Changes in the levels of depressive symptoms and anxiety in Ansan city after the 2014 Sewol ferry disaster

Abstract

BACKGROUND: In April 2014, a ferry carrying 476 passengers sunk on the coast of Korea, resulting in 304 deaths. Of these, 250 were local high school students, and the disaster significantly affected their community. This study aimed to examine the prevalence of depressive symptoms and anxiety among Ansan city residents to understand their recovery process after the accident. METHODS: Two cross-sectional surveys (survey 1, after 4-6 months and survey 2, after 16-18 months of disaster) were used to compare prevalence among residents of Ansan city and adjacent cities. Symptoms were determined by the Center for Epidemiologic Studies-Depression Scale and the Generalized Anxiety Disorder 7-item Scale. RESULTS: A total of 1,773 and 1,748 participants were included in Survey 1 and Survey 2, respectively. Survey 1 showed a significantly higher prevalence of depressive symptoms (19.0%: 95% confidence interval [CI], 16.9-21.1) and anxiety (6.1%: 95% CI, 5.0-7.5) among Ansan city, compared to participants from adjacent cities (depressive symptoms: 14.3%: 95% CI, 12.7-16.1: anxiety: 3.6%: 95% CI, 2.9-4.5). Survey 2 showed a decreased prevalence of depression (15.8%: 95% CI, 14.0-17.9) and anxiety (5.0%: 95% CI, 4.0-6.4) among Ansan city residents. Depressive symptoms and anxiety adjusted odds ratio in survey 2 compared with survey 1 were 0.74 (95% CI 0.62-0.89) and 0.81 (0.60-1.08) among Ansan city, respectively. LIMITATIONS: Cross-sectional study design and lack of pre-disaster baseline data for comparison are limitations of this study. CONCLUSIONS: Psychological distress occurred at a population level, not only among survivors and their families, but also among Ansan city residents indirectly impacted by the traumatic event. Although populations indirectly affected by a disaster show a natural recovery process, timely population-based interventions may be helpful.