Comparison of post-disaster psychiatric disorders after terrorist bombings in Nairobi and Oklahoma City.
BACKGROUND: African disaster-affected populations are poorly represented in disaster mental health literature. AIMS: To compare systematically assessed mental health in populations directly exposed to terrorist bombing attacks on two continents, North America and Africa. METHOD: Structured diagnostic interviews compared citizens exposed to bombings of the US Embassy in Nairobi, Kenya (n=227) and the Oklahoma City Federal Building (n=182). RESULTS: Prevalence rates of post-traumatic stress disorder (PTSD) and major depression were similar after the bombings. No incident (new since the bombing) alcohol use disorders were observed in either site. Symptom group C was strongly associated with PTSD in both sites. The Nairobi group relied more on religious support and the Oklahoma City group used more medical treatment, drugs and alcohol. CONCLUSIONS: Post-disaster psychopathology had many similarities in the two cultures; however, coping responses and treatment were quite different. The findings suggest potential for international generalisability of post-disaster psychopathology, but confirmatory studies are needed.
North, CS; Pfefferbaum, B; Narayanan, P; Thielman, S; McCoy, G; Dumont, C; Kawasaki, A; Ryosho, N; Kim, Y-S; Spitznagel, EL
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