Loss of resources and hurricane experience as predictors of postpartum depression among women in southern Louisiana.
BACKGROUND
After a natural disaster, mental disorders often become a long-term public health concern. Previous studies under smaller-scale natural disaster conditions suggest loss of psychosocial resources is associated with psychological distress.


METHODS
We examined the occurrence of depression 6 and 12 months postpartum among 208 women residing in New Orleans and Baton Rouge, Louisiana, who were pregnant during or immediately after Hurricane Katrina's landfall. Based on the Conservation of Resources (COR) theory, we explored the contribution of both tangible/financial and nontangible (psychosocial) loss of resources (LOR) on the outcome of depression, measured using the Edinburgh Postnatal Depression Scale (EPDS). We also investigated the influence on depression of individuals' hurricane experience through a Hurricane Experience Score (HES) that includes such factors as witnessing death, contact with flood waters, and injury to self or family members.


RESULTS
Both tangible and nontangible LOR were associated with depression cross-sectionally and prospectively. Severe hurricane exposure (high HES) was also associated with depression. Regression analysis showed LOR-associated depression was explained almost entirely by nontangible rather than tangible factors. Consistent with COR theory, however, nontangible LOR explained some of the association between severe hurricane exposure and depression in our models. A similar result was seen prospectively for depression at 12 months, even controlling for depression symptoms at 6 months.


CONCLUSIONS
These results suggest the need for preventive measures aimed at preserving psychosocial resources to reduce the long-term effects of disasters.
Ehrlich
Matthew
M
Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana 70112, USA.
Harville
Emily
E
Xiong
Xu
X
Buekens
Pierre
P
Pridjian
Gabriella
G
Elkind-Hirsch
Karen
K
D000293:Adolescent; D000328:Adult; D055867:Cyclonic Storms / Q000191:economics; D019052:Depression, Postpartum / Q000453:epidemiology*; D004190:Disasters / Q000191:economics; D005260:Female; D006306:Health Surveys; D006801:Humans; D008145:Louisiana / Q000453:epidemiology; D008603:Mental Health; D011247:Pregnancy; D012044:Regression Analysis; D012307:Risk Factors; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*