Preexisting Mental Illness and Risk for Developing a New Disorder After Hurricane Katrina

Sullivan, Greer; Vasterling, Jennifer J.; Han, Xiaotong; Tharp, Andra Teten; Davis, Teri D.; Deitch, Elizabeth A.; Constans, Joseph I.

doi:10.1097/nmd.0b013e31827f636d

Cited by 39 publications

(29 citation statements)

References 24 publications

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“…First, most were cross-sectional and unable to examine GxE at different time points post-disaster. Second, all lacked pre-disaster data, even though prior studies have shown that pre-disaster factors (e.g., mental health status, degree of social support) are among the strongest predictors of post-disaster psychological responses (Ginexi et al, 2000, Norris et al, 2002, Sullivan et al, 2013). As a result, it remains unclear to what extent GxE predicts psychopathology beyond pre-disaster factors.…”

Section: Introductionmentioning

confidence: 99%

Interaction between genetic variants and exposure to Hurricane Katrina on post-traumatic stress and post-traumatic growth: A prospective analysis of low income adults

Dunn¹,

Solovieff²,

Lowe³

et al. 2014

Journal of Affective Disorders

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Background There is considerable variation in psychological reactions to natural disasters, with responses ranging from relatively mild and transitory symptoms to severe and persistent posttraumatic stress (PTS). Some survivors also report post-traumatic growth (PTG), or positive psychological changes due to the experience and processing of the disaster and its aftermath. Gene-environment interaction (GxE) studies could offer new insight into the factors underlying variability in post-disaster psychological responses. However, few studies have explored GxE in a disaster context. Methods We examined whether ten common variants in seven genes (BDNF, CACNA1C, CRHR1, FKBP5, OXTR, RGS2, SLC6A4) modified associations between Hurricane Katrina exposure and PTS and PTG. Data were from a prospective study of 205 low-income non-Hispanic Black parents residing in New Orleans prior to and following Hurricane Katrina. Results We found a significant association (after correction) between RGS2 (rs4606; p=0.0044) and PTG, which was mainly driven by a cross-over GxE (p=0.006), rather than a main genetic effect (p=0.071). The G (minor allele) was associated with lower PTG scores for low levels of Hurricane exposure and higher PTG scores for moderate and high levels of exposure. We also found a nominally significant association between variation in FKBP5 (rs1306780, p=0.0113) and PTG, though this result did not survive correction for multiple testing. Limitations Although the inclusion of low-income non-Hispanic Black parents allowed us to examine GxE among a highly vulnerable group, our findings may not generalize to other populations or groups experiencing other natural disasters. Moreover, not all participants invited to participate in the genetic study provided saliva. Conclusions To our knowledge, this is the first study to identify GxE in the context of post-traumatic growth. Future studies are needed to clarify the role of GxE in PTS and PTG and post-disaster psychological responses, especially among vulnerable populations.

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Section: Introductionmentioning

confidence: 99%

Interaction between genetic variants and exposure to Hurricane Katrina on post-traumatic stress and post-traumatic growth: A prospective analysis of low income adults

Dunn¹,

Solovieff²,

Lowe³

et al. 2014

Journal of Affective Disorders

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“…In some studies, this has been achieved by comparing those exposed to disaster with similar population groups not exposed, [8][9][10] whereas in other cases, time series comparisons have been made of outcomes assessed before and after the disaster. [11][12][13][14][15][16][17] Both methods have limitations and, under ideal circumstances, it would be desirable to assess the outcomes of those exposed to the disaster with the outcomes of a comparison group, with both groups being assessed both before and after the disaster.…”

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confidence: 99%

“…A number of studies have assessed mental health problems using either measures of symptoms 8,11,16 or changes in substance consumption, 15,17,18 whereas others have used categorical measures of meeting criteria for DSM disorders. 10,[12][13][14] There is a growing literature that suggests it is important to assess both categorical and dimensional aspects of mental disorders particularly as there may be individuals who display symptoms of disorder (including impairment) and experience significant distress but whose symptoms do not meet diagnostic criteria. [25][26][27][28] These developments are reflected by the inclusion of dimensional aspects in the assessment of mental disorders in the DSM-5.…”

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confidence: 99%

Impact of a Major Disaster on the Mental Health of a Well-Studied Cohort

et al. 2014

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IMPORTANCE There has been growing research into the mental health consequences of major disasters. Few studies have controlled for prospectively assessed mental health. This article describes a natural experiment in which 57% of a well-studied birth cohort was exposed to a major natural disaster (the Canterbury, New Zealand, earthquakes in 2010-2011), with the remainder living outside of the earthquake area.OBJECTIVE To examine the relationships between the extent of earthquake exposure and mental health outcomes following the earthquakes-net of adjustment for potentially confounding factors related to personal circumstances, prior mental health, and childhood family background. DESIGN, SETTING, AND PARTICIPANTSData were gathered from the Christchurch Health and Development Study, a 35-year longitudinal study of a birth cohort of New Zealand children (635 males and 630 females). This general community sample included 952 participants with available data on earthquake exposure and mental health outcomes at age 35 years. EXPOSURES A composite measure of exposure to the events during and subsequent to the 4 major (Richter Scale >6.0) Canterbury earthquakes during the years 2010-2011.MAIN OUTCOMES AND MEASURES DSM-IV symptom criteria for major depression; posttraumatic stress disorder; anxiety disorder; suicidal ideation/attempt; nicotine dependence; alcohol abuse/dependence; and illicit drug abuse/dependence. Outcomes were measured approximately 20 to 24 months after the onset of exposure to the earthquakes and were assessed using DSM-IV diagnostic criteria and measures of subclinical symptoms. RESULTS After covariate adjustment, cohort members with high levels of exposure to the earthquakes had rates of mental disorder that were 1.4 (95% CI, 1.1-1.7) times higher than those of cohort members not exposed. This increase was due to increases in the rates of major depression; posttraumatic stress disorder; other anxiety disorders; and nicotine dependence. Similar results were found using a measure of subclinical symptoms (incidence rate ratio, 1.4; 95% CI, 1.1-1.6). Estimates of attributable fraction suggested that exposure to the Canterbury earthquakes accounted for 10.8% to 13.3% of the overall rate of mental disorder in the cohort at age 35 years. CONCLUSIONS AND RELEVANCE Following extensive control for prospectively measured confounding factors, exposure to the Canterbury earthquakes was associated with a small to moderate increase in the risk for common mental health problems.

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“…13,14 Similarly, researchers have largely relied on retrospective self-reports on pre-disaster psychopathology. 6,7 There are a few exceptions, [15][16][17] and they generally show that pre-existing psychopathology influences post-disaster mental health. Thus, it awaits to be firmly established the extent to which disasters induce lasting risks of severe psychiatric disorders independently of underlying vulnerabilities.…”

Section: Introductionmentioning

confidence: 99%

Psychiatric disorders and suicide attempts in Swedish survivors of the 2004 southeast Asia tsunami: a 5 year matched cohort study

Arnberg

Guðmundsdóttir

Butwicka

et al. 2015

The Lancet Psychiatry

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Background Survivors of natural disasters are thought to be at an increased risk of psychiatric disorders, however the extent of this risk, and whether it is linked to preexisting psychopathology, is not known. We aimed to establish whether Swedish survivors of tsunamis from the 2004 Sumatra-Andaman earthquake had increased risks of psychiatric disorders and suicide attempts 5 years after repatriation. MethodsWe identified Swedish survivors repatriated from southeast Asia (8762 adults and 3742 children) and 864 088 unexposed adults and 320 828 unexposed children matched for sex, age, and socioeconomic status. We retrieved psychiatric diagnoses and suicide attempts from the Swedish patient register for the 5 years after the tsunami (from Dec 26, 2004, to Jan 31, 2010 and estimated hazard ratios (HRs), then adjusted for pre-tsunami psychiatric disorders, and, for children, for parental pretsunami disorders. 0.86-1.11), although exposed children and adolescents had a higher risk for suicide attempts with uncertain intent (1.43; 1.01-2.02) and stress-related disorders (1.79; 1.30-2.46), mainly during the first 3 months after the tsunami. FindingsInterpretation The 2004 tsunami was, independently of previous psychiatric morbidity, associated with an increased risk of severe psychopathology, mainly stress-related disorders and suicide attempts, in children and adults. Survivors of natural disasters should be targeted with early interventions and active long-term follow-up to prevent, detect, and alleviate psychiatric disorders that might follow. 3 IntroductionIn the last decade, natural disasters afflicted more than 200 million people each year, 1 resulting in loss of lives, property destruction, and psychological suffering worldwide. Literature reviews suggest that survivors are at increased risk of psychiatric disorders, particularly posttraumatic stress disorder (PTSD). [2][3][4][5] As noted previously, [6][7][8] percentile). We matched children and adolescents for sex, birth year, parental cohabitation status, disposable family income, education, and employment of both parents as defined above.The final cohort included 8762 exposed and 864088 unexposed adults and 3742 exposed and 320 828 unexposed children and adolescents. We followed the exposed and matched cohorts from Dec 26, 2004, until emigration, death, or end of follow-up (Jan 31, 2010), whichever came first. The study was approved by the Regional Ethics Committees of Karolinska Institutet and Uppsala University. After register-linkage on national identifiers, unique for every Swedish resident, data analyses were done on deidentified datasets. OutcomesOur assessed outcomes were first presentation of a psychiatric disorder (diagnostic codes F00-F99), a definite suicide attempt based on a diagnosis of intentional selfharm (X60-X84), or an uncertain suicide attempt based on a diagnosis of events of undetermined intent (Y10-Y34). For the sake of precision we report mainly diagnoses in the category of disorders related to stress and adjustment disorder...

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Preexisting Mental Illness and Risk for Developing a New Disorder After Hurricane Katrina

Cited by 39 publications

References 24 publications

Interaction between genetic variants and exposure to Hurricane Katrina on post-traumatic stress and post-traumatic growth: A prospective analysis of low income adults

Interaction between genetic variants and exposure to Hurricane Katrina on post-traumatic stress and post-traumatic growth: A prospective analysis of low income adults

Impact of a Major Disaster on the Mental Health of a Well-Studied Cohort

Psychiatric disorders and suicide attempts in Swedish survivors of the 2004 southeast Asia tsunami: a 5 year matched cohort study

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