Abstract
BACKGROUND: On 4 October 1992, an El Al Boeing 747-F cargo aeroplane crashed on two apartment buildings in Amsterdam. Thirty-nine residents on the ground and the four crew members of the plane died. In the years after, a gradually increasing number of people attributed physical signs and symptoms to their presence at the disaster scene. AIM: To investigate the consistency between patients' symptoms attributed to the crash and GPs' diagnoses and perception of the association with the crash. DESIGN OF STUDY: Comparison between self-reported symptoms to a call centre and GPs' medical records on onset and type of symptoms, diagnoses, and GPs' perception of association with the disaster, assessed by questionnaire. SETTING: Consenting patients (n = 621) contacting the call centre and their GPs. METHOD: Patients were interviewed by the call centre staff and interview data were recorded on a database. Questionnaires were sent to the consenting patients' GPs, requesting their opinions on whether or not their patients' symptoms were attributable to the effects of disaster. Baseline differences and differences in reported symptoms between interviewed patients and their GP records were tested using the chi2 test. RESULTS: The 553 responders reported on average 4.3 symptoms to the call centre. The majority of these symptoms (74%) were reported to the GP. Of the ten most commonly reported symptoms, fatigue, skin complaints, feeling anxious or nervous, dyspnoea, and backache featured in 80% of symptoms reported to the GP. One out of four symptoms was either reported to the GP before the disaster took place, or six or more years after (1998/1999, during a period of much media attention). Depression (7%), post-traumatic stress disorder (PTSD) (5%) and eczema (5%) were most frequently diagnosed by GPs. They related 6% of all reported symptoms to the disaster. CONCLUSIONS: Most of the symptoms attributed to a disaster by patients have been reported to their GP, who related only a small proportion of these to the disaster.
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- Barsky A. J., Borus J. F. Functional somatic syndromes. Ann Intern Med. 1999 Jun 1;130(11):910–921. doi: 10.7326/0003-4819-130-11-199906010-00016. [DOI] [PubMed] [Google Scholar]
- Breslau N., Davis G. C., Andreski P., Peterson E. Traumatic events and posttraumatic stress disorder in an urban population of young adults. Arch Gen Psychiatry. 1991 Mar;48(3):216–222. doi: 10.1001/archpsyc.1991.01810270028003. [DOI] [PubMed] [Google Scholar]
- Bromet E., Dew M. A. Review of psychiatric epidemiologic research on disasters. Epidemiol Rev. 1995;17(1):113–119. doi: 10.1093/oxfordjournals.epirev.a036166. [DOI] [PubMed] [Google Scholar]
- Carlier I. V., Gersons B. P. Stress reactions in disaster victims following the Bijlmermeer plane crash. J Trauma Stress. 1997 Apr;10(2):329–335. doi: 10.1023/a:1024842532117. [DOI] [PubMed] [Google Scholar]
- Gersons B. P., Carlier I. V. Plane crash crisis intervention: a preliminary report from the Bijlmermeer, Amsterdam. Crisis. 1993;14(3):109–116. [PubMed] [Google Scholar]
- Hamilton W. T., Hall G. H., Round A. P. Frequency of attendance in general practice and symptoms before development of chronic fatigue syndrome: a case-control study. Br J Gen Pract. 2001 Jul;51(468):553–558. [PMC free article] [PubMed] [Google Scholar]
- Kessler D., Lloyd K., Lewis G., Gray D. P. Cross sectional study of symptom attribution and recognition of depression and anxiety in primary care. BMJ. 1999 Feb 13;318(7181):436–439. doi: 10.1136/bmj.318.7181.436. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Meijer J. S. Een vliegtuigramp in een huisartspraktijk; posttraumatische reacties in de eerste vier weken na de ramp in de Bijlmermeer. Ned Tijdschr Geneeskd. 1992 Dec 26;136(52):2553–2558. [PubMed] [Google Scholar]
- Mumford D. B., Devereux T. A., Maddy P. J., Johnston J. V. Factors leading to the reporting of 'functional' somatic symptoms by general practice attenders. Br J Gen Pract. 1991 Nov;41(352):454–458. [PMC free article] [PubMed] [Google Scholar]
- Palinkas L. A., Petterson J. S., Russell J., Downs M. A. Community patterns of psychiatric disorders after the Exxon Valdez oil spill. Am J Psychiatry. 1993 Oct;150(10):1517–1523. doi: 10.1176/ajp.150.10.1517. [DOI] [PubMed] [Google Scholar]
- Peveler R., Kilkenny L., Kinmonth A. L. Medically unexplained physical symptoms in primary care: a comparison of self-report screening questionnaires and clinical opinion. J Psychosom Res. 1997 Mar;42(3):245–252. doi: 10.1016/s0022-3999(96)00292-9. [DOI] [PubMed] [Google Scholar]
- Rubonis A. V., Bickman L. Psychological impairment in the wake of disaster: the disaster-psychopathology relationship. Psychol Bull. 1991 May;109(3):384–399. doi: 10.1037/0033-2909.109.3.384. [DOI] [PubMed] [Google Scholar]
- Schuster M. A., Stein B. D., Jaycox L., Collins R. L., Marshall G. N., Elliott M. N., Zhou A. J., Kanouse D. E., Morrison J. L., Berry S. H. A national survey of stress reactions after the September 11, 2001, terrorist attacks. N Engl J Med. 2001 Nov 15;345(20):1507–1512. doi: 10.1056/NEJM200111153452024. [DOI] [PubMed] [Google Scholar]
- Skodol A. E., Schwartz S., Dohrenwend B. P., Levav I., Shrout P. E., Reiff M. PTSD symptoms and comorbid mental disorders in Israeli war veterans. Br J Psychiatry. 1996 Dec;169(6):717–725. doi: 10.1192/bjp.169.6.717. [DOI] [PubMed] [Google Scholar]
- Turnquist D. C., Harvey J. H., Andersen B. L. Attributions and adjustment to life-threatening illness. Br J Clin Psychol. 1988 Feb;27(Pt 1):55–65. doi: 10.1111/j.2044-8260.1988.tb00753.x. [DOI] [PubMed] [Google Scholar]
- Weiner B. "Spontaneous" causal thinking. Psychol Bull. 1985 Jan;97(1):74–84. [PubMed] [Google Scholar]