The mental health consequences of disaster-related loss: findings from primary care one year after the 9/11 terrorist attacks.
This study examines the long-term psychiatric consequences, pain interference in daily activities, work loss, and functional impairment associated with 9/11-related loss among low-income, minority primary care patients in New York City. A systematic sample of 929 adult patients completed a survey that included a sociodemographic questionnaire, the PTSD Checklist, the PRIME-MD Patient Health Questionnaire, and the Medical Outcomes Study Short Form-12 (SF-12). Approximately one-quarter of the sample reported knowing someone who was killed in the attacks of 9/11, and these patients were sociodemographically similar to the rest of the sample. Compared to patients who had not experienced 9/11-related loss, patients who experienced loss were roughly twice as likely (OR = 1.97, 95%; CI = 1.40, 2.77) to screen positive for at least one mental disorder, including major depressive disorder (MDD; 29.2%), generalized anxiety disorder (GAD; 19.4%), and posttraumatic stress disorder (PTSD; 17.1%). After controlling for pre-9/11 trauma, 9/11-related loss was significantly related to extreme pain interference, work loss, and functional impairment. The results suggest that disaster-related mental health care in this clinical population should emphasize evidence-based treatments for mood and anxiety disorders.
Neria
Yuval
Y
Department of Psychiatry, College of Physicians and Surgeons, Columbia University Medical Center, New York City, NY 10032, USA. ny126@columbia
Olfson
Mark
M
Gameroff
Marc J
MJ
Wickramaratne
Priya
P
Gross
Raz
R
Pilowsky
Daniel J
DJ
Blanco
Carlos
C
Manetti-Cusa
Julián
J
Lantigua
Rafael
R
Shea
Steven
S
Weissman
Myrna M
MM
D000293:Adolescent; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000209:etiology; D003865:Major Depressive Disorder / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009519:New York City; D011320:Primary Health Care; D011569:Psychiatric Status Rating Scales; D047851:September 11 Terrorist Attacks / Q000523:psychology*; D018582:Sick Leave; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology; D055815:Young Adult