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Agrest M, Kankan T, Fernández M, Rosales M, Matkovich A, Velzi-Díaz A, Ardila-Gómez S. COVID-19 impact on the provision of psychosocial rehabilitation services in Latin America and the Caribbean. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2022. [DOI: 10.1080/00207411.2022.2154562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Martín Agrest
- Research Unit, Proyecto Suma, Buenos Aires, Argentina
- Facultad de Psicología, Instituto de Investigaciones, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Tanvi Kankan
- Teachers College, Columbia University, New York, NY, USA
| | - Marina Fernández
- Facultad de Psicología, Instituto de Investigaciones, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Melina Rosales
- Facultad de Psicología, Instituto de Investigaciones, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Andrés Matkovich
- Facultad de Psicología, Universidad Nacional de Rosario, Rosario, Argentina
| | - Alberto Velzi-Díaz
- Facultad de Psicología, Universidad Nacional de Rosario, Rosario, Argentina
| | - Sara Ardila-Gómez
- Facultad de Psicología, Instituto de Investigaciones, Universidad de Buenos Aires, Buenos Aires, Argentina
- CONICET, Buenos Aires, Argentina
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Sodeyama N, Takahashi S, Aiba M, Haraguchi Y, Arai T, Tachikawa H. A Comparison of Mental Health among Earthquake, Tsunami, and Nuclear Power Plant Accident Survivors in the Long Term after the Great East Japan Earthquake. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14072. [PMID: 36360954 PMCID: PMC9659037 DOI: 10.3390/ijerph192114072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/25/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
Even now, ten years after the Great East Japan Earthquake (GEJE), thousands of residents of Fukushima Prefecture are still living as evacuees. To understand the mental health states and needs for psychological care of the survivors, we conducted a questionnaire survey of survivors who were evacuated from Fukushima to Ibaraki due to the nuclear power plant accident and of the residents of two areas in Ibaraki where damage was particularly severe due to the tsunami or liquefaction. Our results show that stress related to participants' hometowns and to the disaster was a risk factor for depression and post-traumatic stress among the survivors in the medium to long term in all regions examined. Other risk factors for post-traumatic stress differed by region. This study shows that in a complex disaster such as the GEJE, where damage is widespread, the causes of damage and the experiences of disaster survivors differ greatly from region to region and that risk factors for depression and post-traumatic stress among disaster survivors over the medium to long term may also differ. To provide appropriate care to disaster survivors, it is necessary to determine what is causing the risk of depression and post-traumatic stress at any given time and in specific regions.
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Affiliation(s)
- Noriko Sodeyama
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8577, Japan
| | - Sho Takahashi
- Department of Disaster and Community Psychiatry, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8577, Japan
| | - Miyuki Aiba
- Faculty of Human Sciences, Toyo Gakuen University, 1-26-3 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Yayoi Haraguchi
- College of Humanities and Social Sciences, Ibaraki University, 2-1-1 Bunkyo, Mito 310-8512, Japan
| | - Tetsuaki Arai
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8577, Japan
| | - Hirokazu Tachikawa
- Department of Disaster and Community Psychiatry, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8577, Japan
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Assessing the Feasibility and Effectiveness of a Linkage Into Mental Health Care Program for Adults Affected by Hurricane Sandy. Disaster Med Public Health Prep 2022; 17:e238. [PMID: 36062582 PMCID: PMC9905213 DOI: 10.1017/dmp.2022.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Research indicates that greater exposure to Hurricane Sandy is associated with increased mental health difficulties. This study examined whether Project Restoration, a program that linked adults into mental health care (L2C), was effective in reducing post-Sandy mental health difficulties as compared to a cohort of adults matched on mental health difficulties that were not linked into post-Sandy mental health care. METHODS Project Restoration participants (n = 52) with elevated self-reported mental health difficulties had the option to enroll into L2C. Project LIGHT (n = 63) used similar methodologies but did not have a L2C component and served as the matched control group. RESULTS Multivariable modeling showed significant decreases in all mental health difficulties except for depression in the Project Restoration group, whereas there were no significant decreases in LIGHT. The decrease in anxiety from baseline to follow-up was significantly greater for Project Restoration as compared to LIGHT. CONCLUSION Findings confirm the powerful impact community outreach and treatment have on reducing mental health difficulties after a disaster.
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Langhammer T, Peters C, Ertle A, Hilbert K, Lueken U. Impact of COVID-19 pandemic related stressors on patients with anxiety disorders: A cross-sectional study. PLoS One 2022; 17:e0272215. [PMID: 35980908 PMCID: PMC9387803 DOI: 10.1371/journal.pone.0272215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 07/14/2022] [Indexed: 11/18/2022] Open
Abstract
The COVID-19 pandemic and related containment measures are affecting mental health, especially among patients with pre-existing mental disorders. The aim of this study was to investigate the effect of the first wave and its aftermath of the pandemic in Germany (March–July) on psychopathology of patients diagnosed with panic disorder, social anxiety disorder and specific phobia who were on the waiting list or in current treatment at a German university-based outpatient clinic. From 108 patients contacted, forty-nine patients (45.37%) completed a retrospective survey on COVID-19 related stressors, depression, and changes in anxiety symptoms. Patients in the final sample (n = 47) reported a mild depression and significant increase in unspecific anxiety (d = .41), panic symptoms (d = .85) and specific phobia (d = .38), while social anxiety remained unaltered. Pandemic related stressors like job insecurities, familial stress and working in the health sector were significantly associated with more severe depression and increases in anxiety symptoms. High pre-pandemic symptom severity (anxiety/depression) was a risk factor, whereas meaningful work and being divorced/separated were protective factors (explained variance: 46.5% of changes in anxiety and 75.8% in depressive symptoms). In line with diathesis-stress models, patients show a positive association between stressors and symptom load. Health care systems are requested to address the needs of this vulnerable risk group by implementing timely and low-threshold interventions to prevent patients from further deterioration.
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Affiliation(s)
- Till Langhammer
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
- * E-mail:
| | - Carlotta Peters
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Andrea Ertle
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Kevin Hilbert
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Ulrike Lueken
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
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Who is seeking help for psychological distress associated with the COVID-19 pandemic? Characterization of risk factors in 1269 participants accessing low-threshold psychological help. PLoS One 2022; 17:e0271468. [PMID: 35849591 PMCID: PMC9292095 DOI: 10.1371/journal.pone.0271468] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 06/29/2022] [Indexed: 12/21/2022] Open
Abstract
Background The COVID-19 pandemic and accompanying restrictions are associated with substantial psychological distress. However, it is unclear how this increased strain translates into help-seeking behavior. Here, we aim to characterize those individuals who seek help for COVID-19 related psychological distress, and examine which factors are associated with their levels of distress in order to better characterize vulnerable groups. Methods We report data from 1269 help-seeking participants subscribing to a stepped-care program targeted at mental health problems due to the COVID-19 pandemic. Sample characteristics were compared to population data, and linear regression analyses were used to examine which risk factors and stressors were associated with current symptom levels. Results Seeking for help for COVID-19 related psychological distress was characterized by female gender, younger age, and better education compared to the general population. The majority reported mental health problems already before the pandemic. 74.5% of this help-seeking sample also exceeded clinical thresholds for depression, anxiety, or somatization. Higher individual symptom levels were associated with higher overall levels of pandemic stress, younger age, and pre-existing mental health problems, but were buffered by functional emotion regulation strategies. Conclusions Results suggest a considerable increase in demand for mental-healthcare in the pandemic aftermath. Comparisons with the general population indicate diverging patterns in help-seeking behavior: while some individuals seek help themselves, others should be addressed directly. Individuals that are young, have pre-existing mental health problems and experience a high level of pandemic stress are particularly at-risk for considerable symptom load. Mental-healthcare providers should use these results to prepare for the significant increase in demand during the broader aftermath of the COVID-19 pandemic as well as allocate limited resources more effectively.
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Sumpter DM, Gibson CB. Riding the wave to recovery: Relational energy as an HR managerial resource for employees during crisis recovery. HUMAN RESOURCE MANAGEMENT 2022. [DOI: 10.1002/hrm.22117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Dana McDaniel Sumpter
- Department of Organization Theory and Management Pepperdine Graziadio Business School Malibu California USA
| | - Cristina B. Gibson
- Department of Management Pepperdine Graziadio Business School Malibu California USA
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Masucci MD, Martin V, Le TP, Cohen AS. Negative schizotypy attenuates the effect of momentary stress on social dysfunction related to COVID-19 social distancing. Schizophr Res 2022; 243:24-31. [PMID: 35231831 PMCID: PMC9189049 DOI: 10.1016/j.schres.2022.02.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 01/15/2022] [Accepted: 02/18/2022] [Indexed: 10/19/2022]
Abstract
Schizotypy is associated with a broad range of motivational and social dysfunctions. However, there is reason to suspect that negative schizotypy may limit social dysfunction in specific contexts that typically increase isolation and loneliness. We analyzed whether positive, negative and disorganized facets of schizotypy would mitigate detrimental reactions to stress in the context of a global stressor (the COVID-19 pandemic) that has widely necessitated social and physical isolation. Responses to two measures of schizotypy were compared to ecological momentary assessments of social dysfunction for 85 undergraduates using multilevel modelling techniques. Negative schizotypy moderated the relation between momentary stress and loss of social support, such that negative schizotypy limited the magnitude of social dysfunction stemming from increases in momentary stress. This pattern was not seen for other facets of schizotypy. Implications for the treatment and measurement of schizotypy symptoms are discussed.
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Affiliation(s)
- Michael D. Masucci
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA,Address correspondence to: Michael Masucci, Department of Psychology, Louisiana State University, 236 Audubon Hall, Baton Rouge, LA 70808,
| | - Victoria Martin
- The Graduate Center, City University of New York, New York, NY, USA
| | - Thanh P. Le
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA,Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA
| | - Alex S. Cohen
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
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Kurose S, Funayama M, Takata T, Shimizu Y, Mimura Y, Kudo S, Ogino S, Mimura M. Symptom changes in patients with pre-existing psychiatric disorders in the initial phase of the COVID-19 pandemic: Vulnerability of female patients and patients with mood disorders. Asian J Psychiatr 2022; 68:102966. [PMID: 34974375 PMCID: PMC8677626 DOI: 10.1016/j.ajp.2021.102966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 12/05/2021] [Accepted: 12/14/2021] [Indexed: 11/02/2022]
Abstract
How patients with pre-existing psychiatric disorders are responding to the COVID-19 pandemic remains unclear, and no comprehensive studies have yet been performed. To elucidate (1) which psychiatric disorders were exacerbated during the initial phase of the COVID-19 pandemic and (2) the contributing factors, we prospectively assessed psychiatric symptoms of 1592 psychiatric outpatients in a single-center study using the Global Assessment of Functioning (GAF) before the state of emergency was declared in Japan and during two months under the state of emergency (study period: April 8 to June 7, 2020). We conducted a chi-squared test for the relationship between psychiatric diagnostic category (ICD-10) and exacerbation. To control for confounders, we conducted a logistic regression analysis using sex, age, diagnostic category, and pre-pandemic GAF score as independent variables. Exacerbation rates of patients with mood disorders (F3) and neurotic disorders (F4) were 4.32% and 5.37%, respectively, and were significantly higher than those for patients with organic disorders (F0) and schizophrenic disorders (F2) (X2 (9, N = 1592) = 27.8, p < .01). Logistic regression analysis revealed that patients with F3 and female patients were significantly more affected than patients with other disorders or male patients, respectively (odds ratio (95% confidence interval) = 2.4 (1.2-4.6), p < .01 for F3; 3.1 (1.5-6.6), p < .01 for females). These findings suggest a need for careful management of patients with mood disorders and female psychiatric patients during a pandemic.
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Affiliation(s)
- Shin Kurose
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Tochigi, Japan; Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan; Department of Functional Brain Imaging, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan.
| | - Michitaka Funayama
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Tochigi, Japan
| | - Taketo Takata
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Tochigi, Japan
| | - Yusuke Shimizu
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Tochigi, Japan; Department of Trauma and Critical Care Medicine, Kyorin University School of Medicine, Tokyo, Japan
| | - Yu Mimura
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Tochigi, Japan; Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Shun Kudo
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Tochigi, Japan; Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan; Department of Psychiatry, Saitama City Hospital, Saitama, Japan
| | - Satoyuki Ogino
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Tochigi, Japan; Department of Trauma and Critical Care Medicine, Kyorin University School of Medicine, Tokyo, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
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Di Lorenzo R, Pinelli M, Bertani D, Cutino A, Dragone D, Elia C, Farina R, Fiore G, Luisi F, Panico S, Valeo L, Rovesti S, Ferri P. The Impact of COVID-19 Pandemic on Psychiatric Emergencies in Two Different Settings: Emergency Room and Community Mental Health Service. Front Psychiatry 2022; 13:894939. [PMID: 35693974 PMCID: PMC9178082 DOI: 10.3389/fpsyt.2022.894939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 05/04/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The SARS-CoV-2 pandemic caused a public health emergency with profound consequences on physical and mental health of individuals. Emergency Rooms (ER) and Community Mental Health Services (CMHS) played a key role in the management of psychiatric emergencies during the pandemic. The purpose of the study was to evaluate urgent psychiatric consultations (UPCs) in the ERs of the General Hospitals and in the CMHS of a Northern Italian town during the pandemic period. METHODS This monocentric observational study collected UPCs carried out in ER from 01/03/2020 to 28/02/2021 (the so called "COVID-19 period") and the demographic and clinical characteristics of patients who required UPCs in the 12-months period, comparing these data with those collected from 01/03/2019 to 29/02/2020 (the so called "pre-COVID-19 period"). The same variables were collected for UPCs carried out in CMHS from 01/03/2020 to 31/01/2021 and compared with those collected from 01/03/2019 to 31/01/2020. The data, were statistically analyzed through STATA 12-2011. RESULTS In ER, we reported a 24% reduction in UPCs during the COVID-19 period (n = 909) in comparison with the pre-COVID-19 period (n = 1,194). Differently, we observed an increase of 4% in UPCs carried out in CMHS during the COVID-19 period (n = 1,214) in comparison with the previous period (n = 1,162). We observed an increase of UPCs in ER required by people who lived in psychiatric facilities or with disability pension whereas more UPCs in CMHS were required by older people or those living in other institutions compared to the previous period. In the COVID-19 period, the most frequent reasons for UPCs in ER were aggressiveness, socio-environmental maladjustment and psychiatric symptoms in organic disorders whereas in CMHS we reported an increase of UPCs for control of psychopharmacology therapy and mixed state/mania. CONCLUSION In light of our findings, we conclude that the most vulnerable people required more frequent attention and care in both ER and CMHS during pandemic, which disrupted individuals' ability to adapt and induced many stressful reactive symptoms. In order to reduce the impact of the COVID-19 pandemic on mental health, psychological support interventions for the general population should be implemented, having particular regard for more psychologically fragile people.
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Affiliation(s)
- Rosaria Di Lorenzo
- Service of Psychiatric Diagnosis and Care, Department of Mental Health and Pathological Addictions, AUSL Modena, Modena, Italy
| | - Margherita Pinelli
- Community Mental Health Service, Department of Mental Health and Pathological Addictions, AUSL Reggio Emilia, Reggio Emilia, Italy
| | - Davide Bertani
- School of Psychiatry, University of Modena and Reggio Emilia, Modena, Italy
| | - Anna Cutino
- School of Psychiatry, University of Modena and Reggio Emilia, Modena, Italy
| | - Diego Dragone
- School of Psychiatry, University of Modena and Reggio Emilia, Modena, Italy
| | - Claudia Elia
- School of Nursing, University of Modena and Reggio Emilia, Modena, Italy
| | - Riccardo Farina
- School of Psychiatry, University of Modena and Reggio Emilia, Modena, Italy
| | - Gianluca Fiore
- School of Psychiatry, University of Modena and Reggio Emilia, Modena, Italy
| | - Filippa Luisi
- School of Psychiatry, University of Modena and Reggio Emilia, Modena, Italy
| | - Sofia Panico
- School of Nursing, University of Modena and Reggio Emilia, Modena, Italy
| | - Laura Valeo
- School of Psychiatry, University of Modena and Reggio Emilia, Modena, Italy
| | - Sergio Rovesti
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Paola Ferri
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
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Sodeyama N, Tachikawa H, Takahashi S, Aiba M, Haraguchi Y, Arai T. The Mental Health of Long-Term Evacuees outside Fukushima Prefecture after the Great East Japan Earthquake. TOHOKU J EXP MED 2022; 257:261-271. [DOI: 10.1620/tjem.2022.j038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Noriko Sodeyama
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba
| | - Hirokazu Tachikawa
- Department of Disaster and Community Psychiatry, Faculty of Medicine, University of Tsukuba
| | - Sho Takahashi
- Department of Disaster and Community Psychiatry, Faculty of Medicine, University of Tsukuba
| | - Miyuki Aiba
- Faculty of Human Sciences, Toyo Gakuen University
| | - Yayoi Haraguchi
- College of Humanities and Social Sciences, Ibaraki University
| | - Tetsuaki Arai
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba
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Parekh VK, Swartz KL. Lessons for psychiatrists from the COVID pandemic: the need for expanded roles and additional competencies. Int Rev Psychiatry 2021; 33:668-676. [PMID: 35412423 DOI: 10.1080/09540261.2021.2011709] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The disaster of the COVID-19 pandemic has fundamentally changed the norms of psychiatric practice: from its methods of care delivery to its methods of practice. Traditional methods of care delivery using in-person visits became impractical or unsafe. Meanwhile, the pandemic has resulted in an increased demand for services. The resulting pivot to telepsychiatry required a skillset that was not a part of traditional psychiatry training. To meet the demand for services, many providers needed to join collaborative models of care to help scale their expertise. Although many innovative collaborative models of care exist, providers remain in their traditional consultative roles within many of those models. In a disaster, when there is an expanding mental health care need in the population, psychiatrists need to adapt their practice to meet expanded roles that naturally build on their usual ones. We explore the expanded roles that psychiatrists will need to fill based on what is known about the field of disaster mental health and principles from Psychological First Aid (PFA). In preparation for a new normal, in what George Everly describes as a 'disaster of uncertainty,' we propose evolutions in the way psychiatrists are trained. Specific training on telepsychiatry best practices will prepare psychiatrists to use this method most effectively and appropriately. Additional training should focus on the core competencies of disaster psychiatry: effective crisis leadership and strategic planning, disaster surveillance, knowledge of benign vs. concerning symptoms, psychological triage, implementation of crisis interventions, resource facilitation, crisis communication, and self and peer care. Developing and integrating these competencies into psychiatry training programs will best prepare psychiatrists for the expanding mental health care needs of the community in this ongoing disaster and future ones.
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Affiliation(s)
- Vinay K Parekh
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins Hospital, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Karen L Swartz
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins Hospital, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Langhammer T, Hilbert K, Praxl B, Kirschbaum C, Ertle A, Asbrand J, Lueken U. Mental health trajectories of individuals and families following the COVID-19 pandemic: Study protocol of a longitudinal investigation and prevention program. MENTAL HEALTH & PREVENTION 2021; 24:200221. [PMID: 34608431 PMCID: PMC8482555 DOI: 10.1016/j.mhp.2021.200221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 09/21/2021] [Indexed: 01/23/2023]
Abstract
Introduction Many adults, adolescents and children are suffering from persistent stress symptoms in the face of the COVID-19 pandemic. This study aims to characterize long-term trajectories of mental health and to reduce the transition to manifest mental disorders by means of a stepped care program for indicated prevention. Methods and analysis Using a prospective-longitudinal design, we will assess the mental strain of the pandemic using the Patient Health Questionnaire, Strength and Difficulties Questionnaire and Spence Child Anxiety Scale. Hair samples will be collected to assess cortisol as a biological stress marker of the previous months. Additionally, we will implement a stepped-care program with online- and face-to-face-interventions for adults, adolescents, and children. After that we will assess long-term trajectories of mental health at 6, 12, and 24 months follow-up. The primary outcome will be psychological distress (depression, anxiety and somatoform symptoms). Data will be analyzed with general linear model and machine learning. This study will contribute to the understanding of the impact of the COVID-19 pandemic on mental health. The evaluation of the stepped-care program and longitudinal investigation will inform clinicians and mental health stakeholders on populations at risk, disease trajectories and the sufficiency of indicated prevention to ameliorate the mental strain of the pandemic. Ethics and dissemination The study is performed according to the Declaration of Helsinki and was approved by the Ethics Committee of the Department of Psychology at the Humboldt Universität zu Berlin (no. 2020-35). Trial registration number DRKS00023220.
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Affiliation(s)
- Till Langhammer
- Department of Psychology, Faculty of Life Sciences, Humboldt-Universität zu Berlin, Unter den Linden 6, Berlin 10099, Germany
| | - Kevin Hilbert
- Department of Psychology, Faculty of Life Sciences, Humboldt-Universität zu Berlin, Unter den Linden 6, Berlin 10099, Germany
| | - Berit Praxl
- Department of Psychology, Faculty of Life Sciences, Humboldt-Universität zu Berlin, Unter den Linden 6, Berlin 10099, Germany
| | - Clemens Kirschbaum
- Department of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Andrea Ertle
- Department of Psychology, Faculty of Life Sciences, Humboldt-Universität zu Berlin, Unter den Linden 6, Berlin 10099, Germany
| | - Julia Asbrand
- Department of Psychology, Faculty of Life Sciences, Humboldt-Universität zu Berlin, Unter den Linden 6, Berlin 10099, Germany
| | - Ulrike Lueken
- Department of Psychology, Faculty of Life Sciences, Humboldt-Universität zu Berlin, Unter den Linden 6, Berlin 10099, Germany
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Kyutoku Y, Dan I, Yamashina M, Komiyama R, Liegey‐Dougall AJ. Trajectories of Posttraumatic Growth and Their Associations With Quality of Life After the 2011 Tohoku Earthquake and Tsunami. J Trauma Stress 2021; 34:512-525. [PMID: 33227166 PMCID: PMC8246896 DOI: 10.1002/jts.22628] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 10/12/2020] [Accepted: 10/24/2020] [Indexed: 11/07/2022]
Abstract
The 2011 Tohoku earthquake and tsunami in Japan was an extraordinarily stressful incident that caused harmful psychological reactions, such as posttraumatic stress disorder (PTSD), among affected individuals. However, a proportion of exposed individuals experienced posttraumatic growth (PTG), characterized by a noticeable degree of personal strength, spirituality, life appreciation, perception of new possibilities in life, and enhanced relationships with others. Some researchers have argued that these positive reactions may be an illusory change related to coping with traumatic events. We examined trajectory patterns related to PTG Inventory (PTGI) subscales to elucidate the existence of both real and illusory growth regarding quality of life (QoL), utilizing group-based trajectory models. Three online questionnaires were distributed at 6 months (N = 2,554; M age = 47.04 years, SD = 12.62), 12 months (N = 887; M age = 48.11 years, SD = 12.43), and 42 months (N = 560; M age = 48.86 years, SD = 12.25) postdisaster. Participants responded to items related to demographic characteristics, disaster experiences, posttraumatic stress symptoms, PTG, and QoL. Three main PTG trajectories emerged, characterized by growth, no growth, and illusory growth, with QoL as a time invariant covariate. Compared with the growth trajectory, the odds ratios (ORs) for no growth ranged from 2.27 to 5.04; for illusory growth, the ORs ranged from 2.09 to 4.67. To our knowledge, this was the first study to report growth trajectories related to PTGI subscales and their underlying differences in psychological mechanisms and processes following the 2011 Tohoku earthquake and tsunami.
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Affiliation(s)
- Yasushi Kyutoku
- Research and Development InitiativeChuo UniversityTokyoJapan
| | - Ippeita Dan
- Department of Integrated Science and Engineering for Sustainable Societies, Faculty of Science and EngineeringChuo UniversityTokyoJapan
| | - Mitsuru Yamashina
- Department of Psychology, Faculty of LettersChuo UniversityTokyoJapan
| | - Ren Komiyama
- Department of Integrated Science and Engineering for Sustainable Societies, Faculty of Science and EngineeringChuo UniversityTokyoJapan
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14
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Baldaçara L, da Silva AG, Pereira LA, Malloy-Diniz L, Tung TC. The Management of Psychiatric Emergencies in Situations of Public Calamity. Front Psychiatry 2021; 12:556792. [PMID: 33643085 PMCID: PMC7905390 DOI: 10.3389/fpsyt.2021.556792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 01/04/2021] [Indexed: 11/16/2022] Open
Abstract
The prevalence of mental health problems in the general population during a public calamity is high. In calamities, the number of patients who present with mental disorder outbreaks or crises may increase, but the necessary support systems to help them may be impaired if they have not been planned for. Although there are several models for addressing psychiatric emergencies, the general rules are the same, especially when it comes to making these services easily available to the affected population. In this article, we seek to review and present recommendations for the management of psychiatric emergencies in situations of public calamity, including disasters, physical and medical catastrophes, epidemics, and pandemics.
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Affiliation(s)
- Leonardo Baldaçara
- Associação Brasileira de Psiquiatria, Rio de Janeiro, Brazil.,Medicine, Universidade Federal do Tocantins, Palmas, Brazil
| | - Antônio Geraldo da Silva
- Associação Brasileira de Psiquiatria, Rio de Janeiro, Brazil.,Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Lucas Alves Pereira
- Associação Brasileira de Psiquiatria, Rio de Janeiro, Brazil.,Departamento de Psiquiatria, Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
| | - Leandro Malloy-Diniz
- Mental Health Department, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,Psychology Department, Universidade FUMEC, Belo Horizonte, Brazil
| | - Teng Chei Tung
- Associação Brasileira de Psiquiatria, Rio de Janeiro, Brazil.,Universidade de São Paulo, São Paulo, Brazil
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15
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Hasson-Ohayon I, Lysaker PH. Special challenges in psychotherapy continuation and adaption for persons with schizophrenia in the age of coronavirus (COVID-19). COUNSELLING PSYCHOLOGY QUARTERLY 2020. [DOI: 10.1080/09515070.2020.1781595] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
| | - Paul H. Lysaker
- Department of Psychiatry, Roudebush, VA Medical Center, USA
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, USA
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16
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Inchausti F, MacBeth A, Hasson-Ohayon I, Dimaggio G. Psychological Intervention and COVID-19: What We Know So Far and What We Can Do. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2020; 50:243-250. [PMID: 32836375 PMCID: PMC7250659 DOI: 10.1007/s10879-020-09460-w] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The coronavirus COVID-19 and the global pandemic has already had a substantial disruptive impact on society, posing major challenges to the provision of mental health services in a time of crisis, and carrying the spectre of an increased burden to mental health, both in terms of existing psychiatric disorder, and emerging psychological distress from the pandemic. In this paper we provide a framework for understanding the key challenges for psychologically informed mental health care during and beyond the pandemic. We identify three groups that can benefit from psychological approaches to mental health, and/or interventions relating to COVID-19. These are (i) healthcare workers engaged in frontline response to the pandemic and their patients; (ii) individuals who will experience the emergence of new mental health distress as a function of being diagnosed with COVID-19, or losing family and loved ones to the illness, or the psychological effects of prolonged social distancing; and (iii) individuals with existing mental health conditions who are either diagnosed with COVID-19 or whose experience of social distancing exacerbates existing vulnerabilities. Drawing on existing literature and our own experience of adapting treatments to the crisis we suggest a number of salient points to consider in identifying risks and offering support to all three groups. We also offer a number of practical and technical considerations for working psychotherapeutically with existing patients where COVID-19 restrictions have forced a move to online or technologically mediated delivery of psychological interventions.
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Affiliation(s)
- Felix Inchausti
- Department of Mental Health, Servicio Riojano de Salud, Logroño, Spain
- Centro de Salud Espartero, Unidad de Salud Mental Infanto-Juvenil, Avda. Pío XII, 12 Bis, 26003 Logroño, La Rioja Spain
| | - Angus MacBeth
- Centre for Applied Developmental Psychology, Clinical and Health Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, Scotland
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17
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Jang M, Lee SH, Kim LJ. Post-traumatic stress disorder and behavioral problems of parents and children after the 2015 Nepal earthquakes. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2020. [DOI: 10.1080/00207411.2020.1725719] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Mikyung Jang
- Department of Child Welfare, Namseoul University, Chungnam, Republic of Korea
| | - Se-hwa Lee
- Department of Child Welfare, Namseoul University, Chungnam, Republic of Korea
| | - Lee-jin Kim
- Department of Child Studies, Jon-Buk University, Chonbuk, Republic of Korea
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18
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Rossi R, Socci V, Gregori E, Talevi D, Collazzoni A, Pacitti F, Stratta P, Rossi A, Di Lorenzo G. ResilienCity: Resilience and Psychotic-Like Experiences 10 Years After L'Aquila Earthquake. Front Psychiatry 2020; 11:77. [PMID: 32180736 PMCID: PMC7059251 DOI: 10.3389/fpsyt.2020.00077] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 01/31/2020] [Indexed: 12/15/2022] Open
Abstract
An earthquake hit the city of L'Aquila in central Italy in 2009, leaving the city completely destroyed and 309 casualties. Unexpectedly, lower rates of psychotic experiences in persons affected by the earthquake compared to non-affected persons were found 10 months after the earthquake. The very long-term impact of a natural disaster on the prevalence of psychotic experiences deserves more in-depth detailing. The Authors examined resilience and psychotic experiences in a university student sample of 494. No effect of direct exposure to the earthquake (odds ratio = 0.64, 95%CI [0.37, 1.11]), material damages (odds ratio = 0.86, 95%CI [0.60, 1.23]), psychological suffering (odds ratio = 1.06, 95% CI [0.83, 1.36]), or global impact severity (odds ratio = 0.92, 95%CI [0.76, 1.12]) on psychotic experiences was detected. Resilience levels did not differ between affected and non-affected persons. Resilience showed a strong protective effect on psychotic experiences (odds ratio=0.38, 95% CI [0.28, 0.51]. The protective effect of the RSA factor "Perception of Self" was significantly stronger in individuals affected by the earthquake compared to non-affected subjects. Being affected by an earthquake is not a risk factor for psychotic experiences in a university student sample, as no direct effect of the earthquake was detected after 10 years after the event. Resilience is confirmed as a strong protective factor for psychotic experiences irrespectively of large collective traumatic events. Extension of these results to a general population sample could provide interesting insights into recovery from natural disasters.
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Affiliation(s)
- Rodolfo Rossi
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Valentina Socci
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy
| | - Eleonora Gregori
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy
| | - Dalila Talevi
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy
| | - Alberto Collazzoni
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy
| | - Francesca Pacitti
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy
| | - Paolo Stratta
- Department of Mental Health, ASL1 Abruzzo, L'Aquila, Italy
| | - Alessandro Rossi
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy
| | - Giorgio Di Lorenzo
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
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19
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Tai YM, Lin MW, Tsai CW, Hsu CC, Kao LC, Yang SN. Critical incident stress debriefing for frontline military rescuers in a helicopter crash disaster in Taiwan: A preliminary report. TAIWANESE JOURNAL OF PSYCHIATRY 2020. [DOI: 10.4103/tpsy.tpsy_14_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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20
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Moosavi S, Nwaka B, Akinjise I, Corbett SE, Chue P, Greenshaw AJ, Silverstone PH, Li XM, Agyapong VIO. Mental Health Effects in Primary Care Patients 18 Months After a Major Wildfire in Fort McMurray: Risk Increased by Social Demographic Issues, Clinical Antecedents, and Degree of Fire Exposure. Front Psychiatry 2019; 10:683. [PMID: 31620033 PMCID: PMC6760025 DOI: 10.3389/fpsyt.2019.00683] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 08/23/2019] [Indexed: 11/13/2022] Open
Abstract
Objectives: To assess prevalence of likely posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD) in patients attending the only out-of-hours primary care clinic in Fort McMurray some 18 months following a major fire. Methods: A quantitative cross-sectional survey was used to collect data through self-administered paper-based questionnaires to determine likely PTSD, MDD, and GAD using the PTSD Checklists for Diagnostic and Statistical Manual (DSM) 5, Patient Health Questionnaire (PHQ) 9, and GAD-7, respectively, from residents of Fort McMurray who were impacted by the wildfires. This was carried out eighteen (18) months after a major wildfire, which required the rapid evacuation of the entire city population (approximately 90,000 individuals). Results: We achieved a response rate of 48% and results from the 290 respondents showed the 1 month prevalence rate for likely PTSD was 13.6%, likely MDD was 24.8%, and likely GAD was 18.0%. Compared to self-reported prevalence rates before the wildfire (0%, 15.2%, and 14.5% respectively), these were increased for all diagnoses. After controlling for other factors in a logistic regression model, there were statistically significant associations between individuals who had likely PTSD, MDD, and GAD diagnoses and multiple socio-demographic, clinical, and exposure-related variables as follows: PTSD: History of anxiety disorder and received counselling had odds ratios (ORs) of 5.80 and 7.14, respectively. MDD: Age, witnessed the burning of homes, history of depressive disorder, and receiving low level support from friends and family had ORs of 2.08, 2.29, 4.63, and 2.5, respectively. GAD: Fearful for their lives or the lives of friends/family, history of depressive disorder, and history of anxiety disorder had ORs of 3.52, 3.04, and 2.68, respectively. There were also associations between individuals with a likely psychiatric diagnosis and those who also had likely alcohol or drug abuse/dependence. Conclusion: Our study suggests there are high prevalence rates for mental health and addiction conditions in patients attending the out-of-hours clinic 18 months after the wildfires, with significant associations between multiple variables and likely PTSD, MDD, and GAD. Further studies are needed to explore the impact of population-based mental health interventions on the long-term mental health effects of the wildfires.
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Affiliation(s)
- Shahram Moosavi
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Bernard Nwaka
- Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Idowu Akinjise
- Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Sandra E. Corbett
- Department of Psychiatry, Northern Lights Regional Health Centre, Fort McMurray, AB, Canada
| | - Pierre Chue
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Andrew J. Greenshaw
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Peter H. Silverstone
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Xin-Min Li
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Vincent I. O. Agyapong
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
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21
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Bevilacqua K, Schneider S, Rasul R, Taioli E, Schwartz RM. Engagement in linkage to mental health care program in the Rockaways after Hurricane Sandy. JOURNAL OF COMMUNITY PSYCHOLOGY 2019; 47:743-756. [PMID: 30597560 PMCID: PMC6590356 DOI: 10.1002/jcop.22150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 10/15/2018] [Accepted: 12/11/2018] [Indexed: 06/09/2023]
Abstract
The Rockaways area of New York City was especially devastated by Hurricane Sandy. This study examined participant characteristics associated with acceptance of a linkage to and attendance at appointments for mental health difficulties (MHD). Participants (N = 1,011) completed questionnaires to assess mental health symptoms. Participants who met screening criteria (n = 442) were offered linkage to care. Individuals who had a higher mental health symptom burden (MHSB; i.e., those who screened in on more than one criteria vs. only one criterion) had 2.68 greater odds of accepting services (95% confidence interval [1.68, 4.26]). MHSB was not associated with attending a first appointment (p = 0.80). Female gender and Hispanic ethnicity were also associated with acceptance of linkage to care, though not attendance. Reducing stigma around MHD associated with natural disasters and increasing knowledge about the mental health care system could promote help-seeking behavior among survivors.
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Affiliation(s)
- Kristin Bevilacqua
- Department of Occupational MedicineEpidemiology and Prevention, Northwell Health
- Joint Center for Disaster HealthTrauma and Resilience
| | - Samantha Schneider
- Department of Occupational MedicineEpidemiology and Prevention, Northwell Health
- Joint Center for Disaster HealthTrauma and Resilience
| | - Rehana Rasul
- Department of Occupational MedicineEpidemiology and Prevention, Northwell Health
- Joint Center for Disaster HealthTrauma and Resilience
- Department of BiostatisticsNorthwell Health
| | - Emanuela Taioli
- Joint Center for Disaster HealthTrauma and Resilience
- Institute of Translational Epidemiology, Department of Population Health Science and PolicyThe Icahn School of Medicine at Mount Sinai
| | - Rebecca M. Schwartz
- Department of Occupational MedicineEpidemiology and Prevention, Northwell Health
- Joint Center for Disaster HealthTrauma and Resilience
- Institute of Translational Epidemiology, Department of Population Health Science and PolicyThe Icahn School of Medicine at Mount Sinai
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
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22
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Massazza A, Joffe H, Brewin CR. Earthquakes, attributions, and psychopathology: a study in a rural community. Eur J Psychotraumatol 2019; 10:1661813. [PMID: 31528272 PMCID: PMC6735336 DOI: 10.1080/20008198.2019.1661813] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 08/16/2019] [Accepted: 08/20/2019] [Indexed: 11/24/2022] Open
Abstract
Background: Attributions of both cause and blame form part of the diagnostic criteria for PTSD in DSM-5. Most work on attributions and psychopathology has focused on survivors of interpersonal violence and the two types of attribution have not been investigated together in natural disaster contexts. Previous work has identified that attributions to God's role may be associated with survivors' mental health following disasters. We studied the relation between attributions to God and other actors/entities in a rural community with high levels of religiosity that had suffered extensive damage and loss of life due to a series of earthquakes. Methods: A sample of survivors (N = 127) was assessed for degree of earthquake exposure, resource loss, attributions of cause and blame for the earthquake damage, and psychopathology three months after a series of major earthquakes in Italy. Results: Nature and chance were associated with higher cause than blame attributions whereas the State, the municipality, building firms, and the mafia were associated with higher blame than cause attributions. Additionally, both cause and blame attributions towards God and chance were positively correlated with PTSD and psychological distress symptoms. These associations remained significant while controlling for degree of earthquake exposure, resource loss, gender, age, and education. Conclusion: The current study supports the role played by cognitions about the cause of traumatic events, as introduced into the PTSD diagnosis in DSM-5, and extends this to blame of other entities such as God and chance following disasters.
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Affiliation(s)
- Alessandro Massazza
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Helene Joffe
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Chris R Brewin
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
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23
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Sakuma A, Ueda I, Rengi S, Shingai T, Matsuoka H, Matsumoto K. Increase in the number of admissions to psychiatric hospitals immediately after the Great East Japan Earthquake. Asia Pac Psychiatry 2018; 10:e12307. [PMID: 29285896 PMCID: PMC6175335 DOI: 10.1111/appy.12307] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 09/17/2017] [Accepted: 12/04/2017] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Major natural disasters have a significant impact on the mental health of survivors in affected communities. Although it has been speculated that the number of survivors requiring admission to psychiatric hospital increases immediately after a major disaster, few studies have examined the issue. METHODS On March 11, 2011, the Great East Japan Earthquake and subsequent tsunami devastated the relatively isolated city of Kesennuma. We therefore compared the weekly number of patients admitted to 2 psychiatric hospitals in Kesennuma in the 4 weeks immediately after the earthquake with those in the 4 weeks immediately preceding the earthquake. We also made comparisons between this 8-week period and the corresponding 8-week periods in 2009, 2010, and 2012. RESULTS The number of patients admitted to the 2 psychiatric hospitals increased in 4 weeks after the disaster in 2011, with a weekly median (range) of 13 (9-16), compared with 6 (5-9) in the preceding 4 weeks in 2011. The corresponding figures were 5.5 (2-10) in 2009, 6.5 (5-9) in 2010, and 4 (3-7) in 2012 (P = .01, H = 13.05). By diagnostic category, admissions for schizophrenia spectrum disorder and neurotic stress-related disorder increased significantly following the disaster. DISCUSSION Demands for inpatient psychiatric treatment increased immediately after the Great East Japan Earthquake. Government officials and mental health professionals must strengthen support for survivors with mental illness, especially those with schizophrenia spectrum disorder. This should include support for mental health authorities and medical staff in the affected community.
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Affiliation(s)
- Atsushi Sakuma
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan.,Miyagi Disaster Mental Health Care Center, Kesennuma, Japan
| | - Ikki Ueda
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan.,Miyagi Disaster Mental Health Care Center, Kesennuma, Japan
| | - Shigehito Rengi
- Department of Psychiatry, Mitsumine Hospital, Kesennuma, Japan
| | - Toshiyasu Shingai
- Department of Psychiatry, Hikarigaoka-Hoyouen Hospital, Kesennuma, Japan
| | - Hiroo Matsuoka
- Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kazunori Matsumoto
- Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan.,Department of Preventive Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
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Lee JY, Kim SW, Bae KY, Kim JM, Shin IS, Yoon JS. Factors associated with posttraumatic stress disorder symptoms among community volunteers during the Sewol ferry disaster in Korea. Compr Psychiatry 2017; 77:38-44. [PMID: 28605622 DOI: 10.1016/j.comppsych.2017.05.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 05/01/2017] [Accepted: 05/30/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The aim of this study was to investigate the characteristics associated with volunteerism and identify the factors that contributed to posttraumatic stress disorder symptoms among community volunteers following the Sewol ferry disaster in Korea. METHODS In total, 2,298 adults (aged 30-70 years) from the Jin-do area, where the Sewol ferry disaster occurred, participated in this study. A cross-sectional survey was conducted 1 month after the disaster. Posttraumatic stress disorder (PTSD), depression, and anxiety symptoms were assessed using the Impact of Events Scale Revised (IES-R), Center for Epidemiologic Studies Depression Scale (CES-D), and Beck Anxiety Inventory (BAI). RESULTS Clinically relevant PTSD symptoms were observed in 151 (19.7%) community volunteers. Age, education, socioeconomic status, religion, and lifetime experiences of natural disasters were associated with volunteering following the disaster. Logistic regression analysis revealed that volunteering was a significant risk factor for the development of PTSD symptoms in this sample. Personal experience with property damage associated with a traumatic event, depression, and anxiety were also significantly associated with the PTSD symptoms of community volunteers. CONCLUSIONS Our results suggest the need for assessment and mental health programs for community volunteers performing rescue work to prevent posttraumatic stress symptoms following a community disaster.
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Affiliation(s)
- Ju-Yeon Lee
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.
| | - Kyung-Yeol Bae
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Il-Seon Shin
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jin-Sang Yoon
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
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25
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Wong CH, Sultan Shah ZUB, Teng CL, Lin TQ, Majeed ZA, Chan CW. A systematic review of anxiety prevalence in adults within primary care and community settings in Malaysia. Asian J Psychiatr 2016; 24:110-117. [PMID: 27931891 DOI: 10.1016/j.ajp.2016.08.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 08/27/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Anxiety disorders are common mental health disorders with significant impact on the individual as well as burden on the country as a whole. METHODS A systematic review of databases, reference lists, internet sources, and input from content experts revealed 42 studies that documented the prevalence of anxiety symptoms or disorders. 12 of these studies specifically evaluated anxiety disorders. RESULTS 4 studies looked at the prevalence of anxiety disorders in the general population, whilst the remainder focused on selected population groups: university students (4 studies); substance abuse (3 studies); and victims of abuse (1 study). Studies in the general population showed that the prevalence of generalised anxiety disorder was 0.4-5.6%, mixed anxiety and depression were 3-5%, panic without agoraphobia 0.4%, phobia unspecified 0.5-%, and anxiety not-otherwise-specified 0.3-6.5%. We found significant variability in anxiety disorders in the studies in selected population groups. The variability could also have been affected by methodological factors within each study. CONCLUSION This study provides a broad overview of the prevalence of anxiety disorders in Malaysia. More research is required to develop diagnostic instruments that are validated for local use and comparable with international standards. Reliable prevalence estimates are lacking within certain groups, e.g. those in rural, indigenous, migrant population groups and those exposed to natural disasters.
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Affiliation(s)
- Chin Hoong Wong
- Department of Family Medicine, International Medical University, IMU Clinical School, Jalan Rasah, 70300 Seremban, Negeri Sembilan, Malaysia.
| | - Zia U Bakt Sultan Shah
- Department of Family Medicine, International Medical University, IMU Clinical School, Jalan Rasah, 70300 Seremban, Negeri Sembilan, Malaysia.
| | - Cheong Lieng Teng
- Department of Family Medicine, International Medical University, IMU Clinical School, Jalan Rasah, 70300 Seremban, Negeri Sembilan, Malaysia.
| | - Tzi Quen Lin
- IMU Healthcare, International Medical University, No. 126 Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia.
| | - Zainab Abdul Majeed
- Department of Psychiatry, International Medical University, IMU Clinical School, Jalan Rasah, 70300 Seremban, Negeri Sembilan, Malaysia.
| | - Chun Wai Chan
- Department of Family Medicine, International Medical University, IMU Clinical School, Jalan Rasah, 70300 Seremban, Negeri Sembilan, Malaysia.
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Abstract
Extended functional impairment characterized by sick leave and disability after a single disaster has not been documented before. This prospective, longitudinal, case-control study applied growth mixture modeling to predict trajectories of functional impairment in oil rig workers, survivors (n = 68) and a matched comparison group (n = 84), over 27 years after the 1980 North Sea oil rig disaster. In the initial 12 years post-disaster, survivors displayed higher rates of functional impairment than the comparison group. A minor group of survivors (n = 8, 11.8%) demonstrated persistent functional impairment from the start and remained unable to work during the subsequent three decades. Long-term sick leave and disability were related to perceived peritraumatic death threat and a propensity towards social withdrawal. Most survivors (n = 60) revealed no major functional impairment. The study indicates that functional impairment should be counteracted in the early support after a single disaster.
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Abstract
Disaster mental health is based on the principles of 'preventive medicine' This principle has necessitated a paradigm shift from relief centered post-disaster management to a holistic, multi-dimensional integrated community approach of health promotion, disaster prevention, preparedness and mitigation. This has ignited the paradigm shift from curative to preventive aspects of disaster management. This can be understood on the basis of six 'R's such as Readiness (Preparedness), Response (Immediate action), Relief (Sustained rescue work), Rehabilitation (Long term remedial measures using community resources), Recovery (Returning to normalcy) and Resilience (Fostering). Prevalence of mental health problems in disaster affected population is found to be higher by two to three times than that of the general population. Along with the diagnosable mental disorders, affected community also harbours large number of sub-syndromal symptoms. Majority of the acute phase reactions and disorders are self-limiting, whereas long-term phase disorders require assistance from mental health professionals. Role of psychotropic medication is very limited in preventing mental health morbidity. The role of cognitive behaviour therapy (CBT) in mitigating the mental health morbidity appears to be promising. Role of Psychological First Aid (PFA) and debriefing is not well-established. Disaster management is a continuous and integrated cyclical process of planning, organising, coordinating and implementing measures to prevent and to manage disaster effectively. Thus, now it is time to integrate public health principles into disaster mental health.
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Affiliation(s)
- Suresh Bada Math
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, (Institute of National Importance), Bangalore, Karnataka, India
| | | | - Sydney Moirangthem
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, (Institute of National Importance), Bangalore, Karnataka, India
| | - Naveen C. Kumar
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, (Institute of National Importance), Bangalore, Karnataka, India
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Li J, Chow AYM, Shi Z, Chan CLW. Prevalence and risk factors of complicated grief among Sichuan earthquake survivors. J Affect Disord 2015; 175:218-23. [PMID: 25645702 DOI: 10.1016/j.jad.2015.01.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 01/06/2015] [Accepted: 01/06/2015] [Indexed: 10/24/2022]
Abstract
BACKGROUND Disasters usually involves massive casualties, yet few post-disaster studies explore the prevalence of complicated grief (CG) among survivors. Complicated grief is a distinct psychological disorder, and is associated with impaired physical and psychological functions. Given such gap in the literature and the significance of this topic, this study is hoped to offer more information of complicated grief among survivors who lost their loved ones in disaster. Adopting a large scale survey, the prevalence and risk factors of CG among bereaved survivors one year after the Sichuan earthquake in China were explored. METHODS In total 803 bereaved survivors participated the study by filling a questionnaire on measuring CG symptoms, posttraumatic stress disorder (PTSD) symptoms, intrapersonal factors, earthquake related factors, bereavement related factors, and an interpersonal factor. RESULTS There were 71.1% of the participants scored higher than the cutoff point of CG symptoms. Close relationship with the deceased, PTSD symptoms, losing means of livelihood, physical injury, and terrifying experience in the earthquake, were identified to be risk factors for CG. LIMITATIONS The study was cross-sectional and the data was collected through a self-reported questionnaire. The sample was recruited from one of the most severely affected counties, thus the generalizability of the results should be interpreted with caution. CONCLUSIONS A large portion of bereaved earthquake survivors suffered from CG symptoms one year after the disaster. Risk factors found in this study can be used to identify high risk groups, who need special care, support, and bereavement interventions.
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Affiliation(s)
- Jie Li
- Department of Psychology, Renmin University of China, China.
| | - Amy Y M Chow
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Zhanbiao Shi
- Institute of Psychology, Chinese Academy of Science, China
| | - Cecilia L W Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
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Rucklidge JJ, Blampied N, Gorman B, Gordon HA, Sole E. Psychological functioning 1 year after a brief intervention using micronutrients to treat stress and anxiety related to the 2011 Christchurch earthquakes: a naturalistic follow-up. Hum Psychopharmacol 2014; 29:230-43. [PMID: 24554519 DOI: 10.1002/hup.2392] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Revised: 12/09/2013] [Accepted: 01/02/2014] [Indexed: 11/05/2022]
Abstract
OBJECTIVE We investigated whether micronutrients given acutely following the Christchurch earthquakes continued to confer benefit 1 year following the treatment. METHODS Sixty-four adults from the original 91 participants experiencing heightened anxiety or stress 2-3 months following the 22nd February 2011 earthquake and who had been randomized to receive three different doses of micronutrients completed on-line questionnaires assessing mood, anxiety, stress, and symptoms associated with post-traumatic stress disorder 1 year after completing the initial study. Twenty-one out of 29 nonrandomized controls who did not receive the treatment also completed the questionnaires. RESULTS Both the treated and control groups experienced significant improvement in psychological functioning compared with end-of-trial. However, treated participants had better long-term outcomes on most measures compared with controls (ES=0.69-1.31). Those who stayed on micronutrients through to follow-up or stopped all treatment reported better psychological functioning than those who switched to other treatments including medications. About 10% of the sample continued to have post-traumatic stress disorder symptoms. CONCLUSIONS Disaster survivors improve psychologically over time regardless of receiving intervention; however, those taking micronutrients during the acute phase following a disaster show better outcomes, identifying micronutrients as a viable treatment for acute stress following a natural disaster with maintenance of benefits 1 year later. ACTRN 12611000460909
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Affiliation(s)
- Julia J Rucklidge
- Department of Psychology, University of Canterbury, Christchurch, New Zealand
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Veronese G, Said MS, Castiglioni M. Family crisis intervention in war contexts: a case study of a traumatised Palestinian family. BRITISH JOURNAL OF GUIDANCE & COUNSELLING 2014. [DOI: 10.1080/03069885.2014.907868] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
INTRODUCTION Planned and organized long-term rehabilitation services should be provided to victims of a disaster for social integration, economic self-sufficiency, and psychological health. There are few studies on recovery and rehabilitation issues in disaster situations. This study explores the disaster-related rehabilitation process. METHOD This study was based on qualitative analysis. Participants included 18 individuals (eight male and ten female) with experience providing or receiving disaster health care or services. Participants were selected using purposeful sampling. Data were collected through in-depth and semi-structured interviews. All interviews were transcribed and content analysis was performed based on qualitative content analysis. RESULTS The study explored three main concepts of recovery and rehabilitation after a disaster: 1) needs for health recovery; 2) intent to delegate responsibility; and 3) desire for a wide scope of social support. The participants of this study indicated that to provide comprehensive recovery services, important basic needs should be considered, including the need for physical rehabilitation, social rehabilitation, and livelihood health; the need for continuity of mental health care; and the need for family re-unification services. Providing social activation can help reintegrate affected people into the community. CONCLUSION Effective rehabilitation care for disaster victims requires a clear definition of the rehabilitation process at different levels of the community. Involving a wide set of those most likely to be affected by the process provides a comprehensive, continuous, culturally sensitive, and family-centered plan.
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Natha F, Daiches A. The Effectiveness of EMDR in Reducing Psychological Distress in Survivors of Natural Disasters: A Review. JOURNAL OF EMDR PRACTICE AND RESEARCH 2014. [DOI: 10.1891/1933-3196.8.3.157] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Natural disasters affect whole communities both at an individual level as well as economically and socially. However, the impact of natural disasters on an individual’s mental health is substantial; yet, the response to one’s mental health needs after a disaster is underdeveloped. Nevertheless, the Humanitarian Assistance Programme has attempted to address these needs by providing eye movement desensitization and reprocessing (EMDR) to natural disaster survivors. This systematic review provides evidence for the effectiveness and efficacy of EMDR in the treatment of psychological distress in survivors of natural disasters. Of the 8 studies reviewed, 4 were controlled trials and 1 study part-controlled. All the studies demonstrated statistical and clinical significance in reducing posttraumatic stress disorder (PTSD) symptoms, anxiety, depression, and other distress experienced by survivors of natural disasters. In addition, 4 of the 8 studies demonstrated clinical significance after just 1 session, presenting EMDR as resource-, time-, and cost-efficient intervention. Theoretical framework, adaptation in intervention, methodological issues, and quality assessment of studies are discussed. Implications for future research and clinical practice are also discussed.
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Xu Y, Herrman H, Tsutsumi A, Fisher J. Psychological and social consequences of losing a child in a natural or human-made disaster: a review of the evidence. Asia Pac Psychiatry 2013; 5:237-48. [PMID: 23857912 DOI: 10.1111/appy.12013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2012] [Accepted: 09/20/2012] [Indexed: 11/29/2022]
Abstract
Exposure to natural and human-made disasters is associated with long-term health consequences, including for mental health. Parents who have lost children, particularly their only children, in any circumstances are also at increased risk of developing mental health problems. The aim of this study was to review the available evidence about the psychological and social consequences for parents who had faced these circumstances simultaneously through losing children in a disaster. Systematic searching of the English and Chinese language literatures about the psychological and social functioning of bereaved parents after disasters revealed that a small number of studies met inclusion criteria. The results showed that bereaved parents had more mental health problems than bereaved spouses and non-bereaved parents, and mothers appeared to be more vulnerable to mental health problems than fathers. Potential protective factors for bereaved parents' mental health included having psychological interventions, having adequate social support, seeing their children's bodies and having a subsequent baby. Although the literature was modest and methodologically diverse, there was a consistent finding that parents who have lost children in disasters were at high risk of suffering mental health problems, especially bereaved mothers. As there was little evidence, further studies are needed to understand the best advice and interventions to offer bereaved parents and provide enhanced mental health care of such bereaved populations after disasters.
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Affiliation(s)
- Yao Xu
- Center for Women's Health, Gender and Society, Melbourne School of Population Health, University of Melbourne, Melbourne, Victoria, Australia
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Funayama M, Mizushima J. Severity of pre-existing psychiatric illness and response to the Great East Japan Earthquake. J Psychiatr Res 2013; 47:1479-82. [PMID: 23820110 DOI: 10.1016/j.jpsychires.2013.06.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Revised: 06/07/2013] [Accepted: 06/10/2013] [Indexed: 11/26/2022]
Abstract
Reports have described how psychiatric patients respond to disasters. However, previous reports on the response depending on diagnostic categories have provided no clear consensus. Here we analyzed response to the Great East Japan Earthquake of March 11, 2011, among psychiatric patients in light of severity of pre-existing psychiatric illness. We studied psychiatric change among a population of psychiatric outpatients in Tochigi prefecture, located ~160 km (~100 miles) southeast of the Fukushima nuclear power plant, in an area that suffered moderate damage from the earthquake and radiation. A total of 294 psychiatric outpatients was assessed using the Global Assessment of Functioning (GAF-F). A change of ≥10 points in the GAF-F score was counted as a change in symptoms. The data were stratified by disease category, gender, and GAF-F score and analyzed using the Fisher's exact test. In the 2 months after the earthquake, 5.4% of patients showed evidence of a change in symptoms, with 4.1% worsening and 1.4% improving. Compared with patients having a GAF-F score ≤50, significantly more patients with a score >50 showed evidence of worsening symptoms. No significant difference was found with respect to gender or diagnostic category for patients with worsened or improved symptoms. Our findings reveal that a relatively small percent of patients with pre-existing psychiatric diseases showed evidence of a change in symptoms and that patients with mild-to-moderate psychiatric illness are potentially vulnerable to the impacts of a natural disaster.
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Affiliation(s)
- Michitaka Funayama
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, 284-1 Yobe, Ashikaga-city, Tochigi 326-0843, Japan.
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Trifirò G, Italiano D, Alibrandi A, Sini G, Ferrajolo C, Capuano A, Spina E, Rossi A, L'Aquila group. Effects of L'Aquila earthquake on the prescribing pattern of antidepressant and antipsychotic drugs. Int J Clin Pharm 2013; 35:1053-62. [PMID: 24045997 DOI: 10.1007/s11096-013-9822-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2013] [Accepted: 06/27/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Natural disasters provoke an increase in mental and medical disorders in survivors. Monitoring drug prescription changes after natural disasters can provide an indirect evaluation of trauma impact in the population. Moreover, it could be useful to both identify risk categories that require special assistance and assess possible drug abuse or misuse. OBJECTIVE To assess the effects of earthquake that occurred on April 6, 2009 on the use of antidepressant and antipsychotic drugs in the province of L'Aquila. SETTING General population of L'Aquila and Caserta provinces from Southern Italy. METHOD In a retrospective, drug utilization study we identified all the persons who received at least one dispensing of antidepressant and/or antipsychotic drugs during the period April 1st, 2008-March 31st, 2010. MAIN OUTCOME MEASURE The monthly prevalence of use of these drugs, 1 year prior and after the date of earthquake in L'Aquila was compared between the two provinces, L'Aquila and Caserta. All the analyses were stratified by age groups, gender and drug classes. RESULTS We observed an increase in the use of antipsychotic drugs and, to lesser extent, of antidepressant agents (mostly typicals and tryciclics, respectively) in the first 2 months after the earthquake in L'Aquila but not in Caserta. This increase was almost two-fold higher in women older than 75 years. After the first 2 months from the earthquake, the use of antidepressants and antipsychotics was stabilized at the pre-earthquake levels in L'Aquila. CONCLUSION The earthquake determined a short-term increase in the use of antipsychotics (mostly haloperidol and promazine) and, to lesser extent, of antidepressants (i.e. tryciclics), especially in older women of L'Aquila.
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Affiliation(s)
- Gianluca Trifirò
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy,
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Catanesi R, Martino V, Candelli C, Troccoli G, Grattagliano I, Vella GD, Carabellese F. Posttraumatic stress disorder: protective and risk factors in 18 survivors of a plane crash. J Forensic Sci 2013; 58:1388-1392. [PMID: 23822214 DOI: 10.1111/1556-4029.12178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Revised: 07/27/2012] [Accepted: 07/29/2012] [Indexed: 10/26/2022]
Abstract
The aim of this study is to identify protective and risk factors related to the development of posttraumatic stress disorder (PTSD) on a sample of survivors from a single plane crash. Eighteen survivors were examined 6 months following the event. The subjects all underwent psychiatric interviews, Clinician-Administered PTSD Scale structured interviews, personality and cognitive tests. Only 38.9% of them presented with all of the symptoms of PTSD; 22.2% showed no symptoms for PTSD; remaining survivors exhibited emotional/affective symptoms related to the event. In addition to the severity of the traumatic event itself, other risk factors identified were the loss of a relative, the manifestation of depressive symptoms, and the severity of physical injuries sustained. Low levels of hostility and high levels of self-efficacy represented protective factors against developing PTSD.
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Affiliation(s)
- Roberto Catanesi
- Section of Criminology and Forensic Psychiatry, University of Bari, P.zza G. Cesare, 70124, Bari, Italy
| | - Vito Martino
- Section of Psychiatry, University of Bari, P.zza G. Cesare, 70124, Bari, Italy
| | - Chiara Candelli
- Section of Criminology and Forensic Psychiatry, University of Bari, P.zza G. Cesare, 70124, Bari, Italy
| | | | - Ignazio Grattagliano
- Section of Criminology and Forensic Psychiatry, University of Bari, P.zza G. Cesare, 70124, Bari, Italy
| | - Giancarlo Di Vella
- Section of Legal Medicine, University of Bari, P.zza G. Cesare, 70124, Bari, Italy
| | - Felice Carabellese
- Section of Criminology and Forensic Psychiatry, University of Bari, P.zza G. Cesare, 70124, Bari, Italy
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Farhoudian A, Hajebi A, Bahramnejad A, Katz CL. The perspective of psychosocial support a decade after Bam earthquake: achievements and challenges. Psychiatr Clin North Am 2013; 36:385-402. [PMID: 23954054 DOI: 10.1016/j.psc.2013.05.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The 2003 Bam earthquake was one of the most catastrophic disasters to have struck Iran. This article summarizes the short-term and long-term psychological, social, and economic impacts of the Bam earthquake on survivors across a decade since its occurrence. Identification and definition of capability as well as recognizing the nature and extent of personal and social capabilities in a community are priceless in preventing disasters and reducing their consequent destruction.
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Affiliation(s)
- Ali Farhoudian
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran 1985713834, Iran
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The impact of the Great East Japan earthquake on mandatory psychiatric emergency hospitalizations in Tokyo: a retrospective observational study. Transl Psychiatry 2012; 2:e168. [PMID: 23032944 PMCID: PMC3565828 DOI: 10.1038/tp.2012.98] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
On 11 March 2011, the eastern part of Japan was struck by a magnitude 9.0 quake. About 20 000 people were killed or were missing, and a nuclear crisis followed. In Tokyo, people were indirectly exposed to the earthquake and nuclear crisis by TV broadcast. The aim of our study was to evaluate the potential effect of the series of catastrophes on psychiatric emergency hospitalizations in Tokyo. Clinical records of patients who were mandatorily admitted to Tokyo Metropolitan Matsuzawa Hospital by law because of urgent risk to self or others were reviewed. Records regarding the 2 years of investigation, which include the 6 months after the earthquake, were reviewed. The six months after the earthquake were compared with the eighteen months before the earthquake in clinical and demographic data using independent t-tests or χ(2) tests. During the 6 months before and after the earthquake, 97 and 127 people were mandatorily admitted. χ(2) Tests demonstrated a significant increase in the number of patients after the earthquake (P = 0.045), attributable to the significant increase in the number of patients with schizophrenia after the earthquake (P = 0.011, 32 vs 56), whereas there were no significant differences in the number of patients with other diagnoses between those two periods. Independent t-tests revealed that patients admitted after the earthquake had marginally significantly shorter periods of education compared with those admitted before the earthquake (13.78 vs 12.82 years, P = 0.084). This work suggests that patients with schizophrenia were more sensitive to indirect exposure to the earthquake and that a shorter period of education was a potential risk factor.
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Rate of prescription of antidepressant and anxiolytic drugs after Cyclone Yasi in North Queensland. Prehosp Disaster Med 2012; 27:519-23. [PMID: 23009700 DOI: 10.1017/s1049023x12001392] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
INTRODUCTION The need to manage psychological symptoms after disasters can result in an increase in the prescription of psychotropic drugs, including antidepressants and anxiolytics. Therefore, an increase in the prescription of antidepressants and anxiolytics could be an indicator of general psychological distress in the community. PURPOSE The purpose of this study was to determine if there was a change in the rate of prescription of antidepressant and anxiolytic drugs following Cyclone Yasi. METHODS A quantitative evaluation of new prescriptions of antidepressants and anxiolytics was conducted. The total number of new prescriptions for these drugs was calculated for the period six months after the cyclone and compared with the same six month period in the preceding year. Two control drugs were also included to rule out changes in the general rate of drug prescription in the affected communities. RESULTS After Cyclone Yasi, there was an increase in the prescription of antidepressant drugs across all age and gender groups in the affected communities except for males 14-54 years of age. The prescription of anxiolytic drugs decreased immediately after the cyclone, but increased by the end of the six-month post-cyclone period. Control drug prescription did not change. CONCLUSION There was a quantifiable increase in the prescription of antidepressant drugs following Cyclone Yasi that may indicate an increase in psychosocial distress in the community.
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Kienzler H, Pedersen D. Strange but common bedfellows: the relationship between humanitarians and the military in developing psychosocial interventions for civilian populations affected by armed conflict. Transcult Psychiatry 2012; 49:492-518. [PMID: 22722981 DOI: 10.1177/1363461512447927] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This essay analyses how the relationships between Cold War and post-Cold War politics, military psychiatry, humanitarian aid and mental health interventions in war and post-war contexts have transformed over time. It focuses on the restrictions imposed on humanitarian interventions and aid during the Cold War; the politics leading to the transfer of the PTSD diagnosis and its treatment from the military to civilian populations; humanitarian intervention campaigns in the post-Cold War era; and the development of psychosocial intervention programs and standards of care for civilian populations affected by armed conflict. Viewing these developments in their broader historical, political and social contexts reveals the politics behind mental health interventions conducted in countries and populations affected by warfare. In such militarized contexts, the work of NGOs providing assistance to people suffering from trauma-related health problems is far from neutral as it depends on the support of the military and plays an important role in the shaping of international politics and humanitarian aid programs.
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Affiliation(s)
- Hanna Kienzler
- Douglas Mental Health University Institute, McGill University, 6875 LaSalle Boulevard, Montreal, QC, Canada.
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Pollice R, Bianchini V, di Mauro S, Mazza M, Verni L, Roncone R, Casacchia M. Cognitive function and clinical symptoms in first-episode psychosis and chronic schizophrenia before and after the 2009 L'Aquila earthquake. Early Interv Psychiatry 2012; 6:153-8. [PMID: 22171738 DOI: 10.1111/j.1751-7893.2011.00319.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
AIM On 6 April 2009, at 3:32 GMT, central Italy was struck by a 6.3-magnitude earthquake with its epicentre near L'Aquila, the capital city of the Abruzzo region. Earthquakes may precipitate psychiatric symptoms. The aim of this study was to investigate cognitive functioning and positive and negative symptoms before and after the 2009 L'Aquila earthquake in patients with first-episode psychosis (FEP) and chronic schizophrenia (CS). METHODS A total of 54 FEP patients (34 males and 20 females) and 63 CS patients (39 males and 24 females) were investigated. Psychometric scores were submitted to a 2 × 2 mixed analysis of variance, with group (FEP and CS) as the between-subjects variable and time (pre- and post-earthquake) as the within-subjects variable. RESULTS Positive symptoms increased significantly from the pre- to the post-earthquake assessment in FEP patients but not in those with CS. There were no significant differences between the pre- and post-earthquake period in terms of negative symptoms in both groups. Compared with the pre-earthquake assessment, FEP patients scored significantly worse at the post-earthquake evaluation in terms of Wisconsin Card Sorting Test categories achieved, immediate verbal memory and delayed verbal memory. However, there were no significant differences in cognitive scores between the pre- and post-earthquake periods in patients with CS. CONCLUSIONS Our findings suggest that a disastrous earthquake has a negative impact on cognitive functioning and positive symptoms in FEP patients, but not in those with CS.
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Affiliation(s)
- Rocco Pollice
- Department of Health Sciences, University of L'Aquila, San Salvatore Hospital, L'Aquila, Italy.
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James LE, Noel JR, Favorite TK, Jean JS. Challenges of Postdisaster Intervention in Cultural Context: The Implementation of a Lay Mental Health Worker Project in Postearthquake Haiti. ACTA ACUST UNITED AC 2012. [DOI: 10.1037/a0028321] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Recent disasters have incited controversy regarding whether and how Western psychology can contribute to postdisaster mental health care across cultures. Drawing from experience implementing a Haitian–United States collaborative intervention for displaced earthquake survivors in Port-au-Prince, we propose that when a model is culturally compatible, participants may benefit from both indigenous and Western psychological perspectives simultaneously, even if these approaches are not entirely congruent. We describe the theoretical basis and development of this train-the-trainer lay mental health worker project, called Soulaje Lespri Moun (Relief for the Spirit), and outline its efforts to present empirically informed psychological content to residents of camps for internally displaced peoples using a culturally appropriate and community-focused framework. We detail the evolution of this project to accommodate shifting conditions postearthquake, as well as challenges faced and ongoing evaluation efforts.
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Affiliation(s)
- Leah Emily James
- School of Social Work
- Department of Psychology, University of Michigan
| | | | | | - Jacques Solon Jean
- Department of Psychology, University of Michigan
- Soulaje Lespri Moun, Port-au-Prince, Haiti
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How much stress is needed to increase vulnerability to psychosis? A community assessment of psychic experiences (CAPE) evaluation 10 months after an earthquake in L'Aquila (Italy). Eur Arch Psychiatry Clin Neurosci 2012; 262:265-8. [PMID: 21932082 DOI: 10.1007/s00406-011-0258-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2010] [Accepted: 09/02/2011] [Indexed: 10/17/2022]
Abstract
Since severe stress can induce mental disorder symptoms that interact with vulnerability factors, the Community Assessment of Psychic Experiences (CAPE) was evaluated in a population of 419 young adults who survived an earthquake; results were compared to a database of 1,057 'non-exposed' subjects. Unexpectedly, earthquake survivors showed lower CAPE scores for 'small' to 'medium' effect size. Post-trauma positive changes or re-appraisal for successful adaptation may explain these findings.
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Abstract
The authors describe their experience working and living in L'Aquila, where at 3.32 a.m., early in the morning of 6 April 2009, a 6.3 Richter magnitude earthquake caused serious damages to this 13th century town (with a population of 72 000 and a health district of 103 788), in the mountainous Abruzzo region and to several medieval hill villages in the surrounding areas: 309 residents were killed, over 1600 were injured, 66 000 residents were displaced, and, the centre of L'Aquila, the main historical and artistic centre of Abruzzo, was totally destroyed. Here is described the work done at the Psychiatric Unit of the General Hospital of L'Aquila and in the University. The Authors report the incidence rate of Acute Stress Disorder (ASD) in help-seekers (full ASD 4.9%, and partial ASD 39.3%), and of post-traumatic stress disorder (PTSD) found in different samples of population (range 12-37.5). The authors express their consideration about which real-world variables can reflect the population distress and the naturalistic process of recovery in such natural disasters. After the earthquake they hypothesize that a lot of residents had found their way to recover through 'writing, telling the story', by analogy with what narrative medicine asserts, thus estimating the positive effect of 'emotional disclosure' on health. A large number of materials (books, web-blogs, videos) were produced by residents and a database of memories was implemented. The suffering and struggle to recover in the aftermaths of a traumatic experience often yields remarkable transformations and positive growth. From this point of view, the authors underline the increased virtual relationships of residents through Facebook, to cope with the loss of previous social relationships, to get information about recreational opportunities, or to get organized for public events, despite their displacement. Many collective demonstrations were organized and showed the will to actively participate to the processes of reconstruction of the civil and scientific life of the town. The authors stress the need to prevent natural disasters, instead of preventing mental disorders following natural disasters, reporting that seven Italian seismologists and scientists are on trial for manslaughter, accused to have failed to evaluate the true risks of L'Aquila earthquake.
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Wissow LS, Rutkow L, Kass NE, Rabins PV, Vernick JS, Hodge JG. Ethical issues raised in addressing the needs of people with serious mental disorders in complex emergencies. Disaster Med Public Health Prep 2012; 6:72-8. [PMID: 22217528 DOI: 10.1001/dmp.2011.88] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Recent manmade and natural disasters highlight weaknesses in the public health systems designed to protect populations from harm and minimize disruption of the social and built environments. Emergency planning and response efforts have, as a result, focused largely on ensuring populations' physical well-being during and after a disaster. Many public health authorities, including the World Health Organization, have recognized the importance of addressing both mental and physical health concerns in emergency plans. Individuals with mental disorders represent a notable proportion of the overall population, and anticipating their needs is critical to comprehensive emergency planning and response efforts. Because people with serious mental disorders historically have been stigmatized, and many individuals with mental disorders may be unable to care for themselves, ethical guidance may be of assistance to those engaged in emergency planning and response. This article considers several broad categories of ethical issues that arise during emergencies for people with serious mental disorders and offers recommendations for ways in which emergency planners and other stakeholders can begin to address these ethical challenges.
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Affiliation(s)
- Lawrence S Wissow
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
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Franz VA, Arnkoff DB, Glass CR, Mete M, Dutton MA. Predictors of the impact of the September 11th terrorist attacks on victims of intimate partner violence. J Trauma Stress 2011; 24:530-7. [PMID: 21882248 DOI: 10.1002/jts.20676] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
This study examined the role of several hypothesized predictors of the impact of a potentially traumatic event, the terrorist attacks of September 11, 2001 (9/11), on a sample of women experiencing intimate partner violence (IPV) and related posttraumatic stress symptoms (PTSS). We found that IPV-related PTSS mediated the relationship between IPV and 9/11-related PTSS, confirming the hypothesis that severity of symptoms related to prior trauma plays a role in the development and severity of PTSS related to subsequent potentially traumatic events. Media exposure and threat appraisal were significantly positively associated with 9/11-related PTSS, whereas social support was significantly negatively associated with 9/11-related PTSS, with none of these variables serving as moderators of the relationship between IPV-related and 9/11-related PTSS. Our results suggest that trauma-related psychiatric history is an important factor in the development of PTSS subsequent to an additional potentially traumatic event, even after adjusting for relevant variables occurring at the time of that event.
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Affiliation(s)
- Victoria A Franz
- Department of Psychology, The Catholic University of America, Washington, DC 20064, USA.
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48
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Claassen C, Kashner TM, Kashner TK, Xuan L, Larkin GL. Psychiatric emergency "surge capacity" following acts of terrorism and mass violence with high media impact: what is required? Gen Hosp Psychiatry 2011; 33:287-93. [PMID: 21601726 DOI: 10.1016/j.genhosppsych.2011.01.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2010] [Revised: 01/31/2011] [Accepted: 01/31/2011] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Adequate preparedness for acts of terrorism and mass violence requires a thorough understanding of the postdisaster mental health needs of all exposed groups, including those watching such events from a distance. This study examined emergency psychiatric treatment-seeking patterns following media exposure to four national terrorist or mass casualty events. METHOD An event was selected for study if (a) it precipitated local front-page headlines for >5 consecutive days and (b) emergency service psychiatrists identified it as specifically precipitating help-seeking in the study hospital. Four events qualified: the Oklahoma City bombing (1995), the Columbine High School (1999) and Wedgewood Baptist Church (1999) shootings and the terrorist attacks of September 11, 2001. Time-series analyses were used to correct for autocorrelation in visit patterns during the postdisaster week, and equivalent time periods from years before and after each event were used as control years. RESULTS Overall, disaster week census did not differ significantly from predisaster weeks, although 3-day nonsignificant decreases in visit rate were observed following each disaster. Treatment-seeking for anxiety-related issues showed a nonsignificant increase following each disaster, which became significant in the "all disaster" model (t=5.17; P=.006). Intensity of media coverage did not impact rate of help-seeking in any analysis. CONCLUSIONS Although these sentinel US disasters varied in scope, method, geographic proximity to the study site, perpetrator characteristics, public response, sequelae and degree of media coverage, the extent to which they impacted emergency department treatment-seeking was minimal. Geographically distant mass violence and disaster events of the type and scope studied here may require only minimal mental health "surge capacity" in the days following the event.
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Affiliation(s)
- Cindy Claassen
- Department of Psychiatry, University of North Texas Health Sciences Center, Fort Worth, TX 76107, USA.
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Kulkarni M, Graham-Bermann S, Rauch SA, Seng J. Witnessing versus experiencing direct violence in childhood as correlates of adulthood PTSD. JOURNAL OF INTERPERSONAL VIOLENCE 2011; 26:1264-81. [PMID: 20495101 PMCID: PMC4314106 DOI: 10.1177/0886260510368159] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Research has established that childhood violence exposure plays a considerable role in the development of deleterious outcomes in childhood and adulthood. However, important gaps remain in understanding the complex relationships between early violence exposure, adulthood trauma exposure, and posttraumatic stress disorder (PTSD). This study investigates whether two specific types of childhood violence exposure (witnessing domestic violence and experiencing child abuse) are uniquely associated with PTSD while controlling for additional trauma experience. In a community sample of pregnant women, this study finds that childhood abuse only and combined exposure to abuse and witnessing abuse correlated to current and lifetime PTSD diagnoses, but witnessing alone did not. In addition, adult nonviolence trauma histories account for more variance in PTSD than did any early violence exposure type.
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Affiliation(s)
- Madhur Kulkarni
- Department of Psychology, University of Michigan, Ann Arbor, 530 Church Street, Ann Arbor, MI 48109-1043
| | - Sandra Graham-Bermann
- Department of Psychology, University of Michigan, Ann Arbor, 530 Church Street, Ann Arbor, MI 48109-1043
| | - Sheila A.M. Rauch
- Psychologist, Research Service, VA Ann Arbor Healthcare System, Ann Arbor, MI
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor
| | - Julia Seng
- Institute for Research on Women and Gender, University of Michigan, Ann Arbor
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor
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Rossi A, Maggio R, Riccardi I, Allegrini F, Stratta P. A quantitative analysis of antidepressant and antipsychotic prescriptions following an earthquake in Italy. J Trauma Stress 2011; 24:129-32. [PMID: 21351173 DOI: 10.1002/jts.20607] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Because natural disasters provoke an increase in mental and medical disorders in survivors, an increase in psychotropic prescriptions has been observed following disasters. This study assesses the pharmacoepidemiology of antidepressant and antipsychotic drug prescriptions after an earthquake in Italy by using an administrative database. Statins and diabetic medications served as control medications. Comparison of the rates in the 6 months after the earthquake to the same period one year before revealed a 37% increase of new prescriptions for antidepressants and a 129% increase for antipsychotic prescriptions. Older age and female gender was associated with the increased number of prescriptions.
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Affiliation(s)
- Alessandro Rossi
- Dipartimento di Medicina Sperimentale, Sezione di Psichiatria, Università de L'Aquila.
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