title: Post-traumatic stress disorder in children after the tsunami disaster in Thailand: a 5-year follow-up.
abstract: BACKGROUND
  Children may suffer from post-traumatic stress disorder after disaster. There was a severe tsunami following an undersea earthquake off the Sumatra coast of Indonesia. There were 20,000 children in 6 southwestern provinces of Thailand who were possibly affected.
  
  
  OBJECTIVE
  To study the prevalence of post-traumatic stress disorder (PTSD) in Thai students in the area affected by the December 26th, 2004 tsunami disaster, Thailand.
  
  
  METHODS
  One thousand six hundred and fifteen surviving students from two schools in Takua Pa district located in Phang-nga Province, Thailand participated in this longitudinal study. Screening was done by using Pediatric Symptom Checklists part II (PSC-II), Childhood Depressive Intervention (CDI) and the Revised Child Impact of Events Scales (CRIES 8). PTSD was diagnosed by child and adolescent psychiatrists by using criteria of DSM-IV. The intervention included psychological first aid, psycho-education, cognitive-behavioral therapy, medication in severe cases, group support for students, parents and teachers which was done, beginning at 10 days after the tsunami disaster. Data were analyzed by using SPSS version 12.0.
  
  
  RESULTS
  The prevalence rates of PTSD in the students facing the tsunami disaster in the study group were 573, 46.1, 31.6, 7.6, 4.5, 3.9 and 2.7% at 6 weeks, 6 months, 1 year, 2 years, 3 years, 4 years and 5 years after the disaster, respectively. Female to male ratio was 1.7: 1. The peak age was 9-10 years old. The top five on the list of symptoms in PTSD were distress with cue, intrusive thought, functioning impairment, startled response, terrified and hyper vigilance. Seven cases (3.1%) were diagnosed partial PTSD, still exhibited a wide range of PTSD symptoms but did not fulfill the DSM-IV diagnostic criteria. The top five on the list of symptoms in partial PTSD were avoiding thought/feelings, terrified, avoiding place/activities, distress with cue and startled response.
  
  
  CONCLUSIONS
  The prevalence of PTSD among tsunami victims was 57.3% at 6 weeks after the disaster. It declined sharply at 2 years after the event. Despite receiving financial, rehabilitation and mental health support, 2.7% of the victims continued to suffer from PTSD 5 years after the disaster.
authors: Child & Adolescent Psychiatric Department, Queen Sirikit National Institute of Child Health, College of Medicine, Rangsit University, Bangkok, Thailand. vpiyasil@yahoo.com
authors: Vinadda
authors: V
authors: Piyasil
authors: Panom
authors: P
authors: Ketumarn
authors: Ratanotai
authors: R
authors: Prubrukarn
authors: Sirirat
authors: S
authors: Ularntinon
authors: Nantawat
authors: N
authors: Sitdhiraksa
authors: Nattorn
authors: N
authors: Pithayaratsathien
authors: Pornjira
authors: P
authors: Pariwatcharakul
authors: Tiraya
authors: T
authors: Lerthattasilp
authors: Nattinee
authors: N
authors: Chinajitphant
authors: Ketsiri
authors: K
authors: Liamwanich
authors: Nisarat
authors: N
authors: Wadchareeudomkarn
authors: Janarpar
authors: J
authors: Sookatup
authors: Thanyalak
authors: T
authors: Wanlieng
authors: Chukiat
authors: C
authors: Yongpitayapong
authors: Pranee
authors: P
authors: Paveenchana
authors: Lukkana
authors: L
authors: Tasri
authors: Peerayut
authors: P
authors: Chaiyakun
authors: Naratip
authors: N
authors: Sanguanpanich
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004190:Disasters; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D015995:Prevalence; D011581:Psychological Tests; D012574:Schools; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D013315:Stress, Psychological / Q000523:psychology; D013785:Thailand / Q000453:epidemiology; D055871:Tidal Waves; D013997:Time Factors; D057192:Tsunamis