Psychiatry of disasters.

Two types of disasters – natural and, respectively, generated by humans – have been involved in psychiatric morbidity. Generally, the disasters generated by humans lead more frequently to persistent symptoms and psychiatric disorders. The severity of disaster agents and the degree of individual or population exposure to the disaster are considered predictors of psychiatric morbidity. Gender is a strong predictor of post-traumatic anxiety and depressive disorders. A second robust predictor of disaster mental health outcomes in individuals is represented by preexisting psychiatric disorders. Other but less consistent predictors of post-traumatic stress disorder (PTSD) after disasters include age, education and socioeconomic status. The disasters most frequently associated with detrimental consequences were those with an increased level of community destruction and those from developing countries with lower socioeconomic status. Supportive group interventions are recommended in the first days after the trauma. There is no consistent evidence regarding the effectiveness of early psychopharmacological approaches. Medication is recommended for symptoms’ improvement, especially in severe psychiatric symptoms that significantly impair functioning. Cognitive-behavioral short-term interventions in the first two weeks after trauma, focused on education, anxiety management training, imaginary and in vivo exposure therapy and in cognitive restructuring, proved the most effective. [ABSTRACT FROM AUTHOR]