The trajectory of symptom burden in exposed and unexposed survivors of a major avalanche disaster: a 30 year long-term follow-up study

• Published in: BMC psychiatry Vol. 19; no. 1; p. 175
• Main Authors: Bakker, Lars-Petter, Småstuen, Milada Cvancarova, Reichelt, Jon Gerhard, Gjerstad, Christer Lunde, Tønnessen, Arnfinn, Weisæth, Lars, Herlofsen, Pål Herlof, Grov, Ellen Karine
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 10.06.2019; BioMed Central; BMC
• Subjects: Adult; Analysis; Anxiety; Anxiety - etiology; Anxiety - psychology; Avalanche; Avalanches; Cost of Illness; Disaster; Disaster victims; Disasters; Epidemiology; Follow-Up Studies; Health; Health aspects; Humans; Landslides; Logistic Models; Long-term effects; Long-term follow-up; Longitudinal Studies; Male; Mental disorders; Mental Health; Mental health symptoms; Middle Aged; Military personnel; Military Personnel - psychology; Natural disasters; Norway; Occupational Diseases - etiology; Occupational Diseases - psychology; Occupational Exposure; Post traumatic stress disorder; Posttraumatic stress symptoms; Psychiatry; Psychological aspects; Soldiers; Stress (Psychology); Stress Disorders, Post-Traumatic - etiology; Stress Disorders, Post-Traumatic - psychology; Survivors - psychology; Systematic review; Time Factors; Trauma; Norway; New York; United States > US; Iceland; Posttraumatic stress symptoms; Mental health symptoms; Disaster; Long-term follow-up; Anxiety; Avalanche
• ISSN: 1471-244X; 1471-244X
• DOI: 10.1186/s12888-019-2159-7

Limited research exists concerning the long-term effects of avalanches on survivors' mental health beyond the first years after the accident. The aims of this study were to describe and evaluate possible differences in long-term mental health symptoms after a major avalanche disaster between exposed and unexposed soldiers using a longitudinal design. Present mental health symptoms were examined among avalanche exposed (n = 12) and unexposed (n = 9) soldiers by PTSS-10, IES-15 and STAI-12 in four waves (1986-1987 and 2016). Binary logistic regression revealed that the odds to score above the cut-off were significantly lower for both groups after one year compared to baseline for PTSS-10 (p = 0.018) and significantly lower after 30 days compared to baseline for IES-15 (p = 0.005). Data did not reveal significant differences between the exposed and unexposed groups regarding adjusted PTSS-10, IES-15 or STAI-12 mean scores compared. Linear mixed model-analyses revealed significant effects of time. The adjusted mean scores declined over time for both groups: PTSS-10 (p = 0.001), IES-15 (p = 0.026) and STAI-12 (p = 0.001), and the time trajectories for PTSS-10 were significantly different between the groups (p = 0.013). Although not significant (all p > 0.05), results indicated that a larger proportion of soldiers in the exposed group experienced posttraumatic stress symptoms (5/12) (PTSS-10 score ≥ 4) and distress symptoms (6/12) (IES-15 score ≥ 26) above cut-off points, 30 years post-disaster. The course of mental health symptoms may persist, and even increase, in selected and trained military personnel 30 years after exposure to a natural disaster. These findings may be of great importance for health authorities planning appropriate follow-up.