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Öz E, Küçükkelepçe O, Kurt O, Kapıcı Y. The relationship between earthquake-induced post-traumatic stress disorder and breastfeeding attitude and behavior. BMC Psychiatry 2024; 24:343. [PMID: 38714972 PMCID: PMC11075360 DOI: 10.1186/s12888-024-05803-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 04/30/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND This study aimed to investigate the prevalence and severity of post-traumatic stress disorder (PTSD) and analyze the relationship between PTSD and breastfeeding attitudes and behaviors among breastfeeding mothers and women with children aged 0-24 months, all of whom had experienced the earthquake. METHODS In this cross-sectional survey, a face-to-face questionnaire was administered to 173 earthquake survivors in Adıyaman, Turkey, during June and July 2023. The PTSD Checklist-Civilian scale was used to assess the presence of PTSD, while the Breastfeeding Attitudes of the Evaluation Scale (BAES) was employed to evaluate breastfeeding behaviors in mothers. RESULTS Significantly higher PTSD scores (47.6 ± 17.4) were found among women staying in tents, while lower scores (37.0 ± 16.4) were observed in those who continued breastfeeding. 78.6% of women reported decreased breast milk because of the earthquake. Mothers with reduced milk supply had higher PTSD scores (46.1 ± 17.3). Breastfeeding training was associated with higher BAES scores (106.8 ± 56.8) and lower PTSD scores (32.5 ± 11.0). A significant negative correlation was observed between the PTSD score and BAES (r = -0.742; p < 0.001). CONCLUSIONS The study demonstrated that breastfeeding may protect mothers against PTSD in the aftermath of earthquakes, emphasizing the importance of breastfeeding education. The higher frequency and severity of PTSD observed among earthquake survivor mothers residing in tents underscores the importance of promptly transitioning to permanent housing after the earthquake.
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Affiliation(s)
- Erdoğan Öz
- Adıyaman Provincial Health Directorate, Adıyaman, Türkiye
| | | | - Osman Kurt
- Adıyaman Provincial Health Directorate, Adıyaman, Türkiye
| | - Yaşar Kapıcı
- Faculty of Medicine, Department of Psychiatry, Adıyaman University, Adıyaman, Türkiye.
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Peng Y, Lu B, Wen J. Assessment of post-traumatic stress disorder (PTSD) in elderly survivors of the Wenchuan earthquake: A cross-sectional study. J Evid Based Med 2023; 16:455-464. [PMID: 37795585 DOI: 10.1111/jebm.12557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 09/19/2023] [Indexed: 10/06/2023]
Abstract
OBJECTIVE Post-traumatic stress disorder (PTSD) is a prevalent condition characterized by prolonged psychological distress following traumatic events encompassing serious health threats, domestic abuse, and natural disasters. The onset and persistence of PTSD can be attributed to advanced age. This study aimed to explore the occurrence and influencing factors of enduring post-traumatic stress disorder (PTSD) in survivors aged 60 years and over in the main area of the 2008 Wenchuan earthquake 10 years after the disaster. METHODS Data were collected using a multistage sampling method from individuals aged 60 years and older living in the main impacted areas of Wenchuan 10 years after the Wenchuan earthquake. The PTSD Checklist-Civilian Version (PCL-C) was used to evaluate PTSD symptoms. We evaluated participants based on their PTSD symptoms: those exhibiting and those without. The latter group was four times the size of the former and was matched based on gender and age (within ± 2 years). Conditional logistic regression was used to discern the risk factors. RESULTS Out of the total, 56 participants were recognized as having probable PTSD as per the PCL-C checklist, leading to a rate of 9.4% (56/588). The univariate conditional logistic regression values showed that playing Mahjong/poker (odds ratio (OR) = 0.394, 95% confidence interval (CI) = 0.171-0.911) and displacement (OR = 0.446, 95% CI = 0.220-0.907) were protective factors for the long-term mental health of survivors in the hard-hit areas, while the presence of a 2-week illness (OR = 3.605, 95% CI = 1.751-7.424), possessing insurance (OR = 0.250, 95% CI = 0.072-0.864), suffering from a chronic ailment (OR = 3.132, 95% CI = 1.2-8.174), and having an injured family member (OR = 2.26, 95% CI = 1.136-4.496) emerged as risk factors for PTSD symptoms. Multivariate analysis indicated that the absence of insurance and prevalence of 2-week illness correlated with increased PTSD symptoms. CONCLUSIONS Ten years after the Wenchuan earthquake, the prevalence of probable PTSD remained significantly high in the elderly population. The major risk factors were the absence of insurance and the occurrence of a 2-week illness. Policymakers should incorporate these findings when devising strategies for aging societies.
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Affiliation(s)
- Yang Peng
- Office of the President, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Bingqing Lu
- Hospital of Chengdu, University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Jin Wen
- Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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3
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Wang W, Li N, Yuan Y, Wu X, Lan X. Longitudinal relationships between guilt and suicide risk among adolescents in a postdisaster context: Mediating roles of rumination and posttraumatic stress disorder. Suicide Life Threat Behav 2022; 52:773-781. [PMID: 35355309 DOI: 10.1111/sltb.12861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 05/20/2021] [Accepted: 01/10/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To analyze the pathways and mechanisms underlying the impact of guilt on suicide risk using a well-controlled longitudinal study, we examined the mediating roles of intrusive rumination, deliberate rumination, and posttraumatic stress disorder (PTSD) in this association. METHOD Four hundred and eight adolescent survivors (Mage = 14.05 years) were assessed using self-report questionnaires three and a half years and four and a half years after the Ya'an earthquake. The self-report questionnaires included the Trauma Exposures Questionnaire, the Interpersonal Guilt Questionnaire, the Event-Related Rumination Inventory, the PTSD Checklist for the DSM-5, and the Child Behavior Problems Questionnaire. RESULTS The results indicated that guilt had a direct and positive effect on suicide risk. Intrusive rumination and PTSD mediated the relationship between guilt and suicide risk. Guilt could increase deliberate rumination, but deliberate rumination did not significantly predict PTSD and suicide risk. CONCLUSION Negative postdisaster emotions, such as guilt, can enhance the combined effects of cognition and psychological disorders on suicide risk. Guilt affects suicide risk indirectly through intrusive rumination and PTSD but not through deliberate rumination.
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Affiliation(s)
- Wenchao Wang
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Nan Li
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Yue Yuan
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Xinchun Wu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Xiaoyu Lan
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Faculty of Psychology, Beijing Normal University, Beijing, China
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4
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Tian Y, Xi W, Jiang X, Cao J, Li M. Relationship of Earthquake Exposure, Locus of Control, Coping Strategy, and Posttraumatic Stress Disorder Among Adolescent Survivors. J Psychosoc Nurs Ment Health Serv 2022; 60:41-47. [DOI: 10.3928/02793695-20220520-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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5
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Yang Y, Zeng W, Lu B, Wen J. The Contributing Factors of Delayed-Onset Post-traumatic Stress Disorder Symptoms: A Nested Case-Control Study Conducted After the 2008 Wenchuan Earthquake. Front Public Health 2022; 9:682714. [PMID: 35004555 PMCID: PMC8739781 DOI: 10.3389/fpubh.2021.682714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 11/09/2021] [Indexed: 02/05/2023] Open
Abstract
Background: Delayed-onset post-traumatic stress disorder after catastrophes is a major public health issue. However, good designs for identifying post-traumatic stress disorder (PTSD) among earthquake survivors are rare. This is the first nested case-control study to explore the possible factors associated with delayed-onset PTSD symptoms. Methods: A nested case-control study was conducted. The baseline (2011) and follow-up (2018) surveys were utilized to collect data. A total of 361 survivors of the Wenchuan earthquake were investigated and 340 survivors underwent follow-up. The survivors, from the hardest-hit areas, who met the criteria for PTSD were included in the case group, and PTSD-free survivors from the same area, matched for age, were included in the control group, with a ratio of one to four. Conditional logistic regression was used to evaluate the variables' odds ratio (OR). Results: The overall prevalence of delayed-onset PTSD symptoms in survivors of the Wenchuan earthquake was 9.7% (33/340). The unemployed earthquake survivors had a higher risk of developing delayed-onset PTSD symptoms (OR = 4.731, 95% CI = 1.408-15.901), while higher perceived social support was a protective factor against delayed-onset PTSD symptoms (OR = 0.172, 95% CI = 0.052-0.568). Conclusion: Delayed-onset PTSD symptoms, after a disaster, should not be ignored. Active social support and the provision of stable jobs can contribute to the earthquake survivors' mental health.
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Affiliation(s)
- Yanlin Yang
- Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu, China
| | - Wenqi Zeng
- Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu, China
| | - Bingqing Lu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jin Wen
- Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu, China
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Chen LYA, Wu CY, Lee MB, Lin CH, Kao SC, Tu CC, Chen RC. Predictors for psychological distress of young burn survivors across three years: A cohort study of a burn disaster in Taiwan. J Nurs Scholarsh 2021; 54:56-63. [PMID: 34841644 PMCID: PMC9299193 DOI: 10.1111/jnu.12703] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 08/02/2021] [Accepted: 08/04/2021] [Indexed: 11/29/2022]
Abstract
Purpose The study aims to investigate long‐term psychological distress and its risk factors in the burn survivors. Design A longitudinal study with follow‐up interviews was conducted from November 2015–June 2018. A post‐burn baseline interview was conducted 6 months after the event, followed by annual surveys for three years. Methods The burn survivors received structured assessment through telephone in the four‐wave interviews, including the five‐item Brief Symptom Rating Scale (BSRS‐5); two‐item Patient Health Questionnaire (PHQ‐2); four‐item Startle, Physiological Arousal, Anger, and Numbness Scale (SPAN‐4); and six‐item Impact of Event Scale (IES‐6) alongside demographic data and other health‐related assessment. Findings A total of 180 respondents with the mean age of 23 years old completed the four waves of interview. Using the BSRS‐5 as the outcome, each variable had different input in psychological distress during the follow‐up years. The main finding was that the SPAN‐4 score could predict more than 62% of psychological distress between 6 months and 3 years after the disaster. The generalized estimating equation demonstrated that SPAN‐4, IES‐6, family functioning impairment, hypnotics use, adaptation to the event, and PHQ‐2 could predict psychological distress. However, the variable of follow‐up year did not exemplify significant estimation in the model. Conclusions The results indicated that different factors had various influences on psychological distress across the four follow‐up stages. PTSD‐like symptoms, depression, and anxiety were the most common psychological problems experienced by the young burn cohort in the longitudinal post‐traumatic period. Clinical relevance Healthcare providers should be aware of psychological consequences of traumatic events within up to a 3‐year post‐burn period, particularly post‐traumatic stress, depression, and anxiety symptoms.
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Affiliation(s)
- Lu-Yen Anny Chen
- Institute of Clinical Nursing, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Second Degree Bachelor of Science in Nurisng, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chia-Yi Wu
- School of Nursing, National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan.,Taiwanese Society of Suicidology & Taiwan Suicide Prevention Center, Taipei, Taiwan
| | - Ming-Been Lee
- Taiwanese Society of Suicidology & Taiwan Suicide Prevention Center, Taipei, Taiwan.,Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.,Department of Psychiatry, Shin-Kong Wu-Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Chi-Hung Lin
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Institute of Microbiology and Immunology, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shu-Chen Kao
- Department of Health, New Taipei City Government, Banqiao, Taiwan
| | - Chung-Chieh Tu
- Department of Health, New Taipei City Government, Banqiao, Taiwan
| | - Ran-Chou Chen
- Department of Health, New Taipei City Government, Banqiao, Taiwan
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Lei L, Zhu H, Li Y, Dai T, Zhao S, Zhang X, Muchu X, Su S. Prevalence of post-traumatic stress disorders and associated factors one month after the outbreak of the COVID-19 among the public in southwestern China: a cross-sectional study. BMC Psychiatry 2021; 21:545. [PMID: 34736442 PMCID: PMC8566661 DOI: 10.1186/s12888-021-03527-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 10/06/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Coronavirus Disease 2019 (COVID-19) pandemic has rapidly spread across the whole world and brought strong psychological impact. This study aimed to evaluate the prevalence of post-traumatic stress disorders (PTSD) in the general people of southwestern China and associated factors 1 month after the outbreak of the COVID-19. METHODS This study was started on 4-10 Feb 2020 based on online survey. The present work was carried out in the provinces of southeastern China, including Sichuan Province, Guizhou Province, Yunnan Province, and Chongqing City.1593 respondents aged 18 years and above administered to this study. Data on whether they have experienced confirmed or suspected COVID-19 of themselves/family members/acquaintances were also collected, and based on 'yes' answers, the number of affected individuals (via COVID-19) were categorized into four exposure levels i.e., non-affected, less, moderately, or significantly affected. The civilian version of the PTSD checklist and the self-reported information about COVID-19 were used. RESULTS The prevalence of PTSD was approximately 25.2%(n = 401/1593). The chances of developing PTSD were 6.053(OR = 6.053, 95% CI 1.394 to 26.280) or 3.673(OR = 3.673, 95% CI 1.738 to 7.765) times higher among respondents who had been significantly and moderately affected than those who had not been affected, accordingly. Male (OR = 1.484, 95% CI 1.147 to 1.920),younger age individuals (40 ~ 49 age group/<30 age group, OR = 0.395, 95% CI 0.258 to 0.606) and health care workers (OR = 1.788, 95% CI 1.155 to 2.277) were at higher risk of developing PTSD. CONCLUSION Our findings highlight that a positive correlation between the pandemic and PTSD. It is urgent to establish a screening and prevention systems for the population who are significantly exposed to COVID-19,and provide different psychological intervention strategies for different groups.
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Affiliation(s)
- Lei Lei
- grid.13291.380000 0001 0807 1581Department of Pediatric Intensive Care unit Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing,Sichuan University, No. 20, Section 3, Renmin South Road, Chengdu, Sichuan China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan China
| | - Hongyi Zhu
- grid.13291.380000 0001 0807 1581Department of Pediatric Intensive Care unit Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing,Sichuan University, No. 20, Section 3, Renmin South Road, Chengdu, Sichuan China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan China
| | - Yi Li
- grid.13291.380000 0001 0807 1581Department of Pediatric Intensive Care unit Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing,Sichuan University, No. 20, Section 3, Renmin South Road, Chengdu, Sichuan China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan China
| | - Tao Dai
- grid.13291.380000 0001 0807 1581Department of Pediatric Intensive Care unit Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing,Sichuan University, No. 20, Section 3, Renmin South Road, Chengdu, Sichuan China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan China
| | - Shouju Zhao
- grid.13291.380000 0001 0807 1581Department of Pediatric Intensive Care unit Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing,Sichuan University, No. 20, Section 3, Renmin South Road, Chengdu, Sichuan China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan China
| | - Xiaochao Zhang
- grid.13291.380000 0001 0807 1581Department of Pediatric Intensive Care unit Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing,Sichuan University, No. 20, Section 3, Renmin South Road, Chengdu, Sichuan China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan China
| | - Xiaoluzi Muchu
- grid.13291.380000 0001 0807 1581Department of Pediatric Intensive Care unit Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing,Sichuan University, No. 20, Section 3, Renmin South Road, Chengdu, Sichuan China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan China
| | - Shaoyu Su
- Department of Pediatric Intensive Care unit Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing,Sichuan University, No. 20, Section 3, Renmin South Road, Chengdu, Sichuan, China. .,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China.
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8
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Zhang X, Sheng Q, Wang X, Cai C. The experience of frontline nurses four months after COVID-19 rescue task in China: A qualitative study. Arch Psychiatr Nurs 2021; 35:358-363. [PMID: 34176576 PMCID: PMC8126517 DOI: 10.1016/j.apnu.2021.05.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 03/30/2021] [Accepted: 05/08/2021] [Indexed: 01/15/2023]
Abstract
AIMS The study was to explore the experience of frontline nurses four months after COVID-19 rescue task. BACKGROUND Frontline medical staff are prone to follow-up mental health problems and different feeling after COVID-19 rescue task. However, the experience of frontline nurses after COVID-19 rescue task has not been well described. METHODS The study used a qualitative study design with semi-structured interview guide. Individual semi-structured face-to-face interviews were conducted with 15 frontline nurses who were involved COVID-19 rescue task from two tertiary-A hospitals in Hefei, China from July 10, to August 28, 2020. We followed the consolidated criteria for reporting qualitative research (COREQ) checklist. RESULTS Four main themes emerged from the interviews: recurring involuntary memories about the experience, feeling guilty and depressed, cultivation of occupational ability, increased professional pride and happiness. CONCLUSION The study demonstrated that frontline nurses had both positive and negative experiences four months after COVID-19 rescue task. It is necessary to long-term follow up and attention to the experience of the frontline nurses after COVID-19 rescue task. These insights provide a specific direction for the psychological reconstruction of frontline nurses and the construction of nursing team. RELEVANCE TO CLINICAL PRACTICE Nursing managers should formulate psychological reconstruction plan according to the experience of frontline nurses after COVID-19 rescue task, so as to relieve the psychological stress and promote the mental health of nurses. At the same time, we should strengthen the disaster rescue ability training of nurses should be strengthened to better respond to future rescue task.
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Affiliation(s)
- Xi Zhang
- School of Health Sciences, Wuhan university, Wuhan, Hubei, China
| | - Qingqing Sheng
- School of Health Sciences, Wuhan university, Wuhan, Hubei, China
| | - Xinyu Wang
- School of Health Sciences, Wuhan university, Wuhan, Hubei, China
| | - Chunfeng Cai
- School of Health Sciences, Wuhan university, Wuhan, Hubei, China.
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Prevalence of Suicide Thoughts and Behaviours among Female Garment Workers Who Survived the Rana Plaza Collapse: An In-Depth Inquiry. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126326. [PMID: 34207986 PMCID: PMC8296151 DOI: 10.3390/ijerph18126326] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 06/09/2021] [Accepted: 06/09/2021] [Indexed: 11/17/2022]
Abstract
The Rana Plaza building collapse occurred on 24 April 2013 in Savar, near the capital city of Bangladesh, killing more than 1130 garment workers and injured about 2500, mostly females. Those who survived face ongoing challenges, including socio-cultural constraints, economic hardship, post-traumatic stress disorders (PTSD), depression, and critical health issues, which may lead to suicidal ideation and death. The aim of this article is to explore why and how female garment workers who survived the Rana Plaza collapse are now at risk of suicide thoughts and behaviours, and suicide death. Unstructured face-to-face interviews were held from April to July 2018 with 11 female garment workers who survived the Rana Plaza building collapse. Interviews continued until data saturation was reached. The interviews were tape-recorded and transcribed verbatim while simultaneously being translated into English from Bengali/Bangla. Transcripts were coded and thematically analysed. The study found that all participants were living with multiple risk factors of suicidal ideation (including low socio-economic status, poverty, social stigma, psychological distress, and trauma) which the participants directly linked to the collapse of the Rana Plaza building. Our analysis uses the three-step theory of suicide (3ST, Klonsky & May, 2015) to understand female Rana Plaza survivors’ suicide risk. Female survivors’ overall vulnerability requires urgent attention while taking the socio-cultural setting of Bangladesh into account. In addition, a lifelong caring system (combining financial security and free healthcare) needs to be initiated to accommodate the female survivors with mainstream society to avoid possible future suicides. They require long-term social and economic security and psychological support.
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Carmassi C, Bertelloni CA, Dell'Oste V, Luperini C, Marazziti D, Rossi R, Dell'Osso L. PTSD and Suicidal Behaviors Amongst L'Aquila 2009 Earthquake Young Survivors. Front Public Health 2021; 9:590753. [PMID: 33643987 PMCID: PMC7902690 DOI: 10.3389/fpubh.2021.590753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 01/19/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Post-traumatic stress disorder (PTSD) is one of the most frequent and severe psychiatric consequences of natural disasters, frequently associated with suicidality. The aim of this study was at examining the possible relationships between suicidal behaviors and full-blown or partial PTSD, in a sample of young earthquake survivors. The second aim was at investigating the specific role of PTSD symptoms on suicidality. Methods: A total of 475 young adults who survived the L'Aquila 2009 earthquake, one of the most severe Italian disasters of the last decades, were recruited and assessed after 21 months from the catastrophe. Participants were evaluated by two questionnaires assessing subthreshold psychopathology, the Trauma and Loss Spectrum Self-Report (TALS-SR) to investigate both full and partial PTSD, and two specific Mood Spectrum Self-Report (MOODS-SR) sub-domains exploring suicidality, namely suicidal ideation and suicide attempts. Results: The ensuing findings showed that suicidal ideation and suicide attempts were present, respectively, in 40 (8.4%) and 11 (2.3%) survivors. Rates of suicidal ideation were significantly more elevated in full-blown PTSD subjects (group 1), as compared with those suffering from partial (group 2) or no PTSD (group 3). Interestingly, group 2 subjects showed significantly more suicidal ideation than healthy individuals, and less than those of group 1, while the frequency of suicide attempts was similar across the three groups. Suicidal ideation was associated with higher scores in the following TALS-SR domains: grief-reactions, re-experiencing, avoidance and numbing, maladaptive coping, and personal characteristics/risk factor. Conclusions: The results of the present study support and extend previous findings on the role of PTSD symptoms in suicidality after a severe earthquake. However, as compared with available literature, they also highlight the significant impact of sub-threshold PTSD manifestations in increasing the suicide risk in survivors of a mass disaster.
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Affiliation(s)
- Claudia Carmassi
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Carlo Antonio Bertelloni
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Valerio Dell'Oste
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Chiara Luperini
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy.,Department of Experimental Medicine, University of L'Aquila, L'Aquila, Italy
| | - Donatella Marazziti
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Rodolfo Rossi
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
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11
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Wang S, Shi X, Chen X, Zhu Y, Chen H, Fan F. Earthquake Exposure and PTSD Symptoms Among Disaster-Exposed Adolescents: A Moderated Mediation Model of Sleep Problems and Resilience. Front Psychiatry 2021; 12:577328. [PMID: 33927648 PMCID: PMC8076540 DOI: 10.3389/fpsyt.2021.577328] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 03/19/2021] [Indexed: 11/13/2022] Open
Abstract
Considerable studies have explored the potential mechanisms between trauma exposure and PTSD, but little is known about the role of sleep problems and resilience in this relationship. To address this research gap, the present study examined whether sleep problems mediated the relationship between earthquake exposure and PTSD symptoms, and whether this mediating process was moderated by resilience. A sample of 1,342 adolescents (M age = 15.54 years, SD = 1.26) completed questionnaires regarding earthquake exposure, sleep problems, resilience, and PTSD symptoms 12 months after a devastating earthquake in China. After controlling for demographic variables, earthquake exposure was significantly, and positively associated with PTSD symptoms, and sleep problems partially mediated this relationship. Tests of moderated mediation further revealed that resilience moderated the relationship between earthquake exposure and PTSD symptoms as well as sleep problems and PTSD symptoms. Specifically, the relationship between earthquake exposure and PTSD symptoms was only significant for adolescents with a lower level of resilience; meanwhile, the positive relationship between sleep problems and PTSD symptoms was stronger among low-resilient adolescents. Therefore, sleep-targeted and resilience-based interventions may be effective in alleviating PTSD symptoms resulted from the earthquake.
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Affiliation(s)
- Shuo Wang
- College of Education, Hebei University, Baoding, China
| | - Xuliang Shi
- College of Education, Hebei University, Baoding, China
| | - Xiaoyan Chen
- School of Psychology, South China Normal University, Guangzhou, China
| | - Ya Zhu
- Center for Mental Health Education and Counseling, Guangdong University of Science and Technology, Dongguan, China
| | - Huilin Chen
- Department of Psychology, University of Bath, Bath, United Kingdom
| | - Fang Fan
- School of Psychology, South China Normal University, Guangzhou, China
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Jahangiri K, Yousefi K, Mozafari A, Sahebi A. The Prevalence of Suicidal Ideation after the Earthquake: A Systematic Review and Meta-Analysis. IRANIAN JOURNAL OF PUBLIC HEALTH 2020; 49:2330-2338. [PMID: 34178739 PMCID: PMC8215057 DOI: 10.18502/ijph.v49i12.4815] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background: Disasters have many health consequences such as suicide ideation as one of the relatively common psychological consequences after natural disasters, especially earthquakes. This study aimed to determine the prevalence of post-earthquake suicidal ideation in affected people. Methods: Related keywords of this systematic review and meta-analysis in English and their Persian equivalents were searched in the data resources including Google Scholar, SID, Magiran, Scopus, PubMed, and Web of Science from Jan 2014 to May 2019. The STROBE checklist was used to evaluate the quality of the articles. The I2 index was used to determine the heterogeneity and the random-effects model was used in meta-analysis. Statistical analysis was conducted in the STATA software version 14. Results: Overall, 14347 subjects including 6662 males and 7715 females with the mean age of 23.88 ± 15.81yr old were assessed. The prevalence of post-earthquake suicidal ideation was 20.34% (95% CI: 13.60–27.08, P<0.001, I2=99.1). The prevalence of suicidal ideation showed a decreasing trend based on the year of the study and the duration of post-earthquake follow-up. Conclusion: Although the prevalence of post-earthquake suicidal ideation showed a decreasing trend, the probability of incidence of these thoughts in the long-term is still noticeable. Therefore, implementing a surveillance system is recommended to monitor the mental health status of earthquakes survivors for the possibility of suicidal thoughts in the short and long term recovery phase.
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Affiliation(s)
- Katayoun Jahangiri
- Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Health in Disasters and Emergencies, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kosar Yousefi
- Clinical Research Development Unit, Shahid Mostafa Khomeini Hospital, Ilam University of Medical Sciences, Ilam, Iran
| | - Aliashraf Mozafari
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Sahebi
- Department of Health in Disasters and Emergencies, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Longitudinal associations between adolescents' trajectory membership of depressive symptoms and suicidality in young adulthood: a 10-year cohort of Chinese Wenchuan earthquake survivors. Epidemiol Psychiatr Sci 2020; 29:e175. [PMID: 33070799 PMCID: PMC7681160 DOI: 10.1017/s2045796020000827] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
AIMS Previous studies regarding associations between depressive symptoms and suicidality (suicidal ideation, plans and attempts) have usually employed a variable-centred approach, without considering the individual variance in time-varying changes of depressive symptoms. Through 10-year follow-up of a large cohort of Chinese adolescents exposed to the 2008 Wenchuan earthquake, this study examined whether individual variance in depressive symptoms during the early phases post-earthquake could generate different suicidality outcomes in young adulthood. METHODS A total of 1357 Chinese adolescents exposed to the Wenchuan earthquake were surveyed on depressive symptoms and other variables at 6, 18 and 30 months post-earthquake. In total, 799 participants responded to the 10-year follow-up and completed an online survey covering suicidality and other variables. The analytic sample was 744 participants who had valid data on depressive symptoms and suicidality. Data were analysed using logistic regressions. RESULTS Prevalence estimates of past-year suicidal ideation, suicide plans and suicide attempts measured at 10 years post-earthquake were found to be 10.8%, 7.3% and 3.0%, respectively. Five trajectories of depressive symptoms were classified: resistance (54.4%), chronicity (13.3%), recovery (10.4%), delayed dysfunction (12.0%) and relapsing/remitting (10.0%). After controlling for covariates, whole-sample regressions revealed only the relapsing/remitting depressive trajectory remained significantly predictive of suicidality. Moreover, males not females in the chronic group were more likely to have suicide plans. CONCLUSIONS The findings highlight the importance of detecting disaster survivors with different trajectories of mental status and providing with them individualised and effective mental health services, to decrease their risk of suicidality in the future.
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Acute psychological effects of Coronavirus Disease 2019 outbreak among healthcare workers in China: a cross-sectional study. Transl Psychiatry 2020; 10:348. [PMID: 33051440 PMCID: PMC7552583 DOI: 10.1038/s41398-020-01031-w] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 06/26/2020] [Accepted: 07/03/2020] [Indexed: 01/09/2023] Open
Abstract
To study the acute psychological effects of Coronavirus Disease 2019 (COVID-19) outbreak among healthcare workers (HCWs) in China, a cross-sectional survey was conducted among HCWs during the early period of COVID-19 outbreak. The acute psychological effects including symptoms of depression, anxiety, and post-traumatic stress disorder (PTSD) were assessed using the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder (GAD-7) questionnaire, and the Impact of Event Scale-Revised (IES-R). The prevalence of depression, anxiety, and PTSD was estimated at 15.0%, 27.1%, and 9.8%, respectively. Having an intermediate technical title, working at the frontline, receiving insufficient training for protection, and lacking confidence in protection measures were significantly associated with increased risk for depression and anxiety. Being a nurse, having an intermediate technical title, working at the frontline, and lacking confidence in protection measures were risk factors for PTSD. Meanwhile, not worrying about infection was a protective factor for developing depression, anxiety, and PTSD. Psychological interventions should be implemented among HCWs during the COVID-19 outbreak to reduce acute psychological effects and prevent long-term psychological comorbidities. Meanwhile, HCWs should be well trained and well protected before their frontline exposure.
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Tang W, Kang Y, Xu J, Li T. Associations of Suicidality with Adverse Life Events, Psychological Distress and Somatic Complaints in a Chinese Medical Student Sample. Community Ment Health J 2020; 56:635-644. [PMID: 31919657 DOI: 10.1007/s10597-019-00523-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 12/09/2019] [Indexed: 02/05/2023]
Abstract
The present study aimed to examine the associations of suicidality with psychological distress, somatic symptoms, and stressors in medical school students. We conducted a cross-sectional survey of medical students at a large, top-ranked medical school. A total sample of 662 medical students (269 men) completed a battery of self-reported questionnaire. Of the respondents, 136 (20.5%) reported having suicidal ideation, 40 (6.0%) reported having planned suicide, and 10 (1.5%) reported having attempted suicide during the previous year. Students from rural areas and the 3rd year of study reported higher levels of suicidal ideation than their counterparts. General pain/fatigue was associated with suicidal ideation and planning, while interpersonal difficulties were associated only with suicidal ideation. This study provides evidence linking severe psychological distress, general pain/fatigue, interpersonal stress and psychosocial factors with suicide risk among Chinese medical students which provides targets for future psychological interventions.
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Affiliation(s)
- Wanjie Tang
- Centre for Educational and Health Psychology, Sichuan University, Chengdu, China
- Institute of Emergency Management and Post-disaster Reconstruction, Sichuan University, Chengdu, China
- Mental Health Center, State Key Lab of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Yukun Kang
- Mental Health Center, State Key Lab of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Jiuping Xu
- Institute of Emergency Management and Post-disaster Reconstruction, Sichuan University, Chengdu, China.
| | - Tao Li
- Centre for Educational and Health Psychology, Sichuan University, Chengdu, China.
- Mental Health Center, State Key Lab of Biotherapy, West China Hospital, Sichuan University, Chengdu, China.
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Mamun MA, Griffiths MD. PTSD-related suicide six years after the Rana Plaza collapse in Bangladesh. Psychiatry Res 2020; 287:112645. [PMID: 31685284 DOI: 10.1016/j.psychres.2019.112645] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 10/20/2019] [Accepted: 10/24/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Mohammed A Mamun
- Founder & Director, Undergraduate Research Organization, Savar, Dhaka, Bangladesh; Department of Public Health & Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh.
| | - Mark D Griffiths
- Psychology Department, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ, UK
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Jafari H, Heidari M, Heidari S, Sayfouri N. Risk Factors for Suicidal Behaviours after Natural Disasters: A Systematic Review. Malays J Med Sci 2020; 27:20-33. [PMID: 32684803 PMCID: PMC7337952 DOI: 10.21315/mjms2020.27.3.3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 02/12/2020] [Indexed: 12/31/2022] Open
Abstract
Natural disasters have multiple psychological effects including increased risk of suicide among victims. Reviews have shown that suicidal behaviours can be an aftermath of natural disasters. The present study attempted to identify the suicide-related risk factors after natural disasters. This study was a systematic review probing English language articles related to suicide and its risk factors after natural disasters and published between 1 January 1990 and 27 September 2018 in Google Scholar, PubMed, Web of Science, Science Direct, Scopus, ProQuest and Cumulative Index of Nursing and Allied Health Literature (CINAHL) databases. After reviewing and screening the collected studies by means of specific criteria, only 30 studies were qualified to enter the survey. It was found that most of these studies had investigated suicide after earthquake. Gender, age, serious mental disorders, depression, post-traumatic stress disorder (PTSD), loss of family members, low economic status, low social support, and injury to the person and the family/relatives were identified as the most important risk factors for suicide after natural disasters. Women, adolescents, elderly, people with depression and PTSD, those suffer from low social support and parentless people were found to be among the ones being highly vulnerable to suicide after natural disasters. There is, therefore, a need for providing psychosocial support for these people after such disasters.
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Affiliation(s)
| | - Mohammad Heidari
- Community-Oriented Nursing Midwifery Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Samaneh Heidari
- Trauma and Injury Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Nasrin Sayfouri
- Department of Foreign Languages, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
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Li L, Reinhardt JD, Van Dyke C, Wang H, Liu M, Yamamoto A, Chen Q, Hu X. Prevalence and risk factors of post-traumatic stress disorder among elderly survivors six months after the 2008 Wenchuan earthquake in China. BMC Psychiatry 2020; 20:78. [PMID: 32087728 PMCID: PMC7036222 DOI: 10.1186/s12888-020-2474-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 01/31/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Several studies indicate that older age is a risk factor for probable post-traumatic stress disorder (PTSD). However, evidence on the prevalence and risk factors for elderly disaster survivors is limited. METHODS Multi-stage stratified sampling was applied in this cross-sectional study. The Revised Version of the Impact of Event Scale (IES-R) was used to evaluate symptoms of PTSD. Chi-squared test was used for univariable analysis of prevalence of probable PTSD by possible determinants. Multivariable logistic regression analysis was utilized to further explore risk factors for PTSD. RESULTS 427 elderly survivors age 60 or older participated. The prevalence of probable PTSD was 40.5, 36.3, and 21.5% according to a cut off score of the IES-R of 33, 35, and 2 points on average across items, respectively. In multivariable logistic regression, elderly survivors with a higher number of diagnosed chronic illnesses were more likely to be screened positive for PTSD and those with a greater number of family members living in the same home were less likely to be classified as having probable PTSD for all cut off scores. Elderly survivors with improved economic status and those with primary school or lower education were more often estimated to have probable PTSD with a cut off score of 35 and 2 points on average. CONCLUSIONS Elderly survivors in a high impact area following a major earthquake are at high risk for developing PTSD. Those who live alone and report pre-existing chronic illness are particularly vulnerable.
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Affiliation(s)
- Lan Li
- grid.13291.380000 0001 0807 1581Department of Nursing, West China Hospital, Sichuan University, Chengdu, China ,grid.410578.fDepartment of Nursing, Southwest Medical University, Luzhou, China ,Institute for Disaster Management and Reconstruction of Sichuan University and Hong Kong Polytechnic University, Chengdu, China
| | - Jan D. Reinhardt
- Institute for Disaster Management and Reconstruction of Sichuan University and Hong Kong Polytechnic University, Chengdu, China ,grid.419770.cSwiss Paraplegic Research, Nottwil, Switzerland ,grid.449852.6Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Craig Van Dyke
- grid.13291.380000 0001 0807 1581Department of Nursing, West China Hospital, Sichuan University, Chengdu, China ,grid.266102.10000 0001 2297 6811Department of Psychiatry, University of California San Francisco, San Francisco, CA USA
| | - Heng Wang
- grid.13291.380000 0001 0807 1581Department of Anesthesiology, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, China
| | - Maoqiong Liu
- Department of Nursing, Dujiangyan Second People’s Hospital, Dujiangyan, China
| | - Aiko Yamamoto
- grid.502988.eResearch Institute for Nursing Care, Information Engineering National Institute of Technology, Nara College, Nara, Japan
| | - Qian Chen
- Center of Gerontology and Geriatrics, National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, 610041, Sichuan Province, China.
| | - Xiuying Hu
- Innovation Center for Nursing Research, West China School of Medicine/West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, 610041, Sichuan Province, China.
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Wang Q, Ren L, Wang W, Xu W, Wang Y. The relationship between post-traumatic stress disorder and suicidal ideation among shidu parents: the role of stigma and social support. BMC Psychiatry 2019; 19:352. [PMID: 31703652 PMCID: PMC6842260 DOI: 10.1186/s12888-019-2353-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 10/31/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Losing an only child is a particularly traumatic and heartbreaking event for parents, which can trigger a lot of emotional responses, including PTSD and suicidal ideation (SI). The objectives of this study were mainly to identify predictors of SI and examine the interactions of PTSD with stigma and social support on SI among shidu parents. METHODS A total of 507 shidu parents from Shenyang, China were included in this cross-sectional study. Bivariate logistic regression analyses were conducted to explore risk or protective factors associated with SI. Interactions of PTSD with stigma and social support on SI were also examined by bivariate logistic regression analyses. RESULTS The prevalence of SI among shidu parents was 11.24%. PTSD (OR = 2.23, p < 0.05) and stigma (OR = 4.66, p < 0.01) were positively associated with SI. Social support was negatively associated with SI (OR = 0.90, p < 0.01). For individuals with PTSD, the presence of stigma was more likely to lead to SI. For individuals with PTSD, an increased level of social support was less likely to lead to SI. CONCLUSIONS SI is a serious issue among shidu parents. Stigma aggravated the effect of PTSD on SI, while social support buffered the effect of PTSD on SI among shidu parents.
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Affiliation(s)
- Qiong Wang
- 0000 0000 9678 1884grid.412449.eDepartment of Social Medicine, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New District, Shenyang, Liaoning 110122 People’s Republic of China
| | - Longfei Ren
- 0000 0000 9678 1884grid.412449.eDepartment of Social Medicine, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New District, Shenyang, Liaoning 110122 People’s Republic of China
| | - Wenhao Wang
- 0000 0000 9678 1884grid.412449.eDepartment of Social Medicine, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New District, Shenyang, Liaoning 110122 People’s Republic of China
| | - Weihua Xu
- Department of Medical Care and Maintenance, Health Commission of Shenyang, No. 13 Beiqi Road, Heping District, Shenyang, Liaoning 110003 People’s Republic of China
| | - Yang Wang
- Department of Social Medicine, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New District, Shenyang, Liaoning, 110122, People's Republic of China.
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Gao X, Leng Y, Guo Y, Yang J, Cui Q, Geng B, Hu H, Zhou Y. Association between earthquake experience and depression 37 years after the Tangshan earthquake: a cross-sectional study. BMJ Open 2019; 9:e026110. [PMID: 31434762 PMCID: PMC6707697 DOI: 10.1136/bmjopen-2018-026110] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE To investigate the association between the Tangshan earthquake and depression after 37 years. DESIGN AND SETTING A cross-sectional study conducted in Tangshan from 2013 to 2014. PARTICIPANTS The sample included 5024 participants born before 28 July 1976 the date of the Tangshan earthquake, with available data on their earthquake experiences and depression 37 years post-earthquake. OUTCOMES AND VARIABLES The outcome was depression measured using the Center for Epidemiological Study and Depression Scale. The independent variable was earthquake experience, which was classified into three groups: no earthquake experience, earthquake experience without bereavement and earthquake experience with bereavement. Multivariable logistic regression analysis was used to evaluate the association between earthquake experience and depression after adjusting for gender, age at the time of the earthquake, smoking status, drinking status, education, income, residence in Tangshan 1 to 2 years post-earthquake, hypertension, diabetes and dyslipidaemia. RESULTS Of the 5024 participants, 641 experienced the Tangshan earthquake, and 98 experienced bereavement due to the earthquake. 37 years after the earthquake, survivors who had lost relatives during the earthquake were nearly three times (OR 2.82, 95% CI 1.24 to 6.39) as likely to have depression as those who had not experienced the earthquake, while those who had not lost relatives were 1.69 times as likely (OR 1.69, 95% CI 0.93 to 3.08). Stratified analyses showed that earthquake was significantly associated with depression in women with (OR 3.51, 95% CI 1.21 to 10.16) or without bereavement (OR 3.07, 95% CI 1.44 to 6.56) but not in men; this association was also significant in individuals over 18 years old at the time of the earthquake with (OR 13.16, 95% CI 3.08 to 56.3) or without bereavement (OR 3.39, 95% CI 1.31 to 8.87) but not in individuals less than 18 years old. CONCLUSIONS 37 years after the Tangshan earthquake, earthquake experience was associated with depression among bereaved survivors, women and individuals over 18 years old at the time of the earthquake.
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Affiliation(s)
- Xing Gao
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yue Leng
- Global Brain Health Institute, Department of Psychiatry, University of California, San Francisco, California, USA
| | - Yuchen Guo
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jichun Yang
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences Key Laboratory of Molecular Cardiovascular Science of the Ministry of Education Center for Non-coding RNA Medicine, Peking University Health Science Center, Beijing, China
| | - Qinghua Cui
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences Key Laboratory of Molecular Cardiovascular Science of the Ministry of Education Center for Non-coding RNA Medicine, Peking University Health Science Center, Beijing, China
| | - Bin Geng
- Hypertension Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Cardiovascular Disease, Beijing, China
| | - Hongpu Hu
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yong Zhou
- Sanbo Brain Institute, Sanbo Brain Hospital, Capital Medical University, Beijing, China
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Chen Z, Wang G, Jiang C. Posttraumatic stress symptoms (PTSS) in patients with Cushing's disease before and after surgery: A prospective study. J Clin Neurosci 2019; 66:1-6. [PMID: 31178305 DOI: 10.1016/j.jocn.2019.05.059] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 04/13/2019] [Accepted: 05/27/2019] [Indexed: 12/19/2022]
Abstract
The aim of this study was to investigate the occurrence, correlated factors and prognosis of posttraumatic stress symptoms (PTSS) in patients with Cushing's disease (CD). A total of 49 patients who were newly diagnosed with CD and underwent transsphenoidal surgery in our hospital from April 2015 to August 2017 were asked to participate in this study. Another group of 49 age and sex matched healthy control participants were also included for comparison. PTSS (measured with Impact of Event Scale-Revised, IES-R), depression/anxiety (measured with Hospital Anxiety and Depression scale, HADS) and quality of life (QoL; measured with 36-item short-form, SF-36) were evaluated at pre-surgery, 6 months post-surgery and 12 months post-surgery. The results showed that at preoperative stage, 15 (30.6%) CD patients developed PTSS, and they had higher 24 h UFC, and presented worse levels of depression, anxiety and QoL compared with patients without PTSS. Although most of them recovered postoperatively, there were still 5/15 (33.3%) patients persisted with PTSS for over a year. Additionally, one patient with recurred CD developed PTSS between 6 and 12 months postoperatively. Among the whole group of CD patients, the PTSS severity showed consistent improvement after surgery, which was in accordance with the progressing trends of depression, anxiety and psychological aspects of SF-36. However, compared with healthy individuals, CD patients in remission still performed worse in physical/mental health. In conclusion, patients with CD can develop PTSS, and they may persist for over a year even after successful surgery. Combined psychological intervention is advised for these patients.
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Affiliation(s)
- Zhuang Chen
- Department of Neurology, General Hospital of Southern Theatre Command, Guangzhou, China
| | - Guoliang Wang
- Department of Neurology, General Hospital of Southern Theatre Command, Guangzhou, China
| | - Che Jiang
- Department of Neurology, General Hospital of Southern Theatre Command, Guangzhou, China.
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Tang W, Xu D, Li B, Lu Y, Xu J. The relationship between the frequency of suicidal ideation and sleep disturbance factors among adolescent earthquake victims in China. Gen Hosp Psychiatry 2018; 55:90-97. [PMID: 30448743 DOI: 10.1016/j.genhosppsych.2018.09.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 09/27/2018] [Accepted: 09/27/2018] [Indexed: 01/19/2023]
Abstract
OBJECTIVE This study aimed to examine the frequency of suicidal ideation (SI) and identify exposure variables, mental health, and sleep-related risk factors of SI among adolescents following the 2013 Ya'an earthquake. METHODS Participants consisted of 5563 adolescent students selected through random sampling from 11 primary and high schools in the counties most severely affected by the earthquake. They were asked to complete the Pittsburgh Sleep Quality Index, Children's Revised Impact of Event Scale-13, Short Mood and Feelings Questionnaire, and Screen for Child Anxiety-Related Emotional Disorders. Multinomial logistic analysis was used to identify possible relationships between SI and psychopathology, sleep problems, earthquake exposures or demographic characteristics. The mediation analysis was used to identify direct and indirect effects among sleep problems, psychopathology, earthquake exposures and SI. RESULTS Our findings suggest that 29.5% of the sample experienced SI during the past year (12.9% once, 11.9% twice, 2.6% on 3-4 occasions and 2.1% on at least 5 occasions). Multiple sleeping problems, including trouble falling asleep, shorter sleep duration, and daytime dysfunction, showed independent associations with SI. The mediation analysis suggested that depression and anxiety mainly mediated the association of sleep with SI. LIMITATIONS This study was cross-sectional and did not include controls. No baseline data were collected prior to the earthquake. CONCLUSION SI can be a serious problem among adolescents following a major earthquake, especially those who are older, who live in one-child households, or who are female. Years after a disaster, we found that exposure severity, psychopathology and sleep impairment all contributed to SI, and that earthquake exposure may have disrupted sleep and worsened mood, which in turn may have impacted SI. By enhancing teenagers' sleep management and shaping their activities, post-disaster intervention programs may help prevent SI among Chinese adolescents.
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Affiliation(s)
- Wanjie Tang
- Institute of Emergency Management and Post-disaster Reconstruction, Sichuan University, Chengdu, China; Centre for Educational and Health Psychology, Sichuan University, Chengdu, China; Mental Health Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Dun Xu
- Institute of Emergency Management and Post-disaster Reconstruction, Sichuan University, Chengdu, China
| | - Bin Li
- Mental Health Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Yi Lu
- Institute of Emergency Management and Post-disaster Reconstruction, Sichuan University, Chengdu, China
| | - Jiuping Xu
- Institute of Emergency Management and Post-disaster Reconstruction, Sichuan University, Chengdu, China.
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Guo J, Liu C, Kong D, Solomon P, Fu M. The relationship between PTSD and suicidality among Wenchuan earthquake survivors: The role of PTG and social support. J Affect Disord 2018; 235:90-95. [PMID: 29655080 DOI: 10.1016/j.jad.2018.04.030] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Revised: 03/04/2018] [Accepted: 04/04/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Previous studies have found that suicide rates are likely to increase after the occurrence of earthquakes. Most existing studies that examined the relationship between PTSD and suicidality focus on risk factors. It remains unclear whether protective factors, such as post-traumatic growth (PTG) and social support, play a role in this relationship. OBJECTIVES The aim of this study was to investigate the role of PTG and social support in the association between PTSD and suicidality, using data from a cross-sectional study conducted in China. METHODS 1,369 participants were recruited from two study sites that were severely affected by the Wenchuan earthquake. Univariate and multivariate regression analyses were conducted to examine the relationship between PTSD, PTG, social support, and suicidality. RESULTS The results indicate that the prevalence of suicidal ideation, suicide plans, and suicide attempts among adult survivors were 9.06%, 2.97% and 3.31%, respectively, even after 8 years following the Wenchuan earthquake. Furthermore, the findings show that PTSD was significantly associated with suicidality (OR = 1.96; 95% CI = 1.53, 2.52). Additionally, individuals reporting lower levels of social support and the acquisition of PTSD (OR = 5.99; 95% CI = 1.66, 21.56) were significantly related to suicidality. Moreover, compared to individuals who reported no presence of PTSD and high PTG, those who lived with PTSD and lower levels of PTG (OR = 2.33; 95%CI = 1.00, 5.42) were more likely to report suicidality. LIMITATIONS The cross-sectional design of this study limits our ability to determine causal relationships. Effects of other related factors, such as cultural and life events, were not examined in this study. CONCLUSIONS Suicidality is a long-term health issue among survivors of the Wenchuan earthquake. PTG and social support play important roles on the association between PTSD and suicidality and are important contributing factors to understanding this relationship. These results contribute new knowledge of suicidal risk for a number of years after an earthquake and have implications for further mental health promotion following earthquakes.
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Affiliation(s)
- Jing Guo
- School of Sociology, Huazhong University of Science and Technology, Wuhan 430074, PR China.
| | - Chengcheng Liu
- School of Sociology, Huazhong University of Science and Technology, Wuhan 430074, PR China
| | - Dexia Kong
- School of Social Policy & Practice, University of Pennsylvania, Philadelphia, PA, USA.
| | - Phyllis Solomon
- School of Social Policy & Practice, University of Pennsylvania, Philadelphia, PA, USA
| | - Mingqi Fu
- School of Sociology, Huazhong University of Science and Technology, Wuhan 430074, PR China
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The prevalence of posttraumatic stress in adolescents eight years after the Wenchuan earthquake. Psychiatry Res 2018; 262:262-269. [PMID: 29475105 DOI: 10.1016/j.psychres.2018.02.019] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Revised: 01/12/2018] [Accepted: 02/02/2018] [Indexed: 02/05/2023]
Abstract
In 2008, an 8.0 Richter scale earthquake devastated Wenchuan in China, which resulted in heavy casualties, and had wide-reaching psychological effects on survivors. To examine its impact on the survivors, this study aims to investigate the prevalence of posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG) in adolescents eight years after the earthquake. The cross-section survey was conducted in two different earthquake-affected areas, and data were collected from 4118 respondents. Instruments included the questionnaire on demographic information, the questionnaire on seismic exposure, PTSD Checklist-Civilian Version (PCL-C) questionnaire, Posttraumatic Growth Inventory (PTGI), Perceived Social Support Scale (PSSS) and Simple Coping Style Questionnaire (SCSQ). During the survey, there were 1998 valid questionnaires from the generally affected area and 2120 questionnaires from the severely affected area. The rate of PTSD is 1.9% in the generally affected area and 2.7% in the severely affected disaster area; there is no significant difference between the two differently affected areas. Occurrences of PTSD and PTG are significantly positively correlated in the generally affected area, nevertheless, there is a significant negative correlation between PTSD and PTG in most systems of the severely affected area. The results of this study help to expand our knowledge regarding posttraumatic stress in adolescents 8 years after the Wenchuan earthquake, and it provides suggestions for specific long-term health interventions in such populations. To prevent earthquake-related psychological issues among adolescent survivors, social support, psychological aid, and improvement of the living environment are necessary to buffer negative posttraumatic stress.
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