To study short- and long-term effects of experiencing a disaster in repatriated injured survivors and the differential effect of injury, need for medical treatment, loss of loved ones and danger to life on both physical and mental health.
Prospective online study.
Open online survey among Dutch survivors of the 2004 Asian tsunami.
Of the estimated total of 464 Dutch survivors, the authors recruited 144 unique respondents (59 men and 85 women) with a total of 175 assessments made in various time periods.
Main outcome measures
Health outcomes were Symptom Checklist 90 (SCL-90), Impact of Event Scale (original version, in Dutch) and Beck Depression Inventory II. Correlations were calculated with socio-demographic as well as disaster-related factors: physical injury, medical care, loss of loved ones and duration of threat to life. Assessments were clustered in four post-disaster time periods (0–3, 4–6, 7–30 and 31–48 months).
Across these periods, SCL-90 scores were significantly higher than the reference population (p<0.001), with a significant linear downward trend between the groups over time (p=0.001). The same pattern occurred for the Impact of Event Scale (p<0.001) and the Beck Depression Inventory II (p=0.002). Physical injury, medical care or loss of loved ones was not associated with higher total SCL-90 scores or somatic subscores. Both duration of threat to life and female sex were correlated with all measured outcome parameters.
Exposure to the 2004 Asian tsunami had significant short- and long-term impacts on health complaints in a group of repatriated Dutch tsunami victims. Cross-sectionally, there was a trend towards recovery over 4 years, although 22% still reported high psychological and physical distress 4 years post-disaster. Duration of danger to life and female sex were associated with more physical and mental health complaints. In this study, neither disaster-related injury nor loss of loved ones resulted in negative health outcomes.
Disasters are traumatic events that may result in a wide range of physical and mental health consequences. The aim of this paper was to study short- and long-term effects in injured disaster survivors.
Our hypothesis was that physical injury and psychological trauma (eg, loss of loved ones) would be determinants for physical and mental health outcomes after the disaster.
Despite a trend towards recovery between the cross-sectional groups over 4 years, the 2004 tsunami had significant short- and long-term impacts on health complaints in a Dutch group of tsunami victims.
Physical injury or loss of loved ones did not necessarily result in negative health outcomes.
Duration of danger to life was a predictor for traumatic stress symptoms, general health complaints as well as depressive symptoms over a 4-year period.
Strengths and limitations of this study
One of the few studies of long-term physical and mental health impact of natural disasters and the differential effects of being wounded, danger to life and loss of loved ones.
Combined approach: research on physical as well as mental health—unique set up with a survey on an online post-disaster web service, combined with other features.
Limitations: post-disaster study limited options for longitudinal research.