-Caveat Lector-

Psychiatrists Urged to Prepare For Chemical Or Biological Terrorists Attack

Attack --------------------------------------------------------------------------------

WESTPORT, Oct 12 (Reuters Health) - Biological and chemical weapons pose a
very real domestic threat, and psychiatrists should be trained to deal with
such an attack in the opinion of Dr. Cleto DiGiovanni, Jr., of the National
Naval Medical Center, Bethesda, Maryland.

Dr. DiGiovanni reviews the potential neuropsychiatric effects of such an
attack in the October issue of the American Journal of Psychiatry.

Nerve agents such as sarin, tabun, soman and VX can cause intellectual
impairment, anxiety, psychomotor retardation, and sleep disturbances, Dr.
DiGiovanni writes. In some instances, he says, exposure to nerve agents has
caused "...depressed mood, social withdrawal, insomnia with unpleasant dreams
and 'antisocial thoughts'."

Just the threat of a chemical or biological attack can cause widespread
somatization disorders, acute stress, anger and anxiety, and actual disasters
have long-lasting psychological effects, according to Dr. DiGiovanni.

He notes that 18 months after the 1979 partial meltdown of the reactor core
at the Three Mile Island nuclear power plant, area residents reported
"...significantly greater emotional stress, more global symptoms and somatic
complaints, and higher levels of anxiety and alienation than control groups."

Now is the time for psychiatrists to prepare for such disasters, Dr.
DiGiovanni urges. "The psychiatrist should review his or her hospital's mass
disaster response plan to ensure that the mental health component is more
than token."

He adds that efforts should be made to coordinate services without
duplicating efforts. "This coordination process should serve as a vehicle by
which the psychiatrist can educate others about the potential impact of
psychological casualties on the community, the spectrum of normal-to-abnormal
emotions reactions that may occur, and crisis intervention techniques."

Dr. DiGiovanni concludes with a solemn warning. "Remote though the
possibility of a terrorist-authored chemical or biological incident in an
American community may be, we must prepare for one. The agents are too easy
to acquire or manufacture and too easy to disperse for us to ignore that
possibility."

Am J Psychiatry 1999;156:1500-1505.

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