The Associations of Various Types of Hurricane-Related Exposures with Psychiatric and Substance Use Disorders in Puerto Rico Following Hurricane Maria
Damaris Lopez Mercado, Alexandra C. Rivera-González, Katyana M. Santiago, Jim P. Stimpson, Ligia M. Chavez, Brent Langellier, Jonathan Purtle, Mark Stehr, Jan M. Eberth, Glorisa Canino, Alexander N. OrtegaAbstract
Objective
To examine the associations between various hurricane-related exposures and psychiatric and substance use disorders among Puerto Rican adults following Hurricane Maria and to identify disaster-related exposures that may contribute to psychiatric morbidity in hurricane- and typhoon-prone settings.
Materials and Methods
Hurricane-related exposures were grouped into personal, property, utility/resource losses, and unsanitary/hazardous exposures. Logistic regression models were run to examine the associations between the number of hurricane-related exposures and disorders.
Results
Each additional hurricane-related exposure was associated with a 1.1 percentage-point increase in the probability of any mood disorder ( P < 0.001), a 1.3 percentage-point increase in the probability of any anxiety disorder ( P < 0.001), and a 2.0 percentage-point increase in the probability of any disorder ( P < 0.001). Each additional utility/resource loss exposure was associated with a 2.3 percentage-point increase in the probability of any anxiety disorder ( P = 0.001). Each additional unsanitary/hazardous exposure was associated with a 1.9 percentage-point increase in the probability of any mood disorder ( P = 0.017). Findings varied when individual disorders were examined. No associations were found between exposures and substance use disorders.
Conclusions
Utility/resource losses and unsanitary/hazardous conditions emerged as important correlates of post-disaster psychiatric disorders, suggesting that these often-overlooked exposures should be incorporated into disaster assessments and recovery planning.