title: Symptoms of posttraumatic stress disorder and depression among children in tsunami-affected areas in southern Thailand.
abstract: BACKGROUND
  On December 26, 2004, an undersea earthquake occurred off the northwestern coast of Sumatra, Indonesia. The tsunami that followed severely impacted all 6 southwestern provinces of Thailand, where approximately 20,000 children were directly affected.
  
  
  OBJECTIVE
  To assess trauma experiences and the prevalence of symptoms of posttraumatic stress disorder (PTSD) and depression among children in tsunami-affected provinces in southern Thailand.
  
  
  METHODS
  Population-based mental health surveys were conducted among children aged 7 to 14 years in Phang Nga, Phuket, and Krabi provinces from February 15-22, 2005 (2 months posttsunami), and September 7-12, 2005 (9 months posttsunami).
  
  
  METHODS
  Trauma experiences and symptoms of PTSD and depression as measured by a tsunami-modified version of the PsySTART Rapid Triage System, the UCLA PTSD Reaction Index, and the Birleson Depression Self-Rating Scale.
  
  
  RESULTS
  A total of 371 children (167 displaced and living in camps, 99 not displaced from villages affected by the tsunami, and 105 not displaced from unaffected villages) participated in the first survey. The prevalence rates of PTSD symptoms were 13% among children living in camps, 11% among children from affected villages, and 6% among children from unaffected villages (camps vs unaffected villages, P = .25); for depression symptoms, the prevalence rates were 11%, 5%, and 8%, respectively (P = .39). In multivariate analysis of the first assessment, having had a delayed evacuation, having felt one's own or a family member's life to have been in danger, and having felt extreme panic or fear were significantly associated with PTSD symptoms. Older age and having felt that their own or a family member's life had been in danger were significantly associated with depression symptoms. In the follow-up survey, 72% (151/210) of children from Phang Nga participated. Prevalence rates of symptoms of PTSD and depression among these children did not decrease significantly over time.
  
  
  CONCLUSIONS
  This assessment documents the prevalence of mental health problems among children in tsunami-affected provinces in southern Thailand at 2 and 9 months posttsunami. Traumatic events experienced during the tsunami were significantly associated with symptoms of PTSD and depression. These data may be useful to target mental health services for children and may inform the design of these interventions.
authors.affiliation: Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand.
authors.forename: Warunee
authors.initials: W
authors.lastname: Thienkrua
authors.forename: Barbara Lopes
authors.initials: BL
authors.lastname: Cardozo
authors.forename: M L Somchai
authors.initials: ML
authors.lastname: Chakkraband
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Guadamuz
authors.forename: Wachira
authors.initials: W
authors.lastname: Pengjuntr
authors.forename: Prawate
authors.initials: P
authors.lastname: Tantipiwatanaskul
authors.forename: Suchada
authors.initials: S
authors.lastname: Sakornsatian
authors.forename: Suparat
authors.initials: S
authors.lastname: Ekassawin
authors.forename: Benjaporn
authors.initials: B
authors.lastname: Panyayong
authors.forename: Anchalee
authors.initials: A
authors.lastname: Varangrat
authors.forename: Jordan W
authors.initials: JW
authors.lastname: Tappero
authors.forename: Merritt
authors.initials: M
authors.lastname: Schreiber
authors.forename: Frits
authors.initials: F
authors.lastname: van Griensven
mesh_terms: D000293:Adolescent; D002648:Child; D003863:Depression / Q000453:epidemiology*; D004190:Disasters; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D011159:Population Surveillance; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D013534:Survival / Q000523:psychology*; D013785:Thailand / Q000453:epidemiology