Psychiatric disorders among survivors of the Oklahoma City bombing.

Includes references

Reprinted from JAMA; 1999; v. 282, no. 8; p. 755-762

Disasters expose unselected populations to traumatic events and can be used to study the mental health effects. The Oklahoma City, Oklahoma, bombing is particularly significant for the study of mental health sequelae of trauma because its extreme magnitude and scope have been predicted to render profound psychiatric effects of survivors. The objective of the study was to measure the psychiatric impact of the bombing of the Alfred P. Murrah Federal Building in Oklahoma City on survivors of the direct blast, specifically examining rates of posttraumatic stress disorder (PTSD), diagnostic comorbidity, functional impairment, and predictors of postdisaster psychopathology. The data suggest that a focus on avoidance and numbing symptoms could have provided an effective screening procedure for PTSD and could have identified most psychiatric cases early in the acute postdisaster period. Psychiatric comorbidity further identified those with functional disability and treatment needs. The early universal yet distressing intrusive reexperience and hyperarousal symptoms in the majority on nonpsychiatrically ill persons may be addressed by nonmedical interventions of reassurance and support