Abstract
INTRODUCTION: Cyclone Amphan swept into Bangladesh's southwestern coast at the end of May 2020, wreaking havoc on food security and economic stability, as well as possibly worsening mental health. We studied the prevalence of post-cyclone stressors in adults following the cyclone and its association with symptoms of psychological distress. METHODS: We conducted a cross-sectional study in a coastal district of Bangladesh. A five-item brief symptom rating scale was used to measure the symptoms of psychological distress. Household food insecurity was measured using the USAID Household Food Insecurity Access Scale questionnaire. We estimated adjusted prevalence ratios (aPRs) using robust log-linear models adjusted for potential confounders. RESULTS: A total of 478 adults (mean [SD] age, 37.0[12.6] years; 169[35.4%] women) participated in the study. The prevalence of moderate-to-severe psychological symptoms and suicidal ideation was 55.7% and 10.9%, respectively. Following the cyclone, 40.8% of the adults reported severe food insecurity, and 66% of them reported moderate-to-severe mental health symptoms. Also, 54.4% of women and 33.7% of men reported severe food insecurity in the households. Moreover, 25.5% of respondents reported no income or a significant income loss after the cyclone, and 65.5% of them had moderate-to-severe psychological symptoms. Also, 13.8% of respondents reported housing displacement because of severely damaged houses, and 68.2% of them reported moderate-to-severe psychological symptoms. The high prevalence of mental health symptoms was found in women (aPR = 1.41, 95% CI = 1.06-1.82), people with severe food insecurity (aPR = 1.63, 95% CI = 1.01-2.64), and people who lost jobs or lost a major income source (aPR = 1.25, 95% CI = 1.02-1.54). CONCLUSION: Following cyclone Amphan, many low-income individuals saw their income drop drastically while others were unemployed and living with severe food insecurity. The result suggests gender inequalities in food-security after the cyclone. Immediate action is needed to ensure household food-security for reducing the burden of mental illness. Rising opportunities of paid-jobs and decreasing income-loss, especially for the poor people, can have a protective impact on psychological distress. However, due to the high prevalence of severe psychological symptoms, long-term mental health services are required among the population of coastal Bangladesh.