Impact of bereavement among relatives in Italy and Sweden after the Linate airplane disaster

Objectives: Victims of major disasters are at risk for development of post-traumatic stress disorder (PTSD). The aim of this study was to compare two groups of bereaved relatives from Italy and Sweden, and to examine the role of psychosocial support and psychological reactions 18 months after traumatic bereavement. Methods: In all, 153 bereaved relatives of deceased victims in the Milano/Linate aeroplane crash were assessed by a questionnaire. Reactions of psychological distress were measured by the Impact of Event Scale-Revised (IES-R). Results: In the whole group, 53.2% showed symptoms indicating that they might meet the DSM-IV criteria for PTSD. The frequency was higher among the Italian relatives (58.7%) compared with the Swedish relatives (42.6%). Females showed more signs of post-traumatic reactions compared with males in the total population, as did spouses and parents within the Italian group. The general health status, measured by subjective evaluation, was significantly affected in both groups as a result of the disaster. A significant recovery after 18 months was reported, although not to the pre-accident level. The Swedish relatives had a pattern of using more psychotherapy compared with the Italians, among whom it was more common to use medication for both anxiety and sleeping problems. The need for psychotherapy and medication was related to higher scores on IES-R. Conclusions: (1) Traumatic losses deeply affect bereaved relatives. Health is affected and a large group of these relatives develop strong symptoms of post-traumatic stress. (2) Swedish bereaved relatives seem to be more apt to ask for professional help, e.g. psychotherapy, while in Italy it is more common to rely on family, friends and medication. (3) Acute organized psychosocial support in the aftermath can possibly facilitate for victims to handle a traumatic loss but it does not prevent the development of strong post-traumatic reactions. Future investigations may show how it is possible to optimize the help with more specific interventions of support and treatment.