The effect of a severe disaster on the mental health of adolescents: a controlled study

Disasters greatly affect the mental health of children and adolescents, but quantification of such effects is difficult. Using prospective predisaster and postdisaster data for affected and control populations, we aimed to assess the effects of a severe disaster on the mental health and substance use of adolescents. In January, 2001, a fire in a café in Volendam, Netherlands, wounded 250 adolescents and killed 14. In the 15 months before the disaster, all grade 2 students (aged 12–15 years) from a school in Volendam (of whom 31 were in the café during the fire), and from two other schools, had been selected as controls for a study. 124 Volendam students and 830 from the other two schools had provided data for substance use, and completed the youth self-report (YSR) questionnaire about behavioural and emotional problems. 5 months after the disaster, we obtained follow-up data from 91 (response rate 73·4%) Volendam adolescents and 643 (77·5%) controls from the other two schools. The primary outcome measures were changes in score in YSR categories of total problems, alcohol misuse, smoking, and substance use. We compared changes in scores between groups using logistic regression. Volendam adolescents had larger increases in clinical scores than controls for total problems (odds ratio 1·82, 95% CI 1·01–3·29, p=0·045) and excessive use of alcohol (4·57, 2·73–7·64, p