INTRODUCTION
Compared with other natural disasters, earthquakes are unpredictable and disastrous, usually disposing the residents of the affected area to life-threatening danger. After a disastrous earthquake, both the destroyed infrastructure and the mental health of the affected residents need recovery. In the past several years, destructive earthquakes smashed Wenchuan and Ya’an, two cities of Sichuan, a province in Southwestern China.[1-3] The earthquakes, measuring higher than 7 on the Richter Scale, deprived tens of thousands people of their lives, and left millions of people with various physical and mental injuries.[4,5] According to a systematic review on mental health and psychosocial consequences of natural disasters in Southeast Asia, the reported rates of post-traumatic stress disorder (PTSD) symptoms following natural disasters range widely from 8.6% to 57.3%.[2]
One year after the Wenchuan earthquake, serious mental health problems among the aged survivors triggered social attention. The prevalence of anxiety and depression indicated that PTSD had become a social problem in areas struck by earthquakes.[6,7] In April 2013, five years after the Wenchuan earthquake, Ya’an, another city in Sichuan Province, was also hit by an earthquake, which not only had a serious impact on the lives of the local residents, but also seriously threatened the mental health of the aged.[8,9] Wenchuan earthquake, the most devastating natural disaster in China in the past 30 years, affected an area of more than 440,000 km2. It is estimated that due to this disaster, 400,000 urban people had lost their jobs, more than 5 million farmers’ crops were destroyed, and the total economic loss exceeded 150 billion dollars.[10]
Among the post-disaster mental problems, PTSD is the most harmful one. PTSD is a serious and lasting disorder that develops after exposure to events that cause psychological trauma, such as earthquakes or tsunamis.[11-13] After disasters, the elderly face more problems than other age groups. They are more likely to face a variety of health and mobility problems, such as inadequate financial resources, lack of personal transport, and insufficient social networks.[14,15,16]
There has always been a critical need to study the development of PTSD after earthquakes, especially among the elderly. Some research has been done, but the analysis methodology they used failed to reflect the comprehensive consideration of published articles. Therefore, a meta-analysis was applied in this study to evaluate the occurrence of PTSD after earthquakes among the elderly.
METHODS
Because this was a meta-analysis, all data were available online, with no ethical approval needed.
Literature search strategy
The person who conducted this study searched for articles comparing PTSD and non-PTSD in the elderly after earthquakes published from January 2000 to December 2018. Databases included PubMed, EMBASE, Cochrane Library, and China National Knowledge Infrastructure (CNKI). The following keywords were used: (1) post-traumatic stress disorder; (2) earthquake; (3) elderly. All these words are combined in the strategy with the Boolean operator “and”. The literature search did not restrict the language of publication. In order to maximize the specificity and sensitivity of the search, the reference lists were studied as well to find other relevant studies that were not identified by the search strategy.
Study selection
After the initial selection, a review of potentially relevant research texts was conducted. The included studies must meet the following inclusion criteria: (1) studies comparing patients with and without PTSD; (2) including aged patients after earthquakes; (3) containing occurrence of PTSD; (4) available in full text.
The studies excluded were determined by the following exclusion criteria: (1) studies on other mental health problems; (2) patients suffering from other disasters; (3) studies lacking available data.
Data extraction and quality assessment
Two reviewers independently scanned the full text of the manuscript and extracted the following data from each eligible study: first author’s name, patient’s age and gender, country of origin, publication year, sample size, research period of each article. The methodological quality of this study was evaluated by a revised tool for the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2), which is an improvement over the original tool.[11] The second edition considers more transparent bias ratings and has applicability for primary diagnostic accuracy studies.
Statistical analysis
Review Manager (Version 5.0, the Cochrane Collaboration, 2011) was adopted to estimate the outcomes among selected reports. For continuous results, mean difference and 95% confidence interval (95% CI) were used. The heterogeneity of I2 statistics in the study was a quantitative method to measure the inconsistency of research. The study of I2 25%-50% was considered low heterogeneity, I2 50%-75% was considered to be moderate heterogeneity, and I2 >75% was considered high heterogeneous. If I2 >50%, the potential sources of heterogeneity were analyzed by sensitivity analysis. In addition, when the high heterogeneity was observed, a random-effect model was used. Conversely, the fixed-effect model was adopted considering the heterogeneity was low.
RESULTS
Searching process
The initial search found 784 related publications, among which 212 were selected after removing the duplicated publications. After the screening based on the titles and abstracts, 202 studies were excluded because of duplication, lack of relevance, incomplete data, or incomplete comparison. In the end, 10 articles were selected for this meta-analysis.
Characteristics of included studies
Detailed characteristics of the included studies, containing the first author’s name, year of publication, nation, recruitment time, age range of patients, sample size, and other parameters, were presented in Table 1. All these studies were published from the year 2000 to 2018. The sample size ranged from 138 to 1,509. In total, 1,277 patients with PTSD were included in these studies, and in parallel, 3,557 individuals without PTSD were included.
Table 1 Characteristics of studies included in the meta-analysis
| Study | Year | Language | Country | Age range, years | Groups | n | Year of onset |
|---|---|---|---|---|---|---|---|
| Chen et al[17] | 2012 | English | China | 71.3±11.7 | PTSD | 65 | July 2011 to August 2011 |
| Non-PTSD | 222 | ||||||
| Chen et al[18] | 2014 | English | China | 75.0±13.4 | PTSD | 194 | October 2010 to November 2010 |
| Non-PTSD | 845 | ||||||
| Xiao et al[19] | 2015 | Chinese | China | 78.0±11.2 | PTSD | 491 | October 2010 to November 2010 |
| Non-PTSD | 1,018 | ||||||
| Fan et al[20] | 2009 | Chinese | China | 82.5±7.7 | PTSD | 35 | May 2008 to June 2008 |
| Non-PTSD | 135 | ||||||
| Fan et al[21] | 2010 | Chinese | China | 80.2±7.2 | PTSD | 35 | May 2008 to June 2008 |
| Non-PTSD | 135 | ||||||
| He et al[22] | 2009 | Chinese | China | 72.3±8.2 | PTSD | 154 | June 2008 to July 2008 |
| Non-PTSD | 316 | ||||||
| Jia et al[23] | 2010 | English | China | 58.5±11.9 | PTSD | 31 | August 2009 and September 2009 |
| Non-PTSD | 107 | ||||||
| Kang et al[24] | 2015 | English | China | 62.3±12.5 | PTSD | 66 | December 2010 to January 2011 |
| Non-PTSD | 303 | ||||||
| Kun et al[25] | 2013 | English | China | 59.5±13.5 | PTSD | 134 | August 2008 to September 2008 |
| Non-PTSD | 264 | ||||||
| Zhang et al[26] | 2011 | English | China | 69.0±7.1 | PTSD | 72 | June 2009 to July 2009 |
| Non-PTSD | 212 |
PTSD: post-traumatic stress disorder.
Results of quality assessment
The QUADAS-2 tool was used to evaluate the risk of patient selection problems in nine studies. In view of the applicability, there was no performance problem. In general, there were two studies with bias risk and six studies had low risk of bias. All the tests had no applicability problems. The detailed results of the quality assessment were listed in Table 2.
Table 2 Results of QUADAS-2 quality assessment for each study
| Study | Risk of bias | Concern of applicability | |||||||
|---|---|---|---|---|---|---|---|---|---|
| Patient | Index test | Reference standard | Flow and time | Overall | Patient | Index test | Reference standard | Overall | |
| Chen et al[17] | Yes | ? | Yes | Yes | Low | Yes | Yes | Yes | Low |
| Chen et al[18] | ? | No | Yes | Yes | Low | Yes | Yes | Yes | Low |
| Xiao et al[19] | Yes | No | Yes | No | High | Yes | Yes | Yes | Low |
| Fan et al[20] | Yes | No | Yes | ? | Low | Yes | Yes | Yes | Low |
| Fan et al[21] | ? | ? | Yes | Yes | Low | Yes | Yes | Yes | Low |
| He et al[22] | Yes | ? | Yes | Yes | Low | Yes | Yes | Yes | Low |
| Jia et al[23] | Yes | Yes | No | No | High | Yes | Yes | Yes | Low |
| Kang et al[24] | Yes | Yes | No | Yes | Low | Yes | Yes | Yes | Low |
| Kun et al[25] | Yes | Yes | Yes | No | Low | Yes | Yes | Yes | Low |
| Zhang et al[26] | Yes | Yes | No | Yes | Low | Yes | Yes | Yes | Low |
Yes: low risk; no: high risk; ? means unclear risk.
Results of heterogeneity tests
All the 10 articles reported the differences of PTSD occurrence in the elderly. Figure 1 showed that the heterogeneity in the studies was significant, and I2 was 91.9% with P<0.001 for heterogeneity, which indicated that there were heterogeneities in the studies. Therefore, the random-effect model was used to evaluate the pooled estimates. The overall occurrence of PTSD in the aged was 0.25 with 95% CI (0.20-0.29).
Figure 1.
Figure 1.
Forest plot of post-traumatic stress disorder occurrence among the elderly after earthquake. Weights are from random effects analysis.
Ten studies[17,18,19,20,21,22,23,24,25,26] analyzed the occurrence of post-earthquake PTSD among aged males and females, respectively. The result of heterogeneities displayed the significant difference between males and females, and it indicated that a random-effect model should be adopted (P<0.001, I2=87.7%, relative risk [RR]=1.40, 95% CI [1.23-1.57]). The result of overall effect revealed a significant difference between males and females, which demonstrated that PTSD occurrence in females was higher than that in males.
Ten articles were included for the subgroup analysis of PTSD occurrence in the same province. The results of the heterogeneity test demonstrated that in the same province, the occurrence of post-earthquake PTSD in the aged was about 0.25. In Wenchuan city, the overall occurrence was 0.25 with 95% CI (0.20-0.30) (P<0.001, I2=89.1%) and in Ya’an city, the overall occurrence was 0.24 with 95% CI (0.14-0.35) (P<0.001, I2=95.3%).
Results of sensitivity analysis and publication bias
To examine the stability of the outcome, a sensitivity analysis was needed. When Xiao’s study from 2015 was excluded, the I2 value decreased from 91.9% to 87.1% in the heterogeneity part. It indicated that the results in this study were robust.
A funnel plot for occurrence after earthquakes in the aged was performed, with all the studies included. To some extent, the result implied that the presence of some publication bias since the symmetrical characteristic of the funnel plot was not ideal, which meant that publication bias in this analysis might be present.
DISCUSSION
In this study, the results showed that the occurrence of post-earthquake PTSD among the aged was 0.25 with 95% CI (0.20-0.29), which was consistent with other studies.[27,28,29,30] It has been reported that post-earthquake PTSD is more likely to appear among people over 65 years old, and the overall occurrence of post-earthquake PTSD among people is about 14.1%.[31] It shows that the ability of psychological adjustment of the aged after a disaster is weak, which leads to a high occurrence of mental and psychological crisis. The intervention should be provided to the aged population, and comprehensive measures should be adopted to offer practical psychological assistance.[30]
The occurrence was higher in females than in males, and the reason might be that women were more sensitive and vulnerable to external adverse stimuli than men, possibly due to different psychological characteristics, and women are more prone to traumatic re-experience symptoms.[25] In this study, the occurrence of PTSD in the same province showed little difference in China, which indicated that the occurrence of PTSD in the same region was similar.
Earthquake is one of the most devastating natural disasters. According to statistics from the Ministry of Civil Affairs in China, it has been confirmed that in the Wenchuan earthquake, more than 70,000 people were killed, more than 400,000 were injured, 18,467 were missing, and 6.5 million people became homeless.[31,32] The Wenchuan earthquake not only caused huge loss of lives and properties, but also caused enormous trauma to the mentality of the victims.[33,34] Wenchuan earthquake and Ya’an earthquake highlight the importance of understanding the impact of trauma among disaster survivors.
PTSD is a psychological response after a disaster, and the occurrence ranges from 3.7% to 60.0%.[35] Aged survivors are more likely to have PTSD and other general mental illnesses than young adults, since the elderly have weaker physical and mental status and social supports.[36] Although the use of mental health services can significantly improve mental health, these services are only provided to less than 10% of survivors with mental problems.[35,36] More mental health services should be offered to the elderly to promote the recovery of their mental health in the aftermath of the earthquake.[33,34,35]
According to the characteristics of different gender, including psychology and behavior patterns, interventions such as psychological education, training and exercise can effectively reduce the occurrence of post-earthquake PTSD and other catastrophes.[35] Considering the characteristics of the aged population, the field investigation of their psychology and crisis intervention measures are needed.
It is urgent to develop a diagnostic scale system with good reliability and validity and make it acceptable for the elderly. It is also important to create and evaluate various psychological therapies, and to gradually establish a PTSD intervention model suitable for the elderly. Nevertheless, group treatment, nursing, and rehabilitation are all necessary methods to promote the functional independence of aged patients. The treatment group should include doctors, nurses, physiotherapists, and psychotherapists.[33]
Study limitation
However, there are also some drawbacks of this study. Firstly, more indicators about post-earthquake PTSD occurrence among the aged should be included, which could be evaluated in further research. Secondly, more studies focusing on post-earthquake PTSD occurrence among the elderly in more countries could be included. Thirdly, further meta-analysis like meta-regression was not conducted in our article because included data were not sufficient, which could be used to evaluated risk factors in a regression model.
CONCLUSIONS
The occurrence of post-earthquake PTSD among the elderly is high, and the occurrence in females is higher than that in males. However, in different areas of the same province, the occurrence shows little difference.
Funding: None.
Ethical approval: Not needed.
Conflicts of interest: There are no competing interests involving this work.
Contributors: YL wrote the first draft of this paper. All authors approved the final version.
Reference
Influence factors of post-traumatic stress disorder (PTSD) and depression symptoms in children and adolescents after Wenchuan earthquake in China
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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.
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BACKGROUND: Several task-based functional MRI (fMRI) studies have highlighted abnormal activation in specific regions involving the low-level perceptual (auditory, visual, and somato-motor) network in posttraumatic stress disorder (PTSD) patients. However, little is known about whether the functional connectivity of the low-level perceptual and higher-order cognitive (attention, central-execution, and default-mode) networks change in medication-naive PTSD patients during the resting state. METHODS: We investigated the resting state networks (RSNs) using independent component analysis (ICA) in 18 chronic Wenchuan earthquake-related PTSD patients versus 20 healthy survivors (HSs). RESULTS: Compared to the HSs, PTSD patients displayed both increased and decreased functional connectivity within the salience network (SN), central executive network (CEN), default mode network (DMN), somato-motor network (SMN), auditory network (AN), and visual network (VN). Furthermore, strengthened connectivity involving the inferior temporal gyrus (ITG) and supplementary motor area (SMA) was negatively correlated with clinical severity in PTSD patients. LIMITATIONS: Given the absence of a healthy control group that never experienced the earthquake, our results cannot be used to compare alterations between the PTSD patients, physically healthy trauma survivors, and healthy controls. In addition, the breathing and heart rates were not monitored in our small sample size of subjects. In future studies, specific task paradigms should be used to reveal perceptual impairments. CONCLUSIONS: These findings suggest that PTSD patients have widespread deficits in both the low-level perceptual and higher-order cognitive networks. Decreased connectivity within the low-level perceptual networks was related to clinical symptoms, which may be associated with traumatic reminders causing attentional bias to negative emotion in response to threatening stimuli and resulting in emotional dysregulation.
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Previous studies highlighted the involvement of sensory perception in emotional processes. However, the role of extreme sensory processing patterns expressed in hyper- or hyposensitivity was not thoroughly considered. The present study, in real life conditions, examined the unique sensory processing patterns of individuals with major affective disorders and their relationship with psychiatric symptomatology. The sample consisted of 105 participants with major affective conditions ranging in age from 20 to 84 years (mean=56.7+/-14.6). All participants completed the Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS-A), the second version of the Beck Depression Inventory (BDI-II), and Adolescent/Adult Sensory Profile (AASP). Sensory sensitivity/avoiding hypersensitivity patterns and low registration (a hyposensitivity pattern) were prevalent among our sample as compared to normative data. About seventy percent of the sample showed lower seeking tendency. Stepwise regression analyses revealed that depression and anxious/cyclothymic affective temperaments were predicted by sensory sensory/avoiding. Anxious and irritable affective temperaments were predicted by low registration. Hyperthymic affective temperament and lower severity of depression were predicted by sensation seeking. Hyposensitivity or hypersensitivity may be
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By using the posttraumatic stress disorder (PTSD) module of the Mini International Neuropsychiatric Interview (MINI) as the gold standard to identify PTSD, the current study investigated the diagnostic efficiency of the PTSD Checklist (PCL) as a screening questionnaire in a sample of 152 Chinese victims of the Wenchuan earthquake. The results showed that the area under the receiver operating characteristic (ROC) curve was .96 (SE = .02), and the optimally efficient cutoff score was 44. The findings provide preliminary support of the PCL as a screening questionnaire among Chinese earthquake victims. The present study may contribute to further PTSD-related research and practices in Chinese disaster settings.
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The psychological impact of a mudslide on survivors of the Wenchuan earthquake in China and the risk factors for development of disaster-related post-traumatic stress disorder (PTSD) were investigated. The study design was cross-sectional and included 1321 survivors who had endured both an earthquake and a mudslide. Participants filled out a self-report questionnaire. One month after the mudslide, the rate of PTSD symptoms was 18.7%. Females, the elderly, those with lower educational levels, those that lacked social support, those who did not take precautionary measures, those living with children below 6 years of age, and those who had higher exposure to traumatic events experienced a higher level of PTSD symptoms. Results indicated that timely rescue, abundant material help, and mental rehabilitation after a disaster play important roles in recovery, and that there are still some high-risk groups that need attention, care, and effective intervention from healthcare professionals and society.
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Are the elderly more vulnerable to psychological impact of natural disaster? A population-based survey of adult survivors of the 2008 Sichuan earthquake
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BACKGROUND: The association between ages and psychological impact of natural disasters has not been well characterized. A population-based study was conducted 15 months after the 2008 Sichuan earthquake to assess whether elderly survivors were more likely to develop posttraumatic stress disorder (PTSD) and general psychiatric morbidity. METHODS: A population-based survey of 327 survivors (152 elders, 175 younger adults) was conducted in severely affected areas by the earthquake, using a multi-stage systematic sampling design. RESULTS: Compared with the younger adult survivors, the elderly were more likely to have symptoms of PTSD (22.5% vs. 8.0%, p = 0.001) and general psychiatric morbidity (42.0% vs. 25.4%, p = 0.003). Risk factors, such as being elderly, having been in serious danger, having lost family members, and having felt guilt concerning one's death or injury were significantly associated with developing PTSD; being elderly, having family members or friends seriously injured, and having felt guilt concerning one's death or injury were significantly associated with developing general psychiatric morbidity. Utilization of mental health services is strongly associated with the decreased risk for developing both of the symptoms. CONCLUSION: Compared with the younger adults, the elderly survivors were more likely to develop PTSD and general psychiatric morbidity. More mental health services should be distributed to the elderly and groups at particular risk, to ensure their smooth mental health reconstruction after the earthquake.
Psychological consequences and quality of life among medical rescuers who responded to the 2010 Yushu earthquake: a neglected problem
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What are the determinants of post-traumatic stress disorder: age, gender, ethnicity or other? Evidence from 2008 Wenchuan earthquake
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OBJECTIVE: To estimate the prevalence of post-traumatic stress disorder (PTSD) and assess determinants related to PTSD symptoms among adult earthquake survivors after the 2008 Wenchuan earthquake in China. STUDY DESIGN: Cross-sectional multicluster sample surveys with data collected from four counties. METHODS: Surveys were conducted separately in four counties in Sichuan Province, with a total of 2004 respondents. Beichuan County and Dujiangyan City were damaged more severely than Yaan County and Langzhong County during the earthquake. In total, 1890 households were represented, with a mean of 2.2 respondents per household. Data were collected using structured interviews, and the Harvard Trauma Questionnaire and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria were used to diagnose PTSD. RESULTS: The prevalence rates of suspected PTSD were 47.3% (n = 436) in heavily damaged areas and 10.4% (n = 93) in moderately damaged areas. The prevalence rates of PTSD symptoms among elderly, middle aged and young adults were 55.8%, 50.2% and 28.6% (P = 0.001), respectively, in heavily damaged areas. Older age, female gender, unmarried/divorced/widowed, ethnic minority, death of family member, no household income and damaged household were independent risk factors for PTSD symptoms in heavily damaged areas. CONCLUSION: Interventions designed to reduce PTSD among populations affected by the 2008 earthquake should focus on people without household incomes, those with damaged households and those who experienced the death of a family member. Effective, sustainable and culturally sensitive psychosocial interventions and mental health services are required, and attention should be directed to survivors who experienced the death of a family member, women and older adults following the devastating natural disaster. Governments should support income-generating activities and improve living conditions. Trained field personnel can assist with PTSD assessments and referrals, and existing rural healthcare services can be used to provide treatment for common psychiatric disorders.
Post-traumatic stress disorder, anxiety and depression among the elderly: a survey of the hard-hit areas a year after the Wenchuan earthquake
DOI:10.1002/smi.1403
URL
PMID:22259159
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Few studies to date have examined psychological sequelae of natural disasters among the elderly in China. The aim of this study was to investigate the prevalence rates of probable post-traumatic stress disorder (PTSD), anxiety and depression in the elderly survivors a year after the Wenchuan earthquake as well as to analyse related risk factors. The community-based sample of the study consisted of 284 elderly survivors (>/=60 years). PTSD was assessed by the PTSD Checklist--Civilian version, and anxiety and depression were assessed by the Hopkins Symptoms Checklist. In total, the estimated prevalence rates of probable PTSD, anxiety and depression were 26.3%, 42.9% and 35.2%, respectively. Nearly a fifth of the elderly participants reported symptoms that meet the criteria for all three of these mental disorders. Results indicated that some factors associated with earthquake-exposure intensity, which included loss of livelihood, bereavement, injury and initial fear during the earthquake, were among the significant risk factors for these mental disorders. Women had a higher risk of suffering from probable anxiety as compared to men. Finally, the significance and limitations of this study were also discussed.
Effects of Yoga practice on stress-related symptoms in the aftermath of an earthquake: a community-based controlled trial
DOI:10.1016/j.ctim.2014.01.008
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Objectives: To evaluate the effect of an integrated hatha yoga practice on perceived stress and stress-related symptoms in the aftermath of an earthquake.
Design and setting: Inhabitants, aged 20-67 years, from highly exposed earthquake areas of two villages in South Iceland were offered to participate in a yoga program subsequent to an earthquake. Sixty-six individuals were self-selected into the study and divided by residential convenience into an experimental group (n = 31) and a waiting list control group (n = 35).
Intervention: The yoga program was conducted twice a week for six weeks, in normal situations among the inhabitants in the community.
Main outcome measures: Several validated questionnaires assessing stress and stress-related symptoms, posttraumatic symptoms, depression, anxiety and health related quality of life were administered at pre- and post-intervention.
Results: Multivariate analysis of variance (MANOVA) revealed differences between the experimental group and waiting list control group on sleep quality (p = .03) and social relations (p = .04). These differences did not prevail at Bonferroni correction for multiple testing (at alpha level of .005). Participants in both groups showed significant improvements in stress and some stress-related symptoms such as sleep, concentration, well-being, quality of life, depression and anxiety from pre- to post-intervention.
Conclusions: The data from this small study show no statistically significant improvement of an integrated hatha yoga program above and beyond waiting list control, following exposure to an earthquake. However, the observed trend toward improved sleep quality and social relations deserve further exploration in larger effectiveness studies on the impact of Hatha yoga on recovery after natural disaster. (C) 2014 Elsevier Ltd.
Posttraumatic stress disorder: a serious post-earthquake complication
DOI:10.1590/2237-6089-2016-0029
URL
PMID:28700042
[Cited within: 1]
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.
Vivid intrusive memories in PTSD: responses of child earthquake survivors in Turkey.
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Analysis of acute and post-traumatic stress symptoms and related factors among victims of Wenchuan earthquake in Sichuan Province
Increased serum cortisol and growth hormone levels in earthquake survivors with PTSD or subclinical PTSD
DOI:10.1016/j.psyneuen.2008.05.005
URL
[Cited within: 2]
Summary
Alteration of neuroendocrine systems has been demonstrated to be involved in the pathology of posttraumatic stress disorder (PTSD). Three months after an earthquake in Northern China, cortisol, growth hormone (GH) and prolactin (PRL) levels were assessed in 34 earthquake survivors with PTSD (according to DSM-IV criteria), 30 earthquake survivors with subclinical PTSD and 34 normal controls. Only earthquake survivors diagnosed with PTSD had significantly higher serum GH levels. Also, we found that earthquake survivors (either with PTSD or subclinical PTSD) had significantly higher serum cortisol levels. We concluded that PTSD might be associated with an increased level of serum GH and traumatic survivors might be associated with a higher level of serum cortisol.
Risk factors of post-traumatic stress disorder (PTSD) after Wenchuan earthquake: a case control study
DOI:10.1371/journal.pone.0096644
URL
PMID:24800944
[Cited within: 1]
BACKGROUND: Few clues were found in the literature about the independent risk factors for PTSD among earthquake survivors in Sichuan province three years after the 2008 earthquake. Ours was the first case-control study with matching factors of age and distance from the epicenter among survivors age 16 years or older, three years after the catastrophe. OBJECTIVES: To identify independent risk factors for PTSD among earthquake survivors. METHODS: We performed a population-based matched case-control study. The cases were drawn from earthquake areas three years after the Wenchuan earthquake, including 113 cases who met positive criteria for PTSD symptoms according to the PCL-C (PTSD Checklist-Civilian Version) score and 452 controls who did not meet the criteria. Cases and controls were matched individually by birth year (+ three years) and the town they lived in when the earthquake occurred. RESULTS: Independent risk factors for PTSD symptoms included two-week disease prevalence (odds ratio [OR],1.92; 95% confidence interval [CI],1.18-3.13), witnessing someone being killed in the earthquake (OR, 2.04;95%CI, 1.17-3.58), having no regular income after the earthquake (OR, 0.52; 95%CI, 0.28-0.98), receiving mental health support only one time after the earthquake (OR, 2.43; 95%CI, 1.09-5.42) and lower social support (lower PSSS score) (OR, 0.95; 95%CI, 0.93-0.97). CONCLUSION: Earthquake experience, suffering from physical illnesses, lack of stable income, and lower social support were associated with PTSD symptoms.
Prioritization of factors related to mental health of women during an earthquake: A qualitative study. World
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Social relations and PTSD symptoms: a prospective study on earthquake-impacted adolescents in Taiwan.
[J]
Prevalence and psychosocial risk factors of PTSD: 18 months after Kashmir earthquake in Pakistan.
[J]DOI:10.1016/j.jad.2010.10.035 URL [Cited within: 4]
Prevalence and risk factors for post-traumatic stress reaction among resident survivors of the tsunami that followed the great east Japan earthquake, March 11, 2011
DOI:10.1017/dmp.2016.18
URL
PMID:27075401
[Cited within: 2]
OBJECTIVE: The Great East Japan Earthquake triggered a massive tsunami that devastated the coasts of northern Japan on March 11, 2011. Despite the large number of
