Psych Vivas · Public-community — disaster and mass casualty psychiatry
Disaster and mass casualty psychiatry — structured clinical viva
Fellowship viva covering disaster psychiatry systems, evidence anchors, early intervention principles, and stepped care.
On this page & tools
Target exams
Interpretation
Reveal interpretation
Systems role. Embed under incident command; medical triage first; mental health provides PFA, risk assessment, SMI medication continuity, staff support, and stepped referral — not freelancing in hazard zones.[8]
Epidemiology. Heterogeneous elevated morbidity (Norris); PTSD dose-response (Neria); intentional mass violence epicentre effects (Galea); resilience common (Bonanno); natural disasters increase distress/disorder (Beaglehole); Black Saturday residual need in high-impact communities (Bryant).[1][2][7]
Early intervention. Hobfoll: safety, calming, efficacy, connectedness, hope. PFA operationalises early support. Mandatory single-session CISD is not supported for PTSD prevention (Rose Cochrane).[3][4]
Treatment. For persistent PTSD: individual TF-CBT/EMDR (Bisson). Sertraline 25–50 mg orally daily, titrate 50–200 mg with monitoring if medication indicated. Assess suicide risk despite mixed population suicide patterns after natural disasters.[5][6]
Key points
References
- [1]Norris FH, Friedman MJ, Watson PJ, et al. 60,000 disaster victims speak: Part I Psychiatry, 2002.PMID 12405079
- [2]Neria Y, Nandi A, Galea S Post-traumatic stress disorder following disasters: a systematic review Psychol Med, 2008.PMID 17803838
- [3]Hobfoll SE, Watson P, Bell CC, et al. Five essential elements of immediate and mid-term mass trauma intervention Psychiatry, 2007.PMID 18181708
- [4]Rose S, Bisson J, Churchill R, Wessely S Psychological debriefing for preventing post traumatic stress disorder (PTSD) Cochrane Database Syst Rev, 2002.PMID 12076399
- [5]Bisson JI, Roberts NP, Andrew M, Cooper R, Lewis C Psychological therapies for chronic post-traumatic stress disorder (PTSD) in adults Cochrane Database Syst Rev, 2013.PMID 24338345
- [6]Brady K, Pearlstein T, Asnis GM, Baker D, et al. Efficacy and safety of sertraline treatment of posttraumatic stress disorder JAMA, 2000.PMID 10770145
- [7]Bryant RA, Waters E, Gibbs L, et al. Psychological outcomes following the Victorian Black Saturday bushfires Aust N Z J Psychiatry, 2014.PMID 24852323
- [8]North CS, Pfefferbaum B Mental health response to community disasters: a systematic review JAMA, 2013.PMID 23925621