background  In recent years the psychological and psychiatric consequences of disasters have received increasing attention.
aim  To give an overview of the current state of knowledge concerning the psychiatric epidemiology of disasters and the effectiveness of post-disaster interventions.
method  literature review based on Medline over the period 1990 to 2002 supplemented with references from review articles and Dutch contributions to the 'Tijdschrift voor Psychiatrie' and the 'Maandblad Geestelijke Volksgezondheid'.
results  On the basis of a large quantity of retrospective and cross-sectional research it is generally accepted that there is a causal relationship between the experiencing of a disaster and the ocurrence of psychological problems and psycho-physiological changes. However, prospective studies, except for those conducted among a few specific risk groups, do not provide conclusive evidence of a definite relationship between disasters and the occurrence of psychiatric disorders. Furthermore, there seem to be no empirical grounds for preventive psychological interventions immediately after disaster.
conclusion  More prospective and longitudinal studies are needed if we are to obtain more insight into risk factors and protective factors and the possible usefulness of preventive interventions targeted at risk groups.