Mental Health Outcomes 27 Years After a Major Disaster

Abstract

In March 1980, an oil rig in the North Sea capsized with 212 men on board; 123 died and 89 survived. A research program followed up the 75 Norwegian survivors in 4 waves of data collections: shortly after the disaster (1980), after 1 year (1981), again after 5 years (1985), and eventually after 27 years (2007). In 1985, a matched comparison group was included and followed up until 2007. The comparison group was matched for age, gender, profession, and domicile. So far, this disaster study has the longest follow-up period that is combined with a comparison group.

In this chapter, a description of the disaster itself is given together with a brief introduction of disaster psychiatry, i.e., the study of civilian disasters as a part of the larger research field that is addressing post-traumatic stress.

After 27 years, no significant difference in the general symptom severity or in the number of screened cases was found between the survivors and those from the comparison group when using inventories such as PTSS and GHQ. The same was also found regarding the annual number of weeks in sick leave or disability pension; annually, there was a significant difference between the survivors and the comparison group during the first 12 years, but after that time the annual significant difference disappeared and did not return.

However, when using the SCID I interview in 2007, significant differences were found with regard to diagnoses. The risks were more than three times higher of survivors having one or more psychiatric diagnoses at that time than for those in the comparison group. The biggest difference was found for anxiety disorders, but depressive disorders also demonstrated significant differences. The most prevalent of the lifetime diagnoses was the depressive disorders, about one third of the survivors, while less than one fifth in the comparison group had faced this kind of mental health problems. Lifetime somatoform disorders were only found among the survivors. Lifetime substance misuse was significantly more prevalent among the survivors. About a quarter of the survivors had an early-onset PTSD, but the occurrence dwindled over the decades. Anxiety and depression seemed to become more common, rendering support to the suggestion that post-traumatic symptomatology in the long run may serve as a transitional psychopathology. Comorbidity was far more common among the survivors. Those reporting residual PTSD symptoms were more likely to experience reactivated PTSD later in the post-traumatic course. The reported post-traumatic growth after 27 years was highly correlated with the concurrent symptom severity, and not with higher levels of post-traumatic burden of the past. This indicates that self-reported post-traumatic growth may serve as a means of coping rather than an expression of richer and fuller lives.