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Post-traumatic stress disorder associated with natural and human-made disasters in the World Mental Health Surveys

Published online by Cambridge University Press:  30 August 2016

E. J. Bromet ,
L. Atwoli ,
N. Kawakami ,
F. Navarro-Mateu ,
P. Piotrowski ,
A. J. King ,
S. Aguilar-Gaxiola ,
J. Alonso ,
B. Bunting  and
K. Demyttenaere
...Show all authors
E. J. Bromet*
Affiliation:
Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY, USA
L. Atwoli
Affiliation:
Department of Mental Health, Moi University School of Medicine, Eldoret, Kenya
N. Kawakami
Affiliation:
Department of Mental Health, School of Public Health, The University of Tokyo, Tokyo, Japan
F. Navarro-Mateu
Affiliation:
Subdirección General de Salud Mental, Servicio Murciano de Salud, IMIB-Arrixaca, CIBER de Epidemiología y Salud Pública (CIBERESP), Murcia, Spain
P. Piotrowski
Affiliation:
Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
A. J. King
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
S. Aguilar-Gaxiola
Affiliation:
University of California Davis School of Medicine, Sacramento, CA, USA
J. Alonso
Affiliation:
IMIM-Hospital del Mar Research Institute, Parc de Salut Mar, Barcelona, Spain Pompeu Fabra University (UPF), Barcelona, Spain CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
B. Bunting
Affiliation:
School of Psychology, University of Ulster, Londonderry, UK
K. Demyttenaere
Affiliation:
Department of Psychiatry, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium
S. Florescu
Affiliation:
National School of Public Health, Management and Professional Development, Bucharest, Romania
G. de Girolamo
Affiliation:
IRCCS St. John of God Clinical Research Centre, Brescia, Italy
S. Gluzman
Affiliation:
Ukrainian Psychiatric Association, Kiev, Ukraine
J. M. Haro
Affiliation:
Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain
P. de Jonge
Affiliation:
Department of Psychiatry, Interdisciplinary Center, Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
E. G. Karam
Affiliation:
Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
S. Lee
Affiliation:
Department of Psychiatry, Chinese University of Hong Kong, Tai Po, Hong Kong
V. Kovess-Masfety
Affiliation:
Ecole des Hautes Etudes en Santé Publique (EHESP), EA 4057 Paris Descartes University, Paris, France
M. E. Medina-Mora
Affiliation:
Ramon de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
Z. Mneimneh
Affiliation:
Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
B.-E. Pennell
Affiliation:
Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
J. Posada-Villa
Affiliation:
Colegio Mayor de Cundinamarca University, Bogota, Colombia
D. Salmerón
Affiliation:
Department of Epidemiology, Department of Health and Social Sciences, Murcia Regional Health Council, IMIB-Arrixaca, CIBER Epidemiología y Salud Pública (CIBERESP), Universidad de Murcia, Murcia, Spain
T. Takeshima
Affiliation:
Department of Health and Welfare for the Disabled, Health and Welfare Bureau, Kawasaki City, Japan
R. C. Kessler
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
*
*Address for correspondence: E. J. Bromet, Ph.D., Department of Psychiatry, Stony Brook University, Health Sciences Center, T10-060Z1, Stony Brook, NY 11794, USA. (Email: evelyn.bromet@stonybrookmedicine.edu)
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Abstract

Background

Research on post-traumatic stress disorder (PTSD) following natural and human-made disasters has been undertaken for more than three decades. Although PTSD prevalence estimates vary widely, most are in the 20–40% range in disaster-focused studies but considerably lower (3–5%) in the few general population epidemiological surveys that evaluated disaster-related PTSD as part of a broader clinical assessment. The World Mental Health (WMH) Surveys provide an opportunity to examine disaster-related PTSD in representative general population surveys across a much wider range of sites than in previous studies.

Method

Although disaster-related PTSD was evaluated in 18 WMH surveys, only six in high-income countries had enough respondents for a risk factor analysis. Predictors considered were socio-demographics, disaster characteristics, and pre-disaster vulnerability factors (childhood family adversities, prior traumatic experiences, and prior mental disorders).

Results

Disaster-related PTSD prevalence was 0.0–3.8% among adult (ages 18+) WMH respondents and was significantly related to high education, serious injury or death of someone close, forced displacement from home, and pre-existing vulnerabilities (prior childhood family adversities, other traumas, and mental disorders). Of PTSD cases 44.5% were among the 5% of respondents classified by the model as having highest PTSD risk.

Conclusion

Disaster-related PTSD is uncommon in high-income WMH countries. Risk factors are consistent with prior research: severity of exposure, history of prior stress exposure, and pre-existing mental disorders. The high concentration of PTSD among respondents with high predicted risk in our model supports the focus of screening assessments that identify disaster survivors most in need of preventive interventions.

Keywords

Disasterpost-traumatic stress disorderPTSD
Type
Original Articles
Information
Psychological Medicine , Volume 47 , Issue 2 , January 2017 , pp. 227 - 241
Copyright
Copyright © Cambridge University Press 2016 

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