%0 Journal Article
%T Use of mental health services among disaster survivors: predisposing factors
%A Dirk-Jan den Ouden
%A Peter G van der Velden
%A Linda Grievink
%A Mattijn Morren
%A Anja JE Dirkzwager
%A C Joris Yzermans
%J BMC Public Health
%D 2007
%I BioMed Central
%R 10.1186/1471-2458-7-173
%X Electronic records of survivors (n = 339; over 18 years and older) registered in a mental health service (MHS) were linked with general practice based electronic medical records (EMRs) of survivors and data obtained in surveys. EMR data were available from 16 months pre-disaster until 3 years post-disaster. Symptoms and diagnoses in the EMRs were coded according to the International Classification of Primary Care (ICPC). Surveys were carried out 2每3 weeks and 18 months post-disaster, and included validated questionnaires on psychological distress, post-traumatic stress reactions and social functioning. Demographic and disaster-related variables were available. Predisposing factors for MHS utilization 0每18 months and 18每36 months post-disaster were examined using multiple logistic regression models.In multiple logistic models, adjusting for demographic and disaster related variables, MHS utilization was predicted by demographic variables (young age, immigrant, public health insurance, unemployment), disaster-related exposure (relocation and injuries), self-reported psychological problems and pre- and post-disaster physician diagnosed health problems (chronic diseases, musculoskeletal problems). After controlling for all health variables, disaster intrusions and avoidance reactions (OR:2.86; CI:1.48每5.53), hostility (OR:2.04; CI:1.28每3.25), pre-disaster chronic diseases (OR:1.82; CI:1.25每2.65), injuries as a result of the disaster (OR:1.80;CI:1.13每2.86), social functioning problems (OR:1.61;CI:1.05每2.44) and younger age (OR:0.98;CI:0.96每0.99) predicted MHS utilization within 18 months post-disaster. Furthermore, disaster intrusions and avoidance reactions (OR:2.29;CI:1.04每5.07) and hostility (OR:3.77;CI:1.51每9.40) predicted MHS utilization following 18 months post-disaster.This study showed that several demographic and disaster-related variables and self-reported and physician diagnosed health problems predicted post-disaster MHS-use. The most important factors to pre
%U http://www.biomedcentral.com/1471-2458/7/173