Psychiatric morbidity following a natural disaster: an Australian bushfire.

This study investigated the prevalence of mental health problems after a major bushfire in Australia and examined the validity of the General Health Questionnaire (GHQ) (Goldberg 1978) against the Anxiety, Affective and Post-Traumatic Stress Disorder modules of the Diagnostic Interview Schedule (DIS; Robins et al. 1981). Study 1 was carried out 12 months after the Ash Wednesday bushfires and sought to include all the victims of the fires. Study 2 was conducted 20 months after the fires and included a sample of victims who had experienced major losses in the fires. Twelve months after the fires, 42% (n = 1,526) of the victims were defined as a potential psychiatric case using the GHQ. This rate indicated a significantly greater level of morbidity than found in communities that have not experienced a natural disaster. Twenty months after the fires, 23% (n = 43) were defined as "cases". The 28-item GHQ was found to be a valid instrument for defining the presence of psychiatric disorder in a disaster-effected community. The findings demonstrated that lasting psychiatric morbidity is associated with natural disasters.

Prevalence of psychiatric disorders in rural South Australia.

OBJECTIVE: To determine the prevalence of psychiatric disorders and use of medical services in a South Australian rural community. DESIGN: Survey based on structured self-administered questionnaires. SETTING: Riverland region of South Australia, between May and November, 1991. SUBJECTS: A probability sample of 1009 residents (71.1%) response stratified for age and sex (with replacement) aged 18 years and over from the State electoral roll. OUTCOME MEASURES: DSM-III-R-defined psychiatric disorders diagnosed by means of the University of Washington's Diagnostic Interview Schedule Screening Instrument (DISSI), physical disorders and use of health and allied services. RESULTS: Twenty-six percent had at least one psychiatric disorder in the six months before interview. Prevalence did not differ with sex or age, but was higher in the unemployed (P=0.0001). Those with a current psychiatric disorder were significantly more likely to report a lifetime physical disorder (p=0.0001). The most common disorders were major depression and dysthymia (10.8%), anxiety disorder (9.8%), phobic disorder (7.8%), alcohol abuse and dependence (7.0% and somatisation syndrome (5.3 During the year before interview, 88.5% of those diagnosed with a current psychiatric disorder had consulted a general practitioner and 4.2% a psychiatrist or psychologist. CONCLUSIONS: The prevalence of psychiatric disorders in the Riverland region was comparatively high. General practitioners were the primary care-providers for those with psychiatric disorders. These issues need to be addressed by service providers and health planners.