Long-Term Mental Health Consequences of Chornobyl

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DESCRIPTION (provided by applicant): This competing renewal of MH51947 seeks to examine the long-term well-being of a cohort of mothers and children in Kyiv, Ukraine, first interviewed in 1997, 11 years after the Chornobyl accident. The proposed follow-up field work will be conducted in 2004-05. Our 1997 study focused on children born between 2/1/85 -1/31/87 to families evacuated to Kyiv from the contaminated region around Chornobyl. The control group was composed of gender matched classmates and their mothers. The 1997 results showed that compared with controls, the evacuee mothers reported more health problems in their children, had more anxiety, depressive, somatic, and post-traumatic stress symptoms, and were more concerned about their health and their family's health because of the Chornobyl accident. At that time, there were few differences in the medical evaluations or self-reported well-being of the evacuee children, who were 10-12 years old, compared to classmate controls. We propose to extend our original study by reevaluating the cohort with the CIDI and other measures when the children are age approximately 18, i.e., when depressive, anxiety, and substance disorders emerge, and by including physical examinations and blood tests. This cohort is the highest risk group for thyroid cancer and thus the focus of increased societal concern. To redress the limitation of having only Kyiv controls, the study will be expanded to include population-based controls selected from participants in the national co-morbidity survey of Ukraine conducted in 2002 (MH61905) who are the same age as the evacuee children and live in areas uncontaminated by radiation. The response rate for the original study was close to 90%, and we anticipate a better than 90% follow-up rate because of the residential stability of the sample. The analysis will focus on a set of specific hypotheses, including the prediction that both groups of Kyiv children and mothers will be more symptomatic at follow-up, and that the evacuee teens will report significantly more somatic and psychological symptoms and Chornobyl-related anxiety and will have higher rates of affective, anxiety, and substance use disorders than classmate controls. We further predict that the Kyiv control mothers and children will be more symptomatic and fearful about Chornobyl than the population-based controls. In light of current events, the opportunity to further our understanding of responses to prolonged threat to health is a key strength.