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Mental and Physical Health Consequences of the September 11, 2001 (9/11) Attacks in Primary Care: A Longitudinal Study

Authors

  • Yuval Neria,

    Corresponding author
    1. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, New York, USA
    • Department of Psychiatry, College of Physicians & Surgeons, Columbia University, New York City, New York, USA
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  • Priya Wickramaratne,

    1. Department of Psychiatry, College of Physicians & Surgeons, Columbia University, New York City, New York, USA
    2. Division of Epidemiology, New York State Psychiatric Institute, New York City, New York, USA
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  • Mark Olfson,

    1. Department of Psychiatry, College of Physicians & Surgeons, Columbia University, New York City, New York, USA
    2. Division of Epidemiology, New York State Psychiatric Institute, New York City, New York, USA
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  • Marc J. Gameroff,

    1. Department of Psychiatry, College of Physicians & Surgeons, Columbia University, New York City, New York, USA
    2. Division of Epidemiology, New York State Psychiatric Institute, New York City, New York, USA
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  • Daniel J. Pilowsky,

    1. Department of Psychiatry, College of Physicians & Surgeons, Columbia University, New York City, New York, USA
    2. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, New York, USA
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  • Rafael Lantigua,

    1. Division of General Medicine, Department of Medicine, College of Physicians & Surgeons, Columbia University, New York City, New York, USA
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  • Steven Shea,

    1. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, New York, USA
    2. Division of General Medicine, Department of Medicine, College of Physicians & Surgeons, Columbia University, New York City, New York, USA
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  • Myrna M. Weissman

    1. Department of Psychiatry, College of Physicians & Surgeons, Columbia University, New York City, New York, USA
    2. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, New York, USA
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  • Partial funding was received from the NIMH: 1RO1-MHO72833 (Dr. Neria), NARSAD (Dr. Neria), Eli Lilly & Company (Dr. Weissman), and the New York State Psychiatric Institute (Drs. Neria, Wickramaratne, Olfson, Gameroff, and Weissman).

Correspondence concerning this article should be addressed to Yuval Neria, Department of Psychiatry, College of Physicians & Surgeons, Columbia University, 1051 Riverside Drive, Unit 69, New York, NY, 10032. E-mail: ny126@columbia.edu

Abstract

The magnitude of the September 11, 2001 (9/11) attacks was without precedent in the United States, but long-term longitudinal research on its health consequences for primary care patients is limited. We assessed the prevalence and exposure-related determinants of mental disorders, functioning, general medical conditions, and service utilization, 1 and 4 years after the 9/11 attacks, in an urban primary care cohort (N = 444) in Manhattan. Although the prevalence of posttraumatic stress disorder (PTSD) and levels of functional impairment declined over time, a substantial increase in suicidal ideation and missed work was observed. Most medical outcomes and service utilization indicators demonstrated a short-term increase after the 9/11 attacks (mean change of +20.3%), followed by a minor decrease in the subsequent year (mean change of −3.2%). Loss of a close person was associated with the highest risk for poor mental health and functional status over time. These findings highlight the importance of longitudinal assessments of mental, functional, and medical outcomes in urban populations exposed to mass trauma and terrorism.

Traditional and Simplified Chinese Abstracts by AsianSTSS

標題:911襲擊(在2011年9月十一日)後基層醫療縱向研究:精神和身體健康的後遺症狀。

撮要:911襲擊事件在美國是史無前例的,而長期縱向研究關於基層病人的健康後遺症狀亦罕見。我們在曼哈頓市區一個基層醫療中心病人群體(N = 444)中,在911後1年及4年評估:包括精神病、功能、一般醫療狀況,和醫療服務使用各方面的流行率及與襲擊事件相關的因素。研究顯示:創傷後壓力症病發率和功能障礙隨年月減少,但自殺念頭和曠工情況卻有可觀的增長。一般醫療狀況和服務使用的大多數指標均展示:911事件後有顯著的短期增長(平均變異+20.3%),而在其後一年有輕微減少(平均變異為-3.2%)。精神健康和功能減退情況的最高風險因素與失去至親有關連。上述發現突出在市區群眾面對大型創傷或恐怖襲擊事件後,有必要進行包括身心健康和功能方面的縱向評估。

标题:911袭击(在2011年9月十一日)后基层医疗纵向研究:精神和身体健康的后遗症状。

撮要:911袭击事件在美国是史无前例的,而长期纵向研究关于基层病人的健康后遗症状亦罕见。我们在曼哈顿市区一个基层医疗中心病人群体(N = 444)中,在911后1年及4年评估:包括精神病、功能、一般医疗状况,和医疗服务使用各方面的流行率及与袭击事件相关的因素。研究显示:创伤后压力症病发率和功能障碍随年月减少,但自杀念头和旷工情况却有可观的增长。一般医疗状况和服务使用的大多数指标均展示:911事件后有显着的短期增长(平均变异+20.3%),而在其后一年有轻微减少(平均改变为-3.2%)。精神健康和功能减退情况的最高风险因素与失去至亲有关连。上述发现突出在市区群众面对大型创伤或恐怖袭击事件后,有必要进行包括身心健康和功能方面的纵向评估。

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