Prevalence of Posttraumatic Stress Disorder Following the Earthquake in Iran and Pakistan: A Systematic Review and Meta-Analysis

The prevalence and risk factors for post-traumatic stress disorder, depression and anxiety among older survivors post-earthquake: A systematic review and meta-analysis

BACKGROUND

The occurrence of PTSD, depression, and anxiety is notably high among older adults following an earthquake. This research aimed to assess the prevalence and determinants of mental health conditions among older survivors after an earthquake.

METHODS

The review was conducted in accordance with the PRISMA process. A comprehensive search was conducted across various databases including PubMed, EMBASE, Web of Science, Scopus, CINAHL, Cochrane Library, SinoMed, China National Knowledge Infrastructure (CNKI), the VIP Database for Chinese Technical Periodicals, and the Wan Fang Database for Chinese Periodicals for studies reporting on the prevalence of PTSD, depression, and anxiety among older survivors post-earthquake. Each database was searched from inception to August 1, 2023 each database, and updated the search on October 1, 2024. The random effects model was employed to conduct meta-analysis, and the I2 index was taken into account to evaluate heterogeneity among studies. A narrative synthesis was performed to identify the risk factors associated with these mental health conditions.

RESULTS

A total of 33 studies were analyzed in this meta-analysis, mainly from China, Japan, Nepal, and Mexico. The prevalence rates of PTSD, depression, and anxiety among older earthquake survivors were found to be 19.3 % (95 % CI [16.0-22.6 %]; I2 = 99.486 %, P = 0.000), 23.5 % (95 % CI [13.9-33.1 %]; I2 = 99.901 %, P = 0.000) and 10.9 % (95 % CI [6.7-15.1 %]; I2 = 99.287 %, P = 0.000), respectively. The identified major risk factors were categorized into four dimensions, including demographic variables (e.g., older age, chronic illness), pre-disaster mitigation variables (e.g., lack of insurance), responding in disaster variables (e.g., being injured, property damage) and post-disaster relief variables (e.g., inadequate psychological care, low levels of social/family support).

LIMITATIONS

The optimal cut-off for different screening tools may be sensitive to changes in the prevalence of older survivors post-earthquake. Furthermore, due to the heterogeneity of the studies, a narrative synthesis of risk factors was conducted.

CONCLUSIONS

The findings of this review may increase the awareness of the burden and risk factors associated with PTSD, depression, and anxiety in older survivors post-earthquake. It serves as a reference for the government in formulating recovery policies focusing on interventions, such as financial allocation, psychological treatment, and insurance claims. These policies aim to mitigate the long-term psychological effects on older survivors and ultimately lower the prevalence of mental health conditions.

Prevalence and Risk Factors of PTSD, Depression, and Grief Among Survivors of 2023 Türkiye Earthquake

ABSTRACT

This study investigated the prevalence and risk factors of probable posttraumatic stress disorder (PTSD), depression, and complicated grief among 529 adults residing in a container city, 4 months after the 2023 earthquakes in Türkiye. Participants were assessed using the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, the Hamilton Depression Scale, and the Inventory of Complicated Grief. The prevalence rates of probable PTSD, depression, and complicated grief were 21.4%, 15.9%, and 64.7%, respectively. Logistic regression analyses indicated that PTSD was significantly associated with the loss of a loved one, fear of future earthquakes, and decreased perceived life control. Similarly, depression was associated with being trapped under debris, experiencing fear during the earthquake, and reduced perceived life control. These findings suggest that individuals presenting these risk factors warrant closer follow-up for potential psychological issues. Additionally, the impact of fear related to the earthquake and the role of perceived life control emerge as crucial considerations for psychological interventions.

Posttraumatic stress disorder (PTSD) prevalence: an umbrella review

Posttraumatic stress disorder (PTSD) is one of the most serious and incapacitating mental diseases that can result from trauma exposure. The exact prevalence of this disorder is not known as the literature provides very different results, ranging from 2.5% to 74%. The aim of this umbrella review is to provide an estimation of PTSD prevalence and to clarify whether the prevalence depends on the assessment methods applied (structured interview v. self-report questionnaire) and on the nature of the traumatic event (interpersonal v. not-interpersonal). A systematic search of major databases and additional sources (Google Scholar, EBSCO, Web of Science, PubMed, Galileo Discovery) was conducted. Fifty-nine reviews met the criteria of this umbrella review. Overall PTSD prevalence was 23.95% (95% confidence interval 95% CI 20.74-27.15), with no publication bias or significant small-study effects, but a high level of heterogeneity between meta-analyses. Sensitivities analyses revealed that these results do not change after removing meta-analysis also including data from underage participants (23.03%, 95% CI 18.58-27.48), nor after excluding meta-analysis of low quality (24.26%, 95% CI 20.46-28.06). Regarding the impact of diagnostic instruments on PTSD prevalence, the results revealed a lack of significant differences in PTSD prevalence when structured v. self-report instruments were applied (p = 0.0835). Finally, PTSD prevalence did not differ following event of intentional (25.42%, 95% CI 19.76-31.09) or not intentional (22.48%, 95% CI 17.22-27.73) nature (p = 0.4598). The present umbrella review establishes a robust foundation for future research and provides valuable insights on PTSD prevalence.

The impact of earthquakes on women: assessing women's mental health in aftermath of the Kahramanmaraş-centred earthquake in Türkiye

BACKGROUND

Earthquakes disproportionately affect women and exacerbate gender and social inequalities. This study aims to investigate the psychological impact of the earthquake in Türkiye on women and the associated factors.

METHODS

This is a survey-based study. We collected data from 498 women residing in cities most affected by the earthquake.

RESULTS

Participants' mean age was 27.72 ± 5.4. Over 78% of the participants lost at least one family member, and 43.7% lost at least one child due to the earthquake. The mean average of Brief Symptom Inventory (BSI) scores was 100.8 (SD = 8.37), and the Global Severity Index was 1.9 (SD = 0.16). Regression analysis showed that higher education levels predicted poor outcomes across most BSI dimensions. Losing a family member and shelter and injury status were also predictors for several mental health outcomes of the BSI subscales.

CONCLUSIONS

Earthquakes significantly impact women's well-being and may have a broader impact on the whole family. There is an urgent need to provide psycho-social interventions in the response and recovery phases of the crisis to meet the affected women's needs. This includes providing basic needs with attention to women-specific needs, restoring social networks, addressing gender-based violence and providing gender-sensitive specialized interventions for those who need further support.

Effects of peritraumatic reactions on post-traumatic stress among Kahramanmaras earthquake survivors

PURPOSE

Peritraumatic reactions play a crucial role in the development of mental health problems, including depression and post-traumatic stress disorder. Therefore, this study sought to examine the influence of the peritraumatic reactions, including peritraumatic dissociation, peritraumatic distress, mental defeat, and tonic immobility, on post-traumatic stress disorder and major depressive disorder in earthquake survivors.

MATERIALS AND METHODS

A total of 261 adult participants aged between 18 and 65 (Mage=29.20, SD = 28.06, 162 were female, and 99 were male) who were exposed to the Kahramanmaras earthquake in February 2023 were recruited in the study. Data were collected between April 10 and 18 2023, two months after the earthquake. Participants completed questionnaires, including The International Trauma Questionnaire, The International Depression Questionnaire, The Mental Defeat Questionnaire, The Tonic Immobility Scale, and The Peritraumatic Dissociative Experiences Questionnaire.

RESULTS

Two-step multiple linear regression analyses indicated all peritraumatic reactions predicted both post-traumatic stress disorder and depression. Dominance analysis results showed that the contribution of peritraumatic dissociation in predicting PTSD and depression was higher among other peritraumatic reactions.

CONCLUSION

The findings of the study revealed a robust association between peritraumatic reactions and both depression and PTSD, shedding light on the underlying processes in the development of trauma-related disorders. Early assessment of peritraumatic reactions may be useful in identifying individuals at risk of developing PTSD and depression.

Trajectories of parental posttraumatic stress disorder and children's mental health following Super Typhoon Lekima: The mediating role of feeling of safety

INTRODUCTION

Several studies have examined the impact of parents' posttraumatic stress disorder (PTSD) on their children's mental health, but few have evaluated the role of parents' specific PTSD trajectories. The aim of this study was to assess the mechanisms underlying distinct trajectories of parental PTSD that affect children's PTSD and depression through the feeling of safety.

METHODS

The final sample comprised 242 dyads of parents and their children who experienced Super Typhoon Lekima in 2019. All participants were surveyed at three time points after the typhoon: 3 months (T1), 15 months (T2), and 27 months (T3). Parental PTSD symptoms at three time points and children's PTSD, depression, and feeling of safety at T3 were analyzed.

RESULTS

Four parental PTSD trajectories were identified: recovery, resilience, delayed, and coping. Compared with the resilient group, children of parents with delayed PTSD trajectories reported higher levels of depression at T3, while children of parents in the coping group were more likely to experience severe PTSD at T3. Children of parents in the recovery group, with a reduced feeling of safety, exhibited more severe depression and PTSD at T3, whereas children of parents in the delayed group were at an increased risk of PTSD at T3.

CONCLUSIONS

These findings highlight the heterogeneity of parental PTSD trajectories following natural disasters and their distinct effects on children's PTSD and depression. Furthermore, feeling of safety emerges as a crucial mechanism in this process.

Impact of climate events, pollution, and green spaces on mental health: an umbrella review of meta-analyses

Climate change may affect mental health. We conducted an umbrella review of meta-analyses examining the association between mental health and climate events related to climate change, pollution and green spaces. We searched major bibliographic databases and included meta-analyses with at least five primary studies. Results were summarized narratively. We included 24 meta-analyses on mental health and climate events (n = 13), pollution (n = 11), and green spaces (n = 2) (two meta-analyses provided data on two categories). The quality was suboptimal. According to AMSTAR-2, the overall confidence in the results was high for none of the studies, for three it was moderate, and for the other studies the confidence was low to critically low. The meta-analyses on climate events suggested an increased prevalence of symptoms of post-traumatic stress, depression, and anxiety associated with the exposure to various types of climate events, although the effect sizes differed considerably across study and not all were significant. The meta-analyses on pollution suggested that there may be a small but significant association between PM2.5, PM10, NO2, SO2, CO and mental health, especially depression and suicide, as well as autism spectrum disorders after exposure during pregnancy, but the resulting effect sizes varied considerably. Serious methodological flaws make it difficult to draw credible conclusions. We found reasonable evidence for an association between climate events and mental health and some evidence for an association between pollution and mental disorders. More high-quality research is needed to verify these associations.

Post-Traumatic Stress Disorder after the 6.1 Magnitude Earthquake in Piura, Peru: A Cross-Sectional Study

In Peru, major disasters like the 2007 Pisco earthquake have produced high rates of post-traumatic stress. However, evidence is still needed to strengthen interventions. In 2021, a major earthquake struck Piura, in northern Peru. In this context, we aimed to assess the prevalence of PTSD and its associated factors. A cross-sectional study was conducted during August-September 2021 in people who experienced the 6.1 Piura earthquake on 30 July 2021. The questionnaire included the PCL-C, CD-RISC, ISI, HFIAS, and additional demographic data. Generalized linear models were used. The prevalence of PTSD was 20.3%. Household income was between PEN 2001 and 3000 (PR = 4.26, 95% CI: 1.08-16.75), smoking (PR = 2.49, 95% CI: 1.03-6.01), experience of a nervous breakdown (PR = 1.83, 95% CI: 1.09-3.09), moderate food insecurity (PR = 2.91, 95% CI: 1.10-7.73), and severe insomnia (PR = 8.25, 95% CI: 2.22-30.71) increased the prevalence of PTSD. One out of five individuals experienced post-traumatic stress symptoms after the 2021 earthquake in Piura, which varies depending on socioeconomic, psychosocial, and individual factors. Further research should strengthen these findings to ensure a fair and early mental health intervention against new seismic events in this and other Peruvian regions.