ABSTRACT
This report presents the initial results of a mental health survey of 351 tribal and non-tribal Mount Pinatubo disaster victims 6 years after they were displaced following the volcanic eruption in the Philippines on June 12, 1991. Mental illness prevalence rates in both Filipino ethnic groups were comparable to those found in a U.S. study using the same assessment instrument. Post-traumatic stress disorder (PTSD; 27.6%) and major depression (14.0%) were the two most frequent diagnoses. Diagnostic test-retest interviewer agreement was good for probable alcohol abuse (kappa = .65, agreement = 97%) and any mood disorder (kappa = .53, agreement = 91%) but was reduced for any anxiety disorder (kappa = .15, agreement = 81%) and separately evaluated PTSD (kappa = .18, agreement = 69%). Diagnostic test-retest agreement was good among typical Filipinos (mean kappa = .66, mean agreement = 93%) but was reduced among tribal aborigines (mean = .30, mean agreement = 86%). Internal consistency of the PTSD rating scale was high within and across both ethnic groups, including total scale (alpha = .91) and DSM-IV Criteria B, C, and D sub-scales (alpha = .80, 81, and .78, respectively). With the exception of probable alcohol abuse, construct and criterion validity was demonstrated among both tribal and non-tribal Filipinos for all classes of psychiatric disorders by comparing diagnostic results with respondents' views of their physical and mental health and level of functional impairment. Overall, DSM-IV mood, anxiety, alcohol use, and PTSDs with adequate reliability and construct and criterion validity were made in this culturally diverse, non-Western, disaster victim population. However, test-retest diagnostic agreement was reduced for anxiety disorders and among aboriginal respondents, and validity was not demonstrated for probable alcohol abuse.
Subject(s)
Ethnicity/statistics & numerical data , Native Hawaiian or Other Pacific Islander/statistics & numerical data , Volcanic Eruptions , Adolescent , Adult , Aged , Alcoholism/diagnosis , Alcoholism/epidemiology , Comorbidity , Cross-Cultural Comparison , Cross-Sectional Studies , Depressive Disorder/diagnosis , Depressive Disorder/epidemiology , Ethnicity/psychology , Female , Health Surveys , Humans , Male , Mental Disorders/diagnosis , Mental Disorders/epidemiology , Mental Disorders/ethnology , Middle Aged , Native Hawaiian or Other Pacific Islander/psychology , Philippines/epidemiology , Philippines/ethnology , Prevalence , Psychiatric Status Rating Scales/statistics & numerical data , Racial Groups , Reproducibility of Results , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/epidemiology , United Kingdom/epidemiologyABSTRACT
To obtain accurate, timely data on the health status of persons in evacuation camps after the eruption of the Mt. Pinatubo volcano, the Philippine Department of Health (DOH) conducted a survey of the health needs of the evacuees and established disease surveillance in each camp. Surveys of the camps revealed that sources of potable water, sanitary means of waste disposal, and shelters were inadequate. Disease surveillance showed that measles, acute respiratory infections, and diarrhea were the most important problems. Surveillance detected outbreaks of measles and an outbreak of vomiting and diarrhea in the camps. Deaths, primarily caused by measles (31%), diarrhea (29%), and respiratory infections (22%), totaled 349 in the first 12 weeks. Death rates peaked in the seventh week, when a death rate of 26/10,000 occurred among the Aetas, a tribe evacuated from the slopes of the volcano. The surveys guided the DOH in allocating supplies and medicine, while disease surveillance enabled disaster managers to monitor the effectiveness of health programs, identify high-risk groups, and respond appropriately to the situation.