Hostname: page-component-55f67697df-jr75m Total loading time: 0 Render date: 2025-05-12T04:15:28.878Z Has data issue: false hasContentIssue false
  • English
  • Français

Posttraumatic Stress Following the 2023 Odisha Train Accident: A Cross-sectional Comparison Study of Passengers, Health Professionals, and the Local Community

Published online by Cambridge University Press:  08 May 2025

Nilamadhab Kar Open the ORCID record for Nilamadhab Kar [Opens in a new window] ,
Sarada Prasanna Swain ,
Seema Parija ,
Shraddha Banerjee ,
Sukanya Mahakul ,
Sushree Sangita Behura ,
Bindulata Palei  and
Shreyan Kar
Nilamadhab Kar*
Affiliation:
Black Country Healthcare NHS Foundation Trust, Wolverhampton; Honorary Professor of Psychiatry, University of Wolverhampton, Wolverhampton, UK; Honorary Professor, Faculty of Contemplative and Behavioural Sciences, Sri Sri University, Cuttack, India
Sarada Prasanna Swain
Affiliation:
Mental Health Institute, SCB Medical College & Hospital, Cuttack, Odisha, India
Seema Parija
Affiliation:
Jajati Keshari Medical College, Jajpur, Odisha, India
Shraddha Banerjee
Affiliation:
Odisha Digital Academy for Mental Health, Mental Health Institute, SCB Medical College and Hospital, Cuttack, Odisha, India
Sukanya Mahakul
Affiliation:
Special Education Need Globe, KIIT International School, Bhubaneswar, India
Sushree Sangita Behura
Affiliation:
Odisha Digital Academy for Mental Health, Mental Health Institute, SCB Medical College and Hospital, Cuttack, Odisha, India
Bindulata Palei
Affiliation:
Jajati Keshari Medical College, Jajpur, Odisha, India
Shreyan Kar
Affiliation:
Department of Psychiatry, Black Country Healthcare NHS Foundation Trust, Dudley, UK
*
Corresponding author: Nilamadhab Kar; Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives

We studied posttraumatic stress symptoms (PTSS) and disorder (PTSD), associated factors, and quality of life (QOL) of a group of passengers (n = 58) affected by the 2023 Odisha train accident, comparing it with health professionals (n = 42) such as doctors and nurses who treated them, and individuals from the local community (n = 65). We also checked the anxiety and depression of passengers.

Methods

In a cross-sectional study, we assessed accident experience and used the PTSD checklist, WHO-QOL-BREF, General Anxiety Disorder, and Patient Health Questionnaire scales.

Results

The PTSS were common; specifically, intrusive memories (36.4%), feeling upset while reminded of the experience (33.9%), and avoidance of memories (30.9%). Strong negative feelings, loss of interest, feeling distant, and irritability or anger outbursts were significantly more common among passengers than others. PTSD was present in 20.7% of passengers, 19.0% of health professionals, and 7.7% of local participants. Seeing dead bodies significantly contributed to PTSD. Clinical levels of anxiety (58.3%) and depression (50%) were present in passengers, which were significantly associated with PTSD, along with fear of death. Passengers had the worst QOL and health satisfaction among the groups.

Conclusions

Following the train accident, stress-related psychiatric problems were common and highlighted the intervention needs of the affected people.

Keywords

accidentsanxietydepressionpost-traumatic stress disorderrailroadssurvivors
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 19 , 2025 , e112
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Forsberg, R, Saveman, BI. Survivors’ experiences from a train crash. Int J Qual Stud Health Well-being. 2011;6(4):10.3402/qhw.v6i4.8401. doi:10.3402/qhw.v6i4.8401CrossRefGoogle ScholarPubMed
Hagström, R. The acute psychological impact on survivors following a train accident. J Trauma Stress. 1995;8(3):391–402.CrossRefGoogle ScholarPubMed
Lundin, T. Train disaster survivors: Long-term effects on mental health and well-being. Stress Med. 1991;7(2):87–91. doi:10.1002/smi.2460070206CrossRefGoogle Scholar
Elklit, A, Jørgensen, LK. The Great Belt Bridge railway accident: post-traumatic stress reactions among passengers and bereaved family members. Am J Disaster Med. 2022;17(2):153–161. doi:10.5055/ajdm.2022.0429CrossRefGoogle ScholarPubMed
Zadey, S. Public Health Tragedy of the Triple Train Accident. BMJ Global Health blog. Published August 5, 2023. Accessed May 20, 2024. https://blogs.bmj.com/bmjgh/2023/08/05/public-health-tragedy-of-the-triple-train-accident/Google Scholar
Selley, C, King, E, Peveler, R, et al. Post-traumatic stress disorder symptoms and the Clapham rail accident. Br J Psychiatry. 1997;171(5):478–482. doi:10.1192/bjp.171.5.478CrossRefGoogle Scholar
Maltais, D, Généreux, M, Roy, M, et al. Psychological, physical and behavioral health of adults, 3 years after exposure to a train derailment. Inquiry. 2022;59:00469580221125765. doi:10.1177/00469580221125765CrossRefGoogle ScholarPubMed
Maltais, D, Lavoie-Trudeau, É, Labra, O, et al. Medium-term effects of a train derailment on the physical and psychological health of men. Am J Mens Health. 2019;13(4):1557988319865363. doi:10.1177/1557988319865363CrossRefGoogle ScholarPubMed
Tyano, S, Iancu, I, Solomon, Z, et al. Seven-year follow-up of child survivors of a bus-train collision. J Am Acad Child Adolesc Psychiatry. 1996;35(3):365–373. doi:10.1097/00004583-199603000-00019CrossRefGoogle ScholarPubMed
Miniati, M, Palagini, L, Caruso, D, Mauri, M, Marazziti, D, Dell’Osso, L. Post-traumatic stress disorder in train crash survivors in Italy: the role of mood spectrum dysregulations and intrusiveness. CNS Spectr. 2021;26(1):71–76. doi:10.1017/S1092852920001145CrossRefGoogle ScholarPubMed
Bisson, JI. Psychological and social theories of post-traumatic stress disorder. Psychiatry. 2009;8(8):290–292. doi:10.1016/j.mppsy.2009.05.003CrossRefGoogle Scholar
Ehlers, A, Clark, DM. A cognitive model of posttraumatic stress disorder. Behav Res Ther. 2000;38(4):319–345. doi:10.1016/S0005-7967(99)00123-0CrossRefGoogle ScholarPubMed
Rodrigues, CML, Barletta, JB, Nery, H de M. Post-traumatic stress disorder in major accidents: systematic review and meta-analysis. Rev Bras Med Trab. 2021;19(3):332–341. doi:10.47626/1679-4435-2021-624CrossRefGoogle ScholarPubMed
Pinarowicz, J. Trauma in Transportation: Factors Contributing to Positive and Negative Outcomes of Involvement in Trauma for Railroad Workers. Electronic Theses and Dissertations. Published January 1, 2012. Accessed February 16, 2025. https://digitalcommons.du.edu/etd/516Google Scholar
Kar, N. Indirect victims of catastrophic events: the case of Odisha train accident. J Geriatr Care Res. 2023;10(2):33–34.Google Scholar
Kar, N. Impact of disasters on the disaster responders: a review of stress, coping, resilience, and supportive methods. Odisha J Psychiatry. 2023;19(2):37. doi:10.4103/OJP.OJP_23_23CrossRefGoogle Scholar
Wikipedia. 2023 Odisha Train Collision. Published Apirl 21, 2024. Accessed May 17, 2024. https://en.wikipedia.org/w/index.php?title=2023_Odisha_train_collision&oldid=1220000127Google Scholar
Wikipedia. List of Railway Accidents and Incidents in India. Published Apirl 21, 2024. Accessed May 22, 2024. https://en.wikipedia.org/w/index.php?title=List_of_railway_accidents_and_incidents_in_India&oldid=1220824774Google Scholar
Bagaria, DK, Banerjee, N, Gupta, A, et al. Train-associated injuries pose a significant burden on trauma care systems of emerging economies. World J Surg. 2020;44(9):2993–2999. doi:10.1007/s00268-020-05563-6CrossRefGoogle Scholar
American Psychiatric Association. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 5th ed. American Psychiatric Association; 2013.Google Scholar
Weathers, F, Litz, B, Keane, T, et al. The PTSD Checklist for DSM-5 (PCL-5). Published 2013. Accessed April 6, 2015. http://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.aspGoogle Scholar
Kar, N, Swain, SP, Patra, S, et al. The WHOQOL-BREF: translation and validation of the Odia version in a sample of patients with mental illness. Indian J Soc Psychiatry. 2017;33(3):269–273. doi:10.4103/0971-9962.214599CrossRefGoogle Scholar
WHO. The World Health Organization Quality of Life (WHOQOL) -BREF. Geneva: World Health Organization; 2004.Google Scholar
Spitzer, RL, Kroenke, K, Williams, JBW, et al. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092–1097. doi:10.1001/archinte.166.10.1092CrossRefGoogle ScholarPubMed
Kroenke, K, Spitzer, RL, Williams, JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606–613.CrossRefGoogle ScholarPubMed
Doroga, C, Baban, A. Traumatic exposure and posttraumatic symptoms for train drivers involved in railway incidents. Clujul Med. 2013;86(2):144–149.Google ScholarPubMed
Mehnert, A, Nanninga, I, Fauth, M, et al. Course and predictors of posttraumatic stress among male train drivers after the experience of ‘person under the train’ incidents. J Psychosom Res. 2012;73(3):191–196. doi:10.1016/j.jpsychores.2012.06.007CrossRefGoogle ScholarPubMed
Kar, N, Krishnaraaj, R, Rameshraj, K. Long-term mental health outcomes following the 2004 Asian tsunami disaster. Disaster Health. 2014;2(1):35–45. doi:10.4161/dish.24705CrossRefGoogle ScholarPubMed
Chandna, AS, Suhas, S, Patley, R, et al. Exploring the enigma of low prevalence of post-traumatic stress disorder in India. Indian J Psychiatry. 2023;65(12):1254–1260. doi:10.4103/indianjpsychiatry.indianjpsychiatry_830_23CrossRefGoogle ScholarPubMed
Krishnakumari, K, Munivenkatappa, M, Hegde, S, et al. A systematic chart review of adults with post-traumatic stress disorder: data from a tertiary care psychiatry center in India. Indian J Psychol Med. 2022;44(4):378–383. doi:10.1177/02537176211035074CrossRefGoogle ScholarPubMed
Kar, N, Samantaray, NN, Kar, S, et al. Anxiety, depression, and post-traumatic stress a month after 2019 Cyclone Fani in Odisha, India. Disaster Med Public Health Prep. 2022;16(2):670–677. doi:10.1017/dmp.2020.368CrossRefGoogle Scholar
Suar, D, Kar, N, Panigrahi, GS. Natural hazards, trauma, and its amelioration: lessons learned from India. Int J Disaster Risk Reduct. 2024;108:104548. doi:10.1016/j.ijdrr.2024.104548CrossRefGoogle Scholar
Kar, N, Jagadisha, Sharma P, et al. Mental health consequences of the trauma of super-cyclone 1999 in Orissa. Indian J Psychiatry. 2004;46(3):228–237.Google ScholarPubMed
Arora, D, Belsiyal, CX, Rawat, VS. Prevalence and determinants of posttraumatic stress disorder and depression among survivors of motor vehicle accidents from a hilly Indian state. Indian J Psychiatry. 2021;63(3):250–257. doi:10.4103/psychiatry.IndianJPsychiatry_1059_20CrossRefGoogle ScholarPubMed
Mann, SK, Marwaha, R, Torrico, TJ. Posttraumatic Stress Disorder. In: StatPearls. StatPearls Publishing; 2024. Accessed August 13, 2024. http://www.ncbi.nlm.nih.gov/books/NBK559129/Google Scholar
McCabe, CT, Watrous, JR, Galarneau, MR. Trauma exposure, mental health, and quality of life among injured service members: moderating effects of perceived support from friends and family. Mil Psychol. 2020;32(2):164–175. doi:10.1080/08995605.2019.1691406CrossRefGoogle ScholarPubMed
NIMH. Post-Traumatic Stress Disorder - National Institute of Mental Health (NIMH). 2023. Accessed August 13, 2024. https://www.nimh.nih.gov/health/publications/post-traumatic-stress-disorder-ptsdGoogle Scholar
WHO. Post-Traumatic Stress Disorder. 2024. Accessed August 13, 2024. https://www.who.int/news-room/fact-sheets/detail/post-traumatic-stress-disorderGoogle Scholar
Brienza, A, Suffoletto, BP, Kuhn, E, et al. The role of specific sources of social support on post-injury psychological symptoms. Rehabil Psychol. Published online August 16, 2021:10.1037/rep0000388. doi:10.1037/rep0000388CrossRefGoogle Scholar
Bahadirli, S, Sagaltici, E. Post-traumatic stress disorder in healthcare workers of emergency departments during the pandemic: a cross-sectional study. Am J Emerg Med. 2021;50:251–255. doi:10.1016/j.ajem.2021.08.027CrossRefGoogle ScholarPubMed
Naushad, VA, Bierens, JJ, Nishan, KP, et al. A systematic review of the impact of disaster on the mental health of medical responders. Prehosp Disaster Med. 2019;34(6):632–643. doi:10.1017/S1049023X19004874CrossRefGoogle ScholarPubMed
Tahernejad, S, Ghaffari, S, Ariza-Montes, A, et al. Post-traumatic stress disorder in medical workers involved in earthquake response: a systematic review and meta-analysis. Heliyon. 2023;9(1):e12794. doi:10.1016/j.heliyon.2023.e12794CrossRefGoogle ScholarPubMed
Arnberg, FK, Rydelius, PA, Lundin, T. A longitudinal follow-up of posttraumatic stress: from 9 months to 20 years after a major road traffic accident. Child Adolesc Psychiatry Ment Health. 2011;5(1):8. doi:10.1186/1753-2000-5-8CrossRefGoogle ScholarPubMed
Chung, MC, Farmer, S, Werrett, J, et al. Traumatic stress and ways of coping of community residents exposed to a train disaster. Aust N Z J Psychiatry. 2001;35(4):528–534.CrossRefGoogle ScholarPubMed
Vilaplana-Pérez, A, Sidorchuk, A, Pérez-Vigil, A, et al. Assessment of Posttraumatic Stress Disorder and educational achievement in Sweden. JAMA Netw Open. 2020;3(12):e2028477. doi:10.1001/jamanetworkopen.2020.28477CrossRefGoogle ScholarPubMed
North, CS, Oliver, J, Pandya, A. Examining a comprehensive model of disaster-related Posttraumatic Stress Disorder in systematically studied survivors of 10 Disasters. Am J Public Health. 2012;102(10):e40–e48. doi:10.2105/AJPH.2012.300689CrossRefGoogle ScholarPubMed
Gori, A, Topino, E, Musetti, A. The Relationship among anxiety, worry, perceived stress, defense mechanisms, and high levels of post-traumatic stress symptoms: a discriminant analytic approach. J Pers Med. 2023;13(2):237. doi:10.3390/jpm13020237CrossRefGoogle ScholarPubMed
Shalev, AY. Posttraumatic Stress Disorder (PTSD) and stress related disorders. Psychiatr Clin North Am. 2009;32(3):687–704. doi:10.1016/j.psc.2009.06.001CrossRefGoogle ScholarPubMed
Leoni, B, Radford, T, Schulman, M. Disaster Through a Different Lens: Behind Every Effect, There is a Cause | UNDRR. Published May 26, 2011. Accessed February 23, 2025. https://www.undrr.org/publication/disaster-through-different-lens-behind-every-effect-there-causeGoogle Scholar
First, JM. Post-traumatic stress and depression following disaster: examining the mediating role of disaster resilience. Front Public Health. 2024;12:1272909. doi:10.3389/fpubh.2024.1272909CrossRefGoogle ScholarPubMed
Dhungana, S, Koirala, R, Ojha, SP, et al. Resilience and its association with post-traumatic stress disorder, anxiety, and depression symptoms in the aftermath of trauma: a cross-sectional study from Nepal. SSM - Mental Health. 2022;2:100135. doi:10.1016/j.ssmmh.2022.100135CrossRefGoogle Scholar
Iacoviello, BM, Charney, DS. Psychosocial facets of resilience: implications for preventing posttrauma psychopathology, treating trauma survivors, and enhancing community resilience. Eur J Psychotraumatol. 2014;5:10.3402/ejpt.v5.23970. doi:10.3402/ejpt.v5.23970CrossRefGoogle ScholarPubMed
Martz, E. Death anxiety as a predictor of posttraumatic stress levels among individuals with spinal cord injuries. Death Stud. 2004;28(1):1–17. doi:10.1080/07481180490249201CrossRefGoogle ScholarPubMed
Simske, NM, Joseph, NM, Rascoe, A, et al. “Did you think you would die?”: fear of death and its relationship to the development of Posttraumatic Stress Disorder after traumatic injury. J Am Acad Orthop Surg. 2022;30(2):e272–e278. doi:10.5435/JAAOS-D-20-01438CrossRefGoogle Scholar
van der Vlegel, M, Polinder, S, Toet, H, et al. Anxiety, depression and post-traumatic stress symptoms among injury patients and the association with outcome after injury. Eur J Psychotraumatol. 2022;13(1):2023422. doi:10.1080/20008198.2021.2023422CrossRefGoogle ScholarPubMed
Wang, CH, Tsay, SL, Elaine Bond, A. Post-traumatic stress disorder, depression, anxiety and quality of life in patients with traffic-related injuries. J Adv Nurs. 2005;52(1):22–30. doi:10.1111/j.1365-2648.2005.03560.xCrossRefGoogle ScholarPubMed
Wiseman, TA, Curtis, K, Lam M, et al. Incidence of depression, anxiety and stress following traumatic injury: a longitudinal study. Scand J Trauma Resusc Emerg Med. 2015;23:29. doi:10.1186/s13049-015-0109-zCrossRefGoogle ScholarPubMed
Kar, N, Bastia, BK. Post-traumatic stress disorder, depression and generalised anxiety disorder in adolescents after a natural disaster: a study of comorbidity. Clin Pract Epidemiol Ment Health. 2006;2:17. doi:10.1186/1745-0179-2-17CrossRefGoogle ScholarPubMed
Spinhoven, P, Penninx, BW, van Hemert, AM, et al. Comorbidity of PTSD in anxiety and depressive disorders: prevalence and shared risk factors. Child Abuse Negl. 2014;38(8):1320–1330. doi:10.1016/j.chiabu.2014.01.017CrossRefGoogle ScholarPubMed
Danielsson, FB, Schultz Larsen, M, Nørgaard, B, et al. Quality of life and level of post-traumatic stress disorder among trauma patients: a comparative study between a regional and a university hospital. Scand J Trauma Resusc Emerg Med. 2018;26:44. doi:10.1186/s13049-018-0507-0CrossRefGoogle ScholarPubMed
Kovačević, J, Miškulin, M, Ličanin, MM, et al. Quality of life in road traffic accident survivors. Zdr Varst. 2020;59(4):202–210. doi:10.2478/sjph-2020-0026Google ScholarPubMed
Akanni, OO, Edeh, AN, Agbir, MT, et al. The quality of life and its inter-relationship with posttraumatic stress disorder and social support in two post-conflict communities in Nigeria. J Health Psychol. 2024;29(13):1519–1532. doi:10.1177/13591053231222851CrossRefGoogle ScholarPubMed
Baranyi, A, Leithgöb, O, Kreiner, B, et al. Relationship between posttraumatic stress disorder, quality of life, social support, and affective and dissociative status in severely injured accident victims 12 months after trauma. Psychosomatics. 2010;51(3):237–247. doi:10.1176/appi.psy.51.3.237CrossRefGoogle ScholarPubMed
Martin-Herz, SP, McMahon, RJ, Malzyner, S, et al. Impact of posttraumatic stress disorder and depressive symptoms on quality of life in adolescents after general traumatic injury. J Trauma Stress. 2022;35(2):386–397. doi:10.1002/jts.22750CrossRefGoogle ScholarPubMed
Pacella, ML, Hruska, B, Delahanty, DL. The physical health consequences of PTSD and PTSD symptoms: a meta-analytic review. J Anxiety Disord. 2013;27(1):33–46. doi:10.1016/j.janxdis.2012.08.004CrossRefGoogle ScholarPubMed
Kar, N. Anatomy of a catastrophe: Managing psychosocial consequence of the 2023 Odisha train accident. Ind Psychiatry J. 2024;33(2):219–225. doi:10.4103/ipj.ipj_278_24CrossRefGoogle ScholarPubMed