Tracking levels of psychiatric distress associated with the terrorist events of September 11, 2001: a review of the literature.
BACKGROUND
Early publicized predictions of an onslaught of psychiatric distress following the terrorist events of September 11, 2001, have not materialized, and it remains unlikely at present that the medical and insurance communities will experience a significant increase in psychiatric utilization rates secondary to September 11. A handful of research studies have begun to characterize the psychiatric impact of the events associated with the September 11 terrorist attacks. Information related to the manifestation of psychiatric distress following disasters is of particular interest to the scientific, clinical and disability insurance communities given the ongoing threat of further terrorist attacks.


METHODS
A comprehensive literature search was completed to identify articles that address our current understanding of posttraumatic stress disorder (PTSD) and patterns of psychiatric distress that typically follow manmade disasters. To help in conveying such a conceptual framework, we integrated basic research relating to PTSD with epidemiological data relating to past disasters (e.g., the Oklahoma City bombing) and the events of September 11.


CONCLUSIONS
A critical analysis of the September 11 research literature is offered with suggestions for research that would strengthen our understanding of the manifestation of psychiatric distress associated with manmade disasters.
Lovejoy
David W
DW
Hartford Hospital, Institute of Living, University of Connecticut School of Medicine, USA. dlovejo@harthosp.org
Diefenbach
Gretchen J
GJ
Licht
David J
DJ
Tolin
David F
DF
D006801:Humans; D018868:Insurance, Disability; D008605:Mental Health Services / Q000706:statistics & numerical data; D009519:New York City / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000191:economics* / Q000453:epidemiology* / Q000523:psychology; D023481:Terrorism; D014481:United States / Q000453:epidemiology