Prevalence rates of trauma and posttraumatic stress disorder (PTSD) were estimated from a probability sample of 2,509 adults from 4 cities in Mexico. PTSD was assessed according to Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) criteria using the Composite International Diagnostic Interview (CIDI; WHO, 1997). Lifetime prevalence of exposure and PTSD were 76% and 11.2%, respectively. Risk for PTSD was highest in Oaxaca (the poorest city), persons of lower socioeconomic status, and women. Conditional risk for PTSD was highest following sexual violence, but nonsexual violence and traumatic bereavement had greater overall impact because of their frequency. Of lifetime cases, 62% became chronic; only 42% received medical or professional care. The research demonstrates the importance of expanding the epidemiologic research base on trauma to include developing countries around the world.
Samples of adults representative of Teziutlán, Puebla, and Villahermosa, Tobasco, were interviewed 6, 12, 18, and 24 months after the devastating 1999 flood and mudslides. The interview contained multiple measures of social support that had been normed for Mexico. Comparisons between sample data and population norms suggested minimal mobilization of received support and substantial deterioration of perceived support and social embeddedness. Social support was lowest in Teziutlán, which had experienced mass casualties and displacement, and among women and persons of lower educational attainment. Disparities according to gender, context, and education grew larger as time passed. The results provide compelling evidence that the international health community must be mindful of social as well as psychological functioning when disasters strike the developing world.
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