Postdisaster depression is linked to increased mortality risk

  • JAMA Netw Open

  • International Clinical Digest
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Takeaway

  • Almost one-third of elderly survivors of the 2011 earthquake and tsunami in Japan reported depression more than 3 years after the disaster.
  • This depression was associated with an increased risk for all-cause mortality.
  • One-quarter reported posttraumatic stress disorder (PTSD) at the same time, but PTSD was not associated with increased mortality risk.

Why this matters

  • Long-term follow-up care after disasters, especially among older adults, should include evaluations for postdisaster depression.

Study design

  • Prospective data on 2965 individuals (mean age, 73.4 years) from the Japan Gerontological Evaluation Study were identified.
  • During a mean follow-up of 3.3 years, the association among depression, PTSD, and all-cause mortality was evaluated among the older survivors of the earthquake and tsunami.
  • Funding: NIH; others.

Key results

  • Mean follow-up since the 2013 survey was 3.3 years.
  • 32.8% reported postdisaster depression, and 25.2% reported PTSD.
  • Depression was significantly associated with an elevated risk for mortality: adjusted (a)HR, 2.29 (P<.001>
  • However, the association between PTSD and mortality was not statistically significant: aHR, 1.10 (95% CI, 0.73-1.64).
  • Vs individuals without depression/PTSD:
    • Risk increased with depression only: HR, 2.24 (95% CI, 1.43-3.49).
    • Risk increased nonsignificantly with comorbid depression and PTSD: HR, 2.54 (95% CI, 1.50-4.27).

Limitations

  • Possibility of selection bias.

Coauthored with Chitra Ravi, MPharm