Psychiatric morbidity among children in North Aceh district (Indonesia) exposed to the 26 December 2004 tsunami

Introduction: The aim of the study was to ascertain, using available data from the Bio-psychosocial Program for children, psychiatric morbidity and specific diagnoses among youths in North Aceh in the year after the tsunami disaster. Methods: All youths (n=2,135) who participated in the program were included in the study and screened in two phases. They were first administered the Strengths and Difficulties Questionnaire (SDQ); those with positive scores were then clinically interviewed by a psychiatrist, who then provided a diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders (fourth edition) (DSM-IV). Results: Subjects ranged in age from 4 to 18 years. Female-to-male ratio was 1:1.5. 98.1% of subjects were directly exposed to the trauma. There were significantly higher percentages (P<0.05) of abnormal total SDQ scores among trauma-exposed youths (52.3% among 4 to 10-year-olds and 46.5% among 11 to 18-year-olds, compared with youths in the non-trauma-exposed group (8% among 4 to 10-year-old children and 12% among 11 to 18-year-old adolescents. Clinical interviews revealed that 8.94% of the trauma-exposed youths met criteria for any mental disorder. Among youths with DSM-IV diagnoses, the most common diagnoses were post-traumatic stress disorder (PTSD; 24.6% of total diagnoses among 4 to 10-year-olds and 35.6% among 11 to 18-year-olds), followed by depressive disorders. Discussion: Consistent with our hypotheses, youths directly exposed to the trauma demonstrated more psychiatric difficulties and higher rates of psychiatric diagnoses, most notably PTSD. Also, compared to younger children, adolescents and older children exposed to the trauma appeared to have higher rates of psychiatric disorders. In the face of disasters - natural or otherwise - further research is needed on optimal prevention of child and adolescent psychiatric morbidity.