Health problems presented in general practice by survivors before and after a fireworks disaster: associations with mental health care.
OBJECTIVE
To study the health problems presented to general practitioners by disaster survivors who received specialized ambulatory mental health care.


METHODS
(Longitudinal) case-control study based on general practitioners' electronic medical records.


METHODS
General practice and a mental health institution (MHI) in Enschede, the Netherlands.


METHODS
A total of 728 adult disaster survivors who were registered in 30 study practices and had attended a specialized mental health institution (MHI group), and 728 practice-matched controls.


METHODS
Attendance rates in general practice before and after the disaster; health problems presented to the GP, classified according to the International Classification of Primary Care.


RESULTS
Disaster survivors in the MHI group reported higher GP attendance rates pre- and post-disaster and more health problems than controls. In the year post-disaster, the MHI group reported an increase in psychological, medically unexplained physical symptoms (MUPS), gastrointestinal and musculoskeletal problems, compared with the year pre-disaster. Controls, survivors themselves, showed also an increase in psychological problems in the year post-disaster compared with the year pre-disaster.


CONCLUSIONS
General practitioners should be aware of an increase in consultations and health problems among patients who also receive mental health care following a disaster. The services of GP and mental health care professionals should be integrated when supporting disaster victims. Information on severity of exposure to disasters should be included in disaster databases.
den Ouden
Dirk-Jan
DJ
Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands. d.denouden@nivel.nl
Dirkzwager
Anja J E
AJ
Yzermans
C Joris
CJ
D000328:Adult; D001753:Blast Injuries / Q000150:complications / Q000523:psychology* / Q000628:therapy; D016022:Case-Control Studies; D003156:Community Mental Health Services / Q000706:statistics & numerical data; D004190:Disasters; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health; D009426:Netherlands / Q000453:epidemiology; D011602:Psychophysiologic Disorders / Q000209:etiology / Q000523:psychology / Q000628:therapy; D012944:Social Support; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology / Q000628:therapy; D017741:Survivors / Q000523:psychology*