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Tsunami exposure may have lasting effects on mental well-being of survivors

Swedish adults repatriated by a Southeast Asian tsunami in 2004 had higher risk for stress-related disorders and attempted suicide compared with unexposed adults up to 5 years following the natural disaster, according to study findings in Lancet Psychiatry.

“On Dec. 26, 2004, the massive Sumatra Andaman earthquake caused a series of tsunamis that inundated coastal areas around the Indian Ocean and killed more than 200,000 people. The Swedish Government estimated that 20,000 Swedish tourists were in Southeast Asia at the time of the tsunami; 543 Swedish people died, making Sweden the hardest hit country after those in Southeast Asia. The Swedish Government evacuated survivors via airlift and about 16,000 citizens were repatriated within 20 days,” Filip K. Arnberg, PhD, of Uppsala University in Uppsala, Sweden, and colleagues wrote. “Swedish survivors have reported traumatic experiences and distress, but no studies have explored whether this population has lasting risks of psychiatric disorders diagnosed in health care services.”

Filip K. Arnberg

To determine if survivors of the 2004 tsunami had increased risk for psychiatric diagnoses or suicide, researchers evaluated 8,762 Swedish adults and 3,742 children repatriated from Southeast Asia and 864,088 unexposed adults and 320,828 unexposed children. Psychiatric diagnoses and suicide attempts were determined using Swedish patient register data from December 2004 to January 2010, 5 years after the tsunami.

Adults exposed to the tsunami were more likely to receive a psychiatric diagnosis compared with unexposed adults (6.2% vs. 5.5%; adjusted HR = 1.21; 95% CI, 1.11-1.32), particularly stress-related disorders (2.1% vs. 1%; aHR = 2.27; 95% CI, 1.96-2.62) and suicide attempts (0.43% vs. 0.32%; aHR = 1.54; 95% CI, 1.11-2.13). Risk for mood and anxiety disorders did not differ between exposed and unexposed adults.

Risk for psychiatric diagnoses did not differ between exposed and unexposed children and adolescents; however, exposed children and adolescents had a higher risk for attempted suicide with uncertain intent (aHR = 1.43; 95% CI, 1.01-2.02) and stress-related disorders (aHR = 1.79; 95% CI, 1.3-2.46). Elevated risk among exposed children existed mainly during the first 3 months following the tsunami, according to researchers.

“As [mental illness] rates among adult survivors were elevated during several years after the disaster, mental health professionals may inquire about event-related distress even with patients who present with mental illness years after a highly stressful event. Collecting information about exposure severity and potential bereavement is important for valuing the risk of mental ill health,” Arnberg told Healio.com/Psychiatry. “Our findings further suggest that self-harming or reckless behavior among youth can follow after exposure to a transient disaster.” – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.