ABSTRACT
Objective: Few earthquake survivor studies extend follow-up beyond 2 years, leaving the long-term course of earthquake-related posttraumatic stress disorder (PTSD) unknown. This 10-year survey re-assessed the 1999 İzmit, Turkey, earthquake survivors.
Methods: İzmit earthquake survivors (N = 198), previously assessed for PTSD/partial PTSD at 1–3 months and 18–20 months post-earthquake, were evaluated 10 years post-event from January 2009 through December 2010. A PTSD self-test (Turkish translation) used DSM-IV criteria to characterize full PTSD, “stringent partial PTSD,” “lenient partial PTSD,” or non-PTSD based on symptom type/amount.
Results: Full PTSD prevalence decreased from 37% at 1–3 months post-earthquake to 15% at 18–20 months (P < .001), remaining relatively stable (12%) at 10 years (P = .38). Stringent and lenient partial PTSD decreased between 1–3 months and 18–20 months (from 9% to 3% and from 24% to 12%, respectively; P < .001), remaining stable at 10 years (5% and 9%, respectively; P = .43 and P = .89). PTSD was more prevalent at 1–3 months among those who had a close acquaintance harmed, had been evacuated for long periods (> 1 week), or had more children; this was not observed at 10 years (P = .007–.017). Avoidance symptoms 1–3 months post-earthquake were the best predictor for full PTSD at 10 years (P < .001). Delayed-onset PTSD was observed in only 2% of participants.
Conclusions: Full and partial PTSD decreased over the first 2 years post-trauma, but remained stable at 10 years, suggesting PTSD symptoms at around 2 years remain stable at 10 years. Background characteristics did not predict PTSD long-term course, but avoidance level did. Delayed-onset PTSD was relatively rare.
Continue Reading...
Did you know members enjoy unlimited free PDF downloads as part of their subscription? Subscribe today for instant access to this article and our entire library in your preferred format. Alternatively, you can purchase the PDF of this article individually.
References (36)
- Altindag A, Ozen S, Sir A. One-year follow-up study of posttraumatic stress disorder among earthquake survivors in Turkey. Compr Psychiatry. 2005;46(5):328–333. PubMed CrossRef
- Armenian HK, Morikawa M, Melkonian AK, et al. Loss as a determinant of PTSD in a cohort of adult survivors of the 1988 earthquake in Armenia: implications for policy. Acta Psychiatr Scand. 2000;102(1):58–64. PubMed CrossRef
- Ashraf H. Tsunami wreaks mental health havoc. Bull World Health Organ. 2005;83(6):405–406. PubMed
- Bhushan B, Kumar JS. Emotional distress and posttraumatic stress in children surviving the 2004 tsunami. J Loss Trauma. 2007;12(3):245–257. CrossRef
- Chen CH, Tan HK, Liao LR, et al. Long-term psychological outcome of 1999 Taiwan earthquake survivors: a survey of a high-risk sample with property damage. Compr Psychiatry. 2007;48(3):269–275. PubMed CrossRef
- Galea S, Nandi A, Vlahov D. The epidemiology of post-traumatic stress disorder after disasters. Epidemiol Rev. 2005;27(1):78–91. PubMed CrossRef
- Giannopoulou I, Smith P, Ecker C, et al. Factor structure of the Children’s Revised Impact of Event Scale (CRIES) with children exposed to earthquake. Pers Individ Dif. 2006;40(5):1027–1037. CrossRef
- Karamustafalıoğlu OK, Zohar J, Güveli M, et al. Natural course of posttraumatic stress disorder: a 20-month prospective study of Turkish earthquake survivors. J Clin Psychiatry. 2006;67(6):882–889. PubMed CrossRef
- Kumar MS, Murhekar MV, Hutin Y, et al. Prevalence of posttraumatic stress disorder in a coastal fishing village in Tamil Nadu, India, after the December 2004 tsunami. Am J Public Health. 2007;97(1):99–101. PubMed CrossRef
- Kun P, Chen X, Han S, et al. Prevalence of post-traumatic stress disorder in Sichuan Province, China after the 2008 Wenchuan earthquake. Public Health. 2009;123(11):703–707. PubMed CrossRef
- McMillen JC, North CS, Smith EM. What parts of PTSD are normal: intrusion, avoidance, or arousal? Data from the Northridge, California, earthquake. J Trauma Stress. 2000;13(1):57–75. PubMed CrossRef
- Norris FH. Disaster research methods: past progress and future directions. J Trauma Stress. 2006;19(2):173–184. PubMed CrossRef
- Tsai KY, Chou P, Chou FH, et al. Three-year follow-up study of the relationship between posttraumatic stress symptoms and quality of life among earthquake survivors in Yu-Chi, Taiwan. J Psychiatr Res. 2007;41(1-2):90–96. PubMed CrossRef
- van Griensven F, Chakkraband ML, Thienkrua W, et al; Thailand Post-Tsunami Mental Health Study Group. Mental health problems among adults in tsunami-affected areas in southern Thailand. JAMA. 2006;296(5):537–548. PubMed CrossRef
- Wang X, Gao L, Shinfuku N, et al. Longitudinal study of earthquake-related PTSD in a randomly selected community sample in north China. Am J Psychiatry. 2000;157(8):1260–1266. PubMed CrossRef
- Wang XL, Tan J, Wen SL, et al. Mental health status of victims of Wenchuan earthquake and affecting factors. J Sun Yat-Sen University. 2008;29:367–371.
- Wang L, Zhang Y, Wang W, et al. Symptoms of posttraumatic stress disorder among adult survivors three months after the Sichuan earthquake in China. J Trauma Stress. 2009;22(5):444–450. PubMed CrossRef
- Wang B, Ni C, Chen J, et al. Posttraumatic stress disorder 1 month after 2008 earthquake in China: Wenchuan earthquake survey. Psychiatry Res. 2011;187(3):392–396. PubMed CrossRef
- Yule W. Alleviating the effects of war and displacement on children. Traumatology. 2002;8(3):160–180. CrossRef
- Zhang Y, Ho SMY. Risk factors of posttraumatic stress disorder among survivors after the 512 Wenchuan earthquake in China. PLoS One. 2011;6(7):e22371. PubMed CrossRef
- Zhang Z, Shi Z, Wang L, et al. One year later: mental health problems among survivors in hard-hit areas of the Wenchuan earthquake. Public Health. 2011;125(5):293–300. PubMed CrossRef
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. Fifth Edition. American Psychiatric Association; 2013.
- Steinert C, Hofmann M, Leichsenring F, et al. The course of PTSD in naturalistic long-term studies: high variability of outcomes: a systematic review. Nord J Psychiatry. 2015;69(7):483–496. PubMed CrossRef
- Fink DS, Gradus JL, Keyes KM, et al. Subthreshold PTSD and PTSD in a prospective-longitudinal cohort of military personnel: potential targets for preventive interventions. Depress Anxiety. 2018;35(11):1048–1055. PubMed CrossRef
- North CS, Oliver J. Analysis of the longitudinal course of PTSD in 716 survivors of 10 disasters. Soc Psychiatry Psychiatr Epidemiol. 2013;48(8):1189–1197. PubMed CrossRef
- Dickstein BD, Weathers FW, Angkaw AC, et al; Marine Resiliency Study Team. Diagnostic utility of the Posttraumatic Stress Disorder (PTSD) Checklist for identifying full and partial PTSD in active-duty military. Assessment. 2015;22(3):289–297. PubMed CrossRef
- Foa EB, Davidson JR, Frances A. Treatment of posttraumatic stress disorder. J Clin Psychiatry. 1999;60(suppl 16):1–76. http://kendal-tackett.www.uppitysciencechick.com/ptsdexperttreatmentguidelines.pdf.
- Hosmer DW, Lemeshow S. Applied Logistic Regression. New York: Wiley; 2013.
- Kessler RC, Sonnega A, Bromet E, et al. Posttraumatic stress disorder in the national comorbidity survey. Arch Gen Psychiatry. 1995;52(12):1048–1060. PubMed CrossRef
- Cukor J, Wyka K, Jayasinghe N, et al. The nature and course of subthreshold PTSD. J Anxiety Disord. 2010;24(8):918–923. PubMed CrossRef
- Bryant RA, Harvey AG. Delayed-onset posttraumatic stress disorder: a prospective evaluation. Aust N Z J Psychiatry. 2002;36(2):205–209. PubMed CrossRef
- Smid GE, Mooren TTM, van der Mast RC, et al. Delayed posttraumatic stress disorder: systematic review, meta-analysis, and meta-regression analysis of prospective studies. J Clin Psychiatry. 2009;70(11):1572–1582. PubMed CrossRef
- Andrews B, Brewin CR, Philpott R, et al. Delayed-onset posttraumatic stress disorder: a systematic review of the evidence. Am J Psychiatry. 2007;164(9):1319–1326. PubMed CrossRef
- Hoge CW, Riviere LA, Wilk JE, et al. The prevalence of post-traumatic stress disorder (PTSD) in US combat soldiers: a head-to-head comparison of DSM-5 versus DSM-IV-TR symptom criteria with the PTSD checklist. Lancet Psychiatry. 2014;1(4):269–277. PubMed CrossRef
- Carr VJ, Lewin TJ, Kenardy JA, et al. Psychosocial sequelae of the 1989 Newcastle earthquake, III: role of vulnerability factors in post-disaster morbidity. Psychol Med. 1997;27(1):179–190. PubMed CrossRef
- North CS, Nixon SJ, Shariat S, et al. Psychiatric disorders among survivors of the Oklahoma City bombing. JAMA. 1999;282(8):755–762. PubMed CrossRef
Members enjoy free PDF downloads on all articles.
Save
Cite
Already a member? Login
Advertisement
GAM ID: sidebar-top