Post-Traumatic Stress Disorder Symptoms Among Children of Kathmandu 1 Year After the 2015 Earthquake in Nepal

The psychological impact of the Turkey-Syria earthquake on children: addressing the need for ongoing mental health support and global humanitarian response

This letter aims to explore the potential impact of the Turkey-Syria earthquake on the psychological well-being of the affected children and adolescents. It emphasises the crucial importance of prompt identification and management of emerging mental health disorders in this vulnerable population. The letter draws on existing research evidence to highlight the need for suitable mental health interventions to mitigate the anticipated suffering of many children and adolescents affected by the earthquake. A comprehensive overview of the mediating factors which may play a role in the extent of the impact of an earthquake on the mental health of children is discussed. A range of appropriate strategies and interventions are recommended and the call for continued global support is renewed. We have concluded that major earthquakes can potentially contribute to the development of mental health disorders among children and adolescents. However, by providing timely and effective support, it is possible to prevent long-term psychological consequences and facilitate early recovery. We propose the urgent implementation of effective mental health interventions in the aftermath of the Turkey-Syria earthquake to foster the recovery and resilience of the affected young population.

Children's psychosocial state after the 2018 Lombok earthquake

Background

The current earthquake disaster in Lombok, Indonesia, in July 2018 has caused 564 deaths, and 445.343 were evacuated to refugee camps, including children. Disasters have the potential in resulting short-and long-term effects on the psychological functioning, emotional adjustment, health, and developmental trajectory of children. Nurses play a significant role when a disaster occurs. One of the nurses' roles is to give a traumatic healing intervention to the victims.

Objective

This study sought to assess children's psychosocial state after the 2018 Lombok earthquake.

Methods

A total of 189 children from five regencies in Lombok were selected to participate in the study using accidental sampling. Data were collected using the Strengths and Difficulties Questionnaire (SDQ). Descriptive statistics and cross-tabulation were used for data analysis.

Results

The participants consisted of 98 girls (51.9%) and 91 boys (48.1%), with the majority (n = 142 [75.1%]) being from school-aged children. The SDQ results showed that most of the children were at the abnormal stage for difficulties (n = 103 [54.5%]), and most of them were at a normal stage for strength (n = 97 [51.3%]). The cross-tabulation analysis revealed that gender might influence the SDQ score for the strength (p = 0.034), but not for difficulties (p = 0.482). However, age did not have a correlation with SDQ score, either for strength (p = 0.475) or difficulties (p = 0.836), respectively.

Conclusion

The study found that children in Lombok generally displayed positive behavior and emotional progress after the earthquake. However, some children remained in distress and thus required more observation from parents or other social welfare agencies. This research may help nurses decide on their nursing care for children who experience disasters.

Post-earthquake Self-Reported Depressive Symptoms and Post-Traumatic Stress Disorder and their Correlates among College-Youths in Kathmandu, Nepal

Exposure to earthquake has previously been associated with adverse mental health outcomes, however, evidence is limited among youth in resource-limited settings. This study explored the association of retrospective extent of exposure on current day depressive symptoms and post-traumatic stress disorder (PTSD) symptoms among 125 youth attending a college in Kathmandu, Nepal. A self-administered survey including socio-demographic variables, scale for earthquake exposure and Nepali language validated standardized scales for depressive and PTSD symptoms was used. Prevalence estimates for depressive symptoms was 43.2% and PTSD symptoms was 19.2%. For each increasing unit of the extent of earthquake exposure, the odds of having depressive symptoms increased by a factor of 1.26 (p = 0.001) and PTSD symptoms increased by a factor of 1.26 (p = 0.002). Being in a complicated romantic relationship increased the odds of both depressive symptoms and PTSD symptoms. Exposure to earthquake is an important factor to consider while assessing depressive and PTSD symptoms among youth earthquake survivors in Kathmandu. It is important that programs or policies aimed at youth mental health concurrently address disaster exposures.

Connecting Crises: Young People in Nepal Reflecting on Life Course Transitions and Trajectories during Times of Uncertainty

During certain crises, displacement of populations seeking safe refuge elsewhere can occur without the certainty of a return, if at all. Children and young people in such contexts often face the additional challenge of restrictions or disregard towards engaging their agency in migration decision-making processes. Through 60 in-depth interviews with 30 trans-Himalayan participants (ages of 16–23) and multi-sited ethnography throughout Nepal, this paper investigates multiple experiences of crises experienced by young people and the effects on their life course trajectories. From focusing on the Civil War in 1996–2006, the 2015 earthquake, and most recently the COVID-19 pandemic, this paper proposes that initial displacements from the Civil War, when connected with other crises later on in a participant’s life course, better prepared them to deal with crises and enabled them to create a landscape of resilience. Furthermore, a landscape of resilience that connects past and present life course experiences during crises prepared some participants for helping their larger communities alleviate certain crises-related tension. Overall, this paper extends analysis on an under-researched group of young migrants by connecting crises that shaped their (im)mobility and life trajectories, rather than approaching crises as singular, isolated experiences.

Posttraumatic Stress and Depression in the Aftermath of Environmental Disasters: A Review of Quantitative Studies Published in 2018

PURPOSE OF REVIEW

As interest in the mental health consequences of environmental disasters increases, this review aimed to summarize peer-reviewed studies published in 2018 on posttraumatic stress disorder (PTSD) and depression symptoms after such events.

RECENT FINDINGS

Notable trends in the past year of research included studies focusing on vulnerable populations (e.g., persons with preexisting physical health conditions), assessing the cumulative impact of exposure to multiple disasters, exploring pathway leading to PTSD and depression symptoms, and evaluating the effectiveness of post-disaster interventions. Over 100 articles were identified, focused on 40 disasters that occurred between 1982 and 2017. Prevalence estimates ranged from 0 to 70.51% for PTSD and 1.9 to 59.5% for depression. Consistent predictors of adverse outcomes included female gender, socioeconomic disadvantage, high disaster exposure, and low psychosocial resources. Further research that expands upon recent advances in the literature is critical given the large proportion of the world's population exposed to disasters and the increasing incidence of such events.

Adolescents' perspectives on the psychological effects of natural disasters in China and Nepal

Adolescents are disproportionately represented in nations vulnerable to humanitarian crises. The mental health effects of exposure to trauma are significant, but evidence concerning the experience of disaster-affected adolescents in Asia is limited. The current study aimed to investigate expressions of psychological distress and behavioral effects of exposure to natural disasters among adolescents in China and Nepal. Key informant interviews and focus group discussions were conducted with adolescents, caregivers, teachers and experts in disaster-affected districts of Yunnan Province, China (n = 79), and Kathmandu Valley, Nepal (n = 62). Open coding and thematic content analysis were employed to examine themes within the data. Indicators of distress were categorized in four domains that reflected expressions of anxiety and stress, mood difficulties, somatic complaints, and behavioral changes for adolescent disaster survivors. Differential reports of psychological concerns by gender were evident in Nepal but not China. Post-traumatic growth and strengthened connections between adolescents and their families were described in both settings. The findings complement similar reports from disaster-affected populations globally that have highlighted cross-cultural elements manifest in adolescents' descriptions of distress. Sustainable mental health services that are sensitive to adolescents' experiences of trauma and their unique capabilities will be a necessary component of long-term rehabilitation following disasters.

Epidemiological Characteristics and Risk Factors of Posttraumatic Stress Disorder in Chinese Children After Exposure to an Injury

OBJECTIVE

The aim of this study is to describe the risk factors of injured children's posttraumatic stress disorder (PTSD) in China and provide the scientific data for PTSD prevention and control in children.

METHODS

Electronic databases, including Medline, Science Direct, Google Scholar, and CNKI (China National Knowledge Infrastructure), were searched for articles published on or before October 30, 2018, searching for the words, "PTSD," "child"/"children," "injury"/"injuries," and "China"/"Chinese." Forty-seven articles met the inclusion criteria and were meta-analyzed using random-effect models.

RESULTS

The total sample size in our meta-analysis was 65 298, and there were 13 402 children diagnosed with PTSD. The prevalence of PTSD after suffering from injury was 20.52% (95% CI = 17%-23%). PTSD occurrence was higher in girls than boys (24.61% vs 19.36%, P < 0.001). The PTSD rate for students was 51.82%, 37.12%, and 14.02% in senior, junior high school children, and primary school student, respectively. PTSD prevalence was 58.93% in rural children and higher than the urban children (57.36%). The prevalence of PTSD in ethnic minority children was significantly higher than that of Han Chinese children (35.38% vs 13.50%).

CONCLUSION

PTSD in injured children is significantly higher in girls, senior high school children, in rural areas, and in ethnic minority children. PTSD prevention and control should be focused on these 4 subgroups.

Child and adolescent mental health problems in Nepal: a scoping review

Introduction

Globally, 10–20% of children and adolescents suffer from mental disorders, with half of all them starting by the age of 14 and three-quarters before the age of 25. In Nepal, 40% of the population is younger than 18 years of age, and as such there is a large proportion of the population that is at risk of developing a mental disorder. There has been a recent recognition of child and adolescent mental health problems in Nepal, although prior to this it had remained almost invisible on the health agenda. In response to growing concern, there is a need to conduct a review on children and adolescent mental health problems in Nepal.

Objective

To review the existing studies on child and adolescent mental health problems in Nepal.

Methodology

A scoping review approach was used to identify studies on child and adolescent mental problems in Nepal. A search of Medline and PubMed databases for articles published from the database inception to August 2018 was conducted.

Results

Ten papers were identified, and they all together included 7876 participants. Two studies reported on Post traumatic Stress Symptoms (PTSS) and described a prevalence of 10.7% to 51% of earthquake-affected children and adolescents in the Kathmandu district of Nepal. Another study reported that 53.2% of former child soldiers met the cut-off score for PTSS. Two school surveys found that the prevalence of emotional and behavioural problems in school children ranged between 12.9 and 17.03%, whereas a study on emotional and behavioural disorders in homeless children reported a prevalence of 28.6%. The prevalence of Autism Spectrum Disorder (ASD) was estimated to be as high as three in every 1000 persons in Nepal by one study. The clinical prevalence of anxiety disorders was reported ranging from 18.8% to 24.4% while that of Attention Deficit Hyperactivity Disorder (ADHD) was 10–11.7% in various clinical samples of children and adolescents.

Conclusion

Only a few studies on the prevalence of child and adolescent mental health in Nepal have been conducted. Clearly, there is a need for better study design and larger studies to understand more fully the prevalence of child and adolescent mental health disorders in Nepal, in order to adequately plan public health services accordingly.

Electronic supplementary material

The online version of this article (10.1186/s13033-019-0310-y) contains supplementary material, which is available to authorized users.

The Prevalence of PTSD Symptoms and Depressive Symptoms and Related Predictors in Children and Adolescents 3 Years After the Ya'an Earthquake

The objectives of this study were to investigate the prevalence of post-traumatic stress disorder (PTSD) symptoms and depressive symptoms in teenage survivors three years after the Ya'an earthquake to assess the differences between left-behind (LBC) and non-left-behind (non-LBC) children, and to explore predictors for PTSD symptoms and depressive symptoms. The participants were assessed using children's revised impact of event scale (CRIES) and short mood and feelings questionnaire (SMFQ), after which t tests, Chi square tests, and a multivariate logistic regression were conducted to examine the differences in the LBC and identify the associated predictors. It was found that the PTSD and depressive symptom prevalences were 13.10% and 20.75%, with the LBC having a significantly higher prevalence than the non-LBC. The PTSD and depression symptoms tended to be highly comorbid (r = .52, p < .001). Being female, being aged less than 15, having siblings, being an LBC, and having higher exposure were found to be associated with PTSD and depressive symptoms.

Earthquake exposures and mental health outcomes in children and adolescents from Phulpingdanda village, Nepal: a cross-sectional study

BACKGROUND

Mental health issues can reach epidemic proportions in developed countries after natural disasters, but research is needed to better understand the impact on children and adolescents in developing nations.

METHODS

A cross-sectional study was performed to examine the relationship between earthquake exposures and depression, PTSD, and resilience among children and adolescents in Phulpingdanda village in Nepal, 1 year after the 2015 earthquakes, using the Depression Self-Rating Scale for Children, Child PTSD Symptom Scale, and the Child and Youth Resilience Measure, respectively. To quantify exposure, a basic demographic and household questionnaire, including an earthquake exposure assessment tool for children and adolescents, was created.

RESULTS

Of the 62 respondents interviewed, 3.23% and 4.84% displayed symptomatology of depression and PTSD. A large number of respondents interviewed scored high for resiliency (80.65%). All 62 respondents were displaced from their household and witnessed severe damage of both their homes and village. The number of earthquake exposures had a strong, positive correlation with PTSD symptomatology.

CONCLUSIONS

Although the number of respondents who showed signs of depression and PTSD symptomatology was lower than anticipated, resilience scores were considerably higher. Future research should explore which protective factors may contribute to high resiliency in Nepali children and adolescents.