Post-traumatic stress disorder associated with natural and human-made disasters in the World Mental Health Surveys

E. J. Bromet, L. Atwoli, N. Kawakami, F. Navarro-Mateu, P. Piotrowski, A. J. King, S. Aguilar-Gaxiola, J. Alonso, B. Bunting, K. Demyttenaere, S. Florescu, G. De Girolamo, S. Gluzman, J. M. Haro, P. De Jonge, E. G. Karam, S. Lee, V. Kovess-Masfety, M. E. Medina-Mora, Z. MneimnehB. E. Pennell, J. Posada-Villa, D. Salmerón, T. Takeshima, R. C. Kessler

Research output: Contribution to journalReview articlepeer-review

97 Citations (Scopus)

Abstract

Background Research on post-traumatic stress disorder (PTSD) following natural and human-made disasters has been undertaken for more than three decades. Although PTSD prevalence estimates vary widely, most are in the 20-40% range in disaster-focused studies but considerably lower (3-5%) in the few general population epidemiological surveys that evaluated disaster-related PTSD as part of a broader clinical assessment. The World Mental Health (WMH) Surveys provide an opportunity to examine disaster-related PTSD in representative general population surveys across a much wider range of sites than in previous studies. Method Although disaster-related PTSD was evaluated in 18 WMH surveys, only six in high-income countries had enough respondents for a risk factor analysis. Predictors considered were socio-demographics, disaster characteristics, and pre-disaster vulnerability factors (childhood family adversities, prior traumatic experiences, and prior mental disorders). Results Disaster-related PTSD prevalence was 0.0-3.8% among adult (ages 18+) WMH respondents and was significantly related to high education, serious injury or death of someone close, forced displacement from home, and pre-existing vulnerabilities (prior childhood family adversities, other traumas, and mental disorders). Of PTSD cases 44.5% were among the 5% of respondents classified by the model as having highest PTSD risk. Conclusion Disaster-related PTSD is uncommon in high-income WMH countries. Risk factors are consistent with prior research: Severity of exposure, history of prior stress exposure, and pre-existing mental disorders. The high concentration of PTSD among respondents with high predicted risk in our model supports the focus of screening assessments that identify disaster survivors most in need of preventive interventions.

Original languageEnglish
Pages (from-to)227-241
Number of pages15
JournalPsychological Medicine
Volume47
Issue number2
DOIs
Publication statusPublished - 1 Jan 2017
Externally publishedYes

Keywords

  • Disaster
  • PTSD
  • post-traumatic stress disorder

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