title: The impact of recurrent disasters on mental health: a study on seasonal floods in northern India.
abstract: BACKGROUND
  Very little is known on the impact of recurrent disasters on mental health. Aim The present study examines the immediate impact of a recurrent flood on mental health and functioning among an affected population in the rural district of Bahraich, Uttar Pradesh, India, compared with a population in the same region that is not affected by floods.
  
  
  METHODS
  The study compared 318 affected respondents with 308 individuals who were not affected by floods. Symptoms of anxiety and depression were assessed by the Hopkins Symptom Checklist-25 (HSCL-25). Psychological and physical functioning was assessed by using the Short Form-12 (SF-12).
  
  
  RESULTS
  The affected group showed large to very large differences with the comparison group on symptoms of anxiety (D = .92) and depression (D = 1.22). The affected group scored significantly lower on psychological and physical functioning than the comparison group (respectively D = .33 and D = .80). However, hierarchical linear regressions showed no significant relationship between mental health and the domains of functioning in the affected group, whereas mental health and the domains of functioning were significantly related in the comparison group.
  
  
  CONCLUSIONS
  This study found a large negative impact of the recurrent floods on mental health outcomes and psychological and physical functioning. However, in a context with recurrent floods, disaster mental health status is not a relevant predictor of functioning. The findings suggest that the observed mental health status and impaired functioning in this context are also outcomes of another mechanism: Both outcomes are likely to be related to the erosion of the social and environmental and material context. As such, the findings refer to a need to implement psychosocial context-oriented interventions to address the erosion of the context rather than specific mental health interventions.
authors.affiliation: Department of Research and Development, World Health Organization Collaborating Centre, HealthNet TPO, Amsterdam, the Netherlands. twind@healthnettpo.org
authors.forename: Tim R
authors.initials: TR
authors.lastname: Wind
authors.forename: Pooran C
authors.initials: PC
authors.lastname: Joshi
authors.forename: Rolf J
authors.initials: RJ
authors.lastname: Kleber
authors.forename: Ivan H
authors.initials: IH
authors.lastname: Komproe
mesh_terms: D000328:Adult; D004190:Disasters / Q000706:statistics & numerical data*; D005163:Factor Analysis, Statistical; D005260:Female; D055868:Floods / Q000706:statistics & numerical data*; D006305:Health Status Indicators; D006801:Humans; D007194:India; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D012621:Seasons