Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-04T21:10:46.521Z Has data issue: false hasContentIssue false
  • English
  • Français

Psychopathological consequences after a terrorist attack: An epidemiological study among victims, the general population, and police officers☆

Published online by Cambridge University Press:  16 January 2007

Rafael Gabriel ,
Laura Ferrando ,
Enrique Sainz Cortón ,
Carlos Mingote ,
Eduardo García-Camba ,
Alberto Fernández Liria  and
Sandro Galea
Rafael Gabriel
Affiliation:
Hospital Universitario La Paz, Madrid, Spain
Laura Ferrando*
Affiliation:
Universidad de Alcalá, Departamento de Especialidades Médicas, Universidad de Alcalá, Facultad de Medicina, 28.801 Alcala de Henares, Madrid, Spain
Enrique Sainz Cortón
Affiliation:
Hospital General Universitario Gregorio Marañó, Madrid, Spain
Carlos Mingote
Affiliation:
Hospital Universitario 12 de Octubre, Madrid, Spain
Eduardo García-Camba
Affiliation:
Hospital Universitario de la Princesa, Madrid, Spain
Alberto Fernández Liria
Affiliation:
Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
Sandro Galea
Affiliation:
University of Michigan, Ann Arbor, Spain
*
∗Corresponding author. Tel.: +34 670678910; fax: +34 914115432. E-mail address: [email protected] (L. Ferrando).
Get access

Abstract

Background and aim

To assess the prevalence and correlates of post-traumatic stress disorder (PTSD), major depression and anxiety disorders other than PTSD, among three samples with different level of exposure to the March 11, 2004 terrorist attacks in Madrid.

Method

We sampled three groups of persons—those injured in the attacks, the residents of Alcala de Henares, and police officers involved with the rescue effort—with different exposure to the March 11, 2004 terrorist attacks, using random sampling from comprehensive censuses of all three groups. In person interviews were conducted with all three groups between 5 and 12 weeks after March 11, 2004. Questionnaire included assessment of socio-demographic characteristics, of PTSD using the Davidson trauma scale, and of a range of psychiatric illnesses using the mini international neuropsychiatric interview (MINI).

Results

The overall sample included 127 persons injured in the attack, 485 residents of Alcalá de Henares, and 153 policemen involved in rescue. Of all three groups 57.5%, 25.9% and 3.9% of persons, respectively, reported symptoms consistent with any assessed psychiatric disorder. The use of psychoactive medication before March 11, 2004 was consistently the main predictor of PTSD and major depression among those injured and of major depression and anxiety disorders others than PTSD among residents of Alcala.

Conclusions

There was a substantial burden of psychological consequences of the March 11, 2004 terrorist attacks two months after the event. Persons with prior mental illness are at higher risk of post-event psychopathology, across groups of exposure.

Keywords

Mental disordersDisasterTerrorismVictimsPopulationRescuers
Type
Original article
Information
European Psychiatry , Volume 22 , Issue 6 , September 2007 , pp. 339 - 346
Copyright
Copyright © Elsevier Masson SAS 2007

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.)

Footnotes

☆

Sources of support: Spanish Ministry of Interior. Grant. 97/2004; Universidad de Alcalá. Grant: PI2005/05 and Fondo de Investigacón Sanitaria. Grant: PI05/1048.

Declaration of interest: None.

References

Alonso, J., Angermeyer, M.C., Bernert, S., Bruffaerts, R., Brugha, T.S., Bryson, H.et al.ESEMeD/MHEDEA 2000 Investigators, European Study of the Epidemiology of Mental Disorders (ESEMeD) Project. J. Prevalence of mental disorders in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. J Acta Psych Scandinava 2004;109(Suppl. 420):21–27.Google Scholar
Bobes, J., Calcedo-Barba, A., García, M., Francois, M., Rico-Villademoros, F., González, M.P.y Grupo Español de Trabajo para el Estudio del Trastorno por Estrés Postraumático. Evaluación de las propiedades psicométricas de la versión española de cinco cuestionarios para la evaluación del TEPT. Actas Esp Psiquiatr 2000;28:207–218.Google Scholar
Bobes, J., Gutierrez, M., Palao, D., Ferrando, L., Gibert-Rahola, J., Lecrubier, Y.et al.Validez del MINI (Mini International Neuropsychiatric Interview) en tres centros de AP en España. Psiquitría Biológica 1997;4(Suppl. 2):79.Google Scholar
Boscarino, J.A., Galea, S., Ahern, J., Resnick, H., Vlahov, D.Psychiatric medication use among Manhattan residents following the World Trade Center disaster. J Trauma Stress 2003;16:301–306.CrossRefGoogle ScholarPubMed
Breslau, N., Davis, G.C., Peterson, E.L., Schultz, L.Psychiatric sequelae of posttraumatic stress disorder in women. Arch Gen Psychiatry 1997;54:81–731.CrossRefGoogle ScholarPubMed
Breslau, N.Epidemiologic studies of trauma, posttraumatic stress disorder, and otherpsychiatric disorders. Can J Psychiatry 2002;47:923–929.CrossRefGoogle ScholarPubMed
Centers For Disease Control and Prevention. Mental health status of world trade center rescue and recovery workers and volunteers, New York City, July 2002–August 2004. MMWR September 10, 2004;53(35):812–815.Google Scholar
Clave 20. Revista Interna de SAMUR – Protección Civil “Villa de Madrid”. Especial 11 de Marzo. Junio 2004.Google Scholar
Davidson, J.R.T., Book, S.W., Colket, J.T., Tupler, L.A., Roth, S., David, D.et al.Assessment of a new self-rating scale for post-traumatic stress disorder. Psychol Med 1997;27:153–160.CrossRefGoogle ScholarPubMed
Galea, S., Ahern, J., Resnick, H., Kilpatrick, D., Bucuvalas, M., Gold, J.et al.Psychological sequelae of the September 11 terrorist attacks in New York City. N Engl J Med 2002;346:982–987.CrossRefGoogle ScholarPubMed
Galea, S., Nandi, A., Vlahov, D.The epidemiology of post-traumatic stress disorder after disasters. Epidemiol Rev 2005;27:78–91.CrossRefGoogle ScholarPubMed
Galea, S., Resnick, H., Ahern, J., Gold, J., Bucuvalas, M., Kilpatrick, D.et al.Posttraumatic stress disorder in Manhattan, New York City, after the September 11th terrorist attacks. J Urban Health 2002;79:340–353.CrossRefGoogle ScholarPubMed
Ghaziuddin, M., Ghaziuddin, N., Stein, G.S.Life events and the recurrence of depression. Can J Psychiatry 1990;35:239–242.CrossRefGoogle ScholarPubMed
Goenjian, A.K., Molina, L., Steinberg, A.M., Fairbanks, L.A., Alvarez, M.L., Goenjian, H.A.et al.Posttraumatic stress and depressive reactions among Nicaraguan adolescents after hurricane Mitch. Am J Psychiatry 2001;158:788–794.CrossRefGoogle ScholarPubMed
Hoven, C.W., Duarte, C.S., Lucas, C.P., Wu, P., Mandell, D.J., Goodwin, R.D.et al.Psychopathology among New York city public school children 6 months after September 11. Arch Gen Psychiatry 2005;62:545–552.CrossRefGoogle ScholarPubMed
Instituto Nacional de Estadística. Resultados definitivos del Padrón Municipal 2003. In http://www.ine.es/inebase/cgi.Google Scholar
Jehel, L., Paterniti, S., Brunet, A., Duchet, C., Guelfi, J.D.Prediction of the occurrence and intensity of post-traumatic stress disorder in victims 32 months after bomb attack. Eur Psychiatry 2003;18:172–176.CrossRefGoogle ScholarPubMed
Kendler, K.S., Karkowski, L.M., Prescott, C.A.Causal relationship between stressful life events and the onset of major depression. Am J Psychiatry 1999;156:837–841.CrossRefGoogle ScholarPubMed
Kendler, K.S., Kessler, R.C., Neal, M.C., Heath, A.C., Eaves, L.J.The prediction of major depression in women: toward an integrated etiologic model. Am J Psychiatry 1993;150:1139–1148.Google ScholarPubMed
Kessler, R.C., Sonnega, A., Bromet, E., Hughes, M., Nelson, C.B.Posttraumatic stress disorder in the National Comorbidity Survey. Arch Gen Psychiatry 1995;52:1048–1060.CrossRefGoogle ScholarPubMed
Koopman, C., Classen, C., Spiegel, D.Predictors of posttraumatic stress symptoms among survivors of the Oakland/Berkeley, California firestorm. Am J Psychiatry 1994;151:888–894.Google ScholarPubMed
La cifras de la tragedia. El PAÍS 12 de Septiembre; 2004. p. 20.Google Scholar
Lecrubier, Y., Sheehan, D.V., Weiller, E., Amorim, P., Bonora, I., Harnett Sheehan, K.et al.The Mini International Neuropsychiatric Interview (MINI). A short diagnostic structured interview: reliability and validity according to the CIDI. Eur Psychiatry 1997;12:224–231.CrossRefGoogle Scholar
Los efectos de los atentados del 11 de marzo de 2004, según los indicadores coyunturales. Banco de España. Boletín Económico. Mayo 2004: 31–38.Google Scholar
Ministerio del Interior. Dirección General de Protección Civil y Emergencias. Reflexiones sobre las actuaciones en materia de protección civil tras los atentados terroristas del 11 de marzo de 2004 en Madrid. Disponible en www.proteccioncivil.org/informes/infoactua.htm. 30 de Junio 2004.Google Scholar
Norris, F.H., Friedman, M.J., Watson, P.J., Byrne, C.M., Diaz, E., Kaniasty, K.60,000 disaster victims speak: part I. an empirical review of the empirical literature, 1981–2001. Psychiatry 2002;65:207–239.CrossRefGoogle ScholarPubMed
North, C.S., Nixon, S.J., Shariat, S., Mallonee, S., McMillen, J.C., Spitznagel, E.L.et al.Psychiatric disorders among survivors of the Oklahoma City bombing. JAMA 1999;282:755–762.CrossRefGoogle ScholarPubMed
North, C.S., Tivis, L., McMillen, J.C., Pfefferbaum, B., Spitznagel, E.L., Cox, J.et al.Psychiatric disorders in rescue workers after the Oklahoma city Bombing. Am J Psychiatry 2002;159:857–859.CrossRefGoogle ScholarPubMed
Pole, N., Best, S.R., Weiss, D.S., Metzler, T., Liberman, A.M., Fagan, J.et al.Effects of gender and ethnicity on duty-related posttraumatic stress symptoms among urban police officers. J Nerv Ment Dis 2001;189:442–448.CrossRefGoogle ScholarPubMed
Regier, D.A., Farmer, M.E., Rae, D.S., Myers, J.K., Kramer, M., Robins, L.N.et al.One-month prevalence of mental disorders in the United States and sociodemographic characteristics: the Epidemiologic Catchment Area study. Acta Psychiatr Scand 1993;88:35–47.CrossRefGoogle ScholarPubMed
Rodríguez, P., Serra, J.A.Coordinación general de las actuaciones del 11M en el hospital General Universitario Gregorio Marañón de Madrid. Med Clin 2005;124(Suppl. 1):3–7.CrossRefGoogle Scholar
Sainz-Cortón, E., Gonzalo Franco, S., Gómez Rojo, R.M.Salud mental. Med Clin (Barc) 2005;124(Suppl. 1):39–41.CrossRefGoogle Scholar
Schlenger, W.E., Caddell, J.M., Ebert, L., Jordan, B.K., Rourke, K.M., Wilson, D.et al.Psychological reactions to terrorist attacks: findings from the national study of Americans' reactions to September 11. JAMA 2002;288:581–588.CrossRefGoogle ScholarPubMed
Shalev, A.Y., Freedman, S., Peri, T., Brandes, D., Sahar, T., Orr, S.P.et al.Prospective study of posttraumatic stress disorder and depression following trauma. Am J Psychiatry 1998;155:630–637.CrossRefGoogle ScholarPubMed
Sheehan, D.V., Lecrubier, Y., Harnett Sheehan, K., Janavs, J., Weiller, E., Keskiner, A.et al.The validity of the Mini International Neuropsychiatric Interview (MINI) according to the SCID-P and its reliability. Eur Psychiatry 1997;12:232–241.CrossRefGoogle Scholar
Shore, J.H., Vollmer, W.M., Tatum, E.L.Community patterns of posttraumatic stress disorders. J Nerv Ment Dis 1989;177:681–685.Google ScholarPubMed
Surtees, P.G., Sashidharan, S.P., Dean, C.Affective disorder amongst women in the general population: a longitudinal study. Br J Psychiatry 1986;148:176–186.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.