Anxiety, Mood Disorders and Katrina

Dec 3, 2007
Almost half of pre-hurricane residents of New Orleans and
one-fourth of those living in other affected areas had
evidence of an anxiety or mood disorder five to seven
months following Hurricane Katrina, according to a report
in the December issue of Archives of General Psychiatry,
one of the JAMA/Archives journals.

“Hurricane Katrina was the worst natural disaster in the
United States in the past 75 years, creating a disaster
region as large as Great Britain, killing more than 1,000
people, uprooting 500,000 others and causing more than $100
billion in damage,” the authors write as background
information in the article. “This vast devastation would
lead us to expect a high prevalence of mental illness among
people who lived through Katrina.”

Sandro Galea, M.D., Dr. P.H., of the University of Michigan
School of Public Health, Ann Arbor, and colleagues surveyed
1,043 residents who had been living in affected areas of
Louisiana, Alabama and Mississippi before Hurricane
Katrina. The telephone survey was conducted between Jan. 19
and March 31, 2006, five to seven months after the storm.
Participants were asked about stressors related to the
hurricane and screened for symptoms of mood and anxiety
disorders—which include depression, panic disorders and
post-traumatic stress disorder (PTSD)—within 30 days of the
interview.

A total of 31.2 percent of the participants had an
anxiety-mood disorder, including 49.1 percent of the New
Orleans metropolitan area residents and 26.4 percent of the
other participants. Among all participants, 16.3 percent
had PTSD; this included 30.3 percent of New Orleans
residents and 12.5 percent of the others. Individuals, who
were younger than age 60, female, did not graduate college,
had a low family income or were unmarried or unemployed
before the hurricane were more likely to have anxiety-mood
disorders, and those who were Hispanic or other minorities
excluding blacks had lower rates of these conditions.

“The vast majority of respondents both in the New Orleans
metro (91.9 percent) and in the remainder of the sample
(81.7 percent) reported experiencing at least one of the 10
categories of hurricane-related stressors,” including the
death of a loved one, robbery, injury or property loss, the
authors write. Among New Orleans residents, the extent of
exposure to these stressors was more strongly related to
anxiety-mood disorders than among residents of other areas.
While New Orleans residents were most likely to develop
anxiety-mood disorders following physical illness or injury
and physical adversity, the rest of the participants were
more likely to develop such a disorder following property
loss.

The rate of anxiety and mood disorders in New Orleans
residents was higher than that typically found in studies
of mental illness following natural disasters in the United
States, while the rate among the other respondents was
roughly equivalent, the authors note. In addition, they
conclude, “evidence that avoidable stressors associated
with the slow government response to Hurricane Katrina
(e.g., physical adversity) had important implications for
the mental health of people who lived through Katrina
argues strongly for the importance of efficient provision
of practical and logistical assistance in future disasters,
not only on humanitarian grounds, but also as a way to
minimize the adverse mental health effects of disasters.”

Arch Gen Psychiatry. 2007; 64(12):1427-1434.