Post-traumatic stress disorder, depression and generalised anxiety disorder in adolescents after a natural disaster: a study of comorbidity.

TLDR

Mental‑health sequelae of natural disasters in adolescents from developing countries are poorly understood, and this study examined post‑traumatic psychiatric symptoms, PTSD, depression, and anxiety in Orissa, India, one year after a super‑cyclone. The study aimed to determine the prevalence of PTSD, major depression, generalized anxiety disorder, comorbidity, and school‑performance impairment among adolescents one year after a super‑cyclone in Orissa, India. Diagnoses were made using the Mini International Neuropsychiatric Interview for children and adolescents, applying DSM‑IV criteria. Among the adolescents studied, 26.9% had PTSD, 17.6% major depression, 12.0% generalized anxiety disorder, 37.9% had any diagnosis, and 39% of those diagnosed had comorbidity, with middle‑socioeconomic status adolescents more affected and gender differences in symptom presentation, underscoring the need for post‑disaster psychiatric intervention.

Abstract

Information on mental health sequel in adolescents following natural disasters from developing countries is scant.Around one year after a super-cyclone, proportion of adolescents exhibiting post-traumatic psychiatric symptoms, prevalence of post-traumatic stress disorder (PTSD), major depression and generalized anxiety disorder, comorbidity and impairment of performance in school were studied in Orissa, India. Mini International Neuropsychiatric Interview for children and adolescents was used for evaluation and diagnosis. The criteria for diagnoses were based on Diagnostic and Statistical Manual of Mental Disorders-IV.Post-disaster psychiatric presentation in adolescents was a conglomeration of PTSD, depression and anxiety symptoms. The prevalences of PTSD, major depressive disorder and generalised anxiety disorder were 26.9%, 17.6% and 12.0% respectively. Proportion of adolescents with any diagnosis was 37.9%. Comorbidity was found in 39.0% of adolescents with a psychiatric diagnosis. Adolescents from middle socioeconomic status were more affected. There were gender differences in the presentation of the symptoms rather than on the prevalence of diagnoses. Prolonged periods of helplessness and lack of adequate post-disaster psychological support were perceived as probable influencing factors, as well as the severity of the disaster.The findings of the study highlight the continuing need for identification and intervention for post-disaster psychiatric morbidities in adolescent victims in developing countries.