The course of mental health disorders after a disaster: Predictors and comorbidity

Abstract

Current longitudinal disaster studies usually focus only on posttraumatic stress disorder (PTSD), although some studies have shown that increased risks for other disorders and comorbidity is common. To obtain an insight into the course of postdisaster psychopathology, a community sample of survivors of the Enschede fireworks disaster was followed from 2-3 weeks to 4-years postdisaster. Diagnostic interviews (Composite International Diagnostic Interview [CIDI]; World Health Organization, 1997) and childhood stressor interviews were administered at 2-years postdisaster (n = 260); the CIDI was repeated at 4-years postdisaster (n = 201, response rate 77.3%). At 2-years postdisaster many survivors (40.6%) suffered from PTSD (21.8%), specific phobia (21.5%), and/or depression (16.1%). These disorders were highly comorbid. At 4-years postdisaster, prevalence significantly diminished. Instead of full recovery, diagnostic classifications shifted in several survivors over time. This resulted in low rates of PTSD but still elevated rates of depression and specific phobia. The course of the 3 entangled disorders of PTSD, depression, and specific phobia was further studied by constructing 4 groups of survivors based on the diagnostic status at 2- and 4-years postdisaster: healthy, recovered, chronic, and delayed-onset. Initial depressive symptoms, maternal dysfunction, childhood physical abuse, and disaster exposure were found to discriminate between the groups and predict long-term psychopathology.

Angry, Scared, and Unsure: Mental Health Consequences of Contaminated Water in Flint, Michigan

“…– 7 Neighborhoods with higher collective efficacy generally have better reported overall health8 and better mental health outcomes in the face of natural disasters 910 …”

Factors in Mental Health Problems among Japanese Dialysis Patients Living in Heavily Damaged Prefectures Two Years after the Great East Japan Earthquake

“…However, it has been widely claimed that depression is the most common mental health problem among dialysis patients; this is not only because dialysis patients may have experienced multiple difficulties at home and work, for example, fatigue and sexual dysfunction, but also due to multiple stressors such as dietary constraints and dependency upon treatment [54]. Previous studies have reported that rates of comorbid depression among participants with PTSD were over 40% [30,34,55]. The rate of comorbid depression among participants with PTSD in this sample (23.1%) was lower than that found in other studies of disaster survivors.…”

“…Tracy et al [28] suggested that PTSD and depression might be different predictors. Additionally, there are high comorbidity rates between PTSD and depression, and other mental disorders have been reported [29,30], and the presence of depressive disorders in patients with PTSD has been associated with greater functional impairment [31][32][33][34]. However, little is known about risk factors involved in comorbidity [32,34].…”

Pretyphoon Panic Attack History Moderates the Relationship Between Degree of Typhoon Exposure and Posttyphoon PTSD and Depression in a Vietnamese Sample

“…[1–6] Therefore, it is important to understand what factors predict the onset of psychiatric disorders following exposure to disasters. Dose–response theory posits that as the magnitude of life stress increases, the likelihood of developing various forms of illness, as well as the severity of such illness, increases.…”

“…[10, 11] The degree of exposure to disasters is generally related to postdisaster psychiatric functioning, with greater disaster exposure being related to increased odds of postdisaster psychopathology. [1, 12] However, it is clear that trauma “dose” does not account for a majority of variance in posttrauma functioning. [8] For example, some individuals who experience relatively low levels of disaster exposure will meet criteria for new psychiatric disorders following exposure.…”