Screening for post-traumatic stress disorder among adolescents following floods- a comparative study from private and public schools in Kerala, India

Abstract

Introduction Disasters can have deep physical and psychological impact among survivors. An extraordinary southwest monsoon has unleashed floods and landslides in Kerala state in 2018. Adolescents are more vulnerable to psychological impairment after a disaster and trauma during initial stages of life can etch an indelible signature in the individual’s development and may lead to future disorders. Objectives 1. To screen for PTSD and associated factors among adolescents 8 months post floods in selected schools in flood-affected areas of Alleppey district of Kerala 2. To compare the proportion of adolescents screened positive for PTSD in public and private schools. Methodology A 3-month, Cross-sectional study was done among 670 adolescents in private and public schools using stratified sampling in Alleppey district. The study tool included a structured questionnaire that collected information on sociodemographics, flood-related variables, Trauma screening questionnaire and academic performance. Results The mean age of the participants was 16.03 ± 0.73 years with almost equal gender distribution. One-third of students reported flood-related damage to house/property, and a few lost their pets. Nearly 50% of the students reported that they still re-experience and get upsetting memories about flood events. The prevalence of probable PTSD noted to be 34.9%. We observed that 31% of students in public school screened positive for PTSD compared to 38.8% of private school students. (odds ratio = 1.409, CI 1.024–1.938). Male gender (Odds ratio = 1.503, CI 1.093–2.069), higher age (Odds ratio = 1.701, CI 1.120–2.585), damage during floods (Odds ratio = 2.566, CI 1.814–3.630), presence of morbidity (Odds ratio = 3.568, CI 1.888–6.743), camp stay (Odds ratio = 3.788, CI 2.364–6.067) and loss of pets (Odds ratio = 3.932, CI 2.019–7.657) were the factors significantly associated with PTSD. We noted a deterioration in academic performance in 45.9% of students who screened positive for PTSD. Conclusion and recommendations High prevalence of stress disorder highlights the need for early identification and intervention for PTSD and including trained counsellors as a part of the disaster management team in future.

Landslide disasters in eastern Uganda: post-traumatic stress disorder and its correlates among survivors in Bududa district

“…Facing a disaster of this magnitude would be a different experience for the landslide survivors. These results are consistent with the findings of the study conducted in India among adolescents following floods [ 41 ].…”

Effectiveness of Virtual Teaching Tool on Quality of Life and Post-Traumatic Stress Disorder among Adolescents Affected by Flood at Uttarakhand: A Pilot Study

“…However, the present study showed in pre-test, a high proportion (34-80) of PTSD among adolescents 27 (32.5%) and in post-test, a high proportion (0-33) of PTSD among adolescents 40 (100%) who experienced flood. Reviewing literature, a similar study done by Geethu et al in Alleppey district of Kerala, India showed a high proportion of PTSD (34.9%) among adolescents even after 8 months post disaster who experienced flood 11 . One more similar study done by Deiveegan C et al in Uttarakhand, India, showed that the prevalence of PTSD by the TSQ was found to be 86 (67.7%) among victims 7 .…”

A survey of Post-Traumatic Stress Disorder, Anxiety and Depression among Flood Affected Populations in Kerala, India

“…An earlier study on PTSD in flood survivors of Kerala flood 2018 highlighted the need to carry out post-disaster mental health screening because of the high prevalence of PTSD following the floods [ 16 ]. Similarly, another study revealed that even eight months post disaster, a sizable percentage of adolescents were still experiencing stress-related disorders [ 15 ]. The health department of Kerala trained close to 1000 volunteers to help affected flood victims.…”

“…Notably, such natural disaster may have huge impact on the mental wellbeing of the victims and therefore, exploration of psychological effects on survivors is important to develop coping strategies. Though few studies have reported the prevalence of PTSD among adolescents [ 15 ] and adults [ 16 ] of 2018 flood victims in Kerala, there are no reports available on other associated psychological disorders such as depression and anxiety. Therefore, we assessed the relationship between the socio-economic and flood exposure factors with PTSD, depression and anxiety among the flood survivors in the Kozhikode district of Kerala, India.…”