Prevalence and duration of PTSD in survivors 6 years after a natural disaster

Arnberg, Filip K.; Johannesson, Kerstin Bergh; Michel, Per‐Olof

doi:10.1016/j.janxdis.2013.03.011

Cited by 63 publications

(46 citation statements)

References 34 publications

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Section: Discussionmentioning

confidence: 63%

“…Also, whereas the effect of a disaster itself is usually confounded with the effects of postdisaster stressors, 10,34 in our study the survivors returned to an environment unaffected by the disaster and had very few other post-disaster stressful events during the followup. 21,22,36 We showed a dose-response pattern, increasing our confidence in the direct link between the tsunami and later psychopathology.There are some limitations to our study. First, the outcomes concern severe symptoms with functional impairment suffice for the survivors or their parents to seek professional help and then be referred to specialist care within a public health-care system.…”

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confidence: 63%

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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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Section: Discussionmentioning

confidence: 63%

mentioning

confidence: 63%

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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“…The interviews were conducted at 6 years post-disaster with a random sample of 200 individuals from the exposed group. An examination of the rates of psychopathology has been reported previously (Arnberg et al, 2013). Those who consented to an interview and those who did not were highly similar in age (both groups M = 45 years; t = 0.79, p = .4, partial η 2 < 0.001), gender (43% vs. 41% women, χ 2 = 3.1, p = .22, φ = .03), and employment status (both 94% employed, χ 2 = 0.47, p = .50, φ = .01).…”

Section: Clinical Interviewsmentioning

confidence: 99%

“…Disaster survivors are at risk of developing chronic posttraumatic stress disorder (PTSD; American Psychiatric Association [APA], 2013), which can persist for several years and is associated with significant comorbidity and disability (Arnberg, Johannesson, & Michel, 2013;Kessler, Sonnega, Bromet, Hughes, & Nelson, 1995;Taft, Stern, King, & King, 1999). Screening for PTSD thus serves an important purpose after disasters and evaluations of measures in appropriate contexts are needed.…”

Section: Introductionmentioning

confidence: 99%

Properties of Swedish posttraumatic stress measures after a disaster

Arnberg

Michel

Johannesson

2014

Journal of Anxiety Disorders

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This study evaluated the properties of Swedish versions of self-report measures of posttraumatic stress disorder (PTSD), with emphasis on the Impact of Event ScaleRevised (IES-R). Survey data from adult survivors 1, 3, and 6 years after the 2004 Indian Ocean tsunami (n= 1,506) included the IES-R (from which the IES-6 was derived) and the 12-item General Health Questionnaire (GHQ-12). The PTSD Checklist (PCL) was included in one survey. A structured clinical interview was performed after 6 years (n = 142). Factor analyses of the IES-R and PCL indicated that a dysphoric-arousal model provided good fit invariant across assessments. Both measures were accurate in excluding PTSD while all measures provided poorer positive predictive values. The IES-R, but not the IES-6 and GHQ-12, evidenced stability across assessments. In conclusion, the Swedish IES-R and PCL are sound measures of chronic PTSD, and the findings illustrate important temporal aspects of PTSD assessment.

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“…For some individuals, these experiences are associated with the development of mental health problems such as depression (Mandelli, Petrelli, & Serretti, 2015), substance abuse and stress-related disorders such as posttraumatic stress disorder (PTSD; Arnberg, Bergh Johannesson, & Michel, 2013; Arnberg et al, 2015). However, many individuals experiencing mental health problems after overwhelming events do not receive evidence-based support or treatment (Witteveen et al, 2012), or do not receive treatment until many years after the onset of their problems (Goldstein et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

A pilot study of user satisfaction and perceived helpfulness of the Swedish version of the mobile app PTSD Coach

Cernvall

Sveen

Johannesson

et al. 2018

European Journal of Psychotraumatology

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Background: There is a need for accessible interventions in the aftermath of traumatic events with documented efficacy for preventing or reducing negative mental health consequences. The PTSD Coach is a mobile app that has shown to be effective in reducing symptoms of posttraumatic stress (PTSS). Objective: The purpose of the current study was to evaluate the user satisfaction, perceived helpfulness and potential reductions of PTSS and symptoms of depression among participants using the Swedish version of the PTSD Coach. Method: This was an uncontrolled pre-test post-test open trial including participants recruited from the community via advertisement and from an ongoing observational study who had experienced a potentially traumatic event in the last five years. Participants had access to the Swedish PTSD Coach app for four weeks. Results: Eleven participants (mean age = 38.6, female = 8) completed the study. Nine of the participants met criteria for full or partial PTSD. Results from the PTSD Coach Survey indicated that participants found the app slightly to moderately helpful and were slightly to moderately satisfied with the app. Nominal but not statistically significant reductions of medium effect sizes in PTSS (PCL-5) and depression (PHQ-9) from pre- to post-assessment were found. In interviews, participants indicated that they found elements such as learning about PTSD, breathing exercises and monitoring symptoms helpful in managing symptoms. However, several participants indicated that they had not used the app as much as they had intended to. Participants also had suggestions for improvements such as enhanced app structure and better guidance regarding how to use the app. Conclusions: The perceived helpfulness and user satisfaction were slightly lower compared to research on the original version of the app. Experiences from the study are discussed and a future controlled study of the Swedish version of the PTSD Coach is suggested.

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Prevalence and duration of PTSD in survivors 6 years after a natural disaster

Cited by 63 publications

References 34 publications

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

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

Properties of Swedish posttraumatic stress measures after a disaster

A pilot study of user satisfaction and perceived helpfulness of the Swedish version of the mobile app PTSD Coach

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