title: Symptoms and coping in Sri Lanka 20-21 months after the 2004 tsunami.
abstract: BACKGROUND
  The estimated prevalence of clinically significant psychiatric and somatic symptoms in adults >1 year after the 2004 Asian tsunami is unknown.
  
  
  OBJECTIVE
  To estimate the prevalence of psychiatric and somatic symptoms and impairment in Sri Lanka 20-21 months after the 2004 Asian tsunami, and to assess coping strategies used by tsunami-affected individuals that contribute to post-tsunami adjustment.
  
  
  METHODS
  Homes from one severely affected area were randomly selected, and adult respondents were sampled utilising a modified Kish method. Instruments were administered in Sinhala to assess exposure, post-traumatic stress disorder (PTSD), depression, anxiety, somatic distress and impairment. Demographic variables and culturally-relevant coping activities were assessed.
  
  
  RESULTS
  The prevalence of clinically significant PTSD, depression and anxiety was 21%, 16% and 30% respectively. Respondents reported a mean of eight persistent and bothersome somatic complaints, which were associated with psychiatric symptoms and impairment. Thinking that one's life was in danger was the exposure item most strongly associated with symptoms and impairment. The majority of respondents found their own strength, family and friends, a Western-style hospital and their religious practice to be the most helpful coping aids.
  
  
  CONCLUSIONS
  A large minority of adults in one area of Sri Lanka reported significant psychiatric and somatic symptoms and impairment 20-21 months after the tsunami. Accurate data about risk for and resilience to impairing symptoms >1 year after disasters are necessary in order to develop rational surveillance and interventions.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, 501 E. Broadway, Suite 340, Louisville, KY 40202, USA. m.hollifield@louisville.edu
authors.forename: Michael
authors.initials: M
authors.lastname: Hollifield
authors.forename: Chandanie
authors.initials: C
authors.lastname: Hewage
authors.forename: Charlotte N
authors.initials: CN
authors.lastname: Gunawardena
authors.forename: Piyadasa
authors.initials: P
authors.lastname: Kodituwakku
authors.forename: Kalum
authors.initials: K
authors.lastname: Bopagoda
authors.forename: Krishantha
authors.initials: K
authors.lastname: Weerarathnege
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003469:Culture; D003866:Depressive Disorder / Q000453:epidemiology; D004190:Disasters; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology; D008875:Middle Aged; D015995:Prevalence; D013001:Somatoform Disorders / Q000453:epidemiology; D013188:Sri Lanka / Q000453:epidemiology; D013534:Survival / Q000523:psychology*