Comparison of post-disaster psychiatric disorders after terrorist bombings in Nairobi and Oklahoma City

Abstract

Background: African disaster-affected populations are poorly represented in disaster mental health literature. Aims: To compare systematically assessed mental health in populations directly exposed to terrorist bombing attacks on two continents, North America and Africa. Method: Structured diagnostic interviews compared citizens exposed to bombings of the US Embassy in Nairobi, Kenya (n=227) and the Oklahoma City Federal Building (n=182). Results: Prevalence rates of posttraumatic stress disorder (PTSD) and major depression were similar after the bombings. No incident (new since the bombing) alcohol use disorders were observed in either site. Symptom group C was strongly associated with PTSD in both sites. The Nairobi group relied more on religious support and the Oklahoma City group used more medical treatment, drugs and alcohol. Conclusions: Post-disaster psychopathology had many similarities in the two cultures; however, coping responses and treatment were quite different. The findings suggest potential for international generalisability of post-disaster psychopathology but confirmatory studies are needed.