Background: On December 26, 2004, Asian tsunami attacked the southern part of Thailand. The tsunami induced catastrophic consequences. There was no study of long-term mental health outcomes among adult survivors by natural disasters in Thailand. Objective: The purposes of the present study were to determine prevalence and longitudinal course of PTSD, depression, and anxiety among tsunami affecting Thai people, and to identify factors associated with PTSD, depression, and anxiety in this particular group. Material and Method: The present study was a population-based longitudinal study. The third mental health assessment was conducted among adult survivors older than 17 years at three years after tsunami. PTSD, depression and anxiety were assessed by using the Harvard Trauma Questionnaire (HTQ) and the Hopkins Checklist-25 (HSCL-25) respectively. Results: 550 of 693 affected people in Phang Nga province were enrolled in the follow-up survey at three years after tsunami. Prevalence of PTSD, anxiety, and depression among affected people decreased from 9.5% (66/693), 33.6% (233/693) and 25.7% (178/693), at two months after tsunami, to 2.6% (13/503), 18.7% (94/503), and 14.1% (71/503) at three years after tsunami respectively. Risk factors for mental health problems were post-traumatic life stress such as the loss of livelihood for PTSD, depression and anxiety, and pre-traumatic vulnerabilities such as sex (female), education, and previous mental illness for depression and anxiety. Conclusion: PTSD, depression and anxiety among tsunami affecting Thai people decreased over time. Pre-traumatic vulnerable factors and post-traumatic life stress were associated with PTSD, depression and anxiety. These results are acknowledgeable by two points: first, it is important to provide both mental health intervention and psychosocial intervention in rehabilitation phase for the affected people; second, duration of intervention should be at least three years after severely impacted disaster.
KeywordsMental HealthPrevalenceDisaster
World Bank (2005) Tsunami Thailand-one-year later: National response and contribution of international partners. World Bank Report.
Amstadter, A.B., Acierno, R., Richardson, L.K., Kilpatrick, D.G., Gros, D.F., Gaboury, M.T., et al. (2009) Posttyphoon prevalence of posttraumatic stress disorder, major depressive disorder, panic disorder, and generalized anxiety disorder in a Vietnamese sample. Journal of Traumatic Stress, 22, 180-188. http://dx.doi.org/10.1002/jts.20404
Acierno, R., Ruggiero, K.J., Galea, S., Resnick, H.S., Koenen, K., Roitzsch, J., de Arellano, M., Boyle, J. and Kilpatrick, D.G. (2007) Psychological sequelae resulting from the 2004 Florida hurricanes: Implications for postdisaster intervention. American Journal of Public Health, 97, S103-S108. http://dx.doi.org/10.2105/AJPH.2006.087007
Wang, L., Zhang, Y., Wang, W., Shi, Z., Shen, J., Li, M. and Xin, Y. (2009) Symptoms of posttraumatic stress disorder among adult survivors three months after the Sichuan earthquake in China. Journal of Traumatic Stress, 22, 444-450. http://dx.doi.org/10.1002/jts.20439
Huang, P., Tan, H., Liu, A., Feng, S. and Chen, M. (2010) Prediction of posttraumatic stress disorder among adults in flood district. BMC Public Health, 10, 207. http://www.biomedcentral.com/1471-2458/10/207 http://dx.doi.org/10.1186/1471-2458-10-207
Thavichachart, N., Tangwongchai, S., Worakul, P., Kanchanatawan, B., Suppapitiporn, S., Sukoltapirom, Pattalung, A., et al. (2009) Posttraumatic mental health establishment of the tsunami survivors in Thailand. Clinical Practice & Epidemiology in Mental Health, 5, 11. http://dx.doi.org/10.1186/1745-0179-5-11
Piyasil, V., Ketuman, P., Prubrukarn, R., Ularntinon, S., Sithiraksa, N., Pithayaratsatien, N., et al. (2008) Posttraumatic stress disorder in children after the tsunami disaster in Thailand: A 3 years follow up. ASEAN Journal of Psychiatry, 9, 99-103.
van Griensven, F., Chakkraband, M.L.S., Thienkrua, W., Pengjuntr, W., Cardozo, B.L., Tantipiwatanaskul, P., et al. (2006) Rapid assessment of post-tsunami mental health problems among adults in southern Thailand. JAMA, 296, 537-548. http://dx.doi.org/10.1001/jama.296.5.537
Pietrzak, R.H., Tracy, M., Galea, S., Kilpatrick, D.G., Ruggiero, K.J., Hamblen, J.L., Southwick, S.M., et al. (2012) Resilience in the face of disaster: Prevalence and longitudinal course of mental disorders following Hurricane Ike. Plos ONE, 7, e38964. http://dx.doi.org/10.1371/journal.pone.0038964
Neria, Y., Nandi, A. and Galea, S. (2008) Post-traumatic stress disorder following disasters: A systemic review. Psychological Medicine, 38, 467-480. http://dx.doi.org/10.1017/S0033291707001353
Brewin, C.R., Andrew, B.A. and Valentine, J.D. (2000) Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. Journal of Consulting & Clinical Psychology, 68, 748-766. http://dx.doi.org/10.1037/0022-006X.68.5.748
Piyasil, V., Ketumarn, P., Prubrukarn, R., Ularntinon, S., Sitdhiraksa, N., Pithayaratsathien, N., et al. (2011) Posttraumatic stress disorder in children after the tsunami disaster in Thailand: A 5-years follow-up. Journal of the Medical Association of Thailand, 94, S138-S144.
Thienkrua, W., Lopes Cardozo, B., Chakkraband, S., Guadamaz, T.E., Pengjuntr, W., Tantipiwatanaskul, T., et al. (2006) Tsunami-related post-traumatic stress disorder and depression among children in southern Thailand. JAMA, 296, 549-559. http://dx.doi.org/10.1001/jama.296.5.549
McHorney, C.A., Ware, J.E. and Raczek, A.E. (1993) The MOS 36-item short-form health survey (SF-36): II psychometric and clinical tests of validity in measuring physical and mental health constructs. Medical Care, 31, 247-263. http://dx.doi.org/10.1097/00005650-199303000-00006
Kongsakon, R., Silpakit, C. and Udomsubpayakul, U. (2007) Thai normative data for the SF-36 health survey: Bangkok metropolitan. ASEAN Journal of Psychiatry, 8, 131-137.
Mollica, R.F., Caspi-Yavin, Bollini, P., Truong, T., Tor, S. and Lavelle, J. (1992) The Havard trauma questionnaire: Validity a cross-cultural instrument for measuring torture, trauma, and posttraumatic stress disorder in Indochinese refugees. The Journal of Nervous and Mental Disease, 180, 111-116. http://dx.doi.org/10.1097/00005053-199202000-00008
Mollica, R.F., Wyshak, G., de Marneffe, D., Khuon, F. and Lavelle, J. (1987) Indochinese versions of the Hopkins symptom checklist-25: A screening instrument for the psychiatric care of refugees. Journal of the American, 144, 497-500.
Kar, N., Jagadisha, Sharma, P., Murali, N. and Mehrotra, S. (2004) Mental health consequences of the trauma of super-cyclone 1999 in Orissa. Indian Journal of Psychiatry, 46, 228-237.
Lima, B.R., Pai, S., Toledo, V., Caris, U., Haro, J., Lozano, J.C., et al. (1993) Emotional distress in disaster victims: A follow-up study. Journal of Nervous and Mental Disease, 65, 311-317.
North, C.S., Kawasaki, A., Spitznagel, E.L. and Hong, B.A. (2004) The course of PTSD, major depression, substance abuse, and somatization after a natural disaster. Journal of Nervous and Mental Disease, 92, 823-829. http://dx.doi.org/10.1097/01.nmd.0000146911.52616.22
Chakrabhand, S., Panyayong, B. and Sirivech, P. (2006) Mental health and psychosocial support after the tsunami in Thailand. International Review of Psychiatry, 18, 599605. http://dx.doi.org/10.1080/09540260601038274
Kessler, R.C., McLaughlin, K.A., Koenen, K.C., Petukhova, M., Hill, E.D. and The WHO World Mental Health Survey Consortium (2012) The importance of secondary trauma exposure for post-disaster mental disorder. Epidemiology and Psychiatric Sciences, 21, 35-45. http://dx.doi.org/10.1017/S2045796011000758
Tracy, M., Norris, F.H. and Galea, S. (2011) Differences in the determinants of posttraumatic stress disorder and depression after a mass trauma event. Depress Anxiety, 28, 666-675. http://dx.doi.org/10.1002/da.20838
Galea, S., Brewin, C.R., Gruber, M., Jones, R.T., King, D.W., King, L.A., et al. (2007) Exposure to hurricanerelated stressors and mental illness after Hurricane Katrina. Archives of General Psychiatry, 64, 1427-1434. http://dx.doi.org/10.1001/archpsyc.64.12.1427
Ditlevsen, D.N. and Eiklit, A. (2010) The combined effect of gender and age on posttraumatic stress disorder: Do men and women show differences in the life span distribution of the disorder? Annals of General Psychiatry, 21, 32-39. http://dx.doi.org/10.1186/1744-859X-9-32
Kessler, R.C., Galea, S., Jones, R.T., Parker, H.A. and Hurricane Katrina Community Advisory Group (2006) Mental illness and suicidality after Hurricane Katrina. Bulletin of the World Health Organization, 84, 930-939. http://dx.doi.org/10.2471/BLT.06.033019