Psychological burden after 11 September tragedy

Kay Seong-Ngoo Aberdeen

There is a substantial psychological impact among the residents of Manhattan after the 11 September terrorist attack in New York, according to an evaluation of psychosomatic disorders by a team of epidemiologists. They found many cases of acute post-traumatic stress disorder (PTSD) and depression after the unprecedented catastrophe. People directly exposed to the event are more likely to suffer from PTSD; victims with losses due to the tragedy are more vulnerable to ongoing depression.

About 3000 lives were lost, and many of those who survived lost relatives and property. The surveyors randomly contacted by telephone a sample of mixed adult population living south of 110th Street, Manhattan, and enquired about the residents' background, exposure to the tragedy, and their psychological symptoms five to eight weeks after the attack. Of a total of 1008 adults interviewed, 7.5% had symptoms consistent with PTSD and 9.7% are still clinically depressed. These translate as 67 000 people and about 87 000 individuals suffering from PTSD and depression, respectively, in the densely population region of New York. Furthermore, one in five respondents living closest to the World Trade Center, south of Canal Street, suffered from PTSD.

The epidemiologists also found that Hispanic people are more vulnerable than others to PTSD and depression, although the links are not properly understood.

Respondents with at least two prior stressors and a panic attack during or immediately after the events were also linked with the two psychological morbidities. Those who reside close to the incident site were more prone to PTSD. However, residential factor was not seen among depressed respondents. Those who lost friends, relatives, or jobs were more likely to be depressed, but the loss of possessions was linked to PTSD.

One of the researchers, Sandro Galea, from the Center for Urban Epidemiologic Studies of the New York Academy of Medicine commented, "There was a previous study that looked at non-specific psychological distress in the United States after 11 September. Our study is the first study, to my knowledge, to look at mental health symptoms that are consistent with diagnosable psychiatric conditions. Part of the intent of our study was to inform the mental health response in New York. As such we worked closely with New York and state officials and provided them with very early results, in November, from our study. So, our findings have already been used to impact provision of mental health care to the residents of New York... mostly under the banner of Project Liberty."



studentBMJ 2002;10:131-170 May ISSN 0966-6494