Abstract
This study investigated psychosocial functioning and employment status in association with postdisaster major depression and its course in survivors of 11 different disasters in a sample of 808 directly-exposed survivors of 10 disasters and 373 survivors of the 11 September 2001 (9/11), terrorist attacks on New York City’s World Trade Center (total n = 1181). Participants were assessed between 1987 and 2007 with structured diagnostic interviews in a prospective longitudinal design. Consistent research methods allowed merging of the disaster databases for analysis using multivariate modeling. Postdisaster major depression in the study cohort from the 9/11 disaster was more than twice as prevalent as in the other disasters, possibly reflecting the greater psychosocial/interpersonal loss and bereavement experienced by 9/11 disaster survivors. At follow up, employment was associated with remission of postdisaster major depression, non-development of PTSD, and coping via family or friends. Functioning problems were associated with disaster injuries, but not with persistent major depression. This study is unprecedented in its large sample of survivors across the full range of disaster typology studied using consistent methods and full structured interview diagnostic assessment. These findings may help guide future interventions to address postdisaster depression.
Highlights
Major depressive disorder (MDD) is the mental disorder causing the most functional disability, and it represents a major source of psychosocial impairment globally [1,2,3,4,5].the place of MDD in disaster mental health research has been eclipsed by the centrality of posttraumatic stress disorder (PTSD) in this research [6,7,8,9,10,11]
In the 10-disaster database, postdisaster major depression was identified in 13% at baseline, and in 22% at any time after the disaster
This study examined outcomes and correlates of postdisaster major depression across two databases of a total of 1181 survivors from 11 disasters with collection of full diagnostic data
Summary
Major depressive disorder (MDD) is the mental disorder causing the most functional disability, and it represents a major source of psychosocial impairment globally [1,2,3,4,5]. The place of MDD in disaster mental health research has been eclipsed by the centrality of posttraumatic stress disorder (PTSD) in this research [6,7,8,9,10,11]. Disaster mental health research has established the association of considerable functional disability with. Little is known about the temporal course of MDD, predictors of MDD remission, and functional outcomes of MDD in disaster settings [17]. Studies have shown that recovery from posttraumatic psychopathology was not associated functional outcomes [16,24] and that the improvement in functioning was
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