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Symptoms and coping in Sri Lanka 20–21 months after the 2004 tsunami

Departments of Psychiatry and Behavioral Sciences and Family and Geriatric Medicine, University of Louisville School of Medicine, Louisville, Kentucky, USA

Chandanie Hewage, MD

Department of Psychiatry, University of Ruhuna, Galle, Sri Lanka

Charlotte N. Gunawardena, PhD

Organizational Learning and Instructional Technology Program, University of New Mexico College of Education, Albuquerque, New Mexico, USA

Piyadasa Kodituwakku, MD

Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA

Kalum Bopagoda, MD

Krishantha Weerarathnege, MD

Department of Psychiatry, University of Ruhuna, Galle, Sri Lanka.

Correspondence: Michael Hollifield, Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, 501 E. Broadway, Suite 340, Louisville, KY 40202, USA. Email: m.hollifield{at}louisville.edu

Declaration of interest

None. Funding detailed in Acknowledgements.

Background

The estimated prevalence of clinically significant psychiatric and somatic symptoms in adults >1 year after the 2004 Asian tsunami is unknown.

Aims

To estimate the prevalence of psychiatric and somatic symptoms and impairment in Sri Lanka 20–21 months after the 2004 Asian tsunami, and to assess coping strategies used by tsunami-affected individuals that contribute to post-tsunami adjustment.

Method

Homes from one severely affected area were randomly selected, and adult respondents were sampled utilising a modified Kish method. Instruments were administered in Sinhala to assess exposure, post-traumatic stress disorder (PTSD), depression, anxiety, somatic distress and impairment. Demographic variables and culturally-relevant coping activities were assessed.

Results

The prevalence of clinically significant PTSD, depression and anxiety was 21%, 16% and 30% respectively. Respondents reported a mean of eight persistent and bothersome somatic complaints, which were associated with psychiatric symptoms and impairment. Thinking that one’s life was in danger was the exposure item most strongly associated with symptoms and impairment. The majority of respondents found their own strength, family and friends, a Western-style hospital and their religious practice to be the most helpful coping aids.

Conclusions

A large minority of adults in one area of Sri Lanka reported significant psychiatric and somatic symptoms and impairment 20–21 months after the tsunami. Accurate data about risk for and resilience to impairing symptoms >1 year after disasters are necessary in order to develop rational surveillance and interventions.

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BJP 2008 192: 1-a2-1. [Full Text]