New 9/11 Study Chronicles Psychological Impact

NEW YORK CITY, March 27 - More than 13 percent of Manhattan residents suffered from post-traumatic stress disorder (PTSD) and/or depression after the September 11th terrorist attacks, according to a new study led by researchers at The New York Academy of Medicine.

Psychological trauma was even more widespread among residents south of Canal Street, a short walk from the World Trade Center site, according to lead author Dr. Sandro Galea. An overwhelming one-fifth of those residents suffered from PTSD directly related to the tragedy, the study shows.

The research, to be published in the March 28 issue of the New England Journal of Medicine, represents the first major September 11th study in a peer-reviewed journal. The seven authors include three scientists in the Academy's Center for Urban Epidemiologic Studies (CUES): Galea; CUES director David Vlahov, Ph.D.; and Jennifer Ahern, M.P.H. The other authors are: Dean Kilpatrick, Ph.D., and Heidi Resnick, Ph.D., both of The National Crime Victims' Research and Treatment Center at the Medical University of South Carolina in Charleston; Michael Bucuvalas, Ph.D., of the research firm Schulman, Ronca and Bucuvalas, Inc.; and Dr. Joel Gold of Bellevue Hospital Center. (Click here for full text of journal article)

"Given the scope of this disaster, the high prevalence of mental health problems we documented among residents of Manhattan is not surprising," said Galea, an epidemiologist. "This study provides us with an estimate of psychological consequences in the general population soon after a significant disaster. This will be particularly important for future disaster planning in densely populated urban areas."

The study was organized and conducted by researchers at the Center for Urban Epidemiologic Studies at The New York Academy of Medicine. "We carried out this research quickly to help discern the mental health needs in New York City in the first months after the attacks," said Vlahov, senior author on the paper. Preliminary results from the study were given to the New York City and New York State Departments of Health soon after the study was completed.

The random-digit dialing telephone survey of 1,008 adult Manhattan residents was conducted between Oct. 16 and Nov. 15, 2001. Participants were interviewed for 35 minutes in English or Spanish, and questioned about whether they witnessed the attacks (38 percent did) or feared they would die during the attacks (16 percent did). Residents were also asked whether they lost loved ones in the attacks, which 11 percent did. Other questions asked whether residents had been displaced from their homes, involved in the rescue effort, and/or lost a job or possessions because of the attacks. Those surveyed were also asked about their level of emotional support during the six months before September 11th, such as whether they had someone to make them feel wanted and to give them good advice during a crisis. Furthermore, they were asked if they had experienced another stressful event in the past year, such as a spouse's death.

Among those interviewed, 7.5 percent reported symptoms consistent with PTSD related to the attacks. PTSD symptoms include the prolonged occurrence of distressing dreams, efforts to avoid thoughts related to the tragedy, and difficulty falling asleep or concentrating. That figure represents an estimated 67,000 Manhattan residents living south of 110th street in Manhattan suffering from PTSD, the researchers said. Another 9.7 percent of Manhattan residents reported symptoms consistent with current depression. In total, 13.6 percent of respondents reported symptoms that met the criteria for either PTSD or depression, while 3.7 percent met the criteria for both disorders. Hispanics suffered the worst psychological impact of any ethnic group.

Not surprisingly, PTSD was much more common among those who were directly exposed to the event, Galea said. For example, among people who had a friend or relative killed in the attacks, the prevalence of PTSD was 11.3 percent. Academy researchers are now completing a study quantifying PTSD and depression four months after the tragedy. These results should be published in the next few months.

The research was made possible by funding from the National Institute on Drug Abuse, a division of the National Institutes of Health, and from The September 11th Fund, created by The New York Community Trust and United Way of New York City to support recovery efforts after September 11th.

The New York Academy of Medicine is a non-profit organization founded in 1847 that is dedicated to enhancing the health of the public through research, education and advocacy, with a particular focus on disadvantaged urban populations.

Posted on March 26, 2002

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