New Yorkers together went through severe trauma

Dr Sandro Galea

It says that nearly one in 10 people living in the lower third of Manhattan reported major depression they believe was linked to the atrocity.

Many had trouble sleeping and, when they did, repeatedly dreamt about the disaster.

The study, compiled by Dr Sandro Galea, is the first major investigation of the lasting psychological impact of 11 September.

Major problems

Dr Galea said: "This was not a matter of `have you had a nightmare?' This was, 'You've had nightmares night after night after night.

"New Yorkers together went through severe trauma. There are tremendous mental-health needs."

One in five people living in the immediate neighbourhood of Ground Zero suffered from post traumatic stress disorder.

Symptoms included flashbacks or nightmares in which they re-lived the terrifying feelings they experienced during the attack.

Many of the 1,000 people from Manhattan surveyed had seen the disaster in person and had suffered panic attacks during or after the planes hit the towers.

Sleepless nights

One in four said they suffered from insomnia and were easily startled by loud noises, while nearly one in five said they were having more difficulty concentrating than usual.

Sonny Goldstein, whose daughter Monica was killed in the attack, said he relives the attack every day through memories, dreams and television.

He told the New York Daily News: "It's always on the news, on every programme, even the Academy Awards.

Calls to the mental health helpline Lifenet, which averaged 3,000 per month before 11 September have steadily increased since the attacks, and set a record of 6,600 in January.

The New York City health commission has already spent US$14m on "Project Liberty," a crisis-counselling programme to help people suffering from anxiety.

It has sites in 110 locations across the city and is advertised on subway trains and buses under the slogan "New York Needs Us Strong."

The research is published in the New England Journal of Medicine.