The Swedish Tsunami Cohort

This is a study on risk factors of long-term psychiatric and somatic morbidity of Swedish survivors. We have established a population-based study of Swedish Tsunami survivors with one-year follow-up questionnaire and subsequent 2-4 year register-based follow-up of psychiatric and somatic health and follow-up studies of specific groups with extreme trauma exposure and loss of children and spouses/significant others.

Project description

The Tsunami in Asia on December 26, 2004 is one of the largest natural catastrophes in modern times; hundreds of thousands have lost their lives and the economic- and health consequences for survivors will be enormous. When the Tsunami occurred, about 20.000 Swedish citizens were on holiday in Thailand and other tourist areas in Asia. Most of these have returned home traumatized and/or bereaved - an experience affecting the quality of their personal as well as their occupational life. The risk of lasting long-term psychological and physical morbidity is reasonably contingent upon the different conditions and occurrences that the survivors were exposed to. Of special interest are aspects related to the delay of homecoming to Sweden and delay of identification/homecoming of deceased significant others.

Specific aims:

  • To identify disaster aftermath reactions and the process of recovering over a four-year period
  • To identify high-risk groups
  • To identify risk factors (pre-disposing factors, exposure variations) and protecting factors to develop long-term stress reactions and morbidity
  • To examine the importance of delayed identification of deceased significant others for long-term morbidity
  • To examine the importance of physical injuries and chronic infections for long-term adverse psychological reactions
  • To improve our understanding of disaster preparedness within a cultural frame

Main financing: The Swedish Council for Working Life and Social Research (FAS); Swedish Emergency Management Agency (Krisberedskapsmyndigheten); The National Board of Health and Welfare (Socialstyrelsen) via the National Center for Disaster Psychiatry

Project leader

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Christina Hultman

Affiliated to Research


Centre of Public Health Sciences, University of Iceland: Unnur Valdemarsdottír

National Center for Disaster Psychiatry (KCKP), Uppsala: Tom Lundin, Kerstin Bergh-Johannesson, P-O Michel

Norwegian Center for Violence and Traumatic Stress Studies, Oslo: Lars Weisaeth, Trond Heir

Institute of Public Health, Copenhagen, Denmark: Erik Lykke Mortensen, Henrik Steen Andersen, Susanne Rosenberg

Stockholm County Council, Unit for Public Health, Stockholm: Abbe Schulman

University of Southern California: Margaret Gatz

Department of Computer and Systems Sciences, Stockholm University/the Royal Institute of Technology (KTH): Kristina Höök

Department of Medical Epidemiology and Biostatistics: Nancy Pedersen


The effect of traumatic bereavement on tsunami-exposed survivors.
Johannesson KB, Lundin T, Hultman CM, Lindam A, Dyster-Aas J, Arnberg F, et al
J Trauma Stress 2009 Dec;22(6):497-504

Impact of exposure to trauma on posttraumatic stress disorder symptomatology in Swedish tourist tsunami survivors.
Johannesson KB, Michel PO, Hultman CM, Lindam A, Arnberg F, Lundin T
J. Nerv. Ment. Dis. 2009 May;197(5):316-23

Tsunami-affected Scandinavian tourists: disaster exposure and post-traumatic stress symptoms.
Heir T, Rosendal S, Bergh-Johannesson K, Michel PO, Mortensen EL, Weisaeth L, et al
Nord J Psychiatry 2011 Feb;65(1):9-15

Tsunami-exposed tourist survivors: signs of recovery in a 3-year perspective.
Johannesson KB, Lundin T, Fröjd T, Hultman CM, Michel PO
J. Nerv. Ment. Dis. 2011 Mar;199(3):162-9

After the flood: resilience among tsunami-afflicted adolescents.
Uttervall M, Hultman CM, Ekerwald H, Lindam A, Lundin T
Nord J Psychiatry 2014 Jan;68(1):38-43

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