The Great Belt Bridge railway accident: Post-traumatic stress reactions among passengers and bereaved family members.

Objective: To identify the trauma sequelae after a major train disaster on the Great Belt Bridge in 2019 and to compare two different trauma measures.

Design: Five (T1) and 13 (T2) months after the disaster, a questionnaire included both the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and the new The International Classifications of Diseases (ICD-11) criterion stand-ards for post-traumatic stress disorder (PTSD). Also, anxiety and depression were measured on both occasions.

Participants: All surviving passengers (N = 133) and the bereaved families (N = 8) were invited to participate through an electronic mailbox. At T1, 58 and 46 at T2 filled out all the questionnaires.

Main outcome measures: The primary study outcome measures were the Harvard Trauma Questionnaire (HTQ) and the International Trauma Questionnaire (ITQ).

Results: At T1, the HTQ screened 19 percent positive for PTSD, while the ITQ screened 15.5 percent. At T2, the numbers were 26 percent for the HTQ and 10.9 percent for the ITQ. At T1, 22.8 percent were screened positive for moderate or severe depression and 8.6 percent fulfilled the criteria for an anxiety diagnosis. The numbers at T2 were 19.5 percent for depression and 10.9 percent for anxiety.

Conclusions: There is a remarkable lack of train accident/disaster passenger studies. A large subgroup suffered from several psychological disorders both 5 and 13 months after the disaster. The two diagnostic systems used (DSM-IV and ICD-11) both -identified a considerable number of passengers in need of treatment; the latter identifying fewer than the former. Effective outreach procedures are recommended in the future.