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The course of postdisaster psychiatric disorders in directly exposed civilians after the US Embassy bombing in Nairobi, Kenya: a follow-up study

Abstract

Purpose

While disasters are common in Africa, disaster studies in Africa are underrepresented in the published literature. This study prospectively examined the longitudinal course of psychopathology, coping, and functioning among 128 directly exposed Kenyan civilian survivors of the 1998 US Embassy bombing in Nairobi.

Methods

The Diagnostic Interview Schedule/Disaster Supplement assessed predisaster and postdisaster psychiatric disorders and variables related to coping, functioning, safety, and religion near the end of the first and third postdisaster years.

Results

Total postdisaster prevalence of posttraumatic stress disorder (PTSD) at the 3-year follow-up was 49; 28 % of the sample still had active PTSD. Delayed-onset PTSD was not observed. Posttraumatic symptoms decayed more slowly in individuals with than those without PTSD. PTSD was more prevalent and chronic than major depression. Those with current PTSD or major depression reported more functioning problems than those without. The length of hospitalization for injuries after the bombing predicted major depression remission, but no predictors of PTSD remission were found.

Conclusions

Despite differences in coping and social variables, longitudinal psychopathology in the Nairobi terrorism survivors appeared broadly similar to results in Western disaster populations. These findings contribute to the understanding of disaster mental health in Africa and may have implications for generalizability of psychiatric effects of terrorist attacks around the globe.

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Acknowledgments

This research was supported by National Institute of Mental Health (NIMH) Grant MH40025 to Dr. North and under Award Number MIPT106-113-2000-020 to Dr. Pfefferbaum from the National Memorial Institute for the Prevention of Terrorism (MIPT) and the Office for Domestic Preparedness, US Department of Homeland Security. Points of view in this document are those of the author(s) and do not necessarily represent the official position of MIPT, the US Department of Homeland Security, the US Department of Veterans Affairs, or NIMH.

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Correspondence to Gus Zhang.

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Zhang, G., North, C.S., Narayanan, P. et al. The course of postdisaster psychiatric disorders in directly exposed civilians after the US Embassy bombing in Nairobi, Kenya: a follow-up study. Soc Psychiatry Psychiatr Epidemiol 48, 195–203 (2013). https://doi.org/10.1007/s00127-012-0535-4

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Keywords

  • Disaster
  • Mental health
  • Posttraumatic stress disorder
  • Bombing