Psychological impact of the Spring 2019 flood among adult population of Iran

Aims Although natural hazards (e.g., tropical cyclones, earthquakes) disproportionately affect developing countries, most research on their mental health impact has been conducted in high-income countries. We aimed to summarize prevalences of mental disorders in Global South populations (classified according to the United Nations Human Development Index) affected by natural hazards. Methods To identify eligible studies for this meta-analysis, we searched MEDLINE, PsycINFO and Web of Science up to February 13, 2024, for observational studies with a cross-sectional or longitudinal design that reported on at least 100 adult survivors of natural hazards in a Global South population and assessed mental disorders with a validated instrument at least 1 month after onset of the hazard. Main outcomes were the short- and long-term prevalence estimates of mental disorders. The project was registered on the International Prospective Register of Systematic Reviews (CRD42023396622). Results We included 77 reports of 75 cross-sectional studies (six included a non-exposed control group) comprising 82,400 individuals. We found high prevalence estimates for post-traumatic stress disorder (PTSD) in the general population (26.0% [95% CI 18.5–36.3]; I2 = 99.0%) and depression (21.7% [95% CI 10.5–39.6]; I2 = 99.2%) during the first year following the event, with similar prevalences observed thereafter (i.e., 26.0% and 23.4%, respectively). Results were similar for regions with vs. without recent armed conflict. In displaced samples, the estimated prevalence for PTSD was 46.5% (95% CI 39.0–54.2; k = 6; I2 = 93.3). We furthermore found higher symptom severity in exposed, versus unexposed, individuals. Data on other disorders were scarce, apart from short-term prevalence estimates of generalised anxiety disorder (15.9% [95% CI 4.7–42.0]; I2 = 99.4). Conclusions Global South populations exposed to natural hazards report a substantial burden of mental disease. These findings require further attention and action in terms of implementation of mental health policies and low-threshold interventions in the Global South in the aftermath of natural hazards. However, to accurately quantify the true extent of this public health challenge, we need more rigorous, well-designed epidemiological studies across diverse regions. This will enable informed decision making and resource allocation for those in need.

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Prevalence and determinants of post-traumatic stress disorder five months after the 2019 huge flooding in Iran

Shabani,

Rasoulian,

Naserbakht

et al. 2024

BMC Public Health

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Background Despite the high occurrence of floods in Iran, its psychological consequences have been less discussed. The present paper addresses the prevalence of Post-traumatic Stress Disorder (PTSD) and its determinants among the affected adults by the huge flood of 2019. Methods An analytical cross-sectional study was conducted through household face-to-face surveys in August and September 2019. Individuals who were affected by floods and were at least 16 years old were randomly selected from three provinces in Iran: Lorestan and Khuzestan in the west and southwest, and Golestan in the northeast. The questionnaire of demographic and flood related variables in addition to the Impact of Event Scale-Revised (IES-R) were utilized to collect the data. We applied a complex sample analysis to describe the prevalence of PTSD and logistic regression analyses to find its determinants. Results Out of the 2,305 individuals approached for surveys, 1,671 (72.5%) adults affected by the floods participated in the study. The majority of participants were housewives, married, had either no formal education or primary education, and resided in rural areas. The prevalence of PTSD in the participants was 24.8% (CI 95%: 20.7–28.8%) and was significantly higher in Lorestan province (39.7%, P < 0.001). Determinants of PTSD, were unemployment (adjusted odds ratio [AOR] = 3.53, CI 95%: 1.38-9.00), primary (AOR = 2.44, CI 95%: 1.10–5.41) or high school (AOR = 2.35, CI 95%: 1.25–4.40) education (vs. university), a history of mental disorders (AOR = 2.36, CI 95%: 1.22–4.58), high damage to assets (AOR = 2.29, CI 95%: 1.40–3.75), limited access to health care services after the flood (AOR = 1.95, CI 95%: 1.20–3.19), not receiving compensation for flood damage (AOR = 1.94, CI 95%: 1.01–3.83), high wealth index (AOR = 1.90, CI 95%: 1.23–2.93), and flooded house with a height of more than one meter (AOR = 1.66, CI 95%: 1.02–2.76). Conclusion Results show a notable prevalence of PTSD, especially in Lorestan province, among adults affected by floods. Determinants of PTSD include unemployment, lower education, psychiatric history, extensive property damage, limited post-flood healthcare access, lack of compensation, and increased flood exposure. We recommend adopting an inclusive screening approach for high-risk groups and developing appropriate therapeutic and supportive interventions.

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Psychological impact of the Spring 2019 flood among adult population of Iran

Cited by 4 publications

References 46 publications

Prevalence of post-traumatic stress disorder and its relationship with coping strategies among flood victims: Evidence from Iran

Prevalence of post-traumatic stress disorder and its relationship with coping strategies among flood victims: Evidence from Iran

Prevalence of mental disorders in adult populations from the Global South following exposure to natural hazards: a meta-analysis

Prevalence and determinants of post-traumatic stress disorder five months after the 2019 huge flooding in Iran

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