PSYCHIATRIC DIMENSIONS OF DISASTER - PATIENT-CARE, COMMUNITY CONSULTATION, AND PREVENTIVE MEDICINE

The majority of persons exposed to a disaster do well and have only mi ld, transitory symptoms. However, some individuals develop psychiatric illness postdisaster. Such illnesses include those that are secondary to physical injury and sickness as well as specific trauma-related ps ychiatric disorders such as acute stress disorder. The extent of the p sychiatric morbidity and mortality that develops in individuals in the community depends on the type of disaster, the degree of injury susta ined, the amount of life threat, and the duration of community disrupt ion. In this paper we examine the posttraumatic responses of direct co ncern to psychiatrists working in a community exposed to a disaster. W e review the epidemiology of posttraumatic responses, the interface of psychiatry and traumatic stress, the psychiatric disorders associated with trauma, and psychiatric consultation to the disaster community. Overall, psychiatric intervention after a disaster is based on the pri nciples of preventive medicine and includes community consultation and outreach programs with the goals of identifying high-risk groups, pro moting community recovery, and minimizing social disruption.