occurrence with PD, among Hurricane Katrina survivors remain a concern, especially for those who experienced hurricane-related trauma and had poor mental health or low socioeconomic status before the hurricane.
    Social Science [?] Medicine 11/2011; 74(2):150-7. DOI:10.1016/j.socscimed.2011.10.004 · 2.89 Impact Factor
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