The relationship between predisaster psychological problems and health problems after a man-made disaster.

Background:In May 2000, a fireworks depot exploded in a residential area in The Netherlands, resulting in 22 deaths and 1200 residents who lost their homes. Most studies on the health consequences of disasters lack predisaster data. The present study did include actual predisaster data and aimed to investigate the relationships between victims’ predisaster psychological problems and their post-disaster functioning. Methods: After the disaster two types of studies were implemented. Firstly, victims of the fireworks disaster were examined using self-reportquestionnaires (i.e. Symptom Checklist-90; SF-36) 3 weeks and 18 months after the disaster. Secondly, a longitudinal monitoring using the electronic medical records of the victims’ general practitioners (GPs) was started. Information on predisaster health status was also available. Results are presented for victims who filled in both questionnaires and were registered at the GPs as well (n = 994). Results: Victims presenting psychological problems to their GP in the year before the disaster reported significantly more post-disaster anxiety, depression, sleeping, and somatic problems (SCL-90), and they scored worse on social functioning, bodily pain, and general health (SF-36) when compared with victims without predisaster psychological problems. They also presented more psychological problems (68 versus 39%; x2 ¼ 32.97, P < 0.001) and musculoskeletal problems (54 versus 34%; x2 ¼ 17.21, P < 0.001) to their GP in the first year post-disaster. Conclusions: Victims with predisaster psychological problems appear at risk for both psychological and physical problems after the disaster. Having predisaster and controlled data is very important in order to draw correct conclusions regarding the health impact of a disaster and to identify high-risk groups as soon as possible. (aut.ref.)