Changes in the levels of depressive symptoms and anxiety in Ansan city after the 2014 Sewol ferry disaster.
BACKGROUND
In April 2014, a ferry carrying 476 passengers sunk on the coast of Korea, resulting in 304 deaths. Of these, 250 were local high school students, and the disaster significantly affected their community. This study aimed to examine the prevalence of depressive symptoms and anxiety among Ansan city residents to understand their recovery process after the accident.


METHODS
Two cross-sectional surveys (survey 1, after 4-6 months and survey 2, after 16-18 months of disaster) were used to compare prevalence among residents of Ansan city and adjacent cities. Symptoms were determined by the Center for Epidemiologic Studies-Depression Scale and the Generalized Anxiety Disorder 7-item Scale.


RESULTS
A total of 1,773 and 1,748 participants were included in Survey 1 and Survey 2, respectively. Survey 1 showed a significantly higher prevalence of depressive symptoms (19.0%; 95% confidence interval [CI], 16.9-21.1) and anxiety (6.1%; 95% CI, 5.0-7.5) among Ansan city, compared to participants from adjacent cities (depressive symptoms: 14.3%; 95% CI, 12.7-16.1; anxiety: 3.6%; 95% CI, 2.9-4.5). Survey 2 showed a decreased prevalence of depression (15.8%; 95% CI, 14.0-17.9) and anxiety (5.0%; 95% CI, 4.0-6.4) among Ansan city residents. Depressive symptoms and anxiety adjusted odds ratio in survey 2 compared with survey 1 were 0.74 (95% CI 0.62-0.89) and 0.81 (0.60-1.08) among Ansan city, respectively.


LIMITATIONS
Cross-sectional study design and lack of pre-disaster baseline data for comparison are limitations of this study.


CONCLUSIONS
Psychological distress occurred at a population level, not only among survivors and their families, but also among Ansan city residents indirectly impacted by the traumatic event. Although populations indirectly affected by a disaster show a natural recovery process, timely population-based interventions may be helpful.
['Yang|Hee Jung|HJ|', 'Kim|Gawon|G|', 'Lee|KangUk|K|', 'Lee|Jakyoung|J|', 'Cheong|Hae Kwan|HK|', 'Choi|Bo Youl|BY|', 'Lee|Soon Young|SY|']
D000059:Accidents D000328:Adult D000368:Aged D001008:Anxiety Disorders D003430:Cross-Sectional Studies D003863:Depression D064891:Disaster Victims D004190:Disasters D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D016017:Odds Ratio D015995:Prevalence D012044:Regression Analysis D056910:Republic of Korea D013313:Stress Disorders, Post-Traumatic D017741:Survivors D055815:Young Adult
Depression Anxiety Disaster Community Recovery