The high prevalence of DSM-IV anxiety-mood disorders, the strong associations of hurricane-related stressors with these outcomes, and the independence of sociodemographics from stressors argue that the practical problems associated with ongoing stressors are widespread and must be addressed to reduce the prevalence of mental disorders in this population.

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Objective To estimate the prevalence of serious emotional disturbance (SED) among children and adolescents exposed to Hurricane Katrina along with the associations of SED with hurricane-related stressors, socio-demographics, and family factors 18–27 months following the hurricane. Method A probability sample of pre-hurricane residents of areas affected by Hurricane Katrina was administered a telephone survey. Respondents provided information on up to two of their children (n=797) aged 4–17. The survey assessed hurricane-related stressors and lifetime history of psychopathology in respondents, screened for 12-month SED in respondents’ children using the Strengths and Difficulties Questionnaire (SDQ), and determined whether children’s emotional and behavioral problems were attributable to Hurricane Katrina. Results The estimated prevalence of SED was 14.9%, and 9.3% of youth were estimated to have SED that is directly attributable to Hurricane Katrina. Stress exposure was associated strongly with SED, and 20.3% of youth with high stress exposure had hurricane-attributable SED. Death of a loved one had the strongest association with SED among pre-hurricane residents of New Orleans, whereas exposure to physical adversity had the strongest association in the remainder of the sample. Among children with stress exposure, parental psychopathology and poverty were associated with SED. Conclusions The prevalence of SED among youth exposed to Hurricane Katrina remains high 18–27 months after the storm, suggesting a substantial need for mental health treatment resources in the hurricane-affected areas. Youth who were exposed to hurricane-related stressors, have a family history of psychopathology, and have lower family incomes are at greatest risk for long-term psychiatric impairment.