Pre-disaster Health Vulnerabilities Predict Major Depressive Disorder Symptoms Among High-Risk Puerto Rican Adults after Hurricanes Maria and Irma.

IF 1.8 4区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Disaster Medicine and Public Health Preparedness Pub Date : 2025-02-06 DOI:10.1017/dmp.2024.169

Regina M Musicaro, Zerbrina Valdespino-Hayden, Marijulie Martinez Lozano, Carlamarie Noboa Ramos, Kaumudi Joshipura, Sarah R Lowe

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Abstract

Objective: Robust research has established that preexisting physical and mental health conditions increase risk for adverse psychiatric outcomes after disasters. However, it is unclear if increased risk is independent of disaster exposure, and most studies have relied on retrospective reports of pre-disaster functioning.

Methods: In a pre-post sample of high-risk Puerto Rican adults (N = 361) who experienced Hurricanes Irma and Maria, we assessed: 1) whether indicators of pre-disaster depression and physical health conditions were associated with posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) symptoms; and 2) whether the effects of pre-disaster depression and physical health conditions on PTSD and MDD symptoms were indirect via disaster exposure or had exacerbated the effects of disaster exposure on PTSD and MDD symptoms.

Results: Pre-disaster depression and physical health problems were significantly associated with higher post-disaster MDD symptoms (B = 1.50, SE = 0.36, p < .001, and B = 0.21; SE = 0.09, P = 0.016), but not PTSD symptoms. Indirect effects of pre-disaster depression and physical health symptoms via disaster exposure were non-significant, and neither moderated the association of disaster exposure on PTSD and MDD symptoms.

Conclusions: Research is needed to understand other pathways through which pre-disaster health conditions predict post-disaster mental health.

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灾前健康脆弱性预测高危波多黎各成年人在飓风玛丽亚和厄玛后的严重抑郁障碍症状。

目的：强有力的研究已经证实，先前存在的身体和精神健康状况增加了灾害后不良精神结局的风险。然而，目前尚不清楚风险增加是否与灾害暴露无关，而且大多数研究都依赖于灾前功能的回顾性报告。方法：对经历飓风Irma和Maria的波多黎各高危成人（N = 361）进行灾前调查，评估：1)灾前抑郁和身体健康状况指标是否与创伤后应激障碍（PTSD）和重度抑郁症（MDD）症状相关；2)灾前抑郁和身体健康状况对PTSD和MDD症状的影响是通过灾难暴露间接产生的，还是通过灾难暴露加剧了灾难暴露对PTSD和MDD症状的影响。结果：灾前抑郁和身体健康问题与较高的灾后重度抑郁症症状显著相关(B = 1.50, SE = 0.36, p < 0.001, B = 0.21；SE = 0.09, P = 0.016)，但没有PTSD症状。灾难暴露对灾前抑郁和身体健康症状的间接影响不显著，两者都没有调节灾难暴露对创伤后应激障碍和重度抑郁症症状的影响。结论：需要研究了解灾前健康状况预测灾后心理健康的其他途径。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Disaster Medicine and Public Health Preparedness PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

4.40

自引率

7.40%

发文量

258

审稿时长

6-12 weeks

期刊介绍： Disaster Medicine and Public Health Preparedness is the first comprehensive and authoritative journal emphasizing public health preparedness and disaster response for all health care and public health professionals globally. The journal seeks to translate science into practice and integrate medical and public health perspectives. With the events of September 11, the subsequent anthrax attacks, the tsunami in Indonesia, hurricane Katrina, SARS and the H1N1 Influenza Pandemic, all health care and public health professionals must be prepared to respond to emergency situations. In support of these pressing public health needs, Disaster Medicine and Public Health Preparedness is committed to the medical and public health communities who are the stewards of the health and security of citizens worldwide.