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      Psychosocial impact of the summer 2007 floods in England

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          Abstract

          Background

          The summer of 2007 was the wettest in the UK since records began in 1914 and resulted in severe flooding in several regions. We carried out a health impact assessment using population-based surveys to assess the prevalence of and risk factors for the psychosocial consequences of this flooding in the United Kingdom.

          Methods

          Surveys were conducted in two regions using postal, online, telephone questionnaires and face-to-face interviews. Exposure variables included the presence of flood water in the home, evacuation and disruption to essential services (incident management variables), perceived impact of the floods on finances, house values and perceived health concerns. Validated tools were used to assess psychosocial outcome (mental health symptoms): psychological distress (GHQ-12), anxiety (GAD-7), depression (PHQ-9) and probable post-traumatic stress disorder (PTSD checklist-shortform). Multivariable logistic regression was used to describe the association between water level in the home, psychological exposure variables and incident management variables, and each mental health symptom, adjusted for age, sex, presence of an existing medical condition, employment status, area and data collection method.

          Results

          The prevalence of all mental health symptoms was two to five-fold higher among individuals affected by flood water in the home. People who perceived negative impact on finances were more likely to report psychological distress (OR 2.5, 1.8-3.4), probable anxiety (OR 1.8, 1.3-2.7) probable depression (OR 2.0, 1.3-2.9) and probable PTSD (OR 3.2, 2.0-5.2). Disruption to essential services increased adverse psychological outcomes by two to three-fold. Evacuation was associated with some increase in psychological distress but not significantly for the other three measures.

          Conclusion

          The psychosocial and mental health impact of flooding is a growing public health concern and improved strategies for minimising disruption to essential services and financial worries need to be built in to emergency preparedness and response systems. Public Health Agencies should address the underlying predictors of adverse psychosocial and mental health when providing information and advice to people who are or are likely to be affected by flooding.

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          Most cited references27

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          A brief measure for assessing generalized anxiety disorder: the GAD-7.

          Generalized anxiety disorder (GAD) is one of the most common mental disorders; however, there is no brief clinical measure for assessing GAD. The objective of this study was to develop a brief self-report scale to identify probable cases of GAD and evaluate its reliability and validity. A criterion-standard study was performed in 15 primary care clinics in the United States from November 2004 through June 2005. Of a total of 2740 adult patients completing a study questionnaire, 965 patients had a telephone interview with a mental health professional within 1 week. For criterion and construct validity, GAD self-report scale diagnoses were compared with independent diagnoses made by mental health professionals; functional status measures; disability days; and health care use. A 7-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale. The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.
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            The PHQ-9

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              Global health impacts of floods: epidemiologic evidence.

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                Author and article information

                Journal
                BMC Public Health
                BMC Public Health
                BioMed Central
                1471-2458
                2011
                3 March 2011
                : 11
                : 145
                Affiliations
                [1 ]Department of Primary Care and Public Health, Clinical Epidemiology Interdisciplinary Research Group, School of Medicine, Cardiff University, (5th Floor Neuadd Meirionnydd, Heath Park) Cardiff (CF14 4YS) UK
                [2 ]Emergency Response Department, Health Protection Agency, (Building H11, HPA, Porton Down), Salisbury (SP4 0JG) UK
                [3 ]King's College London, Institute of Psychiatry, (3rd Floor, Weston Education Centre, 10 Cutcombe Road), London (SE5 9RJ) UK
                [4 ]NHS Doncaster and Doncaster Metropolitan Borough Council, (White Rose House, Ten Pound Walk), Doncaster (DN4 5DJ) UK
                [5 ]Sheffield Primary Care Trust and City Council, NHS Sheffield, (722 Prince Of Wales Road), Sheffield (S9 4EU) UK
                [6 ]Health Protection Agency, (Elgar House, Green Street, Kidderminster), Worcestershire, (DY10 1JF) UK
                [7 ]South Yorkshire Health Protection Unit, Health Protection Agency, (Meadowcourt, Hayland Street), Sheffield (S9 1BY) UK
                Article
                1471-2458-11-145
                10.1186/1471-2458-11-145
                3062606
                21371296
                7a9bab4c-af68-46bd-9408-278c43e58ff3
                Copyright ©2011 Paranjothy et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 10 March 2010
                : 3 March 2011
                Categories
                Research Article

                Public health
                Public health

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