Mentalillness 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: 5.11). 12/2006; 84(12):930-9. DOI: 10.1590/S0042-96862006001200008
Source: PubMed

ABSTRACT 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, Aug 19, 2015
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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.
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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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    • "The detrimental effects of large-scale disasters on survivors' psychological well-being have been documented extensively (e.g., Norris et al. 2002a; b; Rubonis and Bickman 1991; Sundin and Horowitz 2003). Studies of the impacts of hurricanes have revealed that as many as half of survivors suffer from some form of disaster-related mental illness (David et al. 1996; Norris et al. 1999; Kessler et al. 2006; Weems et al. 2007; Weisler et al. 2006). "
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    ABSTRACT: This prospective study examined the pathways by which religious involvement affected the post-disaster psychological functioning of women who survived Hurricanes Katrina and Rita. The participants were 386 low-income, predominantly Black, single mothers. The women were enrolled in the study before the hurricane, providing a rare opportunity to document changes in mental health from before to after the storm, and to assess the protective role of religious involvement over time. Results of structural equation modeling indicated that, controlling for level of exposure to the hurricanes, pre-disaster physical health, age, and number of children, pre-disaster religiousness predicted higher levels of post-disaster (1) social resources and (2) optimism and sense of purpose. The latter, but not the former, was associated with better post-disaster psychological outcome. Mediation analysis confirmed the mediating role of optimism and sense of purpose.
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