USPSYCH: 'Katrina Brain' Pervasive After Hurricane

NEW ORLEANS, Nov. 22 -- In the aftermath of hurricane Katrina, patients here suffered from a generalized anxiety disorder dubbed "Katrina Brain," a psychiatrist reported here.

As residents of New Orleans struggled to live in a city with a destroyed infrastructure -- no electricity, no drinkable water, no phone service, no mail -- there were mental health consequences, said Kenneth Sakauye, M.D.

Patients suffered from insomnia, difficulty concentrating, memory deficits, and more, he said. At the time Katrina struck, Dr. Sakauye was at the Louisiana State University Health Sciences Center here.

The traditional stress reaction to the danger and death dealt out by the storm was also a significant factor, Dr. Sakauye said at the U.S. Psychiatric & Mental Health Congress meeting. Since Katrina, Dr. Sakauye has moved to the University of Tennessee Health Science Center in Memphis.

"'Katrina Brain' became a local term describing the fact that we couldn't remember something as simple as a phone number after the hurricane," Dr. Sakauye said. "Our brains weren't working right."

For most New Orleans residents, symptoms did not rise to the level of post-traumatic stress disorder, but they did indicate generalized anxiety disorder (GAD), Dr. Sakauye said. Additional symptoms -- all in line with GAD -- included anxiety, diffuse anger, guilt, and health worries, Dr. Sakauye said.

Other data indicating widespread GAD included a 61% increase to crisis helpline calls in the months following Katrina, despite the fact that less than half of the population of New Orleans remained, Dr. Sakayue said.

About 44% of children in New Orleans had symptoms of new mental health problems post-Katrina, Dr. Sakauye said. Furthermore, the prevalence of depression, anxiety, and other mental health conditions rose to 68% in parents or caregivers of children post-Katrina, Dr. Sakauye said.

The few psychiatrists who remained in New Orleans -- fewer than 30 in all -- could do little to help, Dr. Sakauye said. Their efforts were stymied by the lack of electricity and phone service. Furthermore, most of their patients were no longer employed and didn't have health insurance, he said. There were few offices available, few houses, and almost no psychiatric beds available.

Public health officials can learn lessons in disaster preparedness from Katrina, Dr. Sakauye said. An effective plan to maintain mental health care in the event of a natural disaster should include the following elements:

• How to fill prescriptions when the usual pharmacy system fails. In New Orleans, prescriptions were filled on an "honor" basis, which led to abuse of the system by those seeking controlled substances, Dr. Sakauye said.
• How doctors can communicate with patients when phone and electrical service are no longer available. In New Orleans, some doctors found that despite their cell phone service being unavailable, they could still communicate with patients on their cell phones via text messaging, Dr. Sakauye said.
• How to ensure access to medical records when patients have been evacuated to a new location. Ideally, electronic backup should be easily available and located in a secondary location, Dr. Sakauye said.

Finally, a plan to ensure the safety of pets may be important, especially for the elderly. Many elderly residents of New Orleans refused to evacuate because they could not take their pets with them. Many of these residents died with their beloved animals, Dr. Sakauye said.