Post-traumatic stress and depression following a landslide linked to the 2018 floods in Kerala, India: Relevance of screening

There is scant information on early manifestation of trauma due to catastrophic natural events and its relation with stress-related disorders. The specific objective of this study was to estimate and compare the prevalence of post-traumatic stress and depression on day 3 (D3) and week 6 (W6) following the 2018 flood in Kerala, India. In a cross-sectional study, symptoms of post-traumatic stress and depression were studied at D3 using primary care Post-Traumatic Stress Disorder screen for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) (PC-PTSD-5), and then at W6 using PC-PTSD-5, Screening Questionnaire for Disaster Mental Health, PTSD Checklist for DSM-5 (PCL-5), and Becks Depression Inventory. Majority (70 percent) were screen positive at D3 (n = 20) compared with 30 percent at W6 (n = 50), with a decreased frequency of all symptoms. Being PC-PTSD-5 screen positive at W6 was significantly associated with the presence of threat to life, physical injury, and death of relatives or neighbors. According to PCL-5, at W6, 46 percent had possible PTSD. Except damage to property, other disaster related or sociodemographic variables were not associated with the risk of having PTSD. Positive predictive value of PC-PTSD-5 (D3) for PTSD (PCL-5) at W6 was 64.3 percent. Depression and possibility of PTSD were significantly associated. A considerable proportion of victims continued to have posttraumatic stress and depression although the frequency decreased over time. A simple screening measure may help to identify victims with possible PTSD.