Prevalence and Predictors of Posttraumatic Stress Disorder Among Hemodialysis Patients Following Hurricane Katrina
Received 2 May 2007; accepted 17 July 2007.
Background
Patients with end-stage renal disease reliant on maintenance hemodialysis therapy may be particularly susceptible to developing post-traumatic stress disorder (PTSD) after natural disasters.
Study Design
Cross-sectional study.
Setting & Participants
Patients who received treatment at 9 New Orleans, LA, metropolitan area hemodialysis units before Hurricane Katrina made landfall on August 29, 2005, were recruited for the study. Overall, 391 patients completed the interview between April and October 2006 (participation rate, 85.6%).
Predictors
Demographic, dialysis-related, and evacuation characteristics.
Outcomes & Measurements
PTSD was assessed by using the 17-item PTSD Checklist and defined using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria.
Results
Overall, 23.8% of hemodialysis patients reported symptoms consistent with PTSD. After adjustment for age and sex, black patients were 1.92 (95% confidence interval, 1.31 to 2.83) times more likely than whites to have PTSD. After age, race, and sex adjustment, PTSD was more common in hemodialysis patients who were in their first 2 years of treatment, were evacuated fewer than 2 days before the hurricane made landfall, were evacuated initially to a shelter, and missed 3 or more dialysis treatments because of Hurricane Katrina and its aftermath. Additionally, patients who remained displaced for 3 or more months were more likely to have PTSD.
Limitations
Data were not available to distinguish between the presence of acute, chronic, or delayed-onset PTSD.
Conclusions
A substantial proportion of hemodialysis patients had PTSD symptoms approximately 1 year after Hurricane Katrina. Emergency planning for hemodialysis patients should include the identification and treatment of PTSD after future disasters.
1Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
2Section of Nephrology, Ochsner Health System, New Orleans, LA
3Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GA
4Department of Medicine, Tulane University School of Medicine, New Orleans, LA
5Department of Community and Preventive Medicine, Mount Sinai School of Medicine, New York, NY.
Address correspondence to Paul Muntner, PhD, Department of Community and Preventive Medicine, Mount Sinai School of Medicine, 1 Gustave L. Levy Pl, Box 1057, New York, NY 10029.
ABSTRACT