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Comparison of post-disaster psychiatric disorders after terrorist bombings in Nairobi and Oklahoma City

Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri

BETTY PFEFFERBAUM, MD, JD and PUSHPA NARAYANAN, MBBS, DCH, MA

Department of Psychiatry and Behavioral Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma

SAMUEL THIELMAN, MD, PhD

US Department of State, Office of Medical Services, Washington, DC, and Duke University School of Medicine, Department of Psychiatry and Behavioral Science, Durham, North Carolina

GRETCHEN McCOY, MD and CEDRIC DUMONT, MD, US

Department of State, Office of Medical Services, Washington, DC

AYA KAWASAKI, MSW, LCSW

Washington University School of Medicine, Department of Psychiatry, St Louis, Missouri

NATSUKO RYOSHO, MSW

George Warren Brown School of Social Work, Washington University, St Louis, Missouri

EDWARD L. SPITZNAGEL, PhD

Department of Mathematics and Division of Biostatistics, Washington University, St Louis, Missouri, USA

Correspondence: Dr Carol S. North, Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, St Louis, Missouri 63110, USA. Tel: +1 314 747 2013; fax: +1 314 747 2140; e-mail: NorthC{at}psychiatry.wustl.edu

Declaration of interest None.

Background African disaster-affected populations are poorly represented in disaster mental health literature.

Aims To compare systematically assessed mental health in populations directly exposed to terrorist bombing attacks on two continents, North America and Africa.

Method Structured diagnostic interviews compared citizens exposed to bombings of the US Embassy in Nairobi, Kenya (n=227) and the Oklahoma City Federal Building (n=182).

Results Prevalence rates of post-traumatic stress disorder (PTSD) and major depression were similar after the bombings. No incident (new since the bombing) alcohol use disorders were observed in either site. Symptom group C was strongly associated with PTSD in both sites. The Nairobi group relied more on religious support and the Oklahoma City group used more medical treatment, drugs and alcohol.

Conclusions Post-disaster psychopathology had many similarities in the two cultures; however, coping responses and treatment were quite different. The findings suggest potential for international generalisability of post-disaster psychopathology, but confirmatory studies are needed.

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