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Disaster psychiatry

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chronic dysfunction. Early interventions are crucial for addressing PTSD symptoms after a disaster, as symptoms meeting full diagnostic criteria may not immediately manifest In the initial disaster stages. Psychiatrists may be on-site at the disaster area to emphasize limiting exposure to distressing scenes (scenes of violence, deceased bodies, etc.) and ensuring victim privacy, informing future response planning.
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may be more interested in seeking solace and resources from within. The disruption of psychiatric well-being is directly tied to the degree of community and workplace disruption, including disruption of economic resources. This impact can persist long after the disaster, evident in debates over memorial design and recurrent grief on anniversaries of the disaster. Normalizing feelings of anxiety and fear using
55:, aiming to mitigate both immediate and prolonged psychiatric challenges. Its primary objective is to diminish acute symptoms and long-term psychiatric morbidity by minimizing exposure to stressors, offering education to normalize responses to trauma, and identifying individuals vulnerable to future psychiatric illness. 132:, 40% of those with diagnosed MDD or PTSD had no previous psychiatric history prior to the attack. While research has explored whether certain types of disasters are more prone to causing psychiatric morbidity, the evidence suggests that the severity of a disaster is more influential than its exact typology. 277:
The aftermath of a disaster often brings additional stress and disruption, largely influenced by the response to the event. Communities may feel overwhelmed by outsiders, including intrusive media and curiosity seekers, straining local resources like hotels and restaurants at a time when a community
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In contrast to conventional psychiatric care, disaster psychiatry prioritizes mental health over disease states. The initial primary focus after a disaster is on individuals undergoing a transient and normal psychological response to a traumatic event. In this paradigm of care, less emphasis may be
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Natural resilience in the face of disaster is common, and most victims (70-90%) do not need formal psychiatric treatment. First-year PTSD prevalence is 10-20% in the general population after a disaster (higher in disaster workers), with about 25% of those with PTSD symptoms going on to experience
241:(PFA) – a broadly-applicable therapeutic framework which reduces stigma without formal diagnosis or treatment. PFA takes a flexible, educational, and supportive approach, focusing on psychological safety, community self-reliance, connectedness, and instilling hope by building personal strength. 236:
Debriefing, held shortly after an event, normalizes stress responses, aids psychological recovery, corrects cognitive distortions, and helps individuals return to social and work groups without formal evaluation, which some victims may be hesitant to participate in. This debriefing may involve
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Incorporating psychiatric professionals into community-level disaster planning facilitates their introduction to various stakeholders, including local police, fire departments, schools, and government officials. The principal aim of psychiatry in disaster preparedness is to proactively prevent
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are typically first-line medications. Goals include managing symptoms, treating grief and loss, early recognition and treatment of psychiatric disorders, managing relapses of previously diagnosed psychiatric illness in response to disaster, and differentiating between normal and pathological
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Additionally, the preparedness of local psychiatric resources can be tested with through disaster exercises, identifying areas of weakness and ways to increase the capacity of mental health systems to respond to increase demands during disasters.
51:, regardless of exact type, are characterized by disruption: disruption of family and community support structures, threats to personal safety, and an overwhelming of available support resources. Disaster psychiatry is a crucial component of 220:, which can include considerations for the psychiatric elements of disaster response, making stakeholders aware of available resources and potential adverse effects on community mental health resulting from disasters. 216:
exposure to stressors, ultimately avoiding disasters or minimizing their impact on individuals. Hospitals are mandated to have a disaster response plan to meet accreditation requirements, such as those outlined by
128:) directly resulting from involvement in the disaster. Psychiatric illness may affect individuals with no known previous psychiatric history before the disaster. For example, after the 140:
One of the critical roles of the disaster psychiatrist is identifying individuals more prone to developing genuine psychiatric illnesses in response to a disaster, beyond the typical
207:. In this paradigm, the pathogen (psychiatric symptoms), the source (traumatic event/disaster), and the exposed individuals (patients) are identified. 68:
Psychiatric responses to trauma and disaster encompass a spectrum of emotional and behavioral reactions in individuals. These reactions may include
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is commonly observed. Formal psychiatric diagnoses commonly associated with exposure to acute traumatic events include
144:. The likelihood of future psychiatric morbidity increases with the intensity of traumatic stressors encountered. 318:
Norwood, Ann E.; Ursano, Robert J.; Fullerton, Carol S. (2000). "Disaster Psychiatry: Principles and Practice".
89: 185:, which can be completed in 5–10 minutes, although this scale has not been validated in the disaster setting. 182: 622: 617: 245: 101: 463: 116:. Psychiatric disturbances post-disaster can be attributed to various factors, including exposure to 97: 141: 238: 125: 105: 85: 244:
High-risk or severe cases may necessitate early intervention with psychotherapy, particularly
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placed on assigning diagnostic labels prematurely. Second, disaster psychiatry follows a
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Assessment can involve the use of standardized screening scales, such as the
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Membership in high-risk demographic groups, such as children or the elderly
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Norwood, Ann E.; Ursano, Robert J.; Fullerton, Carol S. (2000-09-01).
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emergencies, and their associated community-wide disruptions and
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model that is more akin to the investigation and outbreak of an
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Role of the Psychiatrist in Disaster Preparedness and Response
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Sustaining injuries, particularly Traumatic Brain Injury (TBI)
397:(2nd ed.). Cambridge: Cambridge university press. 2017. 117: 73: 135: 63: 193: 417: 317: 58: 462:Saeed, Sy Atezaz; Gargano, Steven P. (2022-01-02). 84:, cognition, and mood. Additionally, an uptick in 609: 282:is one approach to addressing these challenges. 420:"Disaster Psychiatry: Principles and Practice" 461: 554:"Mass catastrophe and disaster psychiatry" 503:"Mass catastrophe and disaster psychiatry" 579: 569: 551: 528: 518: 500: 272: 171:Exposure to deceased or mutilated victims 210: 162:Occupying the role of a first responder 136:Risk Factors and Assessment of Patients 64:Normal and Pathological Trauma Response 610: 194:Unique Features of Disaster Psychiatry 464:"Natural disasters and mental health" 389: 387: 385: 313: 311: 309: 307: 305: 303: 301: 299: 297: 295: 227: 457: 455: 453: 383: 381: 379: 377: 375: 373: 371: 369: 367: 365: 159:Lack of control over external forces 90:Post-Trumatic Stress Disorder (PTSD) 13: 501:Raphael, B.; Ma, H. (March 2011). 468:International Review of Psychiatry 292: 246:Cognitive Behavioral Therapy (CBT) 156:Perceived or actual threat to life 14: 634: 545: 450: 362: 59:Psychiatric Outcomes of Disasters 395:Textbook of disaster psychiatry 23:which focuses on responding to 494: 411: 174:History of psychiatric illness 1: 480:10.1080/09540261.2022.2037524 285: 124:, or acute injuries (such as 98:Major Depressive Disorder MDD 153:Proximity to death or injury 7: 168:Previous exposure to trauma 102:separation anxiety disorder 94:Acute Stress Disorder (ASD) 10: 639: 552:Raphael, B; Ma, H (2011). 228:Acute Intervention   258:anti-anxiety medications 148:Associated Risk Factors: 106:substance abuse disorder 436:10.1023/A:1004678010161 332:10.1023/A:1004678010161 239:Psychological First Aid 80:, numbness, as well as 273:Community Intervention 126:traumatic brain injury 424:Psychiatric Quarterly 320:Psychiatric Quarterly 269:responses to trauma. 211:Disaster Preparedness 201:preventative medicine 130:Oklahoma City bombing 82:disturbances in sleep 53:disaster preparedness 623:Emergency management 558:Molecular Psychiatry 507:Molecular Psychiatry 618:Military psychiatry 17:Disaster psychiatry 571:10.1038/mp.2010.68 520:10.1038/mp.2010.68 205:infectious disease 47:implications. All 404:978-1-107-13849-0 25:natural disasters 630: 602: 601: 583: 573: 549: 543: 542: 532: 522: 498: 492: 491: 459: 448: 447: 415: 409: 408: 391: 360: 359: 315: 183:PCL-5 PTSD scale 33:school shootings 638: 637: 633: 632: 631: 629: 628: 627: 608: 607: 606: 605: 550: 546: 499: 495: 460: 451: 416: 412: 405: 393: 392: 363: 316: 293: 288: 275: 250:antidepressants 230: 213: 196: 191: 142:stress-response 138: 66: 61: 12: 11: 5: 636: 626: 625: 620: 604: 603: 564:(3): 247–251. 544: 513:(3): 247–251. 493: 449: 410: 403: 361: 326:(3): 207–226. 290: 289: 287: 284: 274: 271: 229: 226: 212: 209: 195: 192: 190: 187: 179: 178: 175: 172: 169: 166: 163: 160: 157: 154: 137: 134: 65: 62: 60: 57: 29:climate change 19:is a field of 9: 6: 4: 3: 2: 635: 624: 621: 619: 616: 615: 613: 599: 595: 591: 587: 582: 577: 572: 567: 563: 559: 555: 548: 540: 536: 531: 526: 521: 516: 512: 508: 504: 497: 489: 485: 481: 477: 473: 469: 465: 458: 456: 454: 445: 441: 437: 433: 429: 425: 421: 414: 406: 400: 396: 390: 388: 386: 384: 382: 380: 378: 376: 374: 372: 370: 368: 366: 357: 353: 349: 345: 341: 337: 333: 329: 325: 321: 314: 312: 310: 308: 306: 304: 302: 300: 298: 296: 291: 283: 281: 280:popular media 270: 267: 263: 259: 255: 251: 247: 242: 240: 234: 225: 221: 219: 208: 206: 202: 186: 184: 176: 173: 170: 167: 164: 161: 158: 155: 152: 151: 150: 149: 145: 143: 133: 131: 127: 123: 119: 115: 111: 107: 103: 99: 95: 91: 87: 86:substance use 83: 79: 75: 71: 56: 54: 50: 46: 45:mental health 42: 41:public health 38: 34: 30: 26: 22: 18: 561: 557: 547: 510: 506: 496: 474:(1): 16–25. 471: 467: 427: 423: 413: 394: 323: 319: 276: 243: 235: 231: 222: 214: 197: 180: 147: 146: 139: 67: 16: 15: 122:dehydration 120:, illness, 612:Categories 581:1885/53381 530:1885/53381 430:(3): 208. 286:References 254:sleep aids 21:psychiatry 590:1359-4184 539:1476-5578 488:0954-0261 444:1573-6709 340:0033-2720 49:disasters 37:accidents 598:21331093 356:21207487 348:10934746 110:insomnia 35:, large 114:suicide 78:sadness 70:anxiety 596:  588:  537:  486:  442:  401:  354:  346:  338:  256:, and 118:toxins 112:, and 352:S2CID 266:SNRIs 262:SSRIs 218:JCAHO 594:PMID 586:ISSN 535:ISSN 484:ISSN 440:ISSN 399:ISBN 344:PMID 336:ISSN 264:and 74:fear 576:hdl 566:doi 525:hdl 515:doi 476:doi 432:doi 328:doi 614:: 592:. 584:. 574:. 562:16 560:. 556:. 533:. 523:. 511:16 509:. 505:. 482:. 472:34 470:. 466:. 452:^ 438:. 428:71 426:. 422:. 364:^ 350:. 342:. 334:. 324:71 322:. 294:^ 252:, 108:, 104:, 100:, 76:, 72:, 39:, 31:, 27:, 600:. 578:: 568:: 541:. 527:: 517:: 490:. 478:: 446:. 434:: 407:. 358:. 330::

Index

psychiatry
natural disasters
climate change
school shootings
accidents
public health
mental health
disasters
disaster preparedness
anxiety
fear
sadness
disturbances in sleep
substance use
Post-Trumatic Stress Disorder (PTSD)
Acute Stress Disorder (ASD)
Major Depressive Disorder MDD
separation anxiety disorder
substance abuse disorder
insomnia
suicide
toxins
dehydration
traumatic brain injury
Oklahoma City bombing
stress-response
PCL-5 PTSD scale
preventative medicine
infectious disease
JCAHO

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