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Following chemical, biological, radiological, and nuclear disasters, medically unexplained symptoms have been observed among unexposed persons.
This study examined belief in exposure in relation to postdisaster symptoms in a volunteer sample of 137 congressional workers after the 2001 anthrax attacks on Capitol Hill.
Postdisaster symptoms, belief in exposure, and actual exposure status were obtained through structured diagnostic interviews and self-reported presence in offices officially designated as exposed through environmental sampling. Multivariate models were tested for associations of number of postdisaster symptoms with exposure and belief in exposure, controlling for sex and use of antibiotics.
The sample was divided into 3 main subgroups: exposed, 41%; unexposed but believed they were exposed, 17%; and unexposed and did not believe that they were exposed, 42%. Nearly two-thirds (64%) of the volunteers reported experiencing symptoms after the anthrax attacks. Belief in anthrax exposure was significantly associated with the number of ear/nose/throat, musculoskeletal, and all physical symptoms. No significant associations were found between anthrax exposure and the number of postdisaster symptoms.
Given the high incidence of these symptoms, these data suggest that even in the absence of physical injury or illness, there may be surges in health care utilization. (Disaster Med Public Health Preparedness. 2019;13:555-560)
Most previous studies of long-term mortality risk following self-harm
have been conducted in Western countries with few studies from Asia.
To investigate suicide and non-suicide mortality after non-fatal
self-harm in Taipei City, Taiwan.
Prospective cohort study (median follow-up 3.3 years) of 7601 individuals
presenting to hospital with self-harm (January 2004 to December 2006).
Standardised mortality ratios (SMRs) for suicide and non-suicide
mortality were calculated.
Suicide risk in the year following self-harm was over 100 times higher
than in the general population (SMR = 119.6, 95% CI 99.6–142.5). Males
and middle-aged and older adults had the highest subsequent risk of
suicide. Compared with people who took an overdose, individuals who used
hanging or charcoal burning in their index episode had the highest risk
of suicide. For non-suicide mortality the SMRs were 6.7 (95% CI 5.7–7.8)
in the first year and 4.4 (95% CI 3.9–4.9) during the whole follow-up
Patterns of increased all-cause and suicide mortality following an
episode of self-harm are similar in Taipei City to those seen in Western
countries. Designing better aftercare following non-fatal self-harm,
particularly for those with underlying physical disorders or who have
used lethal self-harm methods, should be a priority for suicide
prevention programmes in Asia.