Psychological Medicine

Invited Review

Post-traumatic stress disorder following disasters: a systematic review

Y. Neriaa1a2 c1, A. Nandia3 and S. Galeaa2a4a5

a1 Department of Psychiatry, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA

a2 Department of Epidemiology, Mailman School of Public Health, Columbia University Medical Center, New York, NY, USA

a3 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

a4 Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA

a5 Center for Urban Epidemiologic Studies, New York Academy of Medicine, New York City, NY, USA

Abstract

Background Disasters are traumatic events that may result in a wide range of mental and physical health consequences. Post-traumatic stress disorder (PTSD) is probably the most commonly studied post-disaster psychiatric disorder. This review aimed to systematically assess the evidence about PTSD following exposure to disasters.

Method A systematic search was performed. Eligible studies for this review included reports based on the DSM criteria of PTSD symptoms. The time-frame for inclusion of reports in this review is from 1980 (when PTSD was first introduced in DSM-III) and February 2007 when the literature search for this examination was terminated.

Results We identified 284 reports of PTSD following disasters published in peer-reviewed journals since 1980. We categorized them according to the following classification: (1) human-made disasters (n=90), (2) technological disasters (n=65), and (3) natural disasters (n=116). Since some studies reported on findings from mixed samples (e.g. survivors of flooding and chemical contamination) we grouped these studies together (n=13).

Conclusions The body of research conducted after disasters in the past three decades suggests that the burden of PTSD among persons exposed to disasters is substantial. Post-disaster PTSD is associated with a range of correlates including sociodemographic and background factors, event exposure characteristics, social support factors and personality traits. Relatively few studies have employed longitudinal assessments enabling documentation of the course of PTSD. Methodological limitations and future directions for research in this field are discussed.

(Received February 27 2007)

(Revised July 25 2007)

(Accepted July 26 2007)

(Online publication September 06 2007)

Correspondence

c1 Address for correspondence: Dr Y. Neria, Columbia University, College of Physicians and Surgeons, Department of Psychiatry, 1051 Riverside Drive, Unit 69, New York, NY 10032, USA. (Email: ny126@columbia.edu)

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