The Associations of Various Types of Hurricane-Related Exposures with Psychiatric and Substance Use Disorders in Puerto Rico Following Hurricane Maria.

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.