Post-Traumatic Stress Disorder after Disaster and Mass-Casualty Incidents in Developed and Developing Countries: A Meta-Analysis Study

Changiz Rostami Zarinabadi; Salman Daliri; Marzieh  Rohani-Rasaf; Arezoo  Karimi; Fariba Zare

doi:10.18502/ijps.v20i3.19044

Changiz Rostami Zarinabadi Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
Salman Daliri Health Deputy, Shiraz University of Medical Sciences, Shiraz, Iran.
Marzieh Rohani-Rasaf Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran.
Arezoo Karimi Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran.
Fariba Zare Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/ijps.v20i3.19044

Keywords: Developed and Developing Countries; Disaster; Meta-Analysis; Mass-Casualty Incident; Post-Traumatic Stress Disorder; Prevalence

Abstract

Objective: Disasters impact global health, with Post Traumatic Stress Disorder (PTSD) being a significant early consequence. Countries differ in their response to disasters and health management, affecting PTSD prevalence. This study aims to compare PTSD prevalence in developed and developing countries and investigate its trends post-COVID-19 compared to other mass-casualty incidents.

Method: This study was conducted using systematic review and meta-analysis methods regarding the prevalence of PTSD in the world. Accordingly, all the English language articles published from the beginning of 2010 to the end of 2024 were extracted from the Scopus, Web of Science, PubMed, Cochrane Library, and Google Scholar databases and were investigated. Data analysis was done by random effects model, meta-regression, I² index, and Egger test using the STATA (ver. 17) software.

Results: One hundred and eight studies, with a total sample size of 498,796, were included in the meta-analysis. The prevalence of PTSD in developed countries at various intervals after exposure to disaster was as follows: 26.3% (1-3 months), 44.5% (4-6 months), 11.1% (7-12 months), 24.0% (13-24 months), and 22.0% (25-36 months). In developing countries, the corresponding prevalence rates were 26.0%, 25.2%, 30.4%, 21.4%, and 20.9%, respectively. PTSD prevalence in men was slightly higher in developing countries compared to developed countries, but the difference was minimal.

Conclusion: More than one-fifth of disaster-exposed populations develop PTSD, with no significant prevalence difference between developed and developing countries. PTSD prevalence was higher in men from developing countries, but no significant gender differences were found otherwise. Prompt diagnostic and therapeutic interventions are essential globally to mitigate PTSD’s impacts.