title: Uttarakhand Disaster 2013: A Report on Psychosocial Adversities Experienced by Children and Adolescents.
abstract: OBJECTIVE
  To report the psychosocial adversities faced by children and adolescents in the Uttarkashi, district of Uttarakhand, experienced immediately after the Himalayan Tsunami in June 2013. Also to discuss issues pertinent to the disaster management including the needs of the disaster affected areas and future challenges.
  
  
  METHODS
  This is a cross sectional observational report from the community assessment and interventions that were carried out as part of the disaster relief work by National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore within 1 mo of the disaster. Assessments and interventions were done by a team consisting of psychiatry resident, clinical psychologist, psychiatric social worker and a nurse. All diagnosis were made using International Classification of Diseases 10 (ICD 10) and the data was analysed using descriptive statistics and chi-square tests.
  
  
  RESULTS
  A total of 300 children were screened; the mean age of the sample was 11.5 y and 65(32.5%) were boys. Two hundred (66.7%) children/adolescents reported one or the other psychosocial adversities attributable to the disaster. Psychological distress was present in 54/300 (18%) of the individuals. Loss of shelter and loss of playing space were the social issues having a statistically significant association with psychological distress signals such as feelings of anxiety, helplessness, insecurity, grief and uncertainty. Stress induced diagnosable psychiatric disorder was not present in any child or adolescent, however stress related psychiatric symptoms were present in around 13%.
  
  
  CONCLUSIONS
  Himalayan tsunami of Uttarakhand in 2013 was associated with considerable psychosocial adversities among the resident children and adolescents. As children are a vulnerable population, a public health approach towards assessment and management of the psychosocial adversities in this population is urgently required at the state and national levels.
authors.affiliation: Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, 560029, India.
authors.forename: Dhandapani
authors.initials: D
authors.lastname: Aneelraj
authors.affiliation: Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, 560029, India. cnkumar1974@gmail.com.
authors.forename: Channaveerachari Naveen
authors.initials: CN
authors.lastname: Kumar
authors.affiliation: Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences, Bangalore, India.
authors.forename: Revathi
authors.initials: R
authors.lastname: Somanathan
authors.affiliation: Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bangalore, India.
authors.forename: Dhanya
authors.initials: D
authors.lastname: Chandran
authors.affiliation: Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bangalore, India.
authors.forename: Suvarna
authors.initials: S
authors.lastname: Joshi
authors.affiliation: Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences, Bangalore, India.
authors.forename: Prajna
authors.initials: P
authors.lastname: Paramita
authors.affiliation: Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences, Bangalore, India.
authors.forename: Sekar
authors.initials: S
authors.lastname: Kasi
authors.affiliation: Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bangalore, India.
authors.forename: Roopesh N
authors.initials: RN
authors.lastname: Bangalore
authors.affiliation: Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, 560029, India.
authors.forename: Suresh Bada
authors.initials: SB
authors.lastname: Math
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004189:Disaster Planning; D004190:Disasters / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D013315:Stress, Psychological / Q000453:epidemiology* / Q000209:etiology; D055815:Young Adult
keywords: Children and adolescents; Psychosocial adversities; Uttarakhand disaster 2013