Post Traumatic Stress Disorder in Children after Tsunami Disaster in Thailand: 2 Years Follow-up
Vinadda Piyasil MD*, Panom Ketuman MD**, Ratnotai Plubrukarn MD*, Vajiraporn Jotipanut BSc*, Somsong Tanprasert BSc*, Sumitra Aowjinda BSc*, Somchit Thaeeromanophap BSc*
Affiliation : * Queen Sirikit National Institute of Child Health, Bangkok ** Department of Psychiatry, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok
Background : On December 26, 2004, the tsunami destroyed many families, communities, and residential
areas. Adverse psychological impact on children and adolescents due to a natural disaster of this magnitude
has never been reported in Thailand’s history particularly as Post-Traumatic Stress Disorder (PTSD).
Objective : Investigate clinical symptoms and develop a 2-year monitoring and intervention program for PTSD
in children affected by the December 26, 2004 tsunami natural disaster. The study period started six weeks
after the event and was completed after two years.
Materials and Methods : One thousand six hundred and twenty five surviving students from two schools in
Takuapa district, Phang-nga Province, were enrolled. Screening tests using Pediatric symptom checklists,
Childhood depressive intervention (CDI), and Revised child impact of events scales (CRIES) were done.
Psychiatric evaluations were done by child and adolescent psychiatrists. Post Traumatic Stress Disorder
(PTSD) was diagnosed using criteria from Diagnostic and Statistical Manual of Mental Disorders, 4th edition.
Results : The prevalence of PSTD in the affected students were 57.3, 46.1, 31.6, 10.4, and 7.6% at 6 weeks, 6
months, 1 year, 1(cid:31) years, and 2 years, respectively. The female: male ratio was 1.7:1. The peak age was 9-10
years old. Threatened situations were studied. Of the 176 students who risked their lives in the waves, 48
(27.3%) suffered from PTSD. Meanwhile, of the 1,314 students who were not hit by the waves but were among
affected friends and relatives, 42 students (3.1%) suffered from PTSD. The prevalence of PTSD in those hit by
the waves were significantly higher than those who were not [p-value < 0.01, RR = 5.16 (4.04-.6.6)].
Conclusion : The prevalence of PSTD in children who suffered from the tsunami disaster was as high as 57.3%
at six weeks after the incident. It declined sharply at two years (7.6%) with the help of integrated welfare. The
children continue to get financial, rehabilitation, and mental health support to prevent long-term adverse
outcomes.
Keywords : Tsunami in Thailand, Post-Traumatic Stress Disorder (PTSD)
