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BMC Psychiatry. 2011; 11: 96.
Published online Jun 1, 2011. doi:  10.1186/1471-244X-11-96
PMCID: PMC3120744
Major depressive disorder following terrorist attacks: A systematic review of prevalence, course and correlates
José M Salguero,corresponding author1 Pablo Fernández-Berrocal,2 Itziar Iruarrizaga,3 Antonio Cano-Vindel,3 and Sandro Galea4
1Department of Personality, Evaluation and Psychological Treatment, Psychology Faculty, University of Malaga, Campus de Teatinos s/n. Malaga, 29071 Malaga, Spain
2Department of Basic Psychology, University of Malaga, Malaga, Spain
3Department of Basic Psychology, Complutense University of Madrid, Madrid, Spain
4Department of Epidemiology, Columbia University, New York City, New York, USA
corresponding authorCorresponding author.
José M Salguero: jmsalguero/at/uma.es; Pablo Fernández-Berrocal: berrocal/at/uma.es; Itziar Iruarrizaga: iciariru/at/psi.ucm.es; Antonio Cano-Vindel: canovindel/at/psi.ucm.es; Sandro Galea: sgalea/at/columbia.edu
Received March 14, 2011; Accepted June 1, 2011.
Abstract
Background
Terrorist attacks are traumatic events that may result in a wide range of psychological disorders for people exposed. This review aimed to systematically assess the current evidence on major depressive disorder (MDD) after terrorist attacks.
Methods
A systematic review was performed. Studies included assessed the impact of human-made, intentional, terrorist attacks in direct victims and/or persons in general population and evaluated MDD based on diagnostic criteria.
Results
A total of 567 reports were identified, 11 of which were eligible for this review: 6 carried out with direct victims, 4 with persons in general population, and 1 with victims and general population. The reviewed literature suggests that the risk of MDD ranges between 20 and 30% in direct victims and between 4 and 10% in the general population in the first few months after terrorist attacks. Characteristics that tend to increase risk of MDD after a terrorist attack are female gender, having experienced more stressful situations before or after the attack, peritraumatic reactions during the attack, loss of psychosocial resources, and low social support. The course of MDD after terrorist attacks is less clear due to the scarcity of longitudinal studies.
Conclusions
Methodological limitations in the literature of this field are considered and potentially important areas for future research such as the assessment of the course of MDD, the study of correlates of MDD or the comorbidity between MDD and other mental health problems are discussed.
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