The correspondence between persistent self-reported post-traumatic problems and general practitioners' reports after a major disaster.

ABSTRACT

BACKGROUND: Little is known about the correspondence between persistent self-reported disaster-related psychological problems and these problems reported by general practitioners (GPs). The aim of this study is to analyse this correspondence and to identify the factors associated with GPs' detection of persistent psychological problems. METHOD: This study was conducted in a sample of 879 adult disaster-affected victims, taken from two longitudinal sources the Enschede Firework Disaster Study and the GP-Monitor Study. Participants filled out a questionnaire 2-3 weeks and 18 months post-disaster and these data were combined with data from a GP-monitor collected up to 18 months post-disaster. The correspondence between persistent self-reported and GP-reported psychological problems was analysed with cross-tabulations. Logistic regression analyses were performed to identify variables which predicted GPs' detection of psychological problems. RESULTS: The correspondence rate among victims who visited their GP 18 months post-disaster was 60.4% for persistent intrusions and avoidance reactions, 72.6% for persistent general psychological distress and less than 20% for persistent depression and anxiety symptoms or sleep disturbances. Characteristics that predict GPs' identification of post-traumatic reactions or psychological distress were the level of self-reported post-traumatic symptoms/mental health, the number of contacts the victims had with their GP and the level of the victims' disaster-related experiences. CONCLUSIONS: In general, there is a considerable correspondence between GP-reported and persistent self-reported incidences of post-traumatic stress and general psychological distress in disaster-affected victims. However, the correspondence declines in the case of more specific psychological symptoms.