Prevalence and factors associated with post-traumatic stress disorder among flood-affected adults in a panchayat in Ernakulam district in Kerala

Authors

  • Vinu Cherian Assistant Professor, Department of Community Medicine, Sree Narayana Institute of Medical Sciences, Ernakulam https://orcid.org/0000-0003-0369-4290
  • Joel Philip Consultant Psychiatrist, Peejays Neurocentre, Ayesha Road, Vyttila, Kochi
  • Alexander John Professor & Head of Department, Department of Community Medicine, Sree Narayana Institute of Medical Sciences, Ernakulam https://orcid.org/0000-0003-3100-6088

DOI:

https://doi.org/10.30834/KJP.33.2.2020.222

Keywords:

flood, Kerala, post-traumatic stress disorder

Abstract

Floods affected the state of Kerala following unusually heavy rainfall during the monsoon season in August 2018. Post-Traumatic Stress Disorder (PTSD) is the most common and debilitating psychological disorder among victims of floods or any other massive disaster. This study aimed to determine the prevalence and the factors associated with Post-Traumatic Stress Disorder (PTSD) among flood-affected adults in a panchayat in Kerala. In light of the looming threat of climate change, and with Kerala being especially prone to recurring floods due to its geographical location, there is an urgent need to assess the impact of floods on the psychological wellbeing of the residents of the state. To the best of our knowledge, this is the first study to investigate the occurrence of PTSD among the residents of Kerala following exposure to floods. Methods: This was a cross-sectional study undertaken in 100 households in a flood-affected community in Kerala. The PTSD Checklist for DSM-5 (PCL-5) was administered to diagnose PTSD. The intensity of flood exposure was measured using a checklist of ten factors.

Results: The prevalence of PTSD was 22%. Loss of a relative, physical injury, and affliction with a physical illness were significantly associated with PTSD. A higher intensity of flood exposure was associated with a greater prevalence of PTSD. Conclusion: Our study demonstrates the high prevalence of PTSD following floods in Kerala and the need to conduct post-disaster mental health screening. It highlights those factors that may predict the occurrence of PTSD in the affected population. Recommendations are also put forward to mitigate the psychological impact of floods on the inhabitants of the state in the coming years.

References

World Health Organization (WHO). Disasters and definitions [Internet]. 2002. [cited 2019 September 16]. Available from: http://apps.who.int/disasters/repo/7656.pdf

Norris F, Friedman M, Watson P, Byrne C, Diaz E, Kaniasty K. 60,000 Disaster Victims Speak: Part I. An Empirical Review of the Empirical Literature, 1981–2001. Psychiatry: Interpersonal and Biological Processes 2002; 65:207-39.

Diagnostic and statistical manual of mental disorders. Arlington, VA: American Psychiatric Association; 2017.

Kerala rains: Toll reaches 125, 17 still missing. The Hindu. Thiruvanathapuram. 2019 Aug 21. Available from: https://www.thehindu.com/news/national/kerala/kerala-rains-toll-reaches-125-17-still-missing/article29212558.ece

Ashok V, Premarajan KC, Rajkumar R, Naik B. Mental health status of flood-affected adults in rural Tamil Nadu: A cross-sectional study. CHRISMED J Health Res 2019; 6:97.

Weathers FW, Litz BT, Keane TM, Palmieri PA, Marx BP, Schnurr PP. The PTSD Checklist for DSM-5 (PCL-5). [Internet]. 2013. Available from: https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp

Nayak S, Kamath A, Gupta K, Roy A, Roy S, Chatterjee A. Post-traumatic stress disorder among patients with oral and maxillofacial trauma in a South Indian population. Spec Care Dentist 2019; 39:399-405.

Wortmann JH, Jordan AH, Weathers FW, Resick PA, Dondanville KA, Hall-Clark B, et al. Psychometric analysis of the PTSD Checklist-5 (PCL-5) among treatment-seeking military service members. Psychol Assess 2016; 28:1392-403.

Dai W, Kaminga A, Tan H, Wang J, Lai Z, Wu X, et al. Comorbidity of post-traumatic stress disorder and anxiety in flood survivors. Medicine 2017; 96:e7994.

Hollifield M, Hewage C, Gunawardena C, Kodituwakku P, Bopagoda K, Weerarathnege K. Symptoms and coping in Sri Lanka 20–21 months after the 2004 tsunami. Br J Psychiatry 2008; 192:39-44.

Patel FM, Oswal RM, Meheta RY. Post-traumatic Stress Disorder in Adult Victims of 2006 Flood in Surat, Gujarat. J Res Med Den Sci 2015; 3:303-6.

Ishikawa M, Yamamoto N, Yamanaka G, Suwa K, Nakajima S, Hozo R, et al. Disaster-related psychiatric disorders among survivors of flooding in Ladakh, India. Int J Soc Psychiatry 2013; 59:468-73.

Norris F, Murphy A, Baker C, Perilla J, Rodriguez F, Rodriguez J. Epidemiology of Trauma and Post-traumatic Stress Disorder in Mexico. J Abnorm Psychol 2003; 112:646-56.

Rajkumar A, Mohan T, Tharyan P. Lessons from the 2004 Asian tsunami: Epidemiological and nosological debates in the diagnosis of post-traumatic stress disorder in non-Western post-disaster communities. Int J Soc Psychiatry2011; 59:123-9.

Olff M. Sex and gender differences in post-traumatic stress disorder: an update. Eur. J. Psychotraumatol 2017; 8:1351204.

Goldstein R, Smith S, Chou S, Saha T, Jung J, Zhang H et al. The epidemiology of DSM-5 post-traumatic stress disorder in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions-III. Soc Psychiatry Psychiatr Epidemiol 2016; 51:1137-48.

Brewin CR, Andrews B, Valentine JD. Meta-analysis of risk factors for post-traumatic stress disorder in trauma-exposed adults. J Consult Clin Psychol 2000; 68:748-66.

Li L, Reinhardt JD, Van Dyke C, Wang H, Liu M, Yamamoto A, et al. Prevalence and risk factors of post-traumatic stress disorder among elderly survivors six months after the 2008 Wenchuan earthquake in China. BMC Psychiatry 2020; 20(1).

Neelofar MR, Qadri J, Bhat RA. Socio-economic and Health impacts of Floods in a Trans-Himalayan Ecosystem. Journal of Geography & Natural Disasters 2018; 8:1-4.

Becker SM. Psychosocial care for women survivors of the tsunami disaster in India. Am J Public Health, 2009; 99:654-8.

Downloads

Published

2020-12-06

How to Cite

Cherian, V., Philip, J., & John, A. (2020). Prevalence and factors associated with post-traumatic stress disorder among flood-affected adults in a panchayat in Ernakulam district in Kerala. Kerala Journal of Psychiatry, 33(2), 147–152. https://doi.org/10.30834/KJP.33.2.2020.222

Issue

Section

Research Report