Psychiatric disorders among poor victims following a major disaster: Armero, Colombia.
We evaluated 102 adult victims of low socioeconomic status living in tent camps 8 months following the Armero disaster in Colombia to ascertain the level of psychiatric morbidity. Ninety-one percent of the subjects identified by the screening instrument as being emotionally distressed met DSM-III criteria for a psychiatric disorder. The most frequent diagnoses were posttraumatic stress disorder and major depression. These findings indicate that a simple screening instrument can be reliably used for the detection of significant emotional problems among disaster victims. They also show that these victims are not merely distressed; rather, they present clear and treatable psychiatric disorders that center on anxiety and depression. Interventions for their adequate management need to be designed, implemented, and evaluated. In a developing country, however, the high prevalence of mental disorders among disaster victims far exceeds the specialized mental health resources. The general health sector, particularly the primary level of care, must participate actively in the delivery of mental health services to meet this need, particularly for a socioeconomically disadvantaged population. The narrow range of psychiatric disorders detected among the disaster victims makes it possible to circumscribe the training of the primary care worker in disaster mental health to these priority conditions.
Lima
B R
BR
Department of Psychiatry, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
Pai
S
S
Santacruz
H
H
Lozano
J
J
D000328:Adult; D000342:Affective Symptoms / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D003105:Colombia / Q000453:epidemiology; D003156:Community Mental Health Services; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D004190:Disasters; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D008875:Middle Aged; D011203:Poverty; D011320:Primary Health Care / Q000592:standards; D011569:Psychiatric Status Rating Scales / Q000592:standards / Q000706:statistics & numerical data; D011594:Psychometrics; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy