Risk Factors for Depression Among Civilians After the 9/11 World Trade Center Terrorist Attacks: A Systematic Review and Meta-Analysis

Conclusions This meta-analysis identified risk factors for probable depression associated with the WTC terrorist attacks among mixed-exposure groups from the civilian population in the NYC metro area that was not directly involved in rescue or recovery efforts. We found that social isolation, change in employment, and not being married after the WTC terrorist attacks were three of the four most strongly associated risk factors for probable depression. Furthermore, we found that direct exposure to WTC related traumatic events was not significantly associated with probable depression, while knowing someone injured or killed by the attacks was. Knowing someone injured or killed was the second most strongly associated risk factor for probable depression in this meta-analysis, suggesting that probable depression among civilians after a terrorist attack may primarily be bereavement driven. Finally, we identified minority race/ethnicity and lower income as the only baseline demographic characteristics that predicted elevated odds of probable depression. This association suggests that further efforts are necessary to understand and address the influence of socioeconomic status and probable depression among civilians after terrorist attacks. Our analysis allows for a better understanding of the associations between probable depression and risk factors among civilians who were not involved in rescue or recovery efforts by providing quantitative estimates for each association. The str...
Source: PLOS Currents Disasters - Category: International Medicine & Public Health Authors: Source Type: research