Mental Health Effects in Primary Care Patients 18 Months After a Major Wildfire in Fort McMurray: Risk Increased by Social Demographic Issues, Clinical Antecedents, and Degree of Fire Exposure

Shahram Moosavi; Bernard Nwaka; Idowu Akinjise; Sandra E Corbett; Pierre Chue; Andrew J Greenshaw; Peter H Silverstone; Xin-Min Li; Vincent I O Agyapong

doi:10.3389/fpsyt.2019.00683

Mental Health Effects in Primary Care Patients 18 Months After a Major Wildfire in Fort McMurray: Risk Increased by Social Demographic Issues, Clinical Antecedents, and Degree of Fire Exposure

Front Psychiatry. 2019 Sep 18:10:683. doi: 10.3389/fpsyt.2019.00683. eCollection 2019.

Authors

Shahram Moosavi¹, Bernard Nwaka², Idowu Akinjise², Sandra E Corbett³, Pierre Chue¹, Andrew J Greenshaw¹, Peter H Silverstone¹, Xin-Min Li¹, Vincent I O Agyapong¹

Affiliations

¹ Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
² Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
³ Department of Psychiatry, Northern Lights Regional Health Centre, Fort McMurray, AB, Canada.

Abstract

Objectives: To assess prevalence of likely posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD) in patients attending the only out-of-hours primary care clinic in Fort McMurray some 18 months following a major fire. Methods: A quantitative cross-sectional survey was used to collect data through self-administered paper-based questionnaires to determine likely PTSD, MDD, and GAD using the PTSD Checklists for Diagnostic and Statistical Manual (DSM) 5, Patient Health Questionnaire (PHQ) 9, and GAD-7, respectively, from residents of Fort McMurray who were impacted by the wildfires. This was carried out eighteen (18) months after a major wildfire, which required the rapid evacuation of the entire city population (approximately 90,000 individuals). Results: We achieved a response rate of 48% and results from the 290 respondents showed the 1 month prevalence rate for likely PTSD was 13.6%, likely MDD was 24.8%, and likely GAD was 18.0%. Compared to self-reported prevalence rates before the wildfire (0%, 15.2%, and 14.5% respectively), these were increased for all diagnoses. After controlling for other factors in a logistic regression model, there were statistically significant associations between individuals who had likely PTSD, MDD, and GAD diagnoses and multiple socio-demographic, clinical, and exposure-related variables as follows: PTSD: History of anxiety disorder and received counselling had odds ratios (ORs) of 5.80 and 7.14, respectively. MDD: Age, witnessed the burning of homes, history of depressive disorder, and receiving low level support from friends and family had ORs of 2.08, 2.29, 4.63, and 2.5, respectively. GAD: Fearful for their lives or the lives of friends/family, history of depressive disorder, and history of anxiety disorder had ORs of 3.52, 3.04, and 2.68, respectively. There were also associations between individuals with a likely psychiatric diagnosis and those who also had likely alcohol or drug abuse/dependence. Conclusion: Our study suggests there are high prevalence rates for mental health and addiction conditions in patients attending the out-of-hours clinic 18 months after the wildfires, with significant associations between multiple variables and likely PTSD, MDD, and GAD. Further studies are needed to explore the impact of population-based mental health interventions on the long-term mental health effects of the wildfires.

Keywords: anxiety disorder; counseling; generalized anxiety disorder; major depressive disorder; mental health; support; wildfire.