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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Joseph Boscarino, PhD, MPH1, Sandro Galea, MD, MPH2, Jennifer Ahern, MPH2, Heidi Resnick, PhD3, and David Vlahov, PhD2. (1) Division of Health and Science Policy, New York Academy of Medicine, 1216 Fifth Avenue, New York, NY 10029, 212.419.3551, jboscarino@nyam.org, (2) Center for Urban Epidemiologic Studies, New York Academy of Medicine, 1216 5th Avenue, New York, NY 10029, (3) National Crime Victims' Research and Treatment Center, Medical University of South Carolina, 165 Cannon Street PO Box 2590852, Charleston, SC 250852
Post-disaster studies report different rates of psychiatric medication usage and mental health utilization. We report the prevalence and correlates of these following the September 11th terrorist attacks in Manhattan, based on a random-digit-dial phone survey of adult residents south of 110th Street 5-8 weeks after this catastrophe (completion rate=65%). Among 988 respondents surveyed (female=52%; white=72%; mean age=42), 8.8% (95% confidence interval [CI]=6.9-10.8) and 9.7% (95% CI=7.7-11.8), respectively, met the criteria for current posttraumatic stress disorder (PTSD) or major depressive disorder (MDD). 16.9% (14.4-19.5) and 8.9% (95% CI=7.1-10.3) of residents, respectively, used mental health services or took psychiatric medications 30 days before the attacks, and 19.4% (95% CI=16.7-22.2) and 11.6% (95% CI=9.5-13.7%), respectively, 30 days after. Altogether, 10% (95% CI=7.9-12.0) of New Yorkers increased their visits to mental health professionals after the attacks. However, 26.7% (18.4-37.1) and 25.1% (17.1-35.3) of those with current PTSD, respectively, had increased visits or took medications after the attacks, and 25.5% (95% CI=16.9-36.6) and 25.1% (95% CI=17.3-35.2%) with current MDD, respectively, had increased visits or took psychiatric medications. Factors associated with increased visits in multivariate analysis were: being 45-64 years old (vs. 65+; odds ratio [OR]=8.3, p=0.011), being female (vs. male; OR=2.3, p=0.004), experiencing 4+ lifetime traumatic events (vs. none; OR=3.5, p=0.002), and experiencing peri-disaster panic attacks (vs. none; OR=3.3, p<0.001). Factors associated with post-attack medication use in multivariate analysis were: having experienced 2+ stressful events in the past year (vs. none; OR=3.9, p<0.001), having health insurance (vs. not; OR=3.9, p=0.018), being female (vs. male; OR=2.2, p=0.001), and experiencing peri-disaster panic attacks (OR=2.5, p=0.002). We did not find a major increase in mental health utilization or psychiatric medication use among the general population in Manhattan during the early post-disaster period, except among PTSD and MDD cases. It is plausible that medication usage and service utilization will increase several months after the attacks, especially in light of ongoing terrorist threats. We plan further surveillance surveys in New York City to assess ongoing psychiatric medication and mental health utilization and to assess the mental health status of New Yorkers.
Learning Objectives:
Keywords: Prescription Drug Use Patterns, Psychiatric Epidemiology
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.