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Comparison of post-disaster psychiatric disorders after terrorist bombings in Nairobi and Oklahoma City.

North CS, Pfefferbaum B, Narayanan P, Thielman S, McCoy G, Dumont C, Kawasaki A, Ryosho N, Kim YS, Spitznagel EL

Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, St Louis, Missouri 63110, USA. NorthC@psychiatry.wustl.edu

BACKGROUND: African disaster-affected populations are poorly represented in disaster mental health literature. AIMS: To compare systematically assessed mental health in populations directly exposed to terrorist bombing attacks on two continents, North America and Africa. METHOD: Structured diagnostic interviews compared citizens exposed to bombings of the US Embassy in Nairobi, Kenya (n=227) and the Oklahoma City Federal Building (n=182). RESULTS: Prevalence rates of post-traumatic stress disorder (PTSD) and major depression were similar after the bombings. No incident (new since the bombing) alcohol use disorders were observed in either site. Symptom group C was strongly associated with PTSD in both sites. The Nairobi group relied more on religious support and the Oklahoma City group used more medical treatment, drugs and alcohol. CONCLUSIONS: Post-disaster psychopathology had many similarities in the two cultures; however, coping responses and treatment were quite different. The findings suggest potential for international generalisability of post-disaster psychopathology, but confirmatory studies are needed.

Published 1 June 2005 in Br J Psychiatry, 186: 487-93.
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