Post-traumatic Stress Disorder in Children after the Tsunami Disaster in Thailand: A 5-Year Follow-Up
Vinadda Piyasil MD*, Panom Ketumarn MD**, Ratanotai Prubrukarn MD*, Sirirat Ularntinon MD*, Nantawat Sitdhiraksa MD**, Nattorn Pithayaratsathien MD***, Pornjira Pariwatcharakul MD**, Tiraya Lerthattasilp MD****, Nattinee Chinajitphant MD*****, Ketsiri Liamwanich MD******, Nisarat Wadchareeudomkarn MD***, Janarpar Sookatup MD***, Thanyalak Wanlieng MD***, Chukiat Yongpitayapong MD***, Pranee Paveenchana MD**, Lukkana Tasri BS*, Peerayut Chaiyakun BS*, Naratip Sanguanpanich BSc**
Affiliation : * Child & Adolescent Psychiatric Department, Queen Sirikit National Institute of Child Health, College of Medicine, Rangsit University, Bangkok, Thailand ** Psychiatric Department, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand *** Child & Adolescent Psychiatric Department, Chulalongkorn University, Bangkok, Thailand **** Psychiatric Department, Faculty of Medicine, Thammasat Unversity, Bangkok, Thailand ***** Psychiatric Department, Institute of Child and Adolescent Mental Health Rajanagarindra, Bangkok, Thailand ****** Psychiatric Department, Lampang Hospital, Lampang, Thailand
Background : Children may suffer from post-traumatic stress disorder after disaster. There was a severe tsunami following
an undersea earthquake off the Sumatra coast of Indonesia. There were 20,000 children in 6 southwestern provinces of
Thailand who were possibly affected.
Objective : To study the prevalence of post-traumatic stress disorder (PTSD) in Thai students in the area affected by the
December 26th, 2004 tsunami disaster, Thailand.
Material and Method: One thousand six hundred and fifteen surviving students from two schools in Takua Pa district located
in Phang-nga Province, Thailand participated in this longitudinal study. Screening was done by using Pediatric Symptom
Checklists part II (PSC-II), Childhood Depressive Intervention (CDI) and the Revised Child Impact of Events Scales (CRIES
8). PTSD was diagnosed by child and adolescent psychiatrists by using criteria of DSM-IV. The intervention included
psychological first aid, psycho-education, cognitive-behavioral therapy, medication in severe cases, group support for
students, parents and teachers which was done, beginning at 10 days after the tsunami disaster. Data were analyzed by using
SPSS version 12.0.
Results : The prevalence rates of PTSD in the students facing the tsunami disaster in the study group were 57.3, 46.1, 31.6, 7.6,
4.5, 3.9 and 2.7% at 6 weeks, 6 months, 1 year, 2 years, 3 years, 4 years and 5 years after the disaster, respectively. Female
to male ratio was 1.7: 1. The peak age was 9-10 years old. The top five on the list of symptoms in PTSD were distress with
cue, intrusive thought, functioning impairment, startled response, terrified and hyper vigilance. Seven cases (3.1%) were
diagnosed partial PTSD, still exhibited a wide range of PTSD symptoms but did not fulfill the DSM-IV diagnostic criteria. The
top five on the list of symptoms in partial PTSD were avoiding thought/feelings, terrified, avoiding place/activities, distress
with cue and startled response.
Conclusion : The prevalence of PTSD among tsunami victims was 57.3% at 6 weeks after the disaster. It declined sharply at
2 years after the event. Despite receiving financial, rehabilitation and mental health support, 2.7% of the victims continued to
suffer from PTSD 5 years after the disaster.
Keywords : Post-traumatic stress disorder (PTSD), Tsunami disaster, Thailand
