Emotional and biological stress measures in Katrina survivors relocated to Oklahoma

Abstract

Objectives: The authors assessed relocated Hurricane Katrina survivors' emotional and biological stress measures 20 months postdisaster to understand effects of both hurricane exposure and forced relocation on emotional and physical health.

Design: Psychiatric diagnoses, post-traumatic stress disorder (PTSD) and depressive symptoms, and biological stress measures were compared for total survivor and control groups and subgroups by PTSD diagnoses and lifetime trauma.

Setting: Outpatient university psychiatry clinics in Oklahoma City and Tulsa.

Participants: Thirty-four healthy adult Katrina survivors relocated to Oklahoma, and 34 healthy, demographically matched Oklahoma comparison participants.

Main outcome measures: Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, assessed Axis I psychiatric disorders. Clinician-Administered PTSD Scale and Beck Depression Inventory quantified PTSD and depression symptoms. Biological stress measures were physiologic reactivity (heart rate and blood pressure responses to a trauma interview), interleukin-2 (IL-2; cell-mediated immunity), and interleukin-6 (IL-6; proinflammatory cytokine).

Results: Both groups had high lifetime trauma exposure. Among survivors, current hurricane-related and predisaster PTSD were diagnosed in 35.3 and 11.8 percent. Controls had current (11.8 percent) and lifetime (14.7 percent) PTSD. Survivors' PTSD and depression symptom levels were higher than controls and within illness ranges. The survivors had higher IL-6 than nontraumatized controls, higher IL-6 in the presence of PTSD, and higher baseline heart rates and mean arterial blood pressure reactivity than controls.

Conclusions: Higher IL-6 and autonomic measures for several Katrina survivor subgroups than control subgroups may confer future cardiovascular risks. The results are discussed relative to increased myocardial infarct rates in New Orleans after Katrina. Even healthy survivors should be assessed for cardiovascular risks and mental health sequelae.