A simple interview-format screening measure for disaster mental health: an instrument newly developed after the 1995 Great Hanshin Earthquake in Japan--the Screening Questionnaire for Disaster Mental Health (SQD).
Psychological intervention after a large-scale disaster requires an efficient and practical measure. Using self-reporting scale imposes certain limitations, especially when dealing with the elderly. It is also required that non-experts in mental health should be able to use the screening device, so that it can be easily incorporated into any local level post-disaster health service. To satisfy such requirements, we developed a simple interview-format measure, the Screening Questionnaire for Disaster Mental Health (SQD), which screens for posttraumatic stress disorder (PTSD) and depression. In this article, its validity and usefulness was analyzed. Data were obtained from 68 individuals living in reconstruction housing five years after the 1995 Great Hanshin Earthquake. Applying the Clinician Administered PTSD Scale (CAPS) and the Structured Clinical Interview for DSM-III-R Major Depression Section (SCID) as gold standards, the areas under the Receiver Operating Characteristic curves (ROC-AUC) and stratum-specific likelihood ratios (SSLR) as statistical indices were calculated. The ROC-AUC was 0.91 (95%CI: 0.83-0.99) for diagnosing PTSD, and 0.94 (0.88-1.01) for diagnosing depression. Three strata for PTSD and 2 strata for depression were obtained, and SSLR for each stratum was 0.10 (95%CI: 0.02-0.45), 1.05 (0.37-3.00), 9.64 (3.77-24.69) for PTSD, and 0.3 (0.1-1.0), 7.8 (3.2-18.7) for depression. The results showed that this screening measure had good validity, especially for PTSD. (+info)
Impact of local circumstances on outcome of renal casualties in major disasters.
Early detection of patients at high risk for acute kidney injury during disasters: development of a scoring system based on the Bam earthquake experience.
BACKGROUND: Early prophylactic hydration therapy in patients prone to acute kidney injury (AKI) can reduce its incidence in disasters. As sufficient availability of fluids might be problematic, it is important to discriminate those at risk versus not at risk for AKI. The present study uses biochemical findings from victims of the Bam earthquake to design decision rules for early detection of patients at risk for AKI. METHODS: Data were collected in hospitals admitting Bam earthquake victims. Biochemical factors on day 1 (creatinine, CPK, LDH, SGOT, uric acid, calcium, phosphorus, sodium, potassium, white blood cell count, platelet count) were introduced into multivariate models for prediction of AKI (serum creatinine >1.6 mg/dL) at a later stage. RESULTS: A rule of thumb to assess the absence of risk for AKI was developed, using ROC analysis: if on day 1, serum creatinine was <2 mg/dL, LDH was <2,000 IU and serum uric acid was <6 mg%, the risk for development of AKI was virtually nil. Using multiple regression analysis (0.45 CPK + 2.5 LDH + 2,700 K + 2,000 uric acid - 14,000)/10,000, was most predictive for serum creatinine on day 3. Dichotomizing this value at 2.0 yielded a sensitivity and specificity for prediction of AKI of 96.6% and 95.7%, respectively. CONCLUSIONS: We propose 2 decision rules to predict development of AKI in earthquake victims. These scores can easily be calculated already at an early stage of a disaster, enabling rationalization of prophylactic hydration therapy in crushed earthquake victims. (+info)
Prevalence of HCV and HIV infections in 2005-Earthquake-affected areas of Pakistan.
Post-traumatic stress disorder in bam-survived students who immigrated to Kerman, four months after the earthquake.
BACKGROUND: The 6.3 Richter earthquake in Bam killed 26,000 and injured 30,000 people, and destroyed 85% of houses according to the literature. Children are affected more than others by disasters. In this study, we assessed the rate of post-traumatic stress disorder and psychological problems in survived Bam students in Kerman four months after the earthquake and their relations with demographic factors, family loss, house destruction, and body injury. METHODS: A group of 433 students attended this cross sectional study. Watson post traumatic stress disorder questionnaire and Symptom Checklist-90 were applied for students older than 15 years of age and Yule post-traumatic stress disorder and Rutter (parents' version) questionnaires were used for students younger than 15. Multiple regression analysis was used to assess the effects of variables on psychopathologies. RESULTS: Post-traumatic stress disorder was detected in 36.3% of the students older than 15 years of age and 51.6% of the students younger than 15. Behavioral problems were present in 31.3% of the children and the mean score of Global Symptom Index was 1.13+/-0.59. Body injury and living with family were correlated with post-traumatic stress disorder and Symptom Checklist-90 items in students older than 15. Female sex was correlated with post-traumatic stress disorder and behavioral problems in students younger than 15. CONCLUSION: The prevalence of post-disaster post-traumatic stress disorder was high in children. Younger age, female gender, living apart from family, geographic living conditions, being in the center of stress or not after the earthquake, body injury, and loss of family members form the basis for developing post-disaster psychopathology. Due to incomplete presence of post-traumatic stress disorder criteria or high rate of overlooking post-traumatic stress disorder in children, the disorder may be misdiagnosed or remain undiagnosed in them, which warrants more consideration. (+info)