Psychosocial rehabilitation in disasters: experience of the Spanish toxic oil syndrome.

In May 1981 a new disease caused by widespread food poisoning with adulterated rape-seed oil appeared in Spain. A total of 20,640 people were affected and 380 patients have died. The clinical syndrome consisted of pulmonary, neuromuscular, and systemic symptoms, which evolved to produce mild or severe physical disabilities. Although the disease is not primarily a psychiatric condition, almost 8000 TOS patients have been referred to a psychiatrist: these patients show a well-defined post-traumatic stress disorder, vulnerability being associated with female sex, low income, and class and a personal history of "nervous' disorders. Since January of 1983 the main goal of the health authorities has been social reintegration in the community of TOS patients, and teams of psychiatrists and psychologists have played an important role in this task, moving integrative rehabilitation activities from the hospital into the community.