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APHA Scientific Session and Event Listing

Recorded presentation

Padmini Ranasinghe, MD¹, Ramin Ahmadi, MD², Lisa Calvocoressi, PhD², Haq Nawaz, MD, MPH³, and Becca Levy, PhD⁴. (1) Medical Education, Griffin Hospital, 130 Division Street, Derby, CT 06418, 2036762204, padmini.ranasinghe@yale.edu, (2) National Community Center of Excellence in Women's Health, Griffin Hospital, 130 Division Street, Derby, CT 06418, (3) Griffin Hospital, 130 Division Street, Derby, CT 06418, (4) School of Public Health, Yale University, 60 College Street, New Haven, CT 06520

In December 2004 a massive Indian Ocean Tsunami struck without warning. Within hours more than 35000 people were killed and half a million displaced in coastal Sri Lanka alone. Affected communities may take many years to recover from this unprecedented natural disaster. Six months later several hundred thousand survivors were still confined to transitional camps until communities are rebuilt. Objective of this study is to examine prevalence of PTSD and depression in affected populations still living in temporary housing.

This cross-sectional questionnaire survey was conducted in the areas suffering highest casualties in the south and southwest of the island. A total of 264 subjects, 16 years or older representing 7 camps volunteered to the study with a participation rate of 97%. Survey was administered by native language speaking medical graduates. Questions included a 17-item PTSD scale (DSM-IV) and a 20-item depression questionnaire (CES-D).

Depression prevalence was higher in females (73.1%) than in males (63.1%) but is not statistically significant (OR 1.59; 95% CI, 0.935 to 2.076; p=0.086). In CES-D scale females scored 22.93 and males 19.33. For PTSD females (63.4%) were more than twice as likely as males (43.7%) to exhibit symptoms (OR 2.23; 95% CI, 1.35 to 3.69; p=0.002). After adjusting for age, social support, and self-rated health, gender was a significant predictor of PTSD. Females showed statistically significant levels of avoidance and hyper-arousal symptoms. Self-rated health of this population before and after Tsunami was 3.92 and 3.08 on a scale of 0 to 5.

These results indicate a significantly high prevalence of depression (69.2%) and PTSD (55.7%) in these displaced populations six months in to the recovery, compared to estimated 10% prevalence of psychological disorders among general population. Females also showed higher average scores than males on CES-D scale. High prevalence of trauma-induced psychological effects of both sexes indicates possible recovery issues for many years to come. To prevent overburdening the system healthcare workers maybe required to adopt different evaluation and treatment methods. This data also suggests the need for public health efforts related to disasters to accommodate factors such as gender in planning and managing psychosocial interventions to allow for variations within affected groups.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Define PTSD and depression according to DSM-IV and learn about standard instruments used for measuring them in a population
• Describe the impact of psychological health on general recovery after a traumatic event such as a natural disaster
• Recognize the potential for very high prevalence (upto 50%-70%) of psychological disorders after a natural disaster, and the contribution of factors such as gender

Keywords: Disasters, Mental Health

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation