1
|
Cerna-Turoff I, Casey JA, Keyes K, Rudolph KE, Malinsky D. Longitudinal patterns of natural hazard exposures and anxiety and depression symptoms among young adults in four low- and middle-income countries. Sci Rep 2024; 14:10538. [PMID: 38719874 PMCID: PMC11078992 DOI: 10.1038/s41598-024-60106-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 04/18/2024] [Indexed: 05/12/2024] Open
Abstract
We estimated the effect of community-level natural hazard exposure during prior developmental stages on later anxiety and depression symptoms among young adults and potential differences stratified by gender. We analyzed longitudinal data (2002-2020) on 5585 young adults between 19 and 26 years in Ethiopia, India, Peru, and Vietnam. A binary question identified community-level exposure, and psychometrically validated scales measured recent anxiety and depression symptoms. Young adults with three exposure histories ("time point 1," "time point 2," and "both time points") were contrasted with their unexposed peers. We applied a longitudinal targeted minimum loss-based estimator with an ensemble of machine learning algorithms for estimation. Young adults living in exposed communities did not exhibit substantially different anxiety or depression symptoms from their unexposed peers, except for young women in Ethiopia who exhibited less anxiety symptoms (average causal effect [ACE] estimate = - 8.86 [95% CI: - 17.04, - 0.68] anxiety score). In this study, singular and repeated natural hazard exposures generally were not associated with later anxiety and depression symptoms. Further examination is needed to understand how distal natural hazard exposures affect lifelong mental health, which aspects of natural hazards are most salient, how disaster relief may modify symptoms, and gendered, age-specific, and contextual differences.
Collapse
Affiliation(s)
- Ilan Cerna-Turoff
- Mailman School of Public Health, Department of Environmental Health Sciences, Columbia University, New York City, NY, USA.
| | - Joan A Casey
- Mailman School of Public Health, Department of Environmental Health Sciences, Columbia University, New York City, NY, USA
- School of Public Health, Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Katherine Keyes
- Mailman School of Public Health, Department of Epidemiology, Columbia University, New York City, NY, USA
| | - Kara E Rudolph
- Mailman School of Public Health, Department of Epidemiology, Columbia University, New York City, NY, USA
| | - Daniel Malinsky
- Mailman School of Public Health, Department of Biostatistics, Columbia University, New York City, NY, USA
| |
Collapse
|
2
|
Wang Y, Ge F, Zhang J, Zhang W. Heterogeneity in the co-occurrence of depression and anxiety symptoms among youth survivors: A longitudinal study using latent profile analysis. Early Interv Psychiatry 2021; 15:1612-1625. [PMID: 33398928 DOI: 10.1111/eip.13101] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 10/29/2020] [Accepted: 12/13/2020] [Indexed: 02/05/2023]
Abstract
AIM Depression and anxiety are both common psychological outcomes triggered via trauma-related experience. The current study aimed to identify the prevalence of depression and anxiety among youth survivors, explore the heterogeneity patterns of depression and anxiety symptoms in the chronic phase, and integrate early available information to predict patterns. METHODS The study is a longitudinal study conducted at 2 weeks and 12 months after the Lushan earthquake. Finally, 1725 children and adolescents' survivors who accomplished both two-time stages assessments were included. The heterogeneous patterns of depression and anxiety symptoms assessed by latent profile analysis (LPA) were used to predict heterogeneity patterns of depression and anxiety symptoms by early attained variables. RESULTS A three-class solution characterized mild depression/mild anxiety (64.3%), moderate depression/moderate anxiety (25.9%), and high depression/high anxiety (9.8%) parallel patterns was the most suitable model in our research. Demographic characteristics, earthquake-related exposures, sleep, and somatic symptoms were variables that can be used to predict the parallel profiles. CONCLUSIONS Detection of heterogeneity patterns, especially for youth survivors at high risk, based on the self-reported measurement attained at the early stage, is feasible. Our study may promote operational strategies by enabling targeted intervention.
Collapse
Affiliation(s)
- Yue Wang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Fenfen Ge
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Jun Zhang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Wei Zhang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China.,West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
3
|
Gao R, Chan SKW, Zhang BZ, Lin JX, Peng SR, Yang CG, Tian GJ, Bai JZ, Xu LX, Li YH, Zheng ZJ, Pu DS, Chan CLW, Ran MS. An epidemiological survey of mental disorders 5 years after the Lushan earthquake in Ya'an, China. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1263-1272. [PMID: 33146858 DOI: 10.1007/s00127-020-01974-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 10/24/2020] [Indexed: 12/20/2022]
Abstract
PURPOSE This study aimed to (1) explore the prevalence and relevant influencing factors of different mental disorders 5 years after the Lushan earthquake in Ya'an, China. METHODS An epidemiological mental health survey was conducted to identify the prevalence of mental disorders in general population in Ya'an. A multi-stage, group-matching random sampling method was adopted. Face-to-face interviews were done with a two-stage design by trained interviewers and psychiatrists. The 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) was used for the diagnosis. RESULTS There were 8876 participants who were interviewed in this study. The total 12-month and lifetime prevalence of all mental disorders were 12.5% and 14.7%, respectively. There was a significant difference between males and females in the prevalence patterns of several mental disorders. Han ethnic group had higher prevalence of anxiety disorders (2.7%), and the Tibetan group had higher prevalence of alcohol-related disorders (5.0%). Logistic regression analysis showed that the areas severely affected by the earthquake had significantly higher prevalence of depressive disorders, and the extremely severe affected areas had significantly higher prevalence of trauma- and stressor-related disorders. CONCLUSION Our findings show that the prevalence of a range of mental disorders 5 years after the earthquake in Ya'an are high, and the prevalence of depressive and trauma- and stressor-related disorders may be influenced differently by the various severity of earthquake impact. This study may be crucial for the health policy-making, cultural-specific mental health services and long-term mental recovery after the earthquake.
Collapse
Affiliation(s)
- Ru Gao
- Ya'an Fourth People's Hospital, Ya'an, 625000, Sichuan, China
| | | | - Bing-Zhi Zhang
- Ya'an Fourth People's Hospital, Ya'an, 625000, Sichuan, China
| | - Jing-Xia Lin
- School of Nursing, University of Hong Kong, Hong Kong SAR, China
| | - Shu-Rong Peng
- Ya'an Fourth People's Hospital, Ya'an, 625000, Sichuan, China
| | - Chuan-Gang Yang
- Ya'an Fourth People's Hospital, Ya'an, 625000, Sichuan, China
| | - Guo-Jiao Tian
- Ya'an Fourth People's Hospital, Ya'an, 625000, Sichuan, China
| | - Jing-Zhen Bai
- Ya'an Fourth People's Hospital, Ya'an, 625000, Sichuan, China
| | - Liu-Xiu Xu
- Ya'an Fourth People's Hospital, Ya'an, 625000, Sichuan, China
| | - Yu-Hui Li
- Ya'an Fourth People's Hospital, Ya'an, 625000, Sichuan, China
| | - Zai-Jiang Zheng
- Ya'an Fourth People's Hospital, Ya'an, 625000, Sichuan, China
| | - Dao-Sheng Pu
- Ya'an Fourth People's Hospital, Ya'an, 625000, Sichuan, China
| | - Cecilia Lai-Wan Chan
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China.
| |
Collapse
|
4
|
Qi J, Yang X, Tan R, Wu X, Zhou X. Prevalence and predictors of posttraumatic stress disorder and depression among adolescents over 1 year after the Jiuzhaigou earthquake. J Affect Disord 2020; 261:1-8. [PMID: 31590064 DOI: 10.1016/j.jad.2019.09.071] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 09/19/2019] [Accepted: 09/29/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND On August 8, 2017, a 7-magtitude earthquake struck Jiuzhaigou County in Sichuan, China. This was the third devastating earthquake in that province. The prevalence and predictors of posttraumatic stress disorder (PTSD), depression, and comorbid PTSD/depression among adolescents were unclear after the Jiuzhaigou earthquake. METHODS Participants were 1241 adolescent survivors in Jiuzhaigou. Data were collected using the PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and the Chinese version of the Center for Epidemiologic Studies Depression Scale for Children. RESULTS In total, 46.3% of participants reported PTSD, 64.5% reported depression, and 39.2% reported comorbid PTSD/depression symptoms. Risk factors for symptoms of these disorders were being female, having been injured or trapped, and intrusive rumination. High school students were less likely to report PTSD and comorbid PTSD/depression than middle school students. Participants with family members/friends that were injured or trapped reported more PTSD and comorbid symptoms than those without this experience. Loss of property also predicted PTSD. However, deliberate rumination was a protective factor for depression. LIMITATIONS This study did not cover all adolescents in Jiuzhaigou and all potential predictors. As we used a cross-sectional design, this study could not assess the trajectory of PTSD, depression, and comorbid symptoms after the earthquake. CONCLUSION The findings are meaningful for mental health care among adolescents after natural disasters such as an earthquake.
Collapse
Affiliation(s)
- Junjun Qi
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, 310028, China
| | - Xima Yang
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, 310028, China
| | - Ruyue Tan
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, 310028, China
| | - Xinchun Wu
- Beijing Key Laboratory of Applied Experimental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, 100875, China
| | - Xiao Zhou
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, 310028, China.
| |
Collapse
|
5
|
Abstract
PURPOSE OF REVIEW This paper reviews recent research on the depression in young people following exposure to catastrophic stresses such as disasters, terrorism and political violence. RECENT FINDINGS Depression is one of the commonest outcomes following mass trauma, for all ages including children and adolescents. Recent articles continue to report high prevalence of depression which often continues for years. It is often comorbid with other psychiatric disorders, especially PTSD. Post-traumatic depression in children and adolescence affects purpose of life, impairs scholastic achievements, increases suicidality and has extensive comorbidity. Besides the trauma, individual constructs, personality factors, social support, exposure to other traumatic events are some of the predicting factors. Biological and genetic basis of post-traumatic depression has been reported. Studies suggest some benefit to psychotherapeutic interventions such as trauma-focussed cognitive behavioural therapy and web-based therapy. A considerable proportion of youths develop depression following mass traumatic events. More research is required regarding the effectiveness of interventions in this population.
Collapse
Affiliation(s)
- Nilamadhab Kar
- Black Country Partnership NHS Foundation Trust, Steps to Health, Showell Circus, Low Hill, Wolverhampton, WV10 9TH, UK.
| |
Collapse
|
6
|
Du N, Zhou P, SiTu MJ, Zhu CZ, Huang Y. Post-traumatic stress disorder and depression symptoms of adolescents survived from a seriously-hit area in China: A 3-year follow-up study. Psychiatry Res 2019; 273:288-295. [PMID: 30677716 DOI: 10.1016/j.psychres.2019.01.063] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Revised: 01/06/2019] [Accepted: 01/15/2019] [Indexed: 02/05/2023]
Abstract
The objective of this study is to analyze the prevalence of probable PTSD and depression after earthquake and to find the risk factors. Adolescents having experienced an earthquake were recruited (n = 330) and assessed within 1 month of the trauma. Follow-up surveys were conducted 12 months, 24 months and 36 months later, respectively. Symptoms were assessed by the Children's Revised Impact of Event Scale and the Depression Self-Rating Scale for Children. Results indicate that the prevalence of probable PTSD in different stages was 42.2%, 20.1%, 30.3% and 11.2%. The corresponding rate of depression was 32.3%, 20.7%, 31.0% and 30.3%. The sub-symptoms of PTSD, intrusion and arousal, tended to decrease at the 1st year, followed by a rebound at the 2nd year, then dropping again at the 3rd year. The avoidance showed a consistent diminishing. The PTSD symptoms were significantly associated with gender and the degree of earthquake exposure. However, the gender, family relationship and despair played crucial roles in the development of depressive symptoms. Despite of the tendency of timing abatement, the prevalence of probable PTSD and depression might show rebound at the second year, which remind us a vital threshold for psychological intervention.
Collapse
Affiliation(s)
- Na Du
- Department of Psychiatry, the fourth people's hospital of ChengDu, ChengDu city, SiChuan 610000, China.
| | - Peng Zhou
- Department of Emergency, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Ming-Jing SiTu
- Department of Psychiatry, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Cui-Zhen Zhu
- Department of Clinical Psychology, the second people's hospital, Wannan Medical College, WuHu city, AnHui 241000, China
| | - Yi Huang
- Department of Psychiatry, West China Hospital, Sichuan University, Chengdu 610041, China
| |
Collapse
|
7
|
Moosavi S, Nwaka B, Akinjise I, Corbett SE, Chue P, Greenshaw AJ, Silverstone PH, Li XM, Agyapong VIO. 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. Front Psychiatry 2019; 10:683. [PMID: 31620033 PMCID: PMC6760025 DOI: 10.3389/fpsyt.2019.00683] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 08/23/2019] [Indexed: 11/13/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- Shahram Moosavi
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Bernard Nwaka
- Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Idowu Akinjise
- Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Sandra E Corbett
- Department of Psychiatry, Northern Lights Regional Health Centre, Fort McMurray, AB, Canada
| | - Pierre Chue
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Andrew J Greenshaw
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Peter H Silverstone
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Xin-Min Li
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Vincent I O Agyapong
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| |
Collapse
|
8
|
Zhou X, Zhen R, Wu X. Trajectories of academic burnout in adolescents after the Wenchuan earthquake: A latent growth mixture model analysis. SCHOOL PSYCHOLOGY INTERNATIONAL 2018. [DOI: 10.1177/0143034318810318] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Changes in academic burnout in adolescents have attracted much research attention; however, most studies assume that adolescent academic burnout is characterized by overall homogenous change and overlook the heterogeneity of burnout change. To address this issue, this study examined distinct latent trajectories of academic burnout in adolescents following the Wenchuan earthquake, China. Adolescents were surveyed at 1 (T1), 1.5 (T2), 2 (T3), and 2.5 years (T4) after the earthquake. Self-reported questionnaires were administered to 391 participants aged 12- to 19-years-old. The results identified three academic burnout trajectories: Increasing (3.9%), low (85.4%), and decreasing (10.7%). Additionally, intrusive post-traumatic stress disorder (PTSD) symptoms were more likely in the increasing group, avoidance PTSD symptoms were more likely in the decreasing group, and PTSD hyperarousal symptoms were more likely in the decreasing group, but less likely in the increasing group. These findings indicate that adolescents experienced heterogeneous academic burnout changes following the earthquake.
Collapse
Affiliation(s)
| | - Rui Zhen
- Hangzhou Normal University, China
| | | |
Collapse
|
9
|
Reduced Recovery of Depression in Female T Allele Carriers of TNF-RII rs1061622 at Earlier Stage after Wenchuan Earthquake. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15061075. [PMID: 29799484 PMCID: PMC6025417 DOI: 10.3390/ijerph15061075] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 05/19/2018] [Accepted: 05/21/2018] [Indexed: 12/19/2022]
Abstract
Objective: The aim of current study was to explore longitudinally the prevalence, severity, potential factors, and predictors of depression among Chinese Han adolescent survivors with different genotypes of tumor necrosis factor receptor-II (TNF-RII) rs1061622 after the 2008 Wenchuan earthquake. Method: TNF-RII rs1061622 variants were examined by polymerase chain reaction–restriction fragment length polymorphism and verified by DNA sequencing. Depression symptoms were assessed by Beck Depression Inventory (BDI) among 439 high school students at 6, 12, and 18 months after the earthquake. Results: No significant differences were observed in depression prevalence and BDI scores between the TT homozygotes and the G allele carriers in both the male and female subjects. However, the female TT homozygotes had a higher depression prevalence than the male TT homozygotes at 6, 12, and 18 months, whereas the female G allele carriers had a higher depression prevalence than the male G allele carriers only at 6 and 12 months after the earthquake. Moreover, BDI scores declined in the male subjects with both genotypes and only in the female G allele carriers at 12 months when compared with those at 6 months. Furthermore, the predictors of depression severity or potential factors of depression prevalence were different between the G allele carriers and the TT homozygotes at different times after the earthquake. Conclusion: It is concluded that the association of TNF-RII rs1061622 with depression is longitudinally different in Chinese Han adolescents after the 2008 Wenchuan earthquake. The T allele may be associated with reduced recovery of depression in female adolescents in the earlier stage of depression rehabilitation.
Collapse
|
10
|
|