Rate of psychiatric disorders and associations with quality of life among community members following the Kaohsiung gas explosion: an 18-month cross-sectional follow-up study

Shieh et al. Health and Quality of Life Outcomes https://doi.org/10.1186/s12955-018-1076-7 (2019) 17:7 RESEARCH Open Access Rate of psychiatric disorders and associations with quality of life among community members following the Kaohsiung gas explosion: an 18-month cross-sectional follow-up study Vincent Shieh1, Joh-Jong Huang2, Tsyr-En Grace Wu3, Ju-Yu Chiu4, Yi-Chen Chen5, Guijing Lin6, Chao-Yueh Su7 and Frank Huang-Chih Chou6,8* Abstract Objective: To conduct a follow-up on the rate and related risk factors of probable disaster-related psychiatric disorders such as depressive disorder (major depressive episode, MDE), stress disorders, post-traumatic (posttraumatic stress disorder, PTSD), and the quality of life of the survivors of a fossil gas explosion in Taiwan 18 months after the event. Methods: A community-based survey of residents of a community that experienced a petrochemical gas explosion with cross-sectional assessments was conducted 18 months after the event. Two screening tools, including the Disaster-Related Psychological Screening Test (DRPST) and Short Form 12v2 (SF-12v2), were used to survey a representative sample of 388 participants. Results: The average age of 388 participants is 43.27 ± 15.98 years (males: 203, average age: 41.44 ± 15.74 years; females: 185; average age: 45.27 ± 16.03 years). Probable PTSD, probable MDE, probable PTSD and MDE, and non-PTSD or non-MDE (non-P or -M) were present in 34 (8.8%), 14 (3.6%), 9 (2.3%), and 331 (85.3%) participants, respectively. The significant associated factor for probable PTSD or MDE among those who experienced disaster was financial problems. The associated factors on different quality of life subscales were old age, physical injury, employment, educational level, financial problems, probable PTSD and probable MDE. Conclusion: While participants’ psychiatric status improved after 18 months, their quality of life continued to be affected, especially the quality of life of those with probable PTSD combined with MDE. Postdisaster treatment and follow-up should be addressed to a greater degree, especially for victims with mental illness, physical injuries and financial problems. Keywords: Depressive disorder, Stress disorders, Post-traumatic, Quality of life * Correspondence: Joh-Jong Huang and Tsyr-En Grace Wu shared equally with the first author. Chao-Yueh Su contributed equally to corresponding author. 6 Department of Nursing, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan 8 Superintendent office, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, 130 Kai-Syuan 2nd Rd, Lingya District, Kaohsiung City, Taiwan Full list of author information is available at the end of the article © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Shieh et al. Health and Quality of Life Outcomes (2019) 17:7 Introduction A major petrochemical gas explosion occurred in the Lingya District, Kaohsiung City, Taiwan. That event is known as the “81 petrochemical gas explosion of August 1, 2014.” [1] The incident caused traffic disruptions, casualties, and environmental damage [1, 2]. Three hundred seventy-two casualties were acknowledged as of October 6, 2014, including 32 deaths and 340 serious injuries [1]. This highly stressful event had a severe impact on victims, especially in terms of their mental health. Many studies [3–7] have shown evidence of psychiatric impairment in disaster survivors. The most common disaster-related psychiatric diagnoses are major depressive episode(MDE) and posttraumatic stress disorder(PTSD), which are strongly associated [3, 8]—an issue that continues to gain attention in trauma outcome research. [3] The prevalence of psychiatric diseases, especially PTSD and MDE, is highest at the beginning of a disaster and gradually declines after mental rehabilitation. In addition, rescue workers such as nurses, fire fighters, and soldiers incur a high prevalence of psychiatric disorders after disaster rescue. Physical and psychological trauma after various disasters has been shown to significantly impact the quality of life of survivors of various disasters, and physical damage is strongly related to psychological trauma [1, 2, 9–16]. However, three symptoms of PTSD—namely, re-experiencing, avoidance and numbing, and hyperarousal—are common and may be dismissed as unimportant behavioral shifts, or some physiologic reactivity at exposure to cues that symbolize trauma was under-reported [15, 17, 18]. For example, when a person hears the sound of firecrackers, he or she might be too scared to go out the door. Another might have “hypervigilance”, which is a symptom of hyperarousal syndromes. Although the prevalence of PTSD tends to decrease over time among burn survivors, rates of PTSD have been found to increase over time from injuries due to delayed onset or repercussions from the traumatic event (i.e., job loss, health problems) [15, 19]. Therefore, regardless of the mental affliction involved, early detection and longer periods of effective treatment are most important after a disaster. We know that physical and mental health are interrelated [10] and that physical injuries and material losses are also strongly associated with PTSD [13, 14]. Long-term financial problems are one of the many important factors affecting quality of life (QoL) [8, 12, 20, 21]. Health-related quality of life (HRQoL) includes both physical and mental dimensions [22]. A composite measure of physical and psychological health is HRQoL [19], as assessed by short form-12 or short form-36. Following a disaster, psychological problems have a greater impact on quality of life than injuries do [23]. We know that physical and mental healthcare are interrelated [10] and that physical injuries Page 2 of 10 and material losses are also strongly associated with PTSD [13, 14]. These two dimensions are included in health-related quality of life (HRQoL) [22]. A composite measure of physical and psychological health is HRQoL, as assessed, for example, by short form-12 or − 36 [23]. Experiencing long-term financial problems is one of several important factors affecting quality of life [10, 12, 20, 21]. Through this continuous cycle, trauma may become a personal problem that evolves into a family problem. Therefore, early detection and assistance can reduce the incidence of such problems and improve the QoL of participants and individuals. Furthermore, long-te (...truncated)