It is well established that disasters are associated with an increase in many psychological problems, including depressive symptoms and posttraumatic stress symptoms (PTSS).
1 However, the long-term prognosis of mental disorders following disaster remains sparsely documented. Few studies have followed survivors for more than 3 years.
2,3 Even fewer studies have managed to capture the mental health status of survivors predating their disaster experiences,
2,3 so we cannot determine whether the disaster caused worsening of mental health or whether poor mental health already predated disaster exposure in affected populations.