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Original Article
December 2007

Exposure to Hurricane-Related Stressors and Mental Illness After Hurricane Katrina

Author Affiliations

Author Affiliations: Department of Epidemiology, University of Michigan School of Public Health (Dr Galea), Ann Arbor; Department of Epidemiology, Columbia Mailman School of Public Health, New York, New York (Dr Galea); Department of Psychology, University College London, London, England (Dr Brewin); Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts (Mr Gruber and Drs Petukhova and Kessler); Department of Psychology, Virginia Polytechnic and State University, Blacksburg (Dr Jones); Departments of Psychology and Psychiatry, Boston University, Boston, Massachusetts (Drs D. King and L. King); Department of Psychology, Harvard University, Cambridge, Massachusetts (Dr McNally); and Department of Psychiatry and Center for the Study of Traumatic Stress, Uniformed Services University, Bethesda, Maryland (Dr Ursano).

Arch Gen Psychiatry. 2007;64(12):1427-1434. doi:10.1001/archpsyc.64.12.1427

Context  Uncertainty exists about the prevalence, severity, and correlates of mental disorders among people exposed to Hurricane Katrina.

Objective  To estimate the prevalence and associations between DSM-IV anxiety-mood disorders and hurricane-related stressors separately among prehurricane residents of the New Orleans metropolitan area and the remainder of the areas in Alabama, Louisiana, and Mississippi affected by Katrina.

Design  Community survey.

Setting and Participants  A probability sample of 1043 English-speaking prehurricane residents of the areas affected by Hurricane Katrina was administered via telephone survey between January 19 and March 31, 2006. The survey assessed hurricane-related stressors and screened for 30-day DSM-IV anxiety-mood disorders.

Main Outcome Measures  The K6 screening scale of anxiety-mood disorders and the Trauma Screening Questionnaire scale for posttraumatic stress disorder (PTSD), both calibrated against blinded structured clinical reappraisal interviews to approximate the 30-day prevalence of DSM-IV disorders.

Results  Prehurricane residents of the New Orleans metropolitan area were estimated to have a 49.1% 30-day prevalence of any DSM-IV anxiety-mood disorder (30.3% estimated prevalence of PTSD) compared with 26.4% (12.5% PTSD) in the remainder of the sample. The vast majority of respondents reported exposure to hurricane-related stressors. Extent of stressor exposure was more strongly related to the outcomes in the New Orleans metropolitan area subsample than the remainder of the sample. The stressors most strongly related to these outcomes were physical illness/injury and physical adversity in the New Orleans metropolitan area subsample and property loss in the remainder of the sample. Sociodemographic correlates were not explained either by differential exposure or reactivity to hurricane-related stressors.

Conclusions  The high prevalence of DSM-IV anxiety-mood disorders, the strong associations of hurricane-related stressors with these outcomes, and the independence of sociodemographics from stressors argue that the practical problems associated with ongoing stressors are widespread and must be addressed to reduce the prevalence of mental disorders in this population.