OBJECTIVE: This is a prospective clinical study on survivors of the collapse accident of a major department store building occurred in Seoul in lune 1995 to investigate the incidence of acute PTSD, to identify risk factors affecting the severity of PTSD symptoms, and to evaluate the pattern of symptom changes over time. METHOD: Thirty-two victims were interviewed with modified Korean version of the PTSD-I(DSM-III-R) to determine the severity of symptoms and diagnosis of PTSD. Degrees of anxiety and depression were measured with Hamilton's Anxiety Scale(HAS) and Depression Scales(HDS) respectively. Subjects were assessed in series at one month(time point 1) and three month(time point 2) from the time the accident occurred. RESULTS: The incidence of PTSD in the subjects over the 3 months was 41% using by full criteria and 48% by partial criteria. Regression analysis at the time point 1, the HDS score, which was partially related with death of accompanied persons(friends/relatives/colleagues), contributed significantly to the PTSD-I variances. At the time point 2, loss of consciousness contributed significantly to the variance of the PTSD-1, HDS and HAS scores. Between tire point 1 and time point 2, the overall severity of PTSD symptoms far all the subjects has remained almost unchanged. However, re-experience and hyperarousal symptoms were improved in comparison with avoidance symptoms, although not statistically significant. CONCLUSIONS: This study result show a high risk of developing PTSD and partial PTSD among the building collapse victims. The death of accompanied person, severity of depression and loss of consciousness are all regarded as major factors affecting the severity of PTSD. Of PTSD symptom clusters, avoidance symptoms are likely to be less changeable than reexperience and hyperarousal symptoms over time.
Anxiety ; Depression ; Diagnosis ; Disasters ; Humans ; Incidence* ; Prospective Studies ; Risk Factors ; Seoul* ; Stress Disorders, Post-Traumatic* ; Structure Collapse* ; Survivors* ; Unconsciousness

Following the department store building collapse disaster on June 29, 1995, more than 140 people were brought to emergency care center of the Catholic medical center. Among them three starvated people due to long term confined in the collapsed building and one severe crush injured patient developed to prerenal azotemia and ARF. Case 1, 21- year-old man had been confined in the collapsed building debris for 11 days, he had been able to drink water and showed only mild dehydration on admission. Case 2, 3, 18-year-old woman and 19- year-old woman had been confined for 13 and 17 days even without water intake. They were severely dehydrated, hypotensive and hypernatremia on admission. Case 4, 39-year-old man was crushed by building debris and rescued 22 hours later and was diagnosed as ARF due to traumatic rhabdomyolysis. Case 1, 2 and 3 improved immediately only with fluid therapy. Case 4 progressed to acute tubular necrosis, in spite of therapy, and required hemodialysis. Severe dehydration due to long term starvation in young healthy person over 17 days did not progressed to acute tubular necrosis only with adequate fluid therapy. To prevent acute tubular necrosis in crush injured patient, needs more immediate and intensive fluid therapy at the rescue and careful correction of hypernatremia.
Acute Kidney Injury ; Adolescent ; Adult ; Azotemia ; Dehydration ; Disasters* ; Drinking ; Emergency Medical Services ; Female ; Fluid Therapy ; Humans ; Hypernatremia ; Necrosis ; Renal Dialysis ; Rhabdomyolysis ; Starvation ; Structure Collapse* ; Water