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Cited by 618Posttraumatic Stress Disorder ResearchDisaster Response and ManagementCOVID-19 and Mental Health

Trends in mental illness and suicidality after Hurricane Katrina

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Kessler, R C, Galea, S, Gruber, M J, Sampson, N A, Ursano, R J, Wessely, S·2008·Molecular Psychiatry
DOI 10.1038/sj.mp.4002119PMC PMC2556982
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Abstract

A representative sample of 815 pre-hurricane residents of the areas affected by Hurricane Katrina was interviewed 5-8 months after the hurricane and again 1 year later as the Hurricane Katrina Community Advisory Group (CAG). The follow-up survey was carried out to study patterns-correlates of recovery from hurricane-related post-traumatic stress disorder (PTSD), broader anxiety-mood disorders and suicidality. The Trauma Screening Questionnaire screening scale of PTSD and the K6 screening scale of anxiety-mood disorders were used to generate DSM-IV prevalence estimates. Contrary to results in other disaster studies, where post-disaster mental disorder typically decreases with time, prevalence increased significantly in the CAG for PTSD (20.9 vs 14.9% at baseline), serious mental illness (SMI; 14.0 vs 10.9%), suicidal ideation (6.4 vs 2.8%) and suicide plans (2.5 vs 1.0%). The increases in PTSD-SMI were confined to respondents not from the New Orleans Metropolitan Area, while the increases in suicidal ideation-plans occurred both in the New Orleans sub-sample and in the remainder of the sample. Unresolved hurricane-related stresses accounted for large proportions of the inter-temporal increases in SMI (89.2%), PTSD (31.9%) and suicidality (61.6%). Differential hurricane-related stress did not explain the significantly higher increases among respondents from areas other than New Orleans, though, as this stress was both higher initially and decreased less among respondents from the New Orleans Metropolitan Area than from other areas affected by the hurricane. Outcomes were only weakly related to socio-demographic variables, meaning that high prevalence of hurricane-related mental illness remains widely distributed in the population nearly 2 years after the hurricane.

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  • Exposure to hurricanes and floods is associated with symptoms of acute depression and posttraumatic stress disorder.

    “exposure to hurricanes and floods is associated with symptoms of acute depression as well as posttraumatic stress disorder (22-27)”

    From Empirical evidence of mental health risks posed by climate change (2018) · cites this paper as [22]

    The Socio-demographic predictors of the trends section (page not provided) reports a strong association between hurricane-related stress and PTSD, as well as serious mental illness. The paper studies Hurricane Katrina, but does not establish the claimed association for floods separately or report acute depression as a distinct outcome. (LLM, conf=0.87)

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  • Researchers tend to conceptualize mental health solely as mental illness and mental problems, administering surveys using validated instruments that assess mental health problems such as generalized anxiety disorder, PTSD, and psychological distress following an extreme weather event.

    “Researchers tend to conceptualize mental health solely as mental illness and mental problems, administering surveys using validated instruments that assess mental health problems and issues like: generalized anxiety disorder (using the general anxiety disorder, GAD-2 questionnaire), PTSD (PCL-6 checklist), and psychological distress (via the general health questionnaire, GHQ-12) following an ext”

    From Climate change and mental health: risks, impacts and priority actions (2018) · cites this paper as [65]

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  • Kessler et al. found an increase in mental health disorders as time progressed among Hurricane Katrina survivors, with PTSD increasing from 14.9% at 5-8 months to 20.9% after 1 year.

    “Kessler et al. conducted interviews with Hurricane Katrina survivors 5–8 months post-event and 1-year post-event, these authors found an increase in mental health disorders as time progressed [65]. For example, PTSD increased from 14.9% at 5–8 months to 20.9% after 1 year.”

    From Climate change and mental health: risks, impacts and priority actions (2018) · cites this paper as [65]

    The Abstract reports that PTSD prevalence increased from 14.9% at baseline to 20.9% at follow-up. But follow-up was one year after the 5–8-month interview, not one year after the hurricane; the Discussion describes it as nearly two years after the hurricane. (LLM, conf=0.90)

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  • Most mental health problems following severe stressors are of subclinical severity.

    “Most mental health problems following such severe stressors are of a subclinical severity, e.g., [5].”

    From Promoting Recovery from Disasters, Pandemics, and Trauma: A Systematic Review of Brief Psychological Interventions to Reduce Distress in Adults, Children, and Adolescents (2023) · cites this paper as [5]

    Table 1 (page unavailable) reports that mild–moderate anxiety-mood disorders were more prevalent than serious mental illness in the Katrina-affected sample at both surveys. But the Measures section defines those mild–moderate cases as meeting DSM-IV disorder criteria, not as subclinical, and the study does not establish the claim for severe stressors generally. (LLM, conf=0.84)

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  • A substantial number of survivors of disasters, pandemics, and other severe stressors develop persistent distress that impairs mental health and well-being.

    “A substantial number of survivors of disasters, pandemics, and other severe stressors develop persistent distress that impairs mental health and well-being.”

    From Promoting Recovery from Disasters, Pandemics, and Trauma: A Systematic Review of Brief Psychological Interventions to Reduce Distress in Adults, Children, and Adolescents (2023) · cites this paper as [5]

    The Discussion reports that hurricane-related stress remained common nearly two years after Katrina and was linked to increased mental illness. The Introduction also discusses persistent PTSD after other traumatic events. The paper does not address pandemics, so the claim’s extension to pandemic survivors is unsupported. (LLM, conf=0.86)

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Research works printed but not linked: 2

  1. [25]25. Substance Abuse and Mental Health Services Administration. Final notice establishing definitions for (1) children with a serious emotional disturbance, and (2) adults with a serious mental illness. Fed Regist 1993; 58: 29422-29425.
  2. [27]27. First MB, Spitzer RL, Gibbon M, Williams JBW. Structured Clinical Interview for DSM-IV Axis I Disorders, Research Version, Non- patient Edition (SCID-I/NP). Biometrics Research, New York State Psychiatric Institute: New York, NY, 2002.

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Authors
Kessler, R. C., Galea, S., Gruber, M. J., Sampson, N. A., Ursano, R. J., & Wessely, S.
Affiliations
  • Harvard University (US)
  • University of Michigan (US)
  • Uniformed Services University of the Health Sciences (US)
  • King's College London (GB)
Corresponding author
Kessler, R C
ORCID
Venue
Molecular Psychiatry
Publisher
Springer Science and Business Media LLC
Published
2008-01-08
Volume
13
Issue
4
Pages
374-384
ISSN
  • 1359-4184 (ISSN-L)
  • 1476-5578
DOI
10.1038/sj.mp.4002119
PMC
PMC2556982
OpenAlex
W2014840309
Cited by
617
References
39
Citations by year
2026: 16 · 2025: 16 · 2024: 27 · 2023: 32 · 2022: 38 · 2021: 40 · 2020: 83 · 2019: 24 · 2018: 25 · 2017: 57 · 2016: 24 · 2015: 30 · 2014: 26 · 2013: 41 · 2012: 30
FWCI
40.38
Type
journal article
Language
en
Open access
Licence
Locations
  • Molecular Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • Deep Blue (University of Michigan) (submittedVersion)
  • Research Portal (King's College London) (submittedVersion)
Funders
  • U.S. Department of Health and Human Services
  • National Institutes of Health (5r01mh070884-05)
  • Federal Emergency Management Agency
  • National Institute of Mental Health (R01‐MH070884, MH070884, R01 MH070884-01A2)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Health Sciences › Health Professions › Emergency Medical Services › Disaster Response and Management
  • Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
Keywords
Hurricane Katrina, post-traumatic stress disorder, severe mental illness, suicidality, suicidal ideation, suicide planning, disaster mental health, disaster recovery, New Orleans
MeSH terms
Adolescent, Adult, Age Factors, Aged, Anxiety Disorders, Mental Disorders, Disasters, Female, Follow-Up Studies, Humans, Life Change Events, Louisiana, Male, Middle Aged, Surveys and Questionnaires, Retrospective Studies, Stress Disorders, Post-Traumatic, Stress, Psychological, Suicide, Diagnostic and Statistical Manual of Mental Disorders

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