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The Prevalence of Posttraumatic Stress Disorder Among Survivors After a Typhoon or Hurricane: A Systematic Review and Meta-Analysis

  • Zhipeng Wang (a1), Xin Wu (a1), Wenjie Dai (a1), Atipatsa C. Kaminga (a1) (a2), Xiaoli Wu (a1), Xiongfeng Pan (a1), Ziyan Liu (a1), Shiwu Wen (a1) (a3) (a4) (a5), Shixiong Hu (a6) and Aizhong Liu (a1)...


Posttraumatic stress disorder (PTSD) is a psychological disorder, which could be caused by traumatic events. The prevalence of PTSD among survivors after a typhoon or hurricane varied widely. Therefore, this study aimed to determine a combined prevalence of PTSD among survivors after a typhoon or hurricane. A systematic search of literature was performed in the 3 English databases: PubMed (National Library of Medicine, Bethesda, MD), ISI Web of Science (Thomson Reuters, New York, NY), and Embase (Elsevier, Amsterdam, Netherlands). Also, a similar search was performed in the 2 Chinese databases such as Chinese National Knowledge Infrastructure and WanFang. Loney et al.’s criteria were used to evaluate the quality of the selected articles for this study. The combined prevalence of PTSD among the study population was estimated using the Freeman–Tukey double arcsine transformation method. Subgroup analyses and a meta-regression analysis were carried out to explore the origin of heterogeneity. Thirty-nine eligible articles were included in this study. They comprised 43 123 typhoon and hurricane survivors of which 9373 were diagnosed with PTSD. The combined prevalence of PTSD among this population was 17.81%. Subgroup analyses revealed that the combined prevalence of PTSD related to typhoon and hurricane Categories 5, 4, and 2 showing a corresponding decreasing tendency. About 18% of people who experienced a severe typhoon or hurricane develop PTSD with the prevalence decreasing with reduced severity of the typhoon or hurricane.


Corresponding author

Correspondence and reprint requests to Aizhong Liu, Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China (e-mail:


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1.Wang, CZ. Similarities and differences between typhoon and hurricane. China Meteorological Press. 2006;8:45.
2.Cerda, M, Bordelois, PM, Galea, S, et al. The course of posttraumatic stress symptoms and functional impairment following a disaster: what is the lasting influence of acute versus ongoing traumatic events and stressors? Soc Psychiatry Psychiatr Epidemiol. 2013;48:385395.
3.Galea, S, Brewin, CR, Gruber, M, et al. Exposure to hurricane-related stressors and mental illness after Hurricane Katrina. Arch Gen Psychiatry. 2007;64:14271434.
4.Hugelius, K, Gifford, M, Ortenwall, P, et al. Health among disaster survivors and health professionals after the Haiyan Typhoon: a self-selected Internet-based web survey. Int J Emerg Med. 2017;10:13.
5.Tang, TC, Yen, CF, Cheng, CP, et al. Suicide risk and its correlate in adolescents who experienced typhoon-induced mudslides: a structural equation model. Depress Anxiety. 2010;27:11431148.
6.Amstadter, AB, Acierno, R, Richardson, LK, et al. Posttyphoon prevalence of posttraumatic stress disorder, major depressive disorder, panic disorder, and generalized anxiety disorder in a Vietnamese sample. J Trauma Stress. 2009;22:180188.
7.Pietrzak, RH, Tracy, M, Galea, S, et al. Resilience in the face of disaster: prevalence and longitudinal course of mental disorders following Hurricane Ike. PLoS One. 2012;7:e38964.
8.Careaga, MBL, Girardi, CEN, Suchecki, D. Understanding posttraumatic stress disorder through fear conditioning, extinction and reconsolidation. Neurosci Biobehav Rev. 2016;71:4857.
9.Liu, H, Petukhova, MV, Sampson, NA, et al. Association of DSM-IV posttraumatic stress disorder with traumatic experience type and history in the World Health Organization world mental health surveys. JAMA Psychiatry. 2017;74:270281.
10.Rubens, SL, Vernberg, EM, Felix, ED, et al. Peer deviance, social support, and symptoms of internalizing disorders among youth exposed to Hurricane Georges. Psychiatry. 2013;76:169181.
11.Guo, JC, Tian, ZL, Wang, XD, et al. Post-traumatic stress disorder after typhoon disaster and its correlation with platelet 5-HT concentrations. Asian Pac J Trop Med. 2016;9:913915.
12.American Psychiatric Association. DSM-5 Task Force. Diagnostic and statistical manual of mental disorders, DSM-5. Washington, DC: American Psychiatric Association; 2013.
13.New modification of Saffir-Simpson hurricane wind scale. The Watchers; 2012. Accessed March 13, 2012.
14.Loney, PL, Chambers, LW, Bennett, KJ, et al. Critical appraisal of the health research literature: prevalence or incidence of a health problem. Chronic Dis Can 1998;19:170176.
15.Chen, L, Liu, A. The incidence of posttraumatic stress disorder after floods: a meta-analysis. Disaster Med Public Health Prep. 2015;9:329333.
16.Mordeno, IG, Carpio, JG, Nalipay, MJ, et al. PTSD’s underlying dimensions in typhoon Haiyan survivors: assessing DSM-5 symptomatology-based PTSD models and their relation to posttraumatic cognition. Psychiatr Q. 2017;88:923.
17.McDermott, B, Berry, H, Cobham, V Social connectedness: a potential aetiological factor in the development of child post-traumatic stress disorder. Aust N Z J Psychiatry. 2012;46:109117.
18.King, RV, Polatin, PB, Hogan, D, et al. Needs assessment of Hurricane Katrina evacuees residing temporarily in Dallas. Community Mental Health J. 2016;52:1824.
19.Giarratano, G, Harville, EW, Barcelona de Mendoza, V, et al. Healthy start: description of a safety net for perinatal support during disaster recovery. Matern Child Health J. 2015;19:819827.
20.Banks, DM, Weems, CF. Family and peer social support and their links to psychological distress among hurricane-exposed minority youth. Am J Orthopsychiatry. 2014;84:341352.
21.Paxson, C, Fussell, E, Rhodes, J, et al. Five years later: recovery from post traumatic stress and psychological distress among low-income mothers affected by Hurricane Katrina. Soc Sci Med. 2012;74:150157.
22.Mills, LD, Mills, TJ, Macht, M, et al. Post-traumatic stress disorder in an emergency department population one year after Hurricane Katrina. J Emerg Med. 2012;43:7682.
23.Osofsky, HJ, Osofsky, JD, Arey, J, et al. Hurricane Katrina’s first responders: the struggle to protect and serve in the aftermath of the disaster. Disaster Med Public Health Prep. 2011;5:S214S219.
24.McLaughlin, KA, Berglund, P, Gruber, MJ, et al. Recovery from PTSD following Hurricane Katrina. Depress Anxiety. 2011;28:439446.
25.Beaudoin, CE. Hurricane Katrina: addictive behavior trends and predictors. Public Health Rep. 2011;126:400409.
26.Rhodes, J, Chan, C, Paxson, C, et al. The impact of Hurricane Katrina on the mental and physical health of low-income parents in New Orleans. Am J Orthopsychiatry. 2010;80:237247.
27.Kelley, ML, Self-Brown, S, Le, B, et al. Predicting posttraumatic stress symptoms in children following Hurricane Katrina: a prospective analysis of the effect of parental distress and parenting practices. J Trauma Stress. 2010;23:582590.
28.Hirschel, MJ, Schulenberg, SE On the viability of PTSD Checklist (PCL) short form use: analyses from Mississippi Gulf Coast Hurricane Katrina survivors. Psychol Assess. 2010;22:460464.
29.Cepeda, A, Saint Onge, JM, Kaplan, C, et al. The association between disaster-related experiences and mental health outcomes among drug using African American Hurricane Katrina evacuees. Community Mental Health J. 2010;46:612620.
30.West, C, Bernard, B, Mueller, C, et al. Mental health outcomes in police personnel after Hurricane Katrina. J Occup Environ Med. 2008;50:689695.
31.Kessler, RC, Galea, S, Gruber, MJ, et al. Trends in mental illness and suicidality after Hurricane Katrina. Mol Psychiatry. 2008;13:374384.
32.Galea, S, Tracy, M, Norris, F, et al. Financial and social circumstances and the incidence and course of PTSD in Mississippi during the first two years after Hurricane Katrina. J Trauma Stress. 2008;21:357368.
33.Hyre, AD, Cohen, AJ, Kutner, N, et al. Prevalence and predictors of posttraumatic stress disorder among hemodialysis patients following Hurricane Katrina. Am J Kidney Dis. 2007;50:585593.
34.DeSalvo, KB, Hyre, AD, Ompad, DC, et al. Symptoms of posttraumatic stress disorder in a New Orleans workforce following Hurricane Katrina. J Urban Health. 2007;84:142152.
35.Morris, KA, Deterding, NM. The emotional cost of distance: geographic social network dispersion and post-traumatic stress among survivors of Hurricane Katrina. Soc Sci Med. 2016;165:5565.
36.Lieberman-Cribbin, W, Liu, B, Schneider, S, et al. Self-reported and FEMA flood exposure assessment after Hurricane Sandy: association with mental health outcomes. PLoS One. 2017;12:e0170965.
37.Lowe, SR, Sampson, L, Gruebner, O, et al. Psychological resilience after Hurricane Sandy: the influence of individual- and community-level factors on mental health after a large-scale natural disaster. PLoS One. 2015;10:e0125761.
38.Caramanica, K, Brackbill, RM, Stellman, SD, et al. Posttraumatic stress disorder after Hurricane Sandy among persons exposed to the 9/11 disaster. J Racial Ethnic Health Dispar 2015;17:356362.
39.Palgi, Y, Shrira, A, Hamama-Raz, Y, et al. Not so close but still extremely loud: recollection of the world trade center terror attack and previous hurricanes moderates the association between exposure to Hurricane Sandy and posttraumatic stress symptoms. Compr Psychiatry. 2014;55:807812.
40.Liu, H, Petukhova, MV, Sampson, NA, et al. Association of DSM-IV posttraumatic stress disorder with traumatic experience type and history in the World Health Organization World Mental Health Surveys. JAMA Psychiatry. 2017;74:270.
41.Dai, W, Chen, L, Lai, Z, et al. The incidence of post-traumatic stress disorder among survivors after earthquakes: a systematic review and meta-analysis. BMC Psychiatry. 2016;16:188.
42.Hartl, TL, Rosen, C, Drescher, K, et al. Predicting high-risk behaviors in veterans with posttraumatic stress disorder. J Nerv Ment Dis. 2005;193:464472.
43.Myers, L, Zandberg, L. Prolonged exposure therapy for comorbid psychogenic nonepileptic seizures and posttraumatic stress disorder. Clin Case Studies. 2017;17:320.
44.Wu, X, Wang, JR, Cofie, R, et al. Prevalence of posttraumatic stress disorder among breast cancer patients: a meta-analysis. Iran J Public Health. 2016;45:15331544.
45.Koenen, KC, Amstadter, AB, Nugent, NR Gene-environment interaction in posttraumatic stress disorder: an update. J Trauma Stress. 2009;22:416426.
46.Xiaoling, F, Hua, Z, Baichao, X Typhoon induced post-traumatic stress disorder and its influencing factors in residents of Hainan Island. Chin J Pract Nurs. 2015;31:34.
47.Harville, EW, Jacobs, M, Boynton-Jarrett, R When is exposure to a natural disaster traumatic? Comparison of a trauma questionnaire and disaster exposure inventory. PLoS One. 2015;10:e0123632.
48.Ursano, RJ, McKibben, JB, Reissman, DB, et al. Posttraumatic stress disorder and community collective efficacy following the 2004 Florida hurricanes. PLoS One. 2014;9:e88467.
49.Dongyang, Z, Hua, Z, Weijie, C. The analysis of traumatic stress disorders related to tempest rain in junior high school students in Hainan Island and its influencing factors. Chin J Pract Nurs. 2011;27:4950.
50.La Greca, AM, Silverman, WK, Lai, B, et al. Hurricane-related exposure experiences and stressors, other life events, and social support: concurrent and prospective impact on children’s persistent posttraumatic stress symptoms. J Consult Clin Psychol. 2010;78:794805.
51.Kim, H, Han, SB, Kim, JH, et al. Post-Nargis medical care: experience of a Korean Disaster Relief Team in Myanmar after the cyclone. Euro J Emerg Med. 2010;17:3741.
52.Ruggiero, KJ, Amstadter, AB, Acierno, R, et al. Social and psychological resources associated with health status in a representative sample of adults affected by the 2004 Florida hurricanes. Psychiatry. 2009;72:195210.
53.Kilpatrick, DG, Koenen, KC, Ruggiero, KJ, et al. The serotonin transporter genotype and social support and moderation of posttraumatic stress disorder and depression in hurricane-exposed adults. Am J Psychiatry. 2007;164:16931699.
54.Acierno, R, Ruggiero, KJ, Galea, S, et al. Psychological sequelae resulting from the 2004 Florida hurricanes: implications for postdisaster intervention. Am J Public Health. 2007;97 (Suppl 1):S103108.
55.Garrison, CZ, Bryant, ES, Addy, CL, et al. Posttraumatic stress disorder in adolescents after Hurricane Andrew. J Am Acad Child Adolesc Psychiatry. 1995;34:11931201.


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The Prevalence of Posttraumatic Stress Disorder Among Survivors After a Typhoon or Hurricane: A Systematic Review and Meta-Analysis

  • Zhipeng Wang (a1), Xin Wu (a1), Wenjie Dai (a1), Atipatsa C. Kaminga (a1) (a2), Xiaoli Wu (a1), Xiongfeng Pan (a1), Ziyan Liu (a1), Shiwu Wen (a1) (a3) (a4) (a5), Shixiong Hu (a6) and Aizhong Liu (a1)...


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