Psychiatric disorders among adults seeking emergency disaster assistance after a wildland-urban interface fire.
OBJECTIVE
This study estimated the prevalence of psychopathology at a three-month follow-up among persons seeking emergency relief services after a wildfire and identified a practical screener for use in these disaster assistance settings to aid early identification of persons at risk of subsequent psychopathology.


METHODS
During the October 2003 California firestorm that occurred at the wildland-urban interface, 357 persons who were seeking assistance from adjacent American Red Cross and government relief centers were recruited for this study. Within days of mandatory evacuation, participants completed baseline self-administered questionnaires assessing demographic characteristics, initial subjective reactions, and degree of fire exposure. At the three-month follow-up, symptoms of posttraumatic stress disorder (PTSD) and major depression were measured via a mailed survey.


RESULTS
At follow-up 33% showed evidence of probable major depression; 24% exhibited probable PTSD. On a bivariate basis, seven initial reaction and fire exposure items were significantly associated with subsequent psychopathology. Best-subsets logistic regression analyses revealed that property damage and physical injury were the best multivariate predictors of psychopathology at follow-up. No additional items provided a significant incremental improvement in prediction.


CONCLUSIONS
Individuals seeking immediate emergency assistance related to the wildland-urban interface fire were at elevated risk of psychopathology in the weeks after the fire. A short, easily administered, two-item screener, composed of items assessing fire exposure severity, appears to hold promise for aiding early identification of persons at risk of postfire psychopathology. These findings may also have implications for other mass disasters.
Marshall
Grant N
GN
RAND Corporation, 1776 Main St., Santa Monica, CA 90407, USA. grantm@rand.org
Schell
Terry L
TL
Elliott
Marc N
MN
Rayburn
Nadine R
NR
Jaycox
Lisa H
LH
D000328:Adult; D002140:California; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D042241:Early Diagnosis; D005260:Female; D005380:Financing, Government / Q000706:statistics & numerical data*; D005390:Fires / Q000706:statistics & numerical data*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D011599:Psychopathology; D012011:Red Cross; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D014505:Urban Population / Q000706:statistics & numerical data