title: One-year follow-up of survivors of a mass shooting.
abstract: OBJECTIVE
  This report describes a 1-year follow-up study of survivors of a mass shooting incident. Acute-phase data from this incident were previously reported in this journal.
  
  
  METHODS
  The Diagnostic Interview Schedule/Disaster Supplement was used to assess 136 survivors at 1-2 months and again a year later, with a 91% reinterview rate.
  
  
  RESULTS
  In the acute postdisaster period, 28% of subjects met criteria for posttraumatic stress disorder (PTSD), and 18% of subjects qualified for another active psychiatric diagnosis. At follow-up, 24% of subjects reported a history of postdisaster PTSD (17% were currently symptomatic), and 12% another current psychiatric disorder. Half (54%) of all 46 individuals identified as having had PTSD at either interview were recovered at follow-up, and no index predictors of recovery were identified. There were no cases of delayed-onset PTSD (beyond 6 months). Considerable discrepancy in identified PTSD cases was apparent between index and follow-up. Inconsistency in reporting, rather than report of true delayed-onset, was responsible for all PTSD cases newly identified at 1 year. The majority of subjects with PTSD at index who were recovered at follow-up reported no history of postdisaster PTSD at follow-up, suggesting considerable influence of fading memory.
  
  
  CONCLUSIONS
  This study's findings suggest that disaster research that conducts single interviews at index or a year later may overlook a significant portion of PTSD. The considerable diagnostic comorbidity found in this study was the one robust predictor of PTSD at any time after the disaster. Disaster survivors with a psychiatric history, especially depression, may be most vulnerable to developing PTSD and therefore may deserve special attention from disaster mental health workers.
authors.affiliation: Department of Psychiatry and Mathematics and Biostatistics, Washington University School of Medicine, St. Louis, MO 63110, USA.
authors.forename: C S
authors.initials: CS
authors.lastname: North
authors.forename: E M
authors.initials: EM
authors.lastname: Smith
authors.forename: E L
authors.initials: EL
authors.lastname: Spitznagel
mesh_terms: D000328:Adult; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology; D004190:Disasters; D005260:Female; D005500:Follow-Up Studies; D006708:Homicide / Q000523:psychology*; D006801:Humans; D008297:Male; D008568:Memory; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000453:epidemiology; D017741:Survivors / Q000523:psychology*