Psychology

Topic Assessing the effect of a brief psychotherapeutic intervention in mentally ill people after an earthquake in Asia

Background Natural disasters apart from threatening peoples physical integrity and imposing a great financial burden on society, they also test the readiness and sensitivity of the affected community. Individuals with mental disabilities are especially vulnerable to adversities following natural disasters, including financial loss, displacement, injuries, death and bereavement (Person, 2007  Chou, 2004). This vulnerability may be explained as a result of their poor socio-economical status and their limited access to financial and humanitarian resources. In addition, mentally ill people run a heightened risk of developing secondary psychopathology such as PTSD which may lead to greater impairment. Even when there are no post-traumatic symptoms, the impact of the disaster may worsen the pre-existing psychopathology and increase the overall psychosocial burden (Person, 2007). For these reasons, there is a need to develop post-disaster strategies that will successfully address the needs of mentally disabled citizens.

Purpose The aim of the current study is to investigate the application of a program of on-going clinical support for individuals with mental disease, who have suffered the consequences of a major earthquake in an Asian country. There is a paucity of relevant research and we strongly believe that our findings may prove useful in motivating public policy and improving the efficacy of intervention strategies. The selection of individuals living in a foreign country makes our undertaking even more challenging, given that transcultural parameters should also be taken into account. Mental illness and coping mechanisms are largely influenced by the cultural and religious background of the affected population and consequently any intervention attempt should be tailored to these specific cultural needs, otherwise it will be bound to fail (Martinez, 2009  Bhugra, 2006).

Sample and methods Our study sample will consist of adults previously diagnosed with a mental disorder, which live in the area affected by the earthquake. All patients will be informed for the purpose and the method of the present research and will be asked to provide written consent. All participants will be initially administered the Structured Clinical Interview for DSM Disorders (First, 1997) by a trained member of the research team to confirm previous diagnosis, the Symptom Checklist 90 (SCL-90) to measure psychopathology (Derogatis, 2000) and the Health Survey Short-Form 36 (SF-36) (Ware 2004) to evaluate their health-related quality of life. Subsequently, half of our sample will attend individual weekly sessions of supportive psychotherapy by a qualified psychiatrist or psychologist for a period of six months, while the other half will only have two follow-up meetings for the same time-period. During the therapy sessions and the follow-up meetings, there will be a detailed recording of the interviews content and the patients clinical status and, when appropriate, modifications of treatment regimens. At the end of the 6-month interval, all participants will be re-administered the SCL-90 and the SF-36.

Comparing the quality of life and psychopathology scores between the two groups of patients we anticipate to find that the negative psychosocial impact of the natural disaster may be mitigated by the effects of the psychotherapeutic intervention. In addition, we seek to examine any possible correlations between demographic and clinical parameters and compare our findings to the existing literature. It is possible that a unique pattern of correlations and mediating factors will emerge, characteristic of the wider social and cultural context in which the disaster takes place. The clarification of this pattern might prove especially useful for the design of future interventions.