Controlled study after Dutch caf fire highlights teen mental-health problems after disasters

Dutch authors of a study in this week's issue of THE LANCET highlight the key mental-health outcomes for adolescents who have been directly involved in disaster situations. After a fire in a Dutch caf over two years ago in which 14 teenagers died, the study investigators show that treating anxiety, depression, aggression, and alcohol abuse is a priority for mental-health interventions after disasters have occurred.

Disasters greatly affect the mental health of children and adolescents, but quantification of such effects is difficult. On New Year's Day, 2001, a fire in a café in Volendam, Netherlands, wounded 250 adolescents and killed 14. At the time of the disaster, 124 students (aged 12-15 years) of a school in Volendam--31 of whom were in the café at the time of the fire--and 830 students from two other schools in the Netherlands not involved in the café fire had previously been enrolled in a study on the effects of a school health-promotion programme to prevent behavioural and emotional problems, smoking initiation, excessive use of alcohol, and use of psychoactive substances. Data were available five months after the fire for around three-quarters of students enrolled in the original study.

Volendam adolescents had 75% increased rates of clinical overall mental-health symptom scores compared with the other students: scores for depression, anxiety, incoherent thinking and aggression were around three times greater than among students from the other two schools; alcohol abuse was more than four times more likely. There were similar increases in alcohol abuse and mental-health scores for Volendam students not directly involved in the caf fire. These increases were larger for girls than boys.

Lead investigator Sijmen Reijneveld comments: "Postdisaster health care should be aimed at the physical and psychosocial consequences of disaster. Our results confirm the need for services to ameliorate the negative mental he

Contact: Joe Santangelo

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