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Post-traumatic stress disorder associated with natural and human-made disasters in the World Mental Health Surveys

Published online by Cambridge University Press:  30 August 2016

E. J. Bromet
Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY, USA
L. Atwoli
Department of Mental Health, Moi University School of Medicine, Eldoret, Kenya
N. Kawakami
Department of Mental Health, School of Public Health, The University of Tokyo, Tokyo, Japan
F. Navarro-Mateu
Subdirección General de Salud Mental, Servicio Murciano de Salud, IMIB-Arrixaca, CIBER de Epidemiología y Salud Pública (CIBERESP), Murcia, Spain
P. Piotrowski
Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
A. J. King
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
S. Aguilar-Gaxiola
University of California Davis School of Medicine, Sacramento, CA, USA
J. Alonso
IMIM-Hospital del Mar Research Institute, Parc de Salut Mar, Barcelona, Spain Pompeu Fabra University (UPF), Barcelona, Spain CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
B. Bunting
School of Psychology, University of Ulster, Londonderry, UK
K. Demyttenaere
Department of Psychiatry, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium
S. Florescu
National School of Public Health, Management and Professional Development, Bucharest, Romania
G. de Girolamo
IRCCS St. John of God Clinical Research Centre, Brescia, Italy
S. Gluzman
Ukrainian Psychiatric Association, Kiev, Ukraine
J. M. Haro
Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain
P. de Jonge
Department of Psychiatry, Interdisciplinary Center, Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
E. G. Karam
Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
S. Lee
Department of Psychiatry, Chinese University of Hong Kong, Tai Po, Hong Kong
V. Kovess-Masfety
Ecole des Hautes Etudes en Santé Publique (EHESP), EA 4057 Paris Descartes University, Paris, France
M. E. Medina-Mora
Ramon de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
Z. Mneimneh
Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
B.-E. Pennell
Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
J. Posada-Villa
Colegio Mayor de Cundinamarca University, Bogota, Colombia
D. Salmerón
Department of Epidemiology, Department of Health and Social Sciences, Murcia Regional Health Council, IMIB-Arrixaca, CIBER Epidemiología y Salud Pública (CIBERESP), Universidad de Murcia, Murcia, Spain
T. Takeshima
Department of Health and Welfare for the Disabled, Health and Welfare Bureau, Kawasaki City, Japan
R. C. Kessler
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA



Research on post-traumatic stress disorder (PTSD) following natural and human-made disasters has been undertaken for more than three decades. Although PTSD prevalence estimates vary widely, most are in the 20–40% range in disaster-focused studies but considerably lower (3–5%) in the few general population epidemiological surveys that evaluated disaster-related PTSD as part of a broader clinical assessment. The World Mental Health (WMH) Surveys provide an opportunity to examine disaster-related PTSD in representative general population surveys across a much wider range of sites than in previous studies.


Although disaster-related PTSD was evaluated in 18 WMH surveys, only six in high-income countries had enough respondents for a risk factor analysis. Predictors considered were socio-demographics, disaster characteristics, and pre-disaster vulnerability factors (childhood family adversities, prior traumatic experiences, and prior mental disorders).


Disaster-related PTSD prevalence was 0.0–3.8% among adult (ages 18+) WMH respondents and was significantly related to high education, serious injury or death of someone close, forced displacement from home, and pre-existing vulnerabilities (prior childhood family adversities, other traumas, and mental disorders). Of PTSD cases 44.5% were among the 5% of respondents classified by the model as having highest PTSD risk.


Disaster-related PTSD is uncommon in high-income WMH countries. Risk factors are consistent with prior research: severity of exposure, history of prior stress exposure, and pre-existing mental disorders. The high concentration of PTSD among respondents with high predicted risk in our model supports the focus of screening assessments that identify disaster survivors most in need of preventive interventions.

Original Articles
Copyright © Cambridge University Press 2016 

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