Psychische gezondheid van 13-14-jarigen voor en na de cafébrand in Volendam; een prospectief onderzoek met gegevens van de getroffenen en van een controlepopulatie

To examine the effects of a catastrophe on the mental health of adolescents using prospective data from before and after the catastrophe.

Design

Prospective, comparative.

Method

The Volendam café fire wounded about 250 adolescents, of whom 14 died. In September and October 1999, 15 months before the catastrophe, all grade 2 pupils from the main Volendam secondary school (of whom 31 were in the café as the fire broke out) and from two other schools had been included as control group in a planned study. They had provided self-report data on behavioural and emotional problems (using the questionnaire ‘Youth Self-Report’; YSR) and on substance use. In May 2001, 5 months after the catastrophe, follow-up data were collected in accordance with the protocol from 91 of 124 Volendam children (aged 13-14 years) for whom 1999-data were available (73.4) and from 643 of 830 control children (77.5).

Results

Volendam children exhibited higher increases in the proportion of clinical scores on the YSR scale for total problems (odds ratio: 1.82; 95 CI: 1.01 to 3.29; p = 0.046) and on excessive use of alcohol (4.57; 2.73-7.64; p < 0.0001), but not for smoking (0.87; 0.48-1.56; p = 0.63) and not for the use of marihuana, ecstasy and sedatives. YSR increases were greatest for the syndromes ‘anxiety/depression’ (2.85; 1.23-6.61), ‘thought problems’ (2.16; 1.09-4.30), and ‘aggressive behaviour’ (3.30; 1.30-8.36). Intention to treat analyses, in which all cases of drop-out retained their original baseline values, showed statistically significant effects for the excessive use of alcohol and YSR syndromes. The effects were virtually the same for both the victims and their classmates.

Conclusion

Post-catastrophe interventions should address anxiety, depression, thought problems, aggression and alcohol abuse among both victims and their peer group.