Psychosocial issues

An often overlooked but vitally important issue in bioterrorism is that of psychosocial sequelae. These often take the form of acute anxiety reactions and exacerbations of chronic psychiatric illness during the stress of the event, or posttraumatic stress disorder (PTSD) in its aftermath. Nearly half of the emergency department visits during the Gulf War missile attacks on Israel in 1991 were related to acute psychological illness or exacerbations of underlying psy-chopathology (Karsenty et al., 1991). Data from recent acts of terrorism in the US suggest that PTSD may develop in as many as 35 percent of those affected by the events (Yehuda, 2002). In the early period after the 11 September 2001 attacks in New York, PTSD and depression were nearly twice as prevalent as in historical control subjects (Galea et al., 2002). Although close proximity to the events and personal loss were directly correlated with PTSD and depression, respectively, there was a substantial burden of morbidity among those only indirectly involved. The psychological impact of these events and of persistent international concern over terrorism can be expected to be significant and sustained for society as a whole.

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