Risk factors of mental illness among adult survivors after the Wenchuan earthquake

UK Biobank data demonstrate long-term exposure to floods is a risk factor for incident dementia

BACKGROUND

Flooding has emerged as the most prevalent natural disaster, impacting billions of individuals worldwide. However, the long-term effects of flooding exposure on dementia remain unclear.

METHODS

With a nested case-control design, a risk-set sampling method was used to match cases and controls. Annual cumulative flooding exposure was calculated for each participant. The associations between flooding exposure and incident dementia were assessed using conditional logistic regression models.

RESULTS

Here we show that the risk of flood-related incident dementia is the strongest in the current year and diminished over a span of 6 years. In the fully adjusted model, the cumulative odds ratios (OR) are 1.28 (95% confidence interval [CI]: 1.25-1.31) for any dementia, 1.44 (95% CI: 1.36-1.53) for Alzheimer's disease and 1.65 (95% CI: 1.48-1.83) for vascular dementia, associated with per unit increase in annual cumulative flooding exposure over lag 0-6 years. Participants under the age of 65 years (OR: 1.39, 95% CI: 1.33-1.46) and female participants (OR: 1.41, 95% CI: 1.33-1.49) exhibit a higher risk of incident dementia compared to those aged 65 years and older (OR: 1.25, 95% CI: 1.21-1.28) and male participants (OR: 1.26, 95% CI: 1.23-1.30), respectively. Similar effect estimates are observed in the stratified analyses of Alzheimer's disease according to genetic factors.

CONCLUSIONS

This study provides robust epidemiological evidence supporting the link between floods and an increased risk of dementia. These findings enhance the understanding of the long-term consequences of flood exposure.

Impact of the February 6, 2023, Turkey earthquake on post-traumatic stress disorder, internet addiction and insomnia: A cross-sectional study

BACKGROUND

After earthquakes, individuals may increase their internet usage to cope with post-traumatic stress symptoms, potentially leading to internet addiction and sleep disturbances.

AIMS

This study aims to determine the levels of post-traumatic stress disorder (PTSD), internet addiction and insomnia in earthquake survivors 1 year after the event and to explore the relationships between these variables.

METHODS

This cross-sectional descriptive study was conducted between April and June 2024 through face-to-face interviews with 554 individuals who survived the February 6, 2023 earthquake in Turkey, 1 year after the event. Data were collected using the PTSD Checklist for DSM-5 (PCL-5), the Young Internet Addiction Test-Short Form (YIAT-SF) and the Insomnia Severity Index (ISI).

RESULTS

A statistically significant moderate positive correlation was found between PCL-5, YIAT-SF and ISI based on the Pearson correlation test (r = .32 and .44, respectively; p < .05). According to the logistic regression analysis, experiencing physical injury during the earthquake and the loss of first-degree relatives were found to predict the severity of PTSD symptoms (p = .04, OR = 2.44, 95% CI [1.04, 5.65]; p < .001, OR = 1.98, 95% CI [1.26, 3.06], respectively). Additionally, the YIAT-SF and ISI variables were found to be statistically significant predictors of PTSD symptom severity (p < .001, OR = 1.04, 95% CI [1.01, 1.07]; p < .001, OR = 1.18, 95% CI [1.12, 1.23], respectively).

CONCLUSIONS

It is concluded that the severity of PTSD symptoms in earthquake survivors is associated with the severity levels of insomnia and internet addiction. Additionally, it is determined that experiencing injury or loss of a loved one during the earthquake may increase the severity of PTSD symptoms. To protect earthquake survivors from the risk of PTSD, it may be necessary to provide psychosocial support focussed on positive coping strategies for internet addiction and insomnia.

Posttraumatic stress disorder in the aftermath of the Turkey earthquake: exploring the role of demographics, level of exposure, and personality traits

BACKGROUND AND OBJECTIVES

Post-Traumatic Stress Disorder (PTSD) is an important mental disorder that can develop after mass traumas such as earthquakes. In our study, we aimed to investigate the development of PTSD after the Turkey earthquake (6 February 2023) and its association with some demographic variables, personality traits, and psychological vulnerability.

METHOD

547 participants completed assessments of personality, disaster exposure, and PTSD symptoms. Multiple regression analyses were used to identify predictors of PTSD symptoms.

RESULTS

PTSD scores were higher in women, single people, those with low educational level, those who witnessed someone else's injury or death, those who were injured, and those whose homes were destroyed. Physical injury, conscientiousness, marital status, income, and agreeableness predicted PTSD. Among these variables, physical injury was the strongest predictor of PTSD.

CONCLUSIONS

Psychological vulnerability, conscientiousness, physical injury, employment, witnessing someone else's injury, gender, and emotional stability predicted PTSD score in a significant way. Physical injury, conscientiousness, marital status, income, agreeableness predicted PTSD in a significant way.

The prevalence and risk factors for post-traumatic stress disorder, depression and anxiety among older survivors post-earthquake: A systematic review and meta-analysis

BACKGROUND

The occurrence of PTSD, depression, and anxiety is notably high among older adults following an earthquake. This research aimed to assess the prevalence and determinants of mental health conditions among older survivors after an earthquake.

METHODS

The review was conducted in accordance with the PRISMA process. A comprehensive search was conducted across various databases including PubMed, EMBASE, Web of Science, Scopus, CINAHL, Cochrane Library, SinoMed, China National Knowledge Infrastructure (CNKI), the VIP Database for Chinese Technical Periodicals, and the Wan Fang Database for Chinese Periodicals for studies reporting on the prevalence of PTSD, depression, and anxiety among older survivors post-earthquake. Each database was searched from inception to August 1, 2023 each database, and updated the search on October 1, 2024. The random effects model was employed to conduct meta-analysis, and the I2 index was taken into account to evaluate heterogeneity among studies. A narrative synthesis was performed to identify the risk factors associated with these mental health conditions.

RESULTS

A total of 33 studies were analyzed in this meta-analysis, mainly from China, Japan, Nepal, and Mexico. The prevalence rates of PTSD, depression, and anxiety among older earthquake survivors were found to be 19.3 % (95 % CI [16.0-22.6 %]; I2 = 99.486 %, P = 0.000), 23.5 % (95 % CI [13.9-33.1 %]; I2 = 99.901 %, P = 0.000) and 10.9 % (95 % CI [6.7-15.1 %]; I2 = 99.287 %, P = 0.000), respectively. The identified major risk factors were categorized into four dimensions, including demographic variables (e.g., older age, chronic illness), pre-disaster mitigation variables (e.g., lack of insurance), responding in disaster variables (e.g., being injured, property damage) and post-disaster relief variables (e.g., inadequate psychological care, low levels of social/family support).

LIMITATIONS

The optimal cut-off for different screening tools may be sensitive to changes in the prevalence of older survivors post-earthquake. Furthermore, due to the heterogeneity of the studies, a narrative synthesis of risk factors was conducted.

CONCLUSIONS

The findings of this review may increase the awareness of the burden and risk factors associated with PTSD, depression, and anxiety in older survivors post-earthquake. It serves as a reference for the government in formulating recovery policies focusing on interventions, such as financial allocation, psychological treatment, and insurance claims. These policies aim to mitigate the long-term psychological effects on older survivors and ultimately lower the prevalence of mental health conditions.

Health needs of older people and age-inclusive health care in humanitarian emergencies in low-income and middle-income countries: a systematic review

Health needs of older people in humanitarian settings are poorly documented, negatively affecting the appropriateness of health services they receive. This Review identified the major health needs of older people across humanitarian contexts, including non-communicable diseases and mental health conditions (eg, psychological distress and depression). Barriers to health care of older people included inaccessibility of health-care services; shortage of appropriate health care; insufficient availability of medications and medical equipment; poor geriatric expertise of health-care staff, health policy makers, and health authorities; and age discrimination by health-care personnel. Individual factors included low mobility, poor health literacy, dependence on others for access to care, and self-directed ageism. The participation of older people in shaping health-care services was highlighted as a facilitator of age-inclusive care. Several understudied areas related to the health needs of older people in humanitarian emergencies in low-income and middle-income countries were exposed. We urge governments, academic institutions, humanitarian organisations, and other health-care providers to focus their response and research efforts on the health needs of older people in conflict settings; the health needs of older people in humanitarian emergencies in understudied regions; and on neglected issues such as communicable diseases, cancer, neurocognitive disorders, sexual and reproductive health, genitourinary conditions, and nutrition. The participation of older people in the design, implementation, and evaluation of health-care services is essential to ensure accessibility, appropriateness, and acceptability of care.

Sleep quality and mental health differences following Syria-Turkey earthquakes: A cross-sectional study

BACKGROUND

This study explores the lasting mental health impact of the Syria-Turkey earthquakes in 2023 on a population affected by conflict and trauma. It analyzes pre- and post-event mental health and sleep quality differences, identifying predictors of outcomes.

AIMS

Studying the 2023 Syria-Turkey earthquakes' enduring mental health impact on conflict-affected individuals, this research informs better support and interventions for disaster survivors.

METHODS

This longitudinal, cross-sectional study examined the enduring mental health impact of the Syria-Turkey earthquakes. The present study involved N = 1,413 Syrian survivors, aged 18 years or older, who actively participated by contributing both pre- and post-earthquake data. A meticulously designed digital questionnaire with established metrics assessed sleep disturbances, depressive symptoms, and anxiety levels. Stratification variables (age, gender, education, marital status) were used for subgroup analysis. Arabic versions of PHQ-9, PSQI, and GAD-2 proved reliable for measuring depression, sleep quality, and anxiety.

RESULTS

The majority of participants were female (73.6%) with tertiary education (83.3%). Post-earthquake, a higher percentage reported poor sleep quality (67.7% vs. 59.7%, p < .001) and increased prevalence of MDE (66.1% vs. 56%, p < .001). GAD did not differ significantly. Post-earthquake, women had a higher likelihood of poor sleep quality (OR: 1.58, 95% CI [1.19, 2.10], p < .001) and MDE (OR: 1.55, 95% CI [1.18 to 2.04], p = .003). Predictors varied before and after earthquakes; age and education were significant predictors of poor sleep quality, MDE, and GAD.

CONCLUSION

This study reveals higher rates of poor sleep quality and major depressive episodes among earthquake-affected individuals, especially women. Age, education, and gender contribute to these outcomes. Targeted interventions and comprehensive mental health support are crucial for post-earthquake recovery.

The impact of pandemic-related stress on attentional bias and anxiety in alexithymia during the COVID-19 pandemic

The COVID-19 pandemic had negative consequences for mental health, yet it is unknown how and to what extent the psychological outcomes of this stressful event are moderated by individual traits. Alexithymia is a risk factor for psychopathology, and thus likely predicted individual differences in resilience or vulnerability to stressful events during the pandemic. This study explored the moderating role of alexithymia in the relationships of pandemic-related stress with anxiety levels and attentional bias. The participants were 103 Taiwanese individuals who completed a survey during the outbreak of the Omicron wave. Additionally, an emotional Stroop task including pandemic-related or neutral stimuli was used to measure attentional bias. Our results demonstrate that pandemic-related stress had a lesser impact on anxiety in individuals with a higher level of alexithymia. Moreover, we found that in individuals with higher exposure to pandemic-related stressors, a higher level of alexithymia indicated less attentional bias toward COVID-19-related information. Thus, it is plausible that individuals with alexithymia tended to avoid pandemic-related information, which could temporarily relieve stressors during the pandemic.

Latent classes of posttraumatic stress disorder among survivors of the Bam Earthquake after 17 years

BACKGROUND

The purpose of this study was to identify latent classes of the severity of post-traumatic stress disorder (PTSD) among the survivors of the earthquake in Bam, south-eastern Iran, 17 years after the disaster. The most influential predictor variables of PTSD classes were also investigated.

METHODS

Eight hundred survivors of the Bam earthquake who were at least four years old in that disaster were selected by multistage sampling. The PTSD Checklist-Civilian Version was used. Latent class analysis was performed to identify subgroups of people with different PTSD symptom profiles. Latent class regression analysis was used to explore the influence of demographic and traumatic variables on each class membership.

RESULTS

We found three latent classes of PTSD, with the following profiles emerging: Low Symptom (56.6% of the participants), Moderate Symptom (23.5%), and Severe Symptom (19.9%). Old age [OR = 2.20, 95% CI = (1.46, 3.32)], physical injury [OR = 1.95, 95% CI = (1.24, 3.06)], being trapped under the rubble [OR = 1.81, 95% CI = (1.15, 2.86)], and death of a family member [OR = 1.86, 95% CI = (1.12, 3.09)] were positive risk factors for PTSD and increased the chance of being in classes having more severe symptoms. Having a high educational level was a negative risk factor [OR = 0.86, 95% CI = (0.67, 1.11)].

CONCLUSIONS

The severity of PTSD 17 years after the earthquake shows that natural disasters such as earthquakes have long-term consequences, and earthquake survivors must have psychological support and long term health care. After any catastrophic earthquake, governments should establish psychology and psychotherapy centers for earthquake victims, and these centers should support earthquake victims for a sufficiently long time.

The role of alexithymia and perceived stress in mental health responses to COVID-19: A conditional process model

BACKGROUND

Little is known about the psychological mechanisms underlying the mental health problems related to the COVID-19 pandemic. Hypothetically, perceived stress and alexithymia may be factors involved in the mental distress response to the pandemic; however, this remains largely unstudied. This study aims to explore the moderating role of alexithymia and the moderated mediation effects of perceived stress on the mental health change due to the pandemic.

METHODS

The conditional process model was used to examine the moderated mediation. The sample consists of 659 parents from the FinnBrain Birth Cohort Study who completed the Toronto Alexithymia Scale (TAS-20) at 6 months after delivery, the Edinburgh Postnatal Depression Scale (EPDS) and the Symptom Checklist-90 (SCL-90) at 2 or 4 years postpartum between 2014 and 2019; and a questionnaire for pandemic events, a brief 4-item version of the Perceived Stress Scale (PSS-4) and the follow-up EPDS/SCL-90 in 2020 after 3 months from the outbreak of COVID-19 pandemic in Finland.

RESULTS

Alexithymia moderated the perceived stress-mediated relations between the pandemic events and the changes of depressive and anxiety symptoms through enhancing the detrimental effect of perceived stress on mental health.

LIMITATIONS

This study was mainly limited by the causality and generalizability of the findings.

CONCLUSIONS

Our findings indicate the moderated mediation effects of alexithymia and perceived stress on the psychological symptoms, which has implications for understanding how and when stressful situations translate to mental health problems, identifying vulnerable individuals, and tailoring preventive and psychotherapeutic interventions.

The Association Between Financial Hardship and Mental Health Difficulties Among Adult Wage Earners During the COVID-19 Pandemic in Bangladesh: Findings From a Cross-Sectional Analysis

Background: The ongoing COVID-19 pandemic has created several challenges including financial burdens that may result in mental health conditions. This study was undertaken to gauge mental health difficulties during the COVID-19 pandemic and gain an insight into wage earners' mental health. Method: This cross-sectional study was conducted through an online survey. A t total of 707 individual Bangladeshi wage earners were enrolled between 20 and 30 May 2020. The questionnaire had sections on sociodemographic information, COVID-19 related questions, PHQ-9 and GAD-7 scales. STATA version 14.1 program was used to carry out all the analyses. Results: The study revealed that 58.6 and 55.9% of the respondents had moderate to severe anxiety and depressive symptoms, respectively. The total monthly income was <30,000 BDT (353.73USD) and displayed increased odds of suffering from depressive symptoms (OR = 4.12; 95% CI: 2.68-6.34) and anxiety (OR = 3.31; 95% CI: 2.17-5.03). Participants who did not receive salary income, had no income source during the pandemic, had financial problems, and inadequate food supply and were more likely to suffer from anxiety and depressive symptoms (p ≤ 0.01). Perceiving the upcoming financial crisis as a stressor was a potential risk factor for anxiety (OR = 1.91; 95% CI:1.32-2.77) and depressive symptoms (OR = 1.50; 95% CI:1.04-2.16). Limitations: The online survey method used in this study limits the generalizability of the findings and self-reported answers might include selection and social desirability bias as a community-based survey was not possible during the pandemic. Conclusion: Wage earners in a low resource setting like Bangladesh require mental health attention and financial consideration to deal with mental health difficulties.

Prevalence and risk factors of posttraumatic stress disorder among Chinese shidu parents: A systemic review and meta-analysis

BACKGROUND

Losing the only child is an extremely distressful life event for parents. Previous studies indicated that shidu parents were more vulnerable to develop posttraumatic stress disorder (PTSD). This study aims to calculate the pooled prevalence of PTSD and identify its risk factors.

METHOD

We conducted a systematic literature search in PubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), Wanfang databases, Vip databases. We performed a meta-analysis using random effects models to calculate the pooled PTSD in shidu parents. Associated factors for PTSD was evaluated by determining standardized mean difference (SMD) with 95% CIs. All analyses were performed using the Stata 16.0.

RESULTS

Eight articles (covering 2,722 shidu parents) were included in this study. The pooled prevalence of PTSD was 46.8% (95%CI: 33.2%-60.3%) among Chinese shidu parents. Female (SMD[95%CI]: 0.41[0.20, 0.62]), higher education level (SMD[95%CI]: 0.15[0.03, 0.28]), lower income (SMD[95%CI]: 0.33[0.13, 0.53]), losing a daughter (SMD[95%CI]: 0.16[0.03, 0.28]) and shorter time since loss (SMD[95%CI]: 0.24[0.07, 0.40]) were significantly associated with a higher PTSD prevalence. Registered residence, cause of death, age of the child, and having a grandchild were not associated with PTSD.

LIMITATIONS

Some variables included in this meta-analysis were only measured twice, which limited the conclusions to some extent.

CONCLUSION

This meta-analysis indicated that nearly half of shidu parents experienced PTSD and provided evidence of risk factors for PTSD in shidu parents. Further research is suggested to determine how these factors interact. Effective interventions should be conducted to shidu parents with PTSD.

Mental Health Effects in Primary Care Patients 18 Months After a Major Wildfire in Fort McMurray: Risk Increased by Social Demographic Issues, Clinical Antecedents, and Degree of Fire Exposure

Objectives: To assess prevalence of likely posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD) in patients attending the only out-of-hours primary care clinic in Fort McMurray some 18 months following a major fire. Methods: A quantitative cross-sectional survey was used to collect data through self-administered paper-based questionnaires to determine likely PTSD, MDD, and GAD using the PTSD Checklists for Diagnostic and Statistical Manual (DSM) 5, Patient Health Questionnaire (PHQ) 9, and GAD-7, respectively, from residents of Fort McMurray who were impacted by the wildfires. This was carried out eighteen (18) months after a major wildfire, which required the rapid evacuation of the entire city population (approximately 90,000 individuals). Results: We achieved a response rate of 48% and results from the 290 respondents showed the 1 month prevalence rate for likely PTSD was 13.6%, likely MDD was 24.8%, and likely GAD was 18.0%. Compared to self-reported prevalence rates before the wildfire (0%, 15.2%, and 14.5% respectively), these were increased for all diagnoses. After controlling for other factors in a logistic regression model, there were statistically significant associations between individuals who had likely PTSD, MDD, and GAD diagnoses and multiple socio-demographic, clinical, and exposure-related variables as follows: PTSD: History of anxiety disorder and received counselling had odds ratios (ORs) of 5.80 and 7.14, respectively. MDD: Age, witnessed the burning of homes, history of depressive disorder, and receiving low level support from friends and family had ORs of 2.08, 2.29, 4.63, and 2.5, respectively. GAD: Fearful for their lives or the lives of friends/family, history of depressive disorder, and history of anxiety disorder had ORs of 3.52, 3.04, and 2.68, respectively. There were also associations between individuals with a likely psychiatric diagnosis and those who also had likely alcohol or drug abuse/dependence. Conclusion: Our study suggests there are high prevalence rates for mental health and addiction conditions in patients attending the out-of-hours clinic 18 months after the wildfires, with significant associations between multiple variables and likely PTSD, MDD, and GAD. Further studies are needed to explore the impact of population-based mental health interventions on the long-term mental health effects of the wildfires.

A Meta-Analysis of Risk Factors for Post-Traumatic Stress Disorder (PTSD) in Adults and Children after Earthquakes

PTSD is considered the most common negative psychological reactions among survivors following an earthquake. The present study sought to find out the determinants of PTSD in earthquake survivors using a systematic meta-analysis. Four electronic databases (PubMed, Embase, Web of Science, and PsycInfo) were used to search for observational studies about PTSD following earthquakes. The literature search, study selection, and data extraction were conducted independently by two authors. 52 articles were included in the study. Summary estimates, subgroup analysis, and publication bias tests were performed on the data. The prevalence of PTSD after earthquakes ranged from 4.10% to 67.07% in adults and from 2.50% to 60.00% in children. For adults, the significant predictors were being female, low education level or socio-economic status, prior trauma; being trapped, experiencing fear, injury, or bereavement during the disaster. For children, the significant predictors were being older age, high education level; being trapped, experiencing fear, injury, or bereavement, witnessing injury/death during the earthquakes. Our study provides implications for the understanding of risk factors for PTSD among earthquake survivors. Post-disaster mental health recovery programs that include early identification, on-going monitoring, and sustained psychosocial support are needed for earthquake survivors.

Cognitive appraisal of exposure to specific types of trauma - a study of gender differences

Background

The role of gender in posttraumatic cognitions has increasingly been approached. The current study comparatively evaluates posttraumatic cognitions in men and women exposed to specific nonsexual trauma (motor vehicle accidents, work – related accidents, burns).

Methods

Posttraumatic cognitions and posttraumatic stress symptoms were comparatively assessed in 53 men and 37 women treated in 3 Romanian primary care units after specific accidental trauma. Posttraumatic Cognitions Inventory (PTCI) was used to assess posttraumatic cognitions, and the Short Post-Traumatic Stress Disorder Rating Interview (SPRINT) was used to assess posttraumatic stress symptoms.

Results

Men with significant posttraumatic stress symptoms endorsed more negative cognitions than women. Men with posttraumatic disability more consistently endorsed some negative cognitions regarding instrumentality, strength and control than their female counterparts. Women and men without posttraumatic disability reported similarly low levels of negative posttraumatic cognitions. Time elapsed since trauma increased most negative cognitions in men.

Conclusions

The intensity of PTSD symptoms and presence of posttraumatic disability influence negative cognitions after exposure to accidental trauma. Women experiencing clinically significant PTSD symptoms endorse more cognitions regarding instrumentality, strength and control than male counterparts. Women with permanent disability after trauma report less cognitions involving emotionality, dependence and low self – efficacy than male counterparts. In the absence of permanent posttraumatic disability, men and women endorse similar levels of negative cognitions after accidental trauma. With time elapsed since trauma, men perceive decreasing self – efficacy, problem – solving and emotional control, while women perceive decreasing interpersonal cooperation. Despite limitations (cross-sectional design, lack of normative data for PTCI to ascertain culturally – specific gendered cognitions), this study supports the gender – sensitive approach of accidental trauma, especially when its consequences are pervasive, disabling and increasingly burdensome.

Electronic supplementary material

The online version of this article (10.1186/s12905-017-0468-x) contains supplementary material, which is available to authorized users.

Posttraumatic stress disorder: a serious post-earthquake complication

Abstract Objectives Earthquakes are unpredictable and devastating natural disasters. They can cause massive destruction and loss of life and survivors may suffer psychological symptoms of severe intensity. Our goal in this article is to review studies published in the last 20 years to compile what is known about posttraumatic stress disorder (PTSD) occurring after earthquakes. The review also describes other psychiatric complications that can be associated with earthquakes, to provide readers with better overall understanding, and discusses several sociodemographic factors that can be associated with post-earthquake PTSD Method A search for literature was conducted on major databases such as MEDLINE, PubMed, EMBASE, and PsycINFO and in neurology and psychiatry journals, and many other medical journals. Terms used for electronic searches included, but were not limited to, posttraumatic stress disorder (PTSD), posttraumatic symptoms, anxiety, depression, major depressive disorder, earthquake, and natural disaster. The relevant information was then utilized to determine the relationships between earthquakes and posttraumatic stress symptoms. Results It was found that PTSD is the most commonly occurring mental health condition among earthquake survivors. Major depressive disorder, generalized anxiety disorder, obsessive compulsive disorder, social phobia, and specific phobias were also listed. Conclusion The PTSD prevalence rate varied widely. It was dependent on multiple risk factors in target populations and also on the interval of time that had elapsed between the exposure to the deadly incident and measurement. Females seemed to be the most widely-affected group, while elderly people and young children exhibit considerable psychosocial impact.

Prevalence of probable posttraumatic stress disorder and determination of its relationship with everyday functioning in children and adolescents by using generalized estimating equations

INTRODUCTION

We investigated the prevalence rates for probable PTSD and used generalized estimating equations to identify risk factors for probable PTSD in children and adolescents exposed to the Lushan earthquake.

METHODS

A total of 1623 participants completed 3 assessments, including the Children's Revised Impact of Event Scale, at 2 weeks, 3, and 6 months after experiencing the Lushan earthquake. Additionally, demographic variables and variables related to everyday functioning were evaluated at 2 weeks after the earthquake via a self-constructed questionnaire.

RESULTS

The percentages of children and adolescents who changed from having no PTSD to probable PTSD and probable PTSD to no PTSD at each time point were approximately 8% and 20% of the sample, respectively. The percentage of participants without PTSD increased from 41.1% at the 2-week to 3-month time point to 54.3% at the 3-month to 6-month time point, and the percentage with persistent probable PTSD decreased from 29.6% to 16.4% at the 2 time points, respectively. Female gender, a sedentary lifestyle, and actively helping others were significant risk factors for probable PTSD, whereas initiating communications with others, actively playing with classmates and friends, and the ability to concentrate on academic studies after resuming class were factors that helped protect against probable PTSD.

DISCUSSION

Resistance to PTSD and persistent PTSD symptoms were both common occurrences in child and adolescent survivors. Specific variables related to everyday functioning may be risk factors for probable PTSD. These findings have implications for agencies that provide mental health services after an earthquake.

The effects of spatially varying earthquake impacts on mood and anxiety symptom treatments among long-term Christchurch residents following the 2010/11 Canterbury earthquakes, New Zealand

This study investigates the effects of disruptions to different community environments, community resilience and cumulated felt earthquake intensities on yearly mood and anxiety symptom treatments from the New Zealand Ministry of Health's administrative databases between September 2009 and August 2012. The sample includes 172,284 long-term residents from different Christchurch communities. Living in a better physical environment was associated with lower mood and anxiety treatment rates after the beginning of the Canterbury earthquake sequence whereas an inverse effect could be found for social community environment and community resilience. These results may be confounded by pre-existing patterns, as well as intensified treatment-seeking behaviour and intervention programmes in severely affected areas. Nevertheless, the findings indicate that adverse mental health outcomes can be found in communities with worse physical but stronger social environments or community resilience post-disaster. Also, they do not necessarily follow felt intensities since cumulative earthquake intensity did not show a significant effect.

Social correlates of mental, neurological, and substance use disorders in China and India: a review

Understanding the epidemiological profiles of mental, neurological, and substance use disorders provides opportunities for the identification of high-risk population subgroups and for the development of effective country-specific prevention and intervention strategies. Guided by the Conceptual Framework for Action on the Social Determinants of Health by WHO we reviewed the literature to examine the association between a range of social correlates (eg, sex, age, education, income, urbanicity, marital status, and regional differences) and mental, neurological, and substance use disorders in China and India, the most populous countries in the world. We looked for papers on mental, neurological, and substance use disorders with location identifiers and socioeconomic correlates published between 1990 and 2015 and our search found 65 relevant studies from China and 29 from India. Several association patterns between social correlates and mental, neurological, and substance use disorders were not consistent with those reported in high-income countries, including a high concentration of middle-aged men with alcohol use disorders in China and to a lesser extent in India, and a positive association between being married and depression among women in India. Consistent with previous global reports, low education and poverty were associated with higher occurrence of dementia in both China and India, although there is evidence of an interaction between education and income in the risk for dementia in China. Large variations across regions and ethnic groups were consistently documented in China. These unique correlation patterns for mental, neurological, and substance use disorders identified in China and India emphasise the importance of understanding the local social context when planning targeted strategies to reduce the burden of these disorders. High-quality, up-to-date information about the constantly changing pattern of societal factors correlated with mental, neurological, and substance use disorders is urgently needed to help reduce the large and increasing negative social and economic effects that these conditions are having in China, India, and other low-income and middle-income countries.

Prevalence and Predictors of Somatic Symptoms among Child and Adolescents with Probable Posttraumatic Stress Disorder: A Cross-Sectional Study Conducted in 21 Primary and Secondary Schools after an Earthquake

PURPOSE

To explore the prevalence rates and predictors of somatic symptoms among child and adolescent survivors with probable posttraumatic stress disorder (PTSD) after an earthquake.

METHODS

A total of 3053 students from 21 primary and secondary schools in Baoxing County were administered the Patient Health Questionnaire-13 (PHQ-13), a short version of PHQ-15 without the two items about sexuality and menstruation, the Children's Revised Impact of Event Scale (CRIES), and the self-made Earthquake-Related Experience Questionnaire 3 months after the Lushan earthquake.

RESULTS

Among child and adolescent survivors, the prevalence rates of all somatic symptoms were higher in the probable PTSD group compared with the controls. The most frequent somatic symptoms were trouble sleeping (83.2%), feeling tired or having low energy (74.4%), stomach pain (63.2%), dizziness (58.1%), and headache (57.7%) in the probable PTSD group. Older age, having lost family members, having witnessed someone get seriously injured, and having witnessed someone get buried were predictors for somatic symptoms among child and adolescent survivors with probable PTSD.

CONCLUSIONS

Somatic symptoms among child and adolescent earthquake survivors with probable PTSD in schools were common, and predictors of these somatic symptoms were identified. These findings may help those providing psychological health programs to find the child and adolescent students with probable PTSD who are at high risk of somatic symptoms in schools after an earthquake in China.

Posttraumatic stress disorder and somatic symptoms among child and adolescent survivors following the Lushan earthquake in China: A six-month longitudinal study

OBJECTIVE

To explore somatic conditions in a sample of 2299 child and adolescent survivors of an earthquake and their relationship to posttraumatic stress disorder (PTSD) symptoms.

METHODS

The Children's Revised Impact of Event Scale, the Patient Health Questionnaire (PHQ)-13 scale, a short version of PHQ-15 scale that omits two items involving sexual pain/problems and menstrual problems, and a project-developed questionnaire were administered to participants three and six months after the earthquake.

RESULTS

Among child and adolescent survivors, the prevalence rates of probable PTSD were 37.4 and 24.2% three and six months, respectively, after the earthquake. The most common somatic symptoms were trouble sleeping (58.4 and 48.4%), feeling tired or having low energy (52.0 and 46.1%), and stomach pain (45.8 and 45.4%) after three and six months, respectively. Several specific somatic symptoms evaluated three months after the earthquake including trouble sleeping, headache, and shortness of breath were predictors of the overall PTSD symptoms evaluated six months after the earthquake. Additionally, the symptom of hyperarousal evaluated after three months could predict the overall somatic symptoms evaluated after six months.

CONCLUSIONS

PTSD and somatic symptoms were common after the earthquake, and a longitudinal association between PTSD and somatic symptoms was detected among child and adolescent survivors. These findings have implications in China and possibly elsewhere.

Health-related quality of life for medical rescuers one month after Ludian earthquake

BACKGROUND

An earthquake struck Ludian in Yunnan province of China on August 3, 2014, resulting in 3143 injuries, 617 deaths, and 112 missing persons. Our study aimed at estimating the quality of life and associated determinants among medical rescuers after Ludian earthquake.

METHODS

A cross-sectional survey was performed among personnel from three hospitals that assumed rescue tasks in Ludian earthquake. Descriptive statistics, t-tests, ANOVA and stepwise linear regression analysis were used for data analysis.

RESULTS

The mean scores on the physical component summary (PCS) and mental component summary (MCS) were 49.86 (SD = 6.01) and 35.85(SD = 6.90), respectively. Lower PCS in the aftermath of an earthquake was associated with non-military medical rescuers, elderly age, and being trapped/in danger while lower MSC in the aftermath of an earthquake was associated with non-military medical rescuers, young age, being female, being trapped/in danger and low education degree.

CONCLUSIONS

In conclusion, our study demonstrates that medical rescuers are at risk for a lower HRQoL after exposure to Ludian earthquake. The results of this study help expand our knowledge of health-related quality of life among medical rescuers after the Ludian earthquake.

A meta-analysis of risk factors for combat-related PTSD among military personnel and veterans

Post-traumatic stress disorder (PTSD), a complex and chronic disorder caused by exposure to a traumatic event, is a common psychological result of current military operations. It causes substantial distress and interferes with personal and social functioning. Consequently, identifying the risk factors that make military personnel and veterans more likely to experience PTSD is of academic, clinical, and social importance. Four electronic databases (PubMed, Embase, Web of Science, and PsycINFO) were used to search for observational studies (cross-sectional, retrospective, and cohort studies) about PTSD after deployment to combat areas. The literature search, study selection, and data extraction were conducted by two of the authors independently. Thirty-two articles were included in this study. Summary estimates were obtained using random-effects models. Subgroup analyses, sensitivity analyses, and publication bias tests were performed. The prevalence of combat-related PTSD ranged from 1.09% to 34.84%. A total of 18 significant predictors of PTSD among military personnel and veterans were found. Risk factors stemming from before the trauma include female gender, ethnic minority status, low education, non-officer ranks, army service, combat specialization, high numbers of deployments, longer cumulative length of deployments, more adverse life events, prior trauma exposure, and prior psychological problems. Various aspects of the trauma period also constituted risk factors. These include increased combat exposure, discharging a weapon, witnessing someone being wounded or killed, severe trauma, and deployment-related stressors. Lastly, lack of post-deployment support during the post-trauma period also increased the risk of PTSD. The current analysis provides evidence of risk factors for combat-related PTSD in military personnel and veterans. More research is needed to determine how these variables interact and how to best protect against susceptibility to PTSD.

General Health Among Parents Who Lost Their Children in the Bam Earthquake

AIM

Bam earthquake and its profound tragedy of thousands killed has caused emotional and psychological trauma for tens of thousands of people who have survived. This study aimed to investigate general health of parents who lose their children in Bam earthquake 10 years after the earthquake.

METHOD

General health of 166 parents who lost their children in Bam earthquake was assessed using a translated version of General Health Questionnarie-28 items.

RESULTS

The mean score of GHQ was 25.63±15.28. Among all domains, the higher mean score belonged to the category of "anxiety/insomnia" and the lower one belonged to the category of "severe depression". The results revealed significant correlation between total GHQ mean score and gender as well as educational level (0.003).

CONCLUSION

Providing reflective narrative environments in which survivors can express their own experiences and feelings about earthquake, their loss and how they cope with it seems to be as an effective approach to identify their psychosocial situation and its influential factors. In such narrative environments special attention should be given to older participants, females and those who are single.

A meta-analysis of risk factors for depression in adults and children after natural disasters

Background

A number of studies have shown a range of negative psychological symptoms (e.g. depression) after exposure to natural disasters. The aim of this study was to determine risk factors for depression in both children and adults who have survived natural disasters.

Methods

Four electronic databases (PubMed, Embase, Web of Science, and PsychInfo) were used to search for observational studies (case–control, cross-sectional, and cohort studies) about depression following natural disasters. The literature search, study selection, and data extraction were conducted independently by two authors. Thirty-one articles were included in the study, of which twenty included adult participants and eleven included child participants. Summary estimates were obtained using random-effects models. Subgroup analysis, sensitivity analysis, and publication bias tests were performed on the data.

Results

The prevalence of depression after natural disasters ranged from 5.8% to 54.0% in adults and from 7.5% to 44.8% in children. We found a number of risk factors for depression after exposure to natural disasters. For adults, the significant predictors were being female ;not married;holding religious beliefs; having poor education; prior trauma; experiencing fear, injury, or bereavement during the disaster; or losing employment or property, suffering house damage as a result of the disaster. For children, the significant predictors were prior trauma; being trapped during the disaster; experiencing injury, fear, or bereavement during the disaster; witnessing injury/death during the disaster; or having poor social support.

Conclusions

The current analysis provides evidence of risk factors for depression in survivors of natural disasters. Further research is necessary to design interventions to improve the mental health of survivors of natural disasters.

Psychological consequences and associated risk factors among adult survivors of the 2008 Wenchuan earthquake

BACKGROUND

In 2008, a devastating earthquake measuring 8.0 on the Richter scale struck Wenchuan, China. Following this disaster, several studies were conducted which assessed the degree of mental disorders in the affected population, but very few considered that several disorders may occur at the same time. This paper aims to investigate the psychological effects and risk factors among adult survivors one-year after the earthquake event.

METHODS

2080 adult earthquake survivors from 19 counties in the affected areas were interviewed. A stratified sampling strategy was used to collect the information. Earthquake survivors completed self-report questionnaires, which included a post-traumatic stress disorder (PTSD) checklist, a self-rating depression scale and a self-rating anxiety scale.

RESULTS

Fifty nine percent of the participants were male. The prevalence of probable PTSD in the sample was 40.1% (based on the DSM-IV criteria). Significant differences in the demographic variables were found in the levels of anxiety, depression, and PTSD. Anxiety levels were found to be positively correlated with depression (r = 0.438, p < 0.01) and PTSD (r = 0.322, p < 0.01). Risk factors for each symptom were also identified. Being female, having a low income level and having a low perceived level of social support were found to be the risk factors associated with anxiety, depression, and PTSD. There appeared to be no obvious relationship between the distance from the epicenter of the earthquake event and the severity of the psychological problems.

CONCLUSIONS

PTSD, anxiety, and depression were prevalent among the survivors. Most findings on the predictors were found to be consistent with current research. Positive adjustment and social support were found to be needed for the highest-risk population.