@article{ref1,
title="Lessons from the 2004 Asian tsunami: Epidemiological and nosological debates in the diagnosis of post-traumatic stress disorder in non-Western post-disaster communities",
journal="International journal of social psychiatry",
year="2013",
author="Rajkumar, A. P. and Mohan, T. S. P. and Tharyan, P.",
volume="59",
number="2",
pages="123-129",
abstract="BACKGROUND: The nosological validity of post-traumatic stress disorder (PTSD) remains controversial in non-Western communities. After natural disasters, epidemiological studies often overlook these conceptual debates and assess post-traumatic stress symptoms (PTSS) by short screening instruments. Such PTSS estimates are reported as inflated prevalence rates of PTSD in post-disaster settings. AIMS: To discuss the prevalence and determinants of PTSS within the context of pertinent epidemiological and nosological debates. METHODS: We assessed PTSS and grief symptoms of 643 survivors from five Indian villages struck by the Asian tsunami using the Impact of Events Scale - Revised and Complicated Grief Assessment Scale. We adopted a case control design and employed complex sample multiple logistic regression statistics to study the determinants of PTSS. RESULTS: The prevalence of PTSS was 15.1% (95% CI 12.3%-17.9%). PTSS was significantly associated with traumatic grief, female gender, physical injury, death of children and financial losses, but not with functional disability (p = .91). CONCLUSIONS: Although PTSS were common in this population, elevating them to a psychiatric construct of PTSD is questionable, when functional impairment and avoidance behaviours were absent. Grief reactions, socio-economic burden, and poor support systems contribute towards PTSS. We highlight the important issues regarding the nosological validity and epidemiology of PTSD in non-Western communities.<p /><p>Language: en</p>",
language="en",
issn="0020-7640",
doi="10.1177/0020764011423468",
url="http://dx.doi.org/10.1177/0020764011423468"
}