Open Access Highly Accessed Research article

Exposure to the tsunami disaster, PTSD symptoms and increased substance use – an Internet based survey of male and female residents of Switzerland

Stefan Vetter1*, Astrid Rossegger2, Wulf Rossler3, Jonathan I Bisson4 and Jerome Endrass2

Author Affiliations

1 Centre for Disaster and Military Psychiatry, University of Zurich, Zurich, Switzerland

2 Psychiatric/Psychological Service, Criminal Justice System Canton of Zurich, Zurich, Switzerland

3 Psychiatric University Hospital of Zurich, Research Unit for Clinical and Social Psychiatry, Zurich, Switzerland

4 Department of Psychological Medicine, Cardiff University, Cardiff, UK

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BMC Public Health 2008, 8:92  doi:10.1186/1471-2458-8-92

Published: 19 March 2008



After the tsunami disaster in the Indian Ocean basin an Internet based self-screening test was made available in order to facilitate contact with mental health services. Although primarily designed for surviving Swiss tourists as well as relatives and acquaintances of the victims, the screening instrument was open to anyone who felt psychologically affected by this disaster. The aim of this study was to evaluate the influences between self-declared increased substance use in the aftermath of the tsunami disaster, trauma exposure and current PTSD symptoms.


One section of the screening covered addiction related behavior. We analyzed the relationship between increased substance use, the level of PTSD symptoms and trauma exposure using multivariable logistic regression with substance use as the dependent variable. Included in the study were only subjects who reported being residents of Switzerland and the analyses were stratified by gender in order to control for possible socio-cultural or gender differences in the use of psychotropic substances.


In women PTSD symptoms and degree of exposure enlarged the odds of increased alcohol, pharmaceuticals and cannabis use significantly. In men the relationship was more specific: PTSD symptoms and degree of exposure only enlarged the odds of increased pharmaceutical consumption significantly. Increases in alcohol, cannabis and tobacco use were only significantly associated with the degree of PTSD symptoms.


The tsunami was associated with increased substance use. This study not only replicates earlier findings but also suggests for a gender specificity of post-traumatic substance use increase.