ORIGINAL ARTICLE Psychiatric morbidity among children in North Aceh district (Indonesia) exposed to the 26 December 2004 tsunami Tjhin Wiguna 1 MD MIMH PhD, Anthony P.S. Guerrero 2 MD, Fransiska Kaligis 1 MD & Malik Khamelia 3 MD 1 Child and Adolescent Psychiatry Division, Department of Psychiatry, University of Indonesia, Jakarta, Indonesia 2 Department of Psychiatry, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA 3 Department of Psychiatry, University of Indonesia, Jakarta, Indonesia Keywords children, Indonesia, North Aceh district, psychiatric morbidity, tsunami Correspondence Tjhin Wiguna Child Psychiatrist, Child and Adolescent Psychiatry Division, Department of Psychiatry, University of Indonesia, Jl. Salemba Raya 4, Jakarta 10430, Indonesia. Tel: 162 213 107 741 Fax: 162 213 989 9128 Email: twiga00@yahoo.com Received 29 April 2010 Accepted 21 June 2010 DOI:10.1111/j.1758-5872.2010.00079.x Abstract Introduction: The aim of the study was to ascertain, using available data from the Bio-psychosocial Program for children, psychiatric morbidity and specific diagnoses among youths in North Aceh in the year after the tsunami disaster. Methods: All youths (n = 2,135) who participated in the program were included in the study and screened in two phases. They were first adminis- tered the Strengths and Difficulties Questionnaire (SDQ); those with positive scores were then clinically interviewed by a psychiatrist, who then provided a diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders (fourth edition) (DSM-IV). Results: Subjects ranged in age from 4 to 18 years. Female-to-male ratio was 1:1.5. 98.1% of subjects were directly exposed to the trauma. There were significantly higher percentages (P o 0.05) of abnormal total SDQ scores among trauma-exposed youths (52.3% among 4 to 10-year-olds and 46.5% among 11 to 18-year-olds, compared with youths in the non-trauma- exposed group (8% among 4 to 10-year-old children and 12% among 11 to 18-year-old adolescents. Clinical interviews revealed that 8.94% of the trauma-exposed youths met criteria for any mental disorder. Among youths with DSM-IV diagnoses, the most common diagnoses were post-traumatic stress disorder (PTSD; 24.6% of total diagnoses among 4 to 10-year-olds and 35.6% among 11 to 18-year-olds), followed by depressive disorders. Discussion: Consistent with our hypotheses, youths directly exposed to the trauma demonstrated more psychiatric difficulties and higher rates of psychiatric diagnoses, most notably PTSD. Also, compared to younger children, adolescents and older children exposed to the trauma appeared to have higher rates of psychiatric disorders. In the face of disasters – natural or otherwise – further research is needed on optimal prevention of child and adolescent psychiatric morbidity. Introduction In 2004, several earthquakes hit the eastern part of Indonesia. The largest of these earthquakes, centered in Nanggroe Aceh Darussalam province, occurred on 26 December 2004 and generated a tsunami that devastated Indonesia and several nations bordering the Indian Ocean. This earthquake and tsunami con- stituted the worst natural disaster to affect Indonesia in the past century. North Aceh district, 3,500 km 2 in size, was one of severely devastated areas. In a region inhabited by 470,000 people from mostly low-to-middle socioeco- nomic and educational backgrounds (and mostly em- ployed in fishing, farming, and mining industries), 5,000 children and their families became internal refugees, and several thousand more died or were injured or missing. Several hundred houses and schools were destroyed. While children’s responses to stress and trauma have been less thoroughly researched than adults’ Asia-Pacific Psychiatry 2 (2010) 151–155 Copyright c  2010 Blackwell Publishing Asia Pty Ltd 151 Asia-Pacific Psychiatry ISSN 1758-5864 Official journal of the Pacific Rim College of Psychiatrists