Disastro del Vajont: conseguenze a lungo termine sulla salute psichica e fisica dei sopravvissuti

BACKGROUND AND AIMS The negative impact of traumatic events on psychological functioning has been well-established (Wagner, 2000). Recent research suggests that trauma may have deleterious effects on physical functioning (Schnurr, 1996). Some research (Lauterbach, 2005) indicates that the relationship between traumatic experiences and health problems could be mediated by post-traumatic stress disorder (PTSD) or depression (MDD). Experts (Ford et al., 2004) suggest that only long term studies may allow to understand the trauma exposure consequences on physical health from a statistical-epidemiological point of view. Two studies on Vajont survivors were conducted by our research group. The aim of the first study was to assess the psychiatric consequences of the Vajont disaster more than 36 years after the event, with a particular attention to the presence of post-traumatic stress disorder (PTSD) and major depressive disorder (MDD) and to the relationship between the degree of traumatic exposure and its consequences on psychological functioning. The second study aimed to investigate the relationship between physical health and trauma severiy, post-traumatic stress disorder (PTSD), and major depressive disorder (MDD) in a group of Vajont survivors and in a control group, 44 years after trauma. METHODS In the first study, 90 survivors were assessed by means of a semistructured interview to investigate the extent of the traumatic experience and a structured diagnostic interview for the diagnosis of PTSD and MDD. In the second study, 60 survivors were assessed by means of a semistructured interview to investigate health status, and the extent of the traumatic experience, and a structured diagnostic interview for the diagnosis of PTSD and MDD. The health status was also assessed by the survivor's general practitioner. Some self-reported questionnaires were administred to measure quality of life, social support, temperament and the presence of type D personality. A control group of 48 subjects was assessed, too. RESULTS Our first study shows that large scale disasters such as the Vajont one affect the psychological health of survivors for decades. Moreover our research confirms the role of risk factors such as the degree of trauma exposure and female gender in the development of psychiatric consequences after a disaster. The second study confirms the deleterious effects on physical health of extreme traumatic experiences. This effects do not seem to be related to direct effects of trauma or to the degree of exposure. The study shows the role of PTSD or symptoms of PTSD and social support as mediators between trauma exposure and health status. The trauma consequences, in particular on psychological health, have an influence on the Vajont survivors's quality of life.