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Cheng P, Wang L, Zhou Y, Ma W, Zhao G, Li W. Trajectories and comorbid symptom networks of posttraumatic stress symptoms in frontline rescuers: A longitudinal study. J Affect Disord 2024; 355:73-81. [PMID: 38548201 DOI: 10.1016/j.jad.2024.03.125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 02/23/2024] [Accepted: 03/23/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND Previous research has largely lacked studies that explore the trajectories of Posttraumatic stress symptoms (PTSS) and the structure of comorbid psychiatric symptom networks following traumatic event, while controlling for the severity of traumatic exposure. The present study aims to explore the characteristic trajectories of PTSS, in the context of ensuring controlled levels of traumatic exposure. Furthermore, the PTSS, depressive, and anxiety comorbid symptom networks of different PTSS trajectory subgroups are also investigated. METHODS A total of 296 frontline rescue personnel were enrolled into our study. In an effort to control for variations in traumatic exposure severity, this study ensured that all participants had same responsibilities and cumulative operational duration at the post-disaster rescue circumstance. Growth mixture models (GMMs) were employed to scrutinize the trajectories of PTSS. Additionally, network analysis was used to examine the comorbid symptom network of PTSS, depression, and anxiety. RESULTS Four distinct PTSS trajectories were identified, namely Persisting Symptom, Gradual Recovery, Gradual Aggravation, and Asymptomatic. Although both the Persisting Symptom and Gradual Aggravation groups belong to the high-risk subgroups for persistent PTSS, they exhibit differences in core symptoms within their respective networks. The core symptom for the Persisting Symptom Network is flashbacks, while for the Gradual Aggravation Network, it is sleep disturbances. CONCLUSION To the best of our knowledge, the present study represents the first research endeavor to integrate longitudinal trajectory analysis of PTSS with longitudinal symptom network analysis, clarifying the evolving features of PTSS but also offering valuable insights for early screening and intervention strategies.
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Affiliation(s)
- Peng Cheng
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Lirong Wang
- The Xiangya Hospital of Central South University, Changsha 410008, Hunan, China
| | - Ying Zhou
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Wenjing Ma
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Guangju Zhao
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Weihui Li
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
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Shabani A, Rasoulian M, Naserbakht M, Hakim Shooshtari M, Hajebi A, Tiyuri A, Motevalian SA. Prevalence and determinants of post-traumatic stress disorder five months after the 2019 huge flooding in Iran. BMC Public Health 2024; 24:346. [PMID: 38302994 PMCID: PMC10835963 DOI: 10.1186/s12889-024-17861-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 01/23/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Despite the high occurrence of floods in Iran, its psychological consequences have been less discussed. The present paper addresses the prevalence of Post-traumatic Stress Disorder (PTSD) and its determinants among the affected adults by the huge flood of 2019. METHODS An analytical cross-sectional study was conducted through household face-to-face surveys in August and September 2019. Individuals who were affected by floods and were at least 16 years old were randomly selected from three provinces in Iran: Lorestan and Khuzestan in the west and southwest, and Golestan in the northeast. The questionnaire of demographic and flood related variables in addition to the Impact of Event Scale-Revised (IES-R) were utilized to collect the data. We applied a complex sample analysis to describe the prevalence of PTSD and logistic regression analyses to find its determinants. RESULTS Out of the 2,305 individuals approached for surveys, 1,671 (72.5%) adults affected by the floods participated in the study. The majority of participants were housewives, married, had either no formal education or primary education, and resided in rural areas. The prevalence of PTSD in the participants was 24.8% (CI 95%: 20.7-28.8%) and was significantly higher in Lorestan province (39.7%, P < 0.001). Determinants of PTSD, were unemployment (adjusted odds ratio [AOR] = 3.53, CI 95%: 1.38-9.00), primary (AOR = 2.44, CI 95%: 1.10-5.41) or high school (AOR = 2.35, CI 95%: 1.25-4.40) education (vs. university), a history of mental disorders (AOR = 2.36, CI 95%: 1.22-4.58), high damage to assets (AOR = 2.29, CI 95%: 1.40-3.75), limited access to health care services after the flood (AOR = 1.95, CI 95%: 1.20-3.19), not receiving compensation for flood damage (AOR = 1.94, CI 95%: 1.01-3.83), high wealth index (AOR = 1.90, CI 95%: 1.23-2.93), and flooded house with a height of more than one meter (AOR = 1.66, CI 95%: 1.02-2.76). CONCLUSION Results show a notable prevalence of PTSD, especially in Lorestan province, among adults affected by floods. Determinants of PTSD include unemployment, lower education, psychiatric history, extensive property damage, limited post-flood healthcare access, lack of compensation, and increased flood exposure. We recommend adopting an inclusive screening approach for high-risk groups and developing appropriate therapeutic and supportive interventions.
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Affiliation(s)
- Amir Shabani
- Mental Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
- Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Rasoulian
- Mental Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
- Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Morteza Naserbakht
- Mental Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Mitra Hakim Shooshtari
- Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Hajebi
- Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Research Center for Addiction and Risky Behaviors (ReCARB), Psychosocial Health Research Institute (PHRI), Iran University of Medical Sciences, Tehran, Iran
| | - Amir Tiyuri
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
| | - Seyed Abbas Motevalian
- Research Center for Addiction and Risky Behaviors (ReCARB), Psychosocial Health Research Institute (PHRI), Iran University of Medical Sciences, Tehran, Iran
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
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Vafeiadou A, Banissy MJ, Banissy JF, Higgins JP, Howard G. The influence of climate change on mental health in populations of the western Pacific region: An umbrella scoping review. Heliyon 2023; 9:e21457. [PMID: 38053883 PMCID: PMC10694052 DOI: 10.1016/j.heliyon.2023.e21457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 09/27/2023] [Accepted: 10/21/2023] [Indexed: 12/07/2023] Open
Abstract
The Western Pacific Region (WPR) is on the front line of climate change challenges. Understanding how these challenges affect the WPR populations' mental health is essential to design effective prevention and care policies. Thus, the present study conducted an umbrella scoping review that examined the influence of climate change on mental health in the WPR, using review articles as a source of information. Ten review articles were selected according to eligibility criteria, and the findings were synthesized according to the socio-economic status of the countries identified: Australia, the Republic of Korea, the Philippines, Vietnam, the Pacific Islands (broadly), and China. The findings revealed that each country and sub-region has its own unique profile of climate change-related challenges and vulnerable populations, highlighting the need for specific approaches to mental health care. Specifically, the influence of climate-related challenges differed according to populations' region (e.g., rural populations), demographic characteristics (e.g., age and gender), culture (e.g., traditional tights to land), and employment (e.g., farmers and fishers). The most frequently reported mental health outcomes in response to climate change-related challenges such as droughts, floods, storms, tornadoes, typhoons, and climate-related migration were the decline in mental well-being and the increase in post-traumatic stress disorder symptoms. In addition, using the GRADE framework for assessing the certainty of the findings, we identified that the number of articles discussing associations between a given climate change challenge and a mental health outcome was overall limited. Based on our findings and findings on a global scale, we identified several key research gaps in WPR and provided recommendations for future research and policy strategies.
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Affiliation(s)
| | - Michael J. Banissy
- Department of Psychology, Goldsmiths, University of London, London, UK
- School of Psychological Science, University of Bristol, Bristol, UK
| | | | - Julian P.T. Higgins
- Department of Population Health Sciences, University of Bristol, Bristol, UK
| | - Guy Howard
- Cabot Institute, University of Bristol, Bristol, UK
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Abass K, Gyasi RM, Katey D, Frempong F, Garsonu EK. Flood exposure and psychological distress among Ghanaian adults in flood-prone settings. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 835:155481. [PMID: 35490804 DOI: 10.1016/j.scitotenv.2022.155481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 04/13/2022] [Accepted: 04/19/2022] [Indexed: 06/14/2023]
Abstract
Urban floods have long-term mental health implications, yet this subject remains largely neglected in flood-related studies. This paper examines the psychological distress (PD) of adults exposed to floods in Ghana. Cross-sectional data involving 767 flood-prone community-dwelling household heads aged ≥20 years were analyzed [mean = 47.3 years (SD = 13.7); males = 61.4%]. We used the Exposure to Flood-related Events Scale, and PD was assessed with the Kessler Psychological Distress Scale (K10). Ordinary Least Squares (OLS) regressions evaluated crude and adjusted associations of flood exposure with PD. The mean scores of PD (37[SD = 8]) and exposure to flood events (6[SD = 3]) significantly varied by age and sex (p < .05). After full adjustment for potential confounders, exposure to flood events was significantly and positively associated with PD index in the total sample (β = 0.030; p < .005), among male participants (β = 0.019; p < .05) and female participants (β = 0.048; p < .001). Furthermore, age-wise analysis revealed significant association of flood exposure with PD in young adults (β = 0.033; p < .001) but not in older adults (β = 0.048; p = .062). Exposure to floods increased the risk of PD. Policy and public health efforts to manage PD should include selective flood reduction interventions, including land use regulations and sustained public education.
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Affiliation(s)
- Kabila Abass
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Razak M Gyasi
- Aging and Development Unit, African Population and Health Research Center, Nairobi, Kenya.
| | - Daniel Katey
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Foster Frempong
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Emmanuel Kofi Garsonu
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
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Golitaleb M, Mazaheri E, Bonyadi M, Sahebi A. Prevalence of Post-traumatic Stress Disorder After Flood: A Systematic Review and Meta-Analysis. Front Psychiatry 2022; 13:890671. [PMID: 35815011 PMCID: PMC9259936 DOI: 10.3389/fpsyt.2022.890671] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 06/06/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction Flood as the most common kind of the natural disasters has unpleased short, medium, and long-term consequences on the victims' welfare, relationships, and physical and mental health. One of the most common mental health disorders in these victims is Post-traumatic stress disorder (PTSD). The aim of this study is to investigate the prevalence of PTSD on the flood victims. Methods Data resources including PubMed, Scopus, Web of Science, Science Direct, Embase, Google Scholar, conference and congress papers, key journals, the reference list of selected articles as well as systematic reviews were searched to identify studies that reported the prevalence of PTSD in flood victims. Random Effect Model was used to perform meta-analysis of the studies. Cochran test and I2 indicator were used to explore heterogeneity between the studies. Publication bias of the study was evaluated using Begg'test. Data were analyzed by STATA (version 14) software. Results After a comprehensive search, 515 papers were extracted. After eliminating duplicates and final screening, 23 studies were selected and entered the meta-analysis phase after qualitative evaluation. The results showed that the prevalence of PTSD in flood victims is 29.48% (95% CI: 18.64-40.31, I2 = 99.3%, p-value < 0.001). Conclusion The results of the present study showed that the prevalence of PTSD is relatively high in the flood victims. So, it is necessary to take preventive, supportive, therapeutic and effective actions for them.
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Affiliation(s)
- Mohamad Golitaleb
- Department of Nursing, School of Nursing, Arak University of Medical Sciences, Arak, Iran
| | - Elaheh Mazaheri
- Health Information Technology Research Center, Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahtab Bonyadi
- Non-communicable Diseases Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Ali Sahebi
- Non-communicable Diseases Research Center, Ilam University of Medical Sciences, Ilam, Iran
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Pratiwi A, Muhlisin A, Mardiyo M, Yuniartika W, Widodo A. Mother’s Concern in the Family about Her Child with Post-Traumatic Due to the Tornado in Central Java, Indonesia – A Qualitative Study. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.7741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Natural disasters continue to occur worldwide, influencing the economy, finances, and psychological problems. Traumatic on children is an impact of the catastrophe likely a burden on the family, especially mothers who accompany their children as caregivers.
AIM: The purpose of the study was to explore children’s traumatic experiences from mothers in a family in a rural community in Indonesia.
METHODS: We conducted six focus groups with mothers to explore their traumatic children’s experiences using a qualitative research design. Thirty mothers with children 3−10 years old contributed to the focus groups across all sites. We formed focus groups with six mothers and continued in-depth interviews, including nine mothers.
RESULTS: The mothers had similar experiences understanding their children’s trauma due to natural tornado disasters. This study revealed three overarching themes shaping the mothers’ experience: anxiety in children, trauma trigger, and lingering distress. All themes lead to the main theme is psychological distress in the face of a child suffering from PTSD. From the hermeneutical perspective, topics can be identified as terms, including being-thrownness, being-fallenness and being-alongside.
CONCLUSION: Children with post-traumatic stress disorder may impact family physiological problems, especially the mother. The study found that may place the burden of care for children on the person’s families.
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Daddah D, Glèlè Ahanhanzo Y, Kpozehouen A, Hounkpe Dos Santos B, Ouendo EM, Levêque A. Prevalence and Risk Factors of Post-Traumatic Stress Disorder in Survivors of a Cohort of Road Accident Victims in Benin: Results of a 12-Month Cross-Sectional Study. J Multidiscip Healthc 2022; 15:719-731. [PMID: 35411148 PMCID: PMC8994593 DOI: 10.2147/jmdh.s358395] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 03/25/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Post-traumatic stress disorder (PTSD) is a frequent psychiatric complication in road accident survivors. However, it remains under-explored and is not taken into account in health policies in Benin. The purpose of this study was to determine the prevalence and risk factors of PTSD after a road traffic accident. This will help to improve its diagnosis and management in Benin hospitals. Materials and Methods An institution-based cross-sectional study was conducted from November 2020 to January 2021. Consenting victims of road traffic accidents from three hospitals across Benin, aged 18 years and above, living in the south of the country, were administered various questionnaires at 12-month follow-up. Data on PTSD were collected using a pre-tested, structured and standardized post-traumatic stress disorder questionnaire, the PTSD Checklist (specific version) (PCL-S). A logistic regression model was fitted to identify factors associated with PTSD. An adjusted odds ratio (AOR) followed by a 95% confidence interval was calculated to determine the level of significance with a p-value less than 0.05. Results Out of 865 patients in the cohort eligible for the 12-month follow-up, 734 (85%) participated in the study. The prevalence of PTSD was 26.43% (95% CI: 23.36–29.75). Factors associated with PTSD on multivariate analysis were female gender (adjusted odds ratio (AOR) = 2.14, 95% CI: 1.38–3.33), hospitalization (AOR = 1.87, 95% CI 1.21–2.89), negative impact of the accident on income (AOR = 4.22, 95% CI: 2.16–8.25), and no return to work (AOR = 3.17, 95% CI: 1.99–5.06). Conclusion The prevalence of PTSD is high in road accident survivors in Benin. The results of this study highlight the need for early diagnosis and a multidisciplinary approach to the management of PTSD patients in Benin’s hospitals.
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Affiliation(s)
- Donatien Daddah
- Epidemiology and Biostatistics Department, Regional Institute of Public Health, Ouidah, Benin
- Center for Research in Epidemiology, Biostatistics and Clinical Research, Public Health School, (Université Libre de Bruxelles), Brussels, Belgium
- Correspondence: Donatien Daddah, Epidemiology and Biostatistics Department, Regional Institute of Public Health, P.O. Box 384, Ouidah, Benin, Tel +229 97167245, Email
| | - Yolaine Glèlè Ahanhanzo
- Epidemiology and Biostatistics Department, Regional Institute of Public Health, Ouidah, Benin
| | - Alphonse Kpozehouen
- Epidemiology and Biostatistics Department, Regional Institute of Public Health, Ouidah, Benin
| | - Bella Hounkpe Dos Santos
- Epidemiology and Biostatistics Department, Regional Institute of Public Health, Ouidah, Benin
- Center for Research in Epidemiology, Biostatistics and Clinical Research, Public Health School, (Université Libre de Bruxelles), Brussels, Belgium
| | - Edgard-Marius Ouendo
- Health Policies and Systems Department, Regional Institute of Public Health, Ouidah, Benin
| | - Alain Levêque
- Center for Research in Epidemiology, Biostatistics and Clinical Research, Public Health School, (Université Libre de Bruxelles), Brussels, Belgium
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Wiseman C, Lawrence AD, Bisson JI, Hotham J, Karl A, Zammit S. Study development and protocol for a cohort study examining the impact of baseline social cognition on response to treatment for people living with post-traumatic stress disorder. Eur J Psychotraumatol 2022; 13:2093036. [PMID: 35849639 PMCID: PMC9278429 DOI: 10.1080/20008198.2022.2093036] [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] [Indexed: 11/03/2022] Open
Abstract
Background: Social cognitive impairments, specifically in facial emotion processing and mental state attribution, are common in post-traumatic stress disorder. However few studies so far have examined whether social cognitive ability impacts on PTSD recovery. Objective: To examine whether baseline social cognitive abilities are associated with treatment outcomes following trauma-focused therapy for PTSD. Method: This is a cohort study that will relate treatment outcomes post-discharge to baseline measures of social cognition (five tasks: Emotion Odd-One-Out Task (Oddity), Reading the Mind in the Eyes Task (RMET), Social Shapes Test (SST), Spontaneous Theory of Mind Protocol (STOMP), and Reflective Functioning Questionnaire (RFQ-8)) in people starting a course of psychological therapy for PTSD (target N = 60). The primary outcome will be pre- to post-treatment change in PTSD symptom severity (assessed using the PTSD Checklist for DSM-5). Secondary outcomes include functional impairment (assessed using the Work and Social Adjustment Scale), drop-out rate, and analyses differentiating participants with DSM-5 PTSD and ICD-11 PTSD and CPTSD. Regression models will be used to examine associations between baseline social cognitive performance and outcome measures while adjusting for potential confounders. Two pilot studies informed the development of our study protocol. The first involved qualitative analysis of interviews with nine participants with lived experience of mental health problems to inform our research questions and study protocol. The second involved trialling social cognitive tasks on 20 non-clinical participants to refine our test battery. Discussion: This study will address a gap in the literature about whether abilities in social cognition in people living with PTSD are associated with treatment-related recovery. HIGHLIGHTS Impairments in social cognition are recognised in people with PTSD.Few studies have examined whether social cognitive ability is associated with recovery from PTSD.We present a study protocol, developed after pilot testing, to address this question.
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Affiliation(s)
- Chantelle Wiseman
- Department of Population Health Sciences, Oakfield House, University of Bristol, Bristol, UK
| | - Andrew D Lawrence
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, UK
| | - Jonathan I Bisson
- Division of Psychological Medicine and Clinical Neuroscience, Cardiff University, Cardiff, UK
| | - James Hotham
- Avon and Wiltshire Partnership Trust, Bristol, UK
| | - Anke Karl
- Clinical Psychology and Affective Neuroscience, College of Life and Environmental Sciences (CLES), Psychology, Washington Singer Laboratories, University of Exeter, Exeter, UK
| | - Stan Zammit
- Department of Population Health Sciences, Oakfield House, University of Bristol, Bristol, UK.,Division of Psychological Medicine and Clinical Neuroscience, Cardiff University, Cardiff, UK
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Agyapong B, Shalaby R, Eboreime E, Obuobi-Donkor G, Owusu E, Adu MK, Mao W, Oluwasina F, Agyapong VIO. Cumulative trauma from multiple natural disasters increases mental health burden on residents of Fort McMurray. Eur J Psychotraumatol 2022; 13:2059999. [PMID: 35599978 PMCID: PMC9116266 DOI: 10.1080/20008198.2022.2059999] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Fort McMurray, a city in northern Alberta, Canada, has experienced multiple traumatic events in the last five years, including the 2016 wildfire, the 2020 floods, and the COVID-19 pandemic. Traumatic events often lead to increased mental health burdens in affected communities. OBJECTIVE To assess if the number of traumatic events experienced by residents of Fort McMurray correlates with the prevalence and severity of mental health issues experienced. METHODOLOGY A cross-sectional study using an online survey questionnaire was used to gather demographic, trauma (wildfire, flooding, and COVID-19), and clinical information from the resident of Fort McMurray between April 24 to June 2 2021. Likely Generalized Anxiety Disorder (GAD), Major Depressive Disorder (MDD), Post-Traumatic Stress Disorder (PTSD) and low resilience were measured using standardised rating scales. Data were analyzed with SPSS version 26 using Chi-Square tests and multivariate regression analysis. RESULTS Respondents who experienced COVID-19 and either flood or wildfire traumas (N = 101) were eleven times more likely to have GAD symptoms (OR: 11.39; 95% CI: 1.43-91.04), four times more likely to have likely MDD, (OR: 3.85; 95% CI: .995-14.90), ten times more likely to have likely PTSD (OR: 10.47; 95% CI: 1.28-85.67), and low resilience (OR: 10.56; 95% CI: 1.21-92.17). Respondents who experienced COVID-19, flooding, and wildfire traumas (N = 47) were eighteen times more likely to express GAD symptoms (OR: 18.30; 95% CI: 2.20-152.45) and more than eleven times likely to have likely PTSD (OR: 11.41; 95% CI: 1.34-97.37) in comparison to the respondents who experienced COVID-19 only trauma (N = 19). CONCLUSION Measures to reduce climate change and associated natural disasters could reduce the impact of cumulative trauma and associated mental health burden in vulnerable populations. It is essential that more mental health resources are mobilised to support communities impacted by multiple natural disasters. HIGHLIGHTS The number of traumatic disasters experienced in residents of Fort McMurray five years after the 2016 wildfires, a year after the 2020 flooding, and during the COVID-19 pandemic correlates with the prevalence and severity of the mental health conditions reported in this study.
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Affiliation(s)
- Belinda Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, Canada.,Global Psychological E-Health Foundation, Edmonton, Canada
| | - Reham Shalaby
- Department of Psychiatry, University of Alberta, Edmonton, Canada
| | - Ejemai Eboreime
- Department of Psychiatry, University of Alberta, Edmonton, Canada.,Global Psychological E-Health Foundation, Edmonton, Canada
| | | | - Ernest Owusu
- Department of Psychiatry, University of Alberta, Edmonton, Canada
| | - Medard K Adu
- Department of Psychiatry, University of Alberta, Edmonton, Canada
| | - Wanying Mao
- Department of Psychiatry, University of Alberta, Edmonton, Canada
| | | | - Vincent I O Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, Canada.,Global Psychological E-Health Foundation, Edmonton, Canada.,Department of Psychiatry, Dalhousie University, Halifax, Canada
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10
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Agyapong B, Eboreime E, Shalaby R, Pazderka H, Obuobi-Donkor G, Adu MK, Mao W, Oluwasina F, Owusu E, Greenshaw AJ, Agyapong VIO. Mental Health Impacts of Wildfire, Flooding and COVID-19 on Fort McMurray School Board Staff and Other Employees: A Comparative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010435. [PMID: 35010692 PMCID: PMC8744856 DOI: 10.3390/ijerph19010435] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 12/20/2021] [Accepted: 12/28/2021] [Indexed: 11/24/2022]
Abstract
Background: Fort McMurray, a city in northern Alberta, Canada, has experienced multiple traumas in the last five years, including the 2016 wildfire, the 2020 floods, and the COVID-19 pandemic. Eighteen months after the wildfire, major depressive disorder (MDD), generalized anxiety disorder (GAD), and Post Traumatic Stress Disorder (PTSD) symptoms were elevated among school board employees in the city. Objective: This study aimed to compare employees of the school board and other employees of Fort McMurray in respect to the impact the 2016 wildfires, the 2019 COVID pandemic, and the 2020 floods had on their mental health. Methodology: A quantitative cross-sectional survey was conducted in Fort McMurray from 24 April to 2 June 2021. Online questionnaires were administered through REDCap and were designed to capture socio-demographic characteristics, clinical as well as wildfire, COVID-19, and flooding-related variables. Mental health outcome variables were captured using self-reported standardized assessment scales. Data were analysed with descriptive statistics, Chi-square/Fisher’s Exact tests, and binary regression analysis. Results: Of the 249 residents who accessed the online survey, 186 completed the survey, giving a response rate of 74.7%. Of these respondents, 93.5% (174) indicated their employment status and were included in the Chi-square analysis. Most of the respondents were female (86.2%, (150)), above 40 years (53.4%, (93)), and were in a relationship (71.3%, (124)). The prevalence values for MDD, GAD and PTSD among respondents were 42.4%, 41.0, and 36.8%, respectively. There was a statistically significant difference between employees of the school board and other employees with respect to likely PTSD prevalence (28% vs. 45%, respectively, p < 0.05), although with other factors controlled for, in a binary logistic regression model, employer type did not significantly predict likely PTSD. Conclusions: The study has established that likely PTSD symptoms were significantly higher in other employees compared to those of school board employees. Greater exposure to the traumatic events and a greater perceived lack of support from other employers might have contributed to the significantly higher prevalence of PTSD in other employees.
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Affiliation(s)
- Belinda Agyapong
- Global Psychological e-Health Foundation, Edmonton, AB T6G 2E1, Canada;
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2E1, Canada; (E.E.); (R.S.); (H.P.); (G.O.-D.); (M.K.A.); (W.M.); (F.O.); (E.O.); (A.J.G.)
| | - Ejemai Eboreime
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2E1, Canada; (E.E.); (R.S.); (H.P.); (G.O.-D.); (M.K.A.); (W.M.); (F.O.); (E.O.); (A.J.G.)
| | - Reham Shalaby
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2E1, Canada; (E.E.); (R.S.); (H.P.); (G.O.-D.); (M.K.A.); (W.M.); (F.O.); (E.O.); (A.J.G.)
| | - Hannah Pazderka
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2E1, Canada; (E.E.); (R.S.); (H.P.); (G.O.-D.); (M.K.A.); (W.M.); (F.O.); (E.O.); (A.J.G.)
| | - Gloria Obuobi-Donkor
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2E1, Canada; (E.E.); (R.S.); (H.P.); (G.O.-D.); (M.K.A.); (W.M.); (F.O.); (E.O.); (A.J.G.)
| | - Medard K. Adu
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2E1, Canada; (E.E.); (R.S.); (H.P.); (G.O.-D.); (M.K.A.); (W.M.); (F.O.); (E.O.); (A.J.G.)
| | - Wanying Mao
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2E1, Canada; (E.E.); (R.S.); (H.P.); (G.O.-D.); (M.K.A.); (W.M.); (F.O.); (E.O.); (A.J.G.)
| | - Folajinmi Oluwasina
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2E1, Canada; (E.E.); (R.S.); (H.P.); (G.O.-D.); (M.K.A.); (W.M.); (F.O.); (E.O.); (A.J.G.)
| | - Ernest Owusu
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2E1, Canada; (E.E.); (R.S.); (H.P.); (G.O.-D.); (M.K.A.); (W.M.); (F.O.); (E.O.); (A.J.G.)
| | - Andrew J. Greenshaw
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2E1, Canada; (E.E.); (R.S.); (H.P.); (G.O.-D.); (M.K.A.); (W.M.); (F.O.); (E.O.); (A.J.G.)
| | - Vincent I. O. Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2E1, Canada; (E.E.); (R.S.); (H.P.); (G.O.-D.); (M.K.A.); (W.M.); (F.O.); (E.O.); (A.J.G.)
- Vincent Israel Opoku Agyapong Department of Psychiatry, Faculty of Medicine, Dalhousie University, 5909 Veterans Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS B3H 2E2, Canada
- Correspondence: ; Tel.: +1-780-215-7771; Fax: +902-473-4887
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Sharpe I, Davison CM. Climate change, climate-related disasters and mental disorder in low- and middle-income countries: a scoping review. BMJ Open 2021; 11:e051908. [PMID: 34649848 PMCID: PMC8522671 DOI: 10.1136/bmjopen-2021-051908] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Climate change and climate-related disasters adversely affect mental health. Low- and middle-income countries (LMICs) are particularly vulnerable to the impacts of climate change and climate-related disasters and often lack adequate mental healthcare infrastructure. We used the scoping review methodology to determine how exposure to climate change and climate-related disasters influences the presence of mental disorders among those living in LMICs. We also aimed to recognise existing gaps in this area of literature. METHODS This review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist. To identify relevant studies, we searched five electronic databases (MEDLINE, EMBASE, Global Health, APA PsycInfo and Sociological Abstracts) from 1 January 2007 to 31 December 2019. We also searched the grey literature. Included studies had an adult-focused LMIC population, a climate change or climate-related disaster exposure and a mental disorder outcome. Relevant study information was extracted and synthesised. RESULTS Fifty-eight studies were identified, most of which (n=48) employed a cross-sectional design. The most commonly studied exposure-outcome combinations were flood-related post-traumatic stress disorder (PTSD) (n=28), flood-related depression (n=15) and storm-related PTSD (n=13). The majority of studies identified a positive exposure-outcome association. However, few studies included a baseline or comparator (ie, unexposed) group, thereby limiting our understanding of the magnitude or nature of this association. There was also great heterogeneity in this literature, making studies difficult to pool or compare. Several research gaps were identified including the lack of longitudinal studies and non-uniformity of geographic coverage. CONCLUSION To our knowledge, this was the first scoping review to investigate the relationship between climate change and climate-related disaster exposures and mental disorder outcomes in LMICs. Our findings support the need for further research, but also highlight that mental health should be a priority within LMIC climate change policy considerations.
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Affiliation(s)
- Isobel Sharpe
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Colleen M Davison
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
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Ramesh B, Jagger MA, Zaitchik B, Kolivras KN, Swarup S, Deanes L, Gohlke JM. Emergency department visits associated with satellite observed flooding during and following Hurricane Harvey. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2021; 31:832-841. [PMID: 34267308 PMCID: PMC8448911 DOI: 10.1038/s41370-021-00361-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 06/23/2021] [Accepted: 06/24/2021] [Indexed: 05/04/2023]
Abstract
BACKGROUND Flooding following heavy rains precipitated by hurricanes has been shown to impact the health of people. Earth observations can be used to identify inundation extents for subsequent analysis of health risks associated with flooding at a fine spatio-temporal scale. OBJECTIVE To evaluate emergency department (ED) visits before, during, and following flooding caused by Hurricane Harvey in 2017 in Texas. METHODS A controlled before and after design was employed using 2016-2018 ED visits from flooded and non-flooded census tracts. ED visits between landfall of the hurricane and receding of flood waters were considered within the flood period and post-flood periods extending up to 4 months were also evaluated. Modified Poisson regression models were used to estimate adjusted rate ratios for total and cause specific ED visits. RESULTS Flooding was associated with increased ED visits for carbon monoxide poisoning, insect bite, dehydration, hypothermia, intestinal infectious diseases, and pregnancy complications. During the month following the flood period, the risk for pregnancy complications and insect bite was still elevated in the flooded tracts. SIGNIFICANCE Earth observations coupled with ED visits increase our understanding of the short-term health risks during and following flooding, which can be used to inform preparedness measures to mitigate adverse health outcomes and identify localities with increased health risks during and following flooding events.
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Affiliation(s)
- Balaji Ramesh
- Department of Geography, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | | | - Benjamin Zaitchik
- Morton K. Blaustein Department of Earth and Planetary Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Korine N Kolivras
- Department of Geography, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Samarth Swarup
- Biocomplexity Institute and Initiative, University of Virginia, Charlottesville, VA, USA
| | - Lauren Deanes
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Julia M Gohlke
- Department of Population Health Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA.
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Mao W, Agyapong VIO. The Role of Social Determinants in Mental Health and Resilience After Disasters: Implications for Public Health Policy and Practice. Front Public Health 2021; 9:658528. [PMID: 34095062 PMCID: PMC8170026 DOI: 10.3389/fpubh.2021.658528] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/19/2021] [Indexed: 12/30/2022] Open
Abstract
In this general literature review, we will explore the impacts and contribution of social determinants to mental health and resiliency following both natural and man-made disasters. Natural disasters, such as wildfires, earthquakes, tsunamis, and hurricanes, as well as man-made disasters, such as civil wars, have been known to inflict significant damage to the mental health of the victims. In this paper, we mainly explore some most studied vulnerability and protective social determinant factors such as gender, age, ethnicity, socials support and socioeconomic status for the mental health and resiliency in survivors of such disasters. Several other possible factors such as previous trauma, childhood abuse, family psychiatric history, and subsequent life stress that were explored by some studies were also discussed. We conducted a literature search in major scientific databases, using keywords such as: mental health, social determinants, disasters, wildfires, earthquakes, terrorist attacks, and resilience. We discuss the implications for public health policy and practice.
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Affiliation(s)
- Wanying Mao
- 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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Rates of Occurrence and Influence of Trauma Exposure on Posttraumatic Stress Disorder Symptoms Among Survivors of Terrorist Attacks in Northeast Nigeria. Int J Ment Health Addict 2021. [DOI: 10.1007/s11469-021-00527-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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15
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Lee S, Mansoor S, Amatya B, Sayed T, Galea M, Khan F. Functional outcome and community reintegration of survivors following disasters: A community-based survey in pakistan. THE JOURNAL OF THE INTERNATIONAL SOCIETY OF PHYSICAL AND REHABILITATION MEDICINE 2021. [DOI: 10.4103/jisprm-000115] [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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Long-Term Mental Health Effects of a Devastating Wildfire Are Amplified by Sociodemographic and Clinical Antecedents in College Students. Disaster Med Public Health Prep 2020; 15:707-717. [PMID: 32536354 DOI: 10.1017/dmp.2020.87] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES The aim of this study is to assess prevalence of major depressive disorder (MDD), generalized anxiety disorder (GAD), and posttraumatic stress disorder (PTSD) in students of Keyano College 18 months after a wildfire and to determine the predictors of likely MDD, GAD, and PTSD in the respondents. METHODS A quantitative cross-sectional survey was used to collect data through self-administered, paper-based questionnaires to determine likely MDD, GAD, and PTSD using the PHQ 9, GAD-7, and the PTSD Checklist for DSM 5, Part 3, respectively. Data were analyzed with SPSS version 20 (IBM Corp, Armonk, NY) using univariate analysis with chi-square tests. RESULTS Eighteen months after the wildfire, the 1-month prevalence rates for MDD, GAD, and PTSD among the college students were 23.4%, 18.7%, and 11.0%, respectively. There were statistically significant associations between multiple sociodemographic variables and the likelihood respondents presented with MDD, GAD, and PTSD 18 months after the wildfire. There were also associations between the likely MDD, GAD, and PTSD and abuse/dependence on alcohol and substances in respondents at 18 months. CONCLUSION Our study has established prevalence rates for MDD, GAD, and PTDS among college students 18 months after the Fort McMurray wildfires. Further studies are needed to explore the impact of college-based mental health interventions on the long-term mental health effects of the wildfires.
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Mulchandani R, Armstrong B, Beck CR, Waite TD, Amlôt R, Kovats S, Leonardi G, Rubin GJ, Oliver I. The English National Cohort Study of Flooding & Health: psychological morbidity at three years of follow up. BMC Public Health 2020; 20:321. [PMID: 32223747 PMCID: PMC7104503 DOI: 10.1186/s12889-020-8424-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 02/27/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Flooding is expected to increase due to climate change, population growth and urban development. The longer-term mental health impacts of flooding are not well understood. In 2015, the English National Study of Flooding and Health was established to improve understanding of the impact of flooding on health and inform future public health action. METHODS We used 3 years of data from the English National Study of Flooding and Health. Participants who had consented to follow up were sent a questionnaire. Participants were classified into either "unaffected", "disrupted" or "flooded" according to their exposure. Logistic regression models were used to calculate adjusted odds ratios for probable depression, anxiety and post-traumatic stress disorder (PTSD) in each exposure group. The Wald test was used to assess the difference in probable mental health outcomes for those who did and did not experience "persistent damage" to their home. Conditional logistic regression was conducted to assess change in prevalence over the 3 years and to identify possible determinants of recovery. RESULTS Eight hundred nineteen individuals were included in the final analysis - 119 were classified as unaffected, 421 disrupted and 279 flooded. Overall, 5.7% had probable depression, 8.1% had probable anxiety and 11.8% had probable PTSD, with higher prevalence in the flooded group compared with the unaffected group. After adjustment for potential confounders, probable mental health outcomes were higher in the flooded group compared to the unaffected group, significantly for probable depression (aOR 8.48, 95% CI 1.04-68.97) and PTSD (aOR 7.74, 95% CI 2.24-26.79). Seventy-seven (9.4%) participants reported experiencing persistent damage to their home, most commonly damp (n = 40) and visible mould (n = 26) in liveable rooms. Of the 569 participants who responded at all 3 years, a significant reduction in prevalence for all probable mental health outcomes was observed in the flooded group. CONCLUSIONS Flooding can have severe long-lasting consequences on mental health in affected populations. If these problems are not identified and treated early, they may persist for years. Further research is necessary to develop and evaluate interventions to increase resilience in at risk populations and to ensure timely access to support services following flooding.
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Affiliation(s)
- Ranya Mulchandani
- Field Epidemiology, Field Service, National Infection Service, Public Health England, Bristol, BS1 6EH, UK. .,NIHR Health Protection Research Unit in Evaluation of Interventions, University of Bristol, Bristol, BS8 2BN, UK.
| | - Ben Armstrong
- NIHR Health Protection Research Unit in Environmental Change and Health at the London School of Hygiene and Tropical Medicine, London, WC1H 9SH, UK
| | - Charles R Beck
- Field Epidemiology, Field Service, National Infection Service, Public Health England, Bristol, BS1 6EH, UK.,NIHR Health Protection Research Unit in Evaluation of Interventions, University of Bristol, Bristol, BS8 2BN, UK.,Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
| | - Thomas David Waite
- Field Epidemiology, Field Service, National Infection Service, Public Health England, Bristol, BS1 6EH, UK.,Global Public Health, Field Service, Public Health England, Wellington House, London, SE1 8UG, UK
| | - Richard Amlôt
- Centre for Radiation, Chemicals and Environmental Hazards, Public Health England, Chilton, Didcot, Oxfordshire, OX11 0RQ, UK
| | - Sari Kovats
- NIHR Health Protection Research Unit in Environmental Change and Health at the London School of Hygiene and Tropical Medicine, London, WC1H 9SH, UK
| | - Giovanni Leonardi
- Centre for Radiation, Chemicals and Environmental Hazards, Public Health England, Chilton, Didcot, Oxfordshire, OX11 0RQ, UK
| | - G James Rubin
- NIHR Health Protection Research Unit in Emergency Preparedness and Response at King's College London, London, UK
| | - Isabel Oliver
- Field Epidemiology, Field Service, National Infection Service, Public Health England, Bristol, BS1 6EH, UK.,NIHR Health Protection Research Unit in Evaluation of Interventions, University of Bristol, Bristol, BS8 2BN, UK.,Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
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Lee S, Amatya B, Galea M, Khan F. Preparedness among medical rehabilitation professionals for deployment to future disaster settings. THE JOURNAL OF THE INTERNATIONAL SOCIETY OF PHYSICAL AND REHABILITATION MEDICINE 2020. [DOI: 10.4103/jisprm.jisprm_2_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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19
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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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Sheerin CM, Kovalchick LV, Overstreet C, Rappaport LM, Williamson V, Vladimirov V, Ruggiero KJ, Amstadter AB. Genetic and Environmental Predictors of Adolescent PTSD Symptom Trajectories Following a Natural Disaster. Brain Sci 2019; 9:E146. [PMID: 31226868 PMCID: PMC6627286 DOI: 10.3390/brainsci9060146] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 06/19/2019] [Indexed: 12/20/2022] Open
Abstract
: Genes, environmental factors, and their interplay affect posttrauma symptoms. Although environmental predictors of the longitudinal course of posttraumatic stress disorder (PTSD) symptoms are documented, there remains a need to incorporate genetic risk into these models, especially in youth who are underrepresented in genetic studies. In an epidemiologic sample tornado-exposed adolescents (n = 707, 51% female, Mage = 14.54 years), trajectories of PTSD symptoms were examined at baseline and at 4-months and 12-months following baseline. This study aimed to determine if rare genetic variation in genes previously found in the sample to be related to PTSD diagnosis at baseline (MPHOSPH9, LGALS13, SLC2A2), environmental factors (disaster severity, social support), or their interplay were associated with symptom trajectories. A series of mixed effects models were conducted. Symptoms decreased over the three time points. Elevated tornado severity was associated with elevated baseline symptoms. Elevated recreational support was associated with lower baseline symptoms and attenuated improvement over time. Greater LGLAS13 variants attenuated symptom improvement over time. An interaction between MPHOSPH9 variants and tornado severity was associated with elevated baseline symptoms, but not change over time. Findings suggest the importance of rare genetic variation and environmental factors on the longitudinal course of PTSD symptoms following natural disaster trauma exposure.
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Affiliation(s)
- Christina M Sheerin
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA 23298, USA.
| | - Laurel V Kovalchick
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA 23298, USA.
| | - Cassie Overstreet
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA 23298, USA.
| | - Lance M Rappaport
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA 23298, USA.
- Department of Psychology, University of Windsor, Windsor, ON N9B 3P4, Canada.
| | - Vernell Williamson
- Molecular Diagnostics Laboratory, Virginia Commonwealth University, Richmond, VA 23298, USA.
| | - Vladimir Vladimirov
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA 23298, USA.
| | - Kenneth J Ruggiero
- Departments of Nursing and Psychiatry, Medical University of South Carolina, Charleston, SC 29425, USA.
| | - Ananda B Amstadter
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA 23298, USA.
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Chan EYY, Ho JY, Hung HHY, Liu S, Lam HCY. Health impact of climate change in cities of middle-income countries: the case of China. Br Med Bull 2019; 130:5-24. [PMID: 31070715 PMCID: PMC6587073 DOI: 10.1093/bmb/ldz011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 01/31/2019] [Accepted: 04/23/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND This review examines the human health impact of climate change in China. Through reviewing available research findings under four major climate change phenomena, namely extreme temperature, altered rainfall pattern, rise of sea level and extreme weather events, relevant implications for other middle-income population with similar contexts will be synthesized. SOURCES OF DATA Sources of data included bilingual peer-reviewed articles published between 2000 and 2018 in PubMed, Google Scholar and China Academic Journals Full-text Database. AREAS OF AGREEMENT The impact of temperature on mortality outcomes was the most extensively studied, with the strongest cause-specific mortality risks between temperature and cardiovascular and respiratory mortality. The geographical focuses of the studies indicated variations in health risks and impacts of different climate change phenomena across the country. AREAS OF CONTROVERSY While rainfall-related studies predominantly focus on its impact on infectious and vector-borne diseases, consistent associations were not often found. GROWING POINTS Mental health outcomes of climate change had been gaining increasing attention, particularly in the context of extreme weather events. The number of projection studies on the long-term impact had been growing. AREAS TIMELY FOR DEVELOPING RESEARCH The lack of studies on the health implications of rising sea levels and on comorbidity and injury outcomes warrants immediate attention. Evidence is needed to understand health impacts on vulnerable populations living in growing urbanized cities and urban enclaves, in particular migrant workers. Location-specific climate-health outcome thresholds (such as temperature-mortality threshold) will be needed to support evidence-based clinical management plans and health impact mitigation strategies to protect vulnerable communities.
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Affiliation(s)
- Emily Y Y Chan
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), Division of Global Health and Humanitarian Medicine, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
- Division of Global Health and Humanitarian Medicine, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- François-Xavier Bagnoud Center for Health & Human Rights, Harvard University, Boston, MA, USA
| | - Janice Y Ho
- Division of Global Health and Humanitarian Medicine, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Heidi H Y Hung
- Division of Global Health and Humanitarian Medicine, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Sida Liu
- Division of Global Health and Humanitarian Medicine, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Holly C Y Lam
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), Division of Global Health and Humanitarian Medicine, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
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Agyapong VIO, Juhas M, Omege J, Denga E, Nwaka B, Akinjise I, Corbett SE, Brown M, Chue P, Li XM, Greenshaw A. Prevalence Rates and Correlates of Likely Post-Traumatic Stress Disorder in Residents of Fort McMurray 6 Months After a Wildfire. Int J Ment Health Addict 2019. [DOI: 10.1007/s11469-019-00096-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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Ludin SM, Rohaizat M, Arbon P. The association between social cohesion and community disaster resilience: A cross-sectional study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2019; 27:621-631. [PMID: 30345603 DOI: 10.1111/hsc.12674] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 06/04/2018] [Accepted: 09/25/2018] [Indexed: 06/08/2023]
Abstract
A cross-sectional study design was created, using the Index of Perceived Community Resilience (IPCR) and Buckner's Index of Cohesion (BIC) to survey 386 flood evacuees from six communities in Kelantan, Malaysia, in 2015. The respondents were mostly female (54.7%); lived in basic housing (95.6%); average income (55.9%); secondary level schooling (81.1%); not involved with community organisations (95.1%), volunteering activities (91.2%), or emergency teams (96.9%); inexperience with injury during flooding (94%); experienced the emergency disaster (61.6%); and their mean age was 49 years old. Overall, respondents scored a high level of community disaster resilience (CDR) (mean 3.9) and social cohesion (mean 3.79). Also, respondents' housing type, event of injury during disaster, volunteering in post-disaster activities, and emergency team participation were significantly associated with CDR (p = 0.001-0.002), organisational involvement (p = 0.016), and emergency disaster experience (p = 0.028) were significantly associated with social cohesion. The Pearson correlation coefficient results mostly showing a moderate, weak, and one with a strong relationship. There is a strong relationship between community participation (CDR) in events and BIC variables (r = 0.529, p = 0.001). Other analysis shows a moderate but significant relationship with BIC; is open to ideas (r = 0.332, p = 0.001); community has similar values/ideas (r = 0.421, p = 0.001); sense of pride (r = 0.389, p = 0.001); strong leadership (r = 0.339, p = 0.001); positive change (r = 0.484, p = 0.001); and able to handle problems (r = 0.454, p = 0.001). Overall, the results show that respondents had high levels of CDR and social cohesion, while the demographic characteristics show the impact of CDR and social cohesion. In conclusion, the data gives original insight into the level of association between social cohesion and disaster resilience, which could be used as a building block in sustainable disaster recovery. There is a need to explore this further on programmes designed to improve social cohesion across communities.
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Affiliation(s)
- Salizar M Ludin
- Department of Critical Care, Kulliyyah of Nursing, International Islamic University Malaysia, Pahang, Malaysia
| | - Munirah Rohaizat
- Kulliyyah of Nursing, International Islamic University Malaysia, Pahang, Malaysia
| | - Paul Arbon
- Torrens Resilience Institute, Flinders University South Australia, Adelaide, Australia
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Zeligman M, McElroy-Heltzel SE, Davis EB, Dispenza F, Davis DE, DeBlaere C. Posttraumatic Growth and Trauma in Flood Survivors: Contributions of Attitudes Toward God. ACTA ACUST UNITED AC 2019. [DOI: 10.17744/mehc.41.2.03] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Natural disasters, including floods, affect entire communities and often lead survivors to report symptoms of posttraumatic stress (PTS). Although the vast majority of disaster research focuses on negative emotional outcomes, individuals may simultaneously experience positive outcomes such as posttraumatic growth (PTG). This study examined the influence of attitudes toward God (i.e., positive attitudes toward God and disappointment/anger with God) on perceived PTG and PTS following the 2016 floods in Baton Rouge, Louisiana (N = 416). Hierarchical regressions revealed that flood exposure and attitudes toward God predicted perceived PTG and PTS. In addition, disappointment/anger with God helped to moderate the relationship between flood exposure and perceived PTG in flood survivors. Findings underscore the role that counselors can play in facilitating growth in disaster survivors and in processing spiritual topics with clients when relevant.
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25
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Paterson DL, Wright H, Harris PNA. Health Risks of Flood Disasters. Clin Infect Dis 2018; 67:1450-1454. [DOI: 10.1093/cid/ciy227] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 03/20/2018] [Indexed: 12/31/2022] Open
Affiliation(s)
- David L Paterson
- Centre for Clinical Research, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Hugh Wright
- Centre for Clinical Research, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Patrick N A Harris
- Centre for Clinical Research, Faculty of Medicine, University of Queensland, Brisbane, Australia
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26
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Jermacane D, Waite TD, Beck CR, Bone A, Amlôt R, Reacher M, Kovats S, Armstrong B, Leonardi G, James Rubin G, Oliver I. The English National Cohort Study of Flooding and Health: the change in the prevalence of psychological morbidity at year two. BMC Public Health 2018. [PMID: 29514665 PMCID: PMC5842606 DOI: 10.1186/s12889-018-5236-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background The longer term impact of flooding on health is poorly understood. In 2015, following widespread flooding in the UK during winter 2013/14, Public Health England launched the English National Study of Flooding and Health. The study identified a higher prevalence of probable psychological morbidity one year after exposure to flooding. We now report findings after two years. Methods In year two (2016), a self-assessment questionnaire including flooding-related exposures and validated instruments to screen for probable anxiety, depression and post-traumatic stress disorder (PTSD) was sent to all participants who consented to further follow-up. Participants exposure status was categorised according to responses in year one; we assessed for exposure to new episodes of flooding and continuing flood-related problems in respondents homes. We calculated the prevalence and odds ratio for each outcome by exposure group relative to unaffected participants, adjusting for confounders. We used the McNemar test to assess change in outcomes between year one and year two. Results In year two, 1064 (70%) people responded. The prevalence of probable psychological morbidity remained elevated amongst flooded participants [n = 339] (depression 10.6%, anxiety 13.6%, PTSD 24.5%) and disrupted participants [n = 512] (depression 4.1%, anxiety 6.4%, PTSD 8.9%), although these rates were reduced compared to year one. A greater reduction in anxiety 7.6% (95% confidence interval [CI] 4.6–9.9) was seen than depression 3.8% (95% CI 1.5–6.1) and PTSD: 6.6% (95% CI 3.9–9.2). Exposure to flooding was associated with a higher odds of anxiety (adjusted odds ratio [aOR] 5.2 95%, 95% CI 1.7–16.3) and depression (aOR 8.7, 95% CI 1.9–39.8) but not PTSD. Exposure to disruption caused by flooding was not significantly associated with probable psychological morbidity. Persistent damage in the home as a consequence of the original flooding event was reported by 119 participants (14%). The odds of probable psychological morbidity amongst flooded participants who reported persistent damage, compared with those who were unaffected, were significantly higher than the same comparison amongst flooded participants who did not report persistent damage. Conclusions This study shows a continuance of probable psychological morbidity at least two years following exposure to flooding. Commissioners and providers of health and social care services should be aware that the increased need in populations may be prolonged. Efforts to resolve persistent damage to homes may reduce the risk of probable psychological morbidity. Electronic supplementary material The online version of this article (10.1186/s12889-018-5236-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Daiga Jermacane
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control, (ECDC), Stockholm, Sweden.,National Infection Service, Public Health England, 2, Rivergate, Bristol, BS1 6EH, UK
| | - Thomas David Waite
- Centre for Radiation, Chemicals and Environmental Hazards, Public Health England, OX11 0RQ, Chilton, Didcot, Oxfordshire, UK
| | - Charles R Beck
- National Infection Service, Public Health England, 2, Rivergate, Bristol, BS1 6EH, UK.,School of Social and Community Medicine, University of Bristol, Bristol, UK.,NIHR Health Protection Research Unit in Evaluation of Interventions at the University of Bristol, Bristol, UK
| | - Angie Bone
- Centre for Radiation, Chemicals and Environmental Hazards, Public Health England, OX11 0RQ, Chilton, Didcot, Oxfordshire, UK
| | - Richard Amlôt
- Emergency Response Department, Public Health England, Porton Down, Wilts, SP4 0JG, Salisbury, UK.,NIHR Health Protection Research Unit in Emergency Preparedness and Response at King's College London, London, UK.,NIHR Health Protection Research Unit in Evaluation of Interventions at the University of Bristol, Bristol, UK
| | - Mark Reacher
- National Infection Service, Public Health England, Cambridge, UK.,Cambridge Institute of Public Health, Cambridge, UK
| | - Sari Kovats
- NIHR Health Protection Research Unit in Environmental Change and Health at the London School of Hygiene and Tropical Medicine, London, UK
| | - Ben Armstrong
- NIHR Health Protection Research Unit in Environmental Change and Health at the London School of Hygiene and Tropical Medicine, London, UK
| | - Giovanni Leonardi
- Centre for Radiation, Chemicals and Environmental Hazards, Public Health England, OX11 0RQ, Chilton, Didcot, Oxfordshire, UK
| | - G James Rubin
- NIHR Health Protection Research Unit in Emergency Preparedness and Response at King's College London, London, UK
| | - Isabel Oliver
- National Infection Service, Public Health England, 2, Rivergate, Bristol, BS1 6EH, UK. .,School of Social and Community Medicine, University of Bristol, Bristol, UK. .,NIHR Health Protection Research Unit in Evaluation of Interventions at the University of Bristol, Bristol, UK.
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27
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Lin W, Gong L, Xia M, Dai W. Prevalence of posttraumatic stress disorder among road traffic accident survivors: A PRISMA-compliant meta-analysis. Medicine (Baltimore) 2018; 97:e9693. [PMID: 29505023 PMCID: PMC5779792 DOI: 10.1097/md.0000000000009693] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Involvement in road traffic accidents (RTAs) may put individuals at increased risk for a wide range of psychiatric disorders, among which posttraumatic stress disorder (PTSD) presents a public health issue. However, a great disparity was observed among studies exploring the prevalence of PTSD among RTA survivors. This meta-analysis aimed to explore the pooled prevalence of PTSD among RTA survivors. METHODS Electronic databases of PubMed, Embase, Web of Science, PsycARTICLES, PsycINFO, and CINAHL were searched to identify relevant studies. Study selection and data extraction were conducted independently by 2 investigators, and a meta-analysis was performed to synthesize the data. Heterogeneity among studies was evaluated using the Cochran Q test and quantified using the I statistic. Subgroup analyses were performed to identify the source of the heterogeneity. The possibility of publication bias was assessed using Egger linear test. RESULTS Fifteen eligible studies containing 6804 RTA survivors were identified in this meta-analysis, of which 1489 were identified with PTSD. The pooled prevalence of PTSD among RTA survivors was 22.25% (95% confidence interval: 16.71%-28.33%). A high degree of heterogeneity was observed across studies (I = 97.1%, P < .001), with reported PTSD prevalence ranging from 6.3% to 58.3%. Subgroup analyses found that the prevalence of PTSD among RTA survivors varied significantly across studies in relation to the instrument used to assess PTSD, country, race, gender, and education level (P < .05). CONCLUSION The high pooled prevalence of PTSD among RTA survivors found in this study significantly underscores the need for providing timely and effective intervention strategies for RTA survivors.
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Affiliation(s)
| | | | | | - Wenjie Dai
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
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28
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Dai W, Kaminga AC, Tan H, Wang J, Lai Z, Wu X, Xiong Y, Deng J, Liu A. Comorbidity of post-traumatic stress disorder and anxiety in flood survivors: Prevalence and shared risk factors. Medicine (Baltimore) 2017; 96:e7994. [PMID: 28885358 PMCID: PMC6393105 DOI: 10.1097/md.0000000000007994] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Post-traumatic stress disorder (PTSD) and anxiety are both prevalent in trauma-related populations. However, comorbidity of these 2 psychiatric disorders has not been investigated in flood survivors. This study aimed to estimate the extent to which PTSD and anxiety co-occur in flood survivors, and identify shared risk factors for PTSD only and comorbidity of PTSD and anxiety.Individuals who experienced Dongting Lake flood in 1998 were enrolled in this study using stratified and systematic random sampling method. Information on social support, personality traits, PTSD, and anxiety was collected using self-report questionnaires. The intensity of exposure to the flood was measured by some questions. Logistic regression analyses were used to identify factors associated with PTSD only and comorbidity of PTSD and anxiety.In all, 325 participants were enrolled in this study. The prevalence of PTSD, anxiety, and comorbidity of PTSD and anxiety among survivors of the 1998 Dongting Lake flood at 17-year follow-up was 9.54%, 9.23%, and 6.15%, respectively. Furthermore, 64.52% of those with PTSD had anxiety and 66.67% of those with anxiety had PTSD. Loss of relative, injury of body, damage of house, and emotional instability were shared risk factors for PTSD only and comorbidity of PTSD and anxiety, in comparison with neither PTSD nor anxiety.Post-traumatic stress disorder only and comorbidity of PTSD and anxiety are prevalent in flood survivors, and are both related to the intensity of exposure to the flood and personality traits, indicating that integrated intervention strategies of PTSD and anxiety for flood survivors are needed.
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Affiliation(s)
- Wenjie Dai
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
| | - Atipatsa C. Kaminga
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
- Department of Mathematics, Mzuzu University, Mzuzu, Malawi
| | - Hongzhuan Tan
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
| | - Jieru Wang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Zhiwei Lai
- Hunan Provincial Center for Disease Control and Prevention, Hunan, China
| | - Xin Wu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
| | - Yuan Xiong
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
| | - Jing Deng
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
| | - Aizhong Liu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
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Brain-Derived Neurotropic Factor Val66Met Polymorphism and Posttraumatic Stress Disorder among Survivors of the 1998 Dongting Lake Flood in China. BIOMED RESEARCH INTERNATIONAL 2017; 2017:4569698. [PMID: 28589140 PMCID: PMC5446855 DOI: 10.1155/2017/4569698] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 04/20/2017] [Indexed: 12/29/2022]
Abstract
OBJECTIVE This study mainly aimed to explore the association between brain-derived neurotropic factor (BDNF) Val66Met polymorphism and posttraumatic stress disorder (PTSD) among flood survivors in China. METHODS Individuals who experienced the 1998 Dongting Lake flood in Southeast Huarong, China, were enrolled in this study. Qualified health personnel carried out face-to-face interviews with participants. PTSD was identified using PTSD Checklist-Civilian version (PCL-C). Blood samples were collected from the participants to extract DNA for genotyping. RESULTS A total of 175 participants were enrolled in this study. The prevalence of PTSD among flood survivors at 17-year follow-up was 16.0% (28/175). Individuals with PTSD were more likely to be female, experience at least three flood-related stressors, experience at least three postflood stressors, and carry the Met than those without PTSD. Compared with Val/Val homozygotes, Met carriers had higher scores of PCL-C (mean ± standard error: 23.60 ± 7.23 versus 27.19 ± 9.48, P < 0.05). Multivariable logistic regression analysis indicated that Met carriers (aOR = 4.76, 95% CI = 1.02-22.15, P < 0.05) were more likely to develop PTSD than Val/Val homozygotes. CONCLUSIONS Met carriers for BDNF rs6265 are at higher risk of developing PTSD and also exhibit more severe PTSD symptoms than Val/Val homozygotes among flood survivors in China.
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Dai W, Kaminga AC, Tan H, Wang J, Lai Z, Wu X, Liu A. Long-term psychological outcomes of flood survivors of hard-hit areas of the 1998 Dongting Lake flood in China: Prevalence and risk factors. PLoS One 2017; 12:e0171557. [PMID: 28170427 PMCID: PMC5295691 DOI: 10.1371/journal.pone.0171557] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 01/23/2017] [Indexed: 12/11/2022] Open
Abstract
Background Although numerous studies have indicated that exposure to natural disasters may increase survivors’ risk of post-traumatic stress disorder (PTSD) and anxiety, studies focusing on the long-term psychological outcomes of flood survivors are limited. Thus, this study aimed to estimate the prevalence of PTSD and anxiety among flood survivors 17 years after the 1998 Dongting Lake flood and to identify the risk factors for PTSD and anxiety. Methods This cross-sectional study was conducted in December 2015, 17 years after the 1998 Dongting Lake flood. Survivors in hard-hit areas of the flood disaster were enrolled in this study using a stratified, systematic random sampling method. Well qualified investigators conducted face-to-face interviews with participants using the PTSD Checklist-Civilian version, the Zung Self-Rating Anxiety Scale, the Chinese version of the Social Support Rating Scale and the Revised Eysenck Personality Questionnaire-Short Scale for Chinese to assess PTSD, anxiety, social support and personality traits, respectively. Logistic regression analyses were used to identify factors associated with PTSD and anxiety. Results A total of 325 participants were recruited in this study, and the prevalence of PTSD and anxiety was 9.5% and 9.2%, respectively. Multivariable logistic regression analyses indicated that female sex, experiencing at least three flood-related stressors, having a low level of social support, and having the trait of emotional instability were risk factors for long-term adverse psychological outcomes among flood survivors after the disaster. Conclusions PTSD and anxiety were common long-term adverse psychological outcomes among flood survivors. Early and effective psychological interventions for flood survivors are needed to prevent the development of PTSD and anxiety in the long run after a flood, especially for individuals who are female, experience at least three flood-related stressors, have a low level of social support and have the trait of emotional instability.
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Affiliation(s)
- Wenjie Dai
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Atipatsa C. Kaminga
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
- Department of Mathematics, Mzuzu University, Mzuzu, Malawi
| | - Hongzhuan Tan
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Jieru Wang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
| | - Zhiwei Lai
- Immune Planning Division, Hunan Provincial Center for Disease Control and Prevention, Changsha, Hunan, China
| | - Xin Wu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Aizhong Liu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
- * E-mail:
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