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Clinical Atlas Prestige · Evidence-first

Psych VivasPublic-community — disaster and mass casualty psychiatry

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.

clinical
On this page & tools

Target exams

FRANZCPMRCPsychABPNMD-DNB

Target exams

FRANZCPMRCPsychABPNMD-DNB
Prompt
You are the psychiatry registrar. After a mass casualty bushfire, you join the emergency operations briefing. Discuss definitions and phases, exposure gradients, epidemiology anchors (Norris, Neria, Galea, Bonanno, Beaglehole, Bryant), Hobfoll five elements, PFA versus mandatory CISD (Rose Cochrane), stepped treatment including TF-CBT/EMDR and sertraline dosing, first-responder care, suicide risk nuance (Kõlves), and disposition — without inventing emergency statute section numbers.

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

Hobfoll five

Safety, calming, efficacy, connectedness, hope.[3]

No mandatory CISD

Rose Cochrane — not useful PTSD prevention.[4]

Name the papers

Norris, Neria, Galea, Bonanno, Beaglehole, Bryant, Bisson, Brady.[1][2][5][7]

References

  1. [1]Norris FH, Friedman MJ, Watson PJ, et al. 60,000 disaster victims speak: Part I Psychiatry, 2002.PMID 12405079
  2. [2]Neria Y, Nandi A, Galea S Post-traumatic stress disorder following disasters: a systematic review Psychol Med, 2008.PMID 17803838
  3. [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. [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. [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. [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. [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. [8]North CS, Pfefferbaum B Mental health response to community disasters: a systematic review JAMA, 2013.PMID 23925621