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. 2017 Jan;47(2):227-241.
doi: 10.1017/S0033291716002026. Epub 2016 Aug 30.

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

E J Bromet  1 , L Atwoli  2 , N Kawakami  3 , F Navarro-Mateu  4 , P Piotrowski  5 , A J King  6 , S Aguilar-Gaxiola  7 , J Alonso  8 , B Bunting  9 , K Demyttenaere  10 , S Florescu  11 , G de Girolamo  12 , S Gluzman  13 , J M Haro  14 , P de Jonge  15 , E G Karam  16 , S Lee  17 , V Kovess-Masfety  18 , M E Medina-Mora  19 , Z Mneimneh  20 , B-E Pennell  20 , J Posada-Villa  21 , D Salmerón  22 , T Takeshima  23 , R C Kessler  6
Affiliations

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

E J Bromet et al. Psychol Med. 2017 Jan.

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.

Keywords: Disaster; PTSD; post-traumatic stress disorder.

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Conflict of interest statement

Declaration of Interest

In the past 3 years, Dr Kessler has served as a consultant for or received research support from Johnson & Johnson Wellness and Prevention, the Lake Nona Life Project, and Shire Pharmaceuticals. Dr Kessler is a co-owner of DataStat, Inc., a market research company that carries out healthcare research. The other authors report no biomedical financial interests or potential conflicts of interest.

Figures

Fig. 1
Fig. 1
Area under the curve (AUC) of predicted probabilities based on model 4 overall and in selected subgroups.
See this image and copyright information in PMC

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