Many U.S. Gulf Coast residents are thinking seriously about suicide or showing symptoms of post-traumatic stress disorder after Hurricane Katrina.
The survey is a follow-up to one done six months after the hurricane, which found that few people in Louisiana, Mississippi and Alabama - about 3 percent - had contemplated suicide in the storm's aftermath.
That figure has now doubled in the three-state area and is up to 8 percent in the New Orleans area, according to Ronald Kessler of Harvard Medical School, lead researcher for the Hurricane Katrina Community Advisory Group.
More people also showed signs of post-traumatic stress disorder, 21 percent of those interviewed this year compared to 16 percent in the earlier survey.
It's not surprising, said Karen Binder-Brynes, a New York psychologist who specializes in PTSD.
"It's a community that's in terrible distress. It's not like other things where, once everything's over, everything's getting rebuilt," she said.
Kessler team interviewed 1,000 people last year and was able to track down 800 of them for this year's survey. The latest survey is not yet ready for publication, but Kessler said the preliminary results for suicide and PTSD were striking.
Kessler said that in the months after the Aug. 29, 2005 hurricane, an underlying optimism protected many people from suicidal thoughts. Now, that optimism has worn thin - something the earlier report warned could happen if rebuilding didn't keep pace with expectations.
The recovery from Katrina has been slow in some areas, especially in New Orleans. In addition to losses due directly to the storm, violent crime, poor schools and other problems have piled trauma atop trauma.
Kessler, whose study is supported by the National Institutes of Health and the World Health Organization, said most disasters have relatively rapid recoveries, so rates for such ailments as depression and PTSD usually improve after a year.
The results of the New Orleans survey are more like those of people who lost their jobs in Detroit during the 1980s and couldn't find new work, he said.