Prevalence and risk factors of post-traumatic stress disorder among elderly survivors six months after the 2008 Wenchuan earthquake in China

Correlation Between Post-Traumatic Stress Disorder and Sleep Hygiene in Adults Surviving the 2023 Kahramanmaraş Earthquakes

On February 6, 2023, two major earthquakes with magnitudes of 7,7 and 7,6 struck the Kahramanmaraş region in Turkey. Over 50.000 people lost their lives and more than half a million buildings were damaged as a result of these earthquakes. Earthquake survivors may develop post-traumatic stress disorder and sleep hygiene problems. This study aims to evaluate the correlation between post-traumatic stress and sleep hygiene among surviving adults six months after the February 6th Kahramanmaraş Earthquakes in Turkey. This study was conducted with 1004 earthquake survivors in 11 provinces influenced by the February 6th Kahramanmaraş earthquakes in Turkey. The data was collected with Personal Information Form, Impact of Events Scale-Revised, and the Sleep Hygiene Index. It has been determined that 54.1% of earthquake survivors scored ≥ 33 on the Impact of Events Scale-Revised. The level of post-traumatic stress disorder was high and their sleep hygiene index level was above average among earthquake survivors. A strongly significant positive correlation was observed between the Impact of Events Scale-Revised and the Sleep Hygiene Index. It is recommended to plan and implement community-based psychological interventions to reduce post-traumatic stress disorder and improve sleep hygiene among survivors after earthquakes.

Quality of life and post-traumatic stress disorder among elderly earthquake survivors: a focus on the February earthquake in Turkey

BACKGROUND

On 6 February, 2023, Turkey experienced a disaster resulting from two major earthquakes. The elderly population stands out as one of the most vulnerable and least adaptable. This study aims to identify the quality of life (QOL) and post-traumatic stress disorder (PTSD) symptoms among elderly earthquake survivors in Turkey.

METHODS

This research was conducted between 1 October, 2023 and 15 December, 2023 as a cross-sectional design. During the data collection process, survey questions prepared by the researchers (29 questions) and the Elderly Quality of Life Scale (OPQOL-Bref) and the Impact of Events Scale (IES-R) were used.

RESULTS

Three hundred and eighty-four elderly people participated in the study. PTSD was more common in those diagnosed with chronic diseases after the earthquake, in those who had a drug-free period after the earthquake, in those who smoked and quit smoking, and in those who started psychiatric medication after the earthquake. Post-traumatic stress was seen more frequently in those with low QOL scores and in those who had a longer period of not using medication after the earthquake. It was observed that QOL was better in married people, high school graduates, those with average income levels, those who did not have chronic diseases before and after the earthquake, those who did not have a drug-free period after the earthquake, those who were physically active, and those who did not use psychiatric medication after the earthquake.

CONCLUSION

Chronic disease diagnosis post-earthquake, drug-free periods, smoking habits, and psychiatric medication usage were identified as influential factors in PTSD occurrence. Additionally, the study shed light on the profound effect of earthquake-related experiences, such as house damage, injuries, deaths in first-degree relatives, displacement, and changes in living conditions, on PTSD prevalence.

Prevalence and determinants of post-traumatic stress disorder five months after the 2019 huge flooding in Iran

BACKGROUND

Despite the high occurrence of floods in Iran, its psychological consequences have been less discussed. The present paper addresses the prevalence of Post-traumatic Stress Disorder (PTSD) and its determinants among the affected adults by the huge flood of 2019.

METHODS

An analytical cross-sectional study was conducted through household face-to-face surveys in August and September 2019. Individuals who were affected by floods and were at least 16 years old were randomly selected from three provinces in Iran: Lorestan and Khuzestan in the west and southwest, and Golestan in the northeast. The questionnaire of demographic and flood related variables in addition to the Impact of Event Scale-Revised (IES-R) were utilized to collect the data. We applied a complex sample analysis to describe the prevalence of PTSD and logistic regression analyses to find its determinants.

RESULTS

Out of the 2,305 individuals approached for surveys, 1,671 (72.5%) adults affected by the floods participated in the study. The majority of participants were housewives, married, had either no formal education or primary education, and resided in rural areas. The prevalence of PTSD in the participants was 24.8% (CI 95%: 20.7-28.8%) and was significantly higher in Lorestan province (39.7%, P < 0.001). Determinants of PTSD, were unemployment (adjusted odds ratio [AOR] = 3.53, CI 95%: 1.38-9.00), primary (AOR = 2.44, CI 95%: 1.10-5.41) or high school (AOR = 2.35, CI 95%: 1.25-4.40) education (vs. university), a history of mental disorders (AOR = 2.36, CI 95%: 1.22-4.58), high damage to assets (AOR = 2.29, CI 95%: 1.40-3.75), limited access to health care services after the flood (AOR = 1.95, CI 95%: 1.20-3.19), not receiving compensation for flood damage (AOR = 1.94, CI 95%: 1.01-3.83), high wealth index (AOR = 1.90, CI 95%: 1.23-2.93), and flooded house with a height of more than one meter (AOR = 1.66, CI 95%: 1.02-2.76).

CONCLUSION

Results show a notable prevalence of PTSD, especially in Lorestan province, among adults affected by floods. Determinants of PTSD include unemployment, lower education, psychiatric history, extensive property damage, limited post-flood healthcare access, lack of compensation, and increased flood exposure. We recommend adopting an inclusive screening approach for high-risk groups and developing appropriate therapeutic and supportive interventions.

Perceived organizational support and PTSD symptoms of frontline healthcare workers in the outbreak of COVID-19 in Wuhan: The mediating effects of self-efficacy and coping strategies

The present study aimed to examine the effect of perceived organizational support on the PTSD symptoms of frontline healthcare workers, and to examine the mediating effects of coping self-efficacy and coping strategies in this relationship. A short-term longitudinal study design was used to conduct two waves of online surveys in March and April 2020. Participants comprised 107 medical staff in both waves of investigation. Self-efficacy, coping strategies, and perceived organizational support were reported at Wave 1, and PTSD symptoms were reported at Wave 2. Results indicated that (1) The prevalence of probable PTSD was 9.3% and 4.7% on the Chinese version of the Impact of Events Scale-Revised of 33 and 35, respectively. Local healthcare workers had greater risks of PTSD than the members of medical rescue teams. Doctors reported higher PTSD symptoms than nurses. (2) Perceived organizational support had a significant indirect effect on PTSD symptoms through the mediation of problem-focused coping strategies and the sequential mediating effect of coping self-efficacy and problem-focused coping strategies. The findings highlight the importance of providing adequate organizational support to reduce PTSD symptoms in frontline medical staff during the COVID-19 pandemic.

The Effect of Post-Traumatic Stress Disorder on Women After The Earthquake in Central Sulawesi

Background: Posttraumatic stress disorder (PTSD) is a psychological disorder caused by uncommon occurrences such as threats or catastrophic events. Women are particularly susceptible to developing PTSD, as they have a range of threat perceptions. Purpose: The aim of this study was to examine the effect of PTSD on women survivor of the earthquake in the Sigi Biromaru sub-district of Central Sulawesi. Methods: This was a descriptive study conducted using a cross-sectional design. The population for this study were housewives who have been displaced by the earthquake and are currently residing in temporary shelters (Huntara) in a village located in the Sigi Biromaru sub-district. The instrument used in this study was the PTSD measurement questionnaire sheet. It was conducted from March to April 2020 and included a total of 115 participants. Univariate analysis was used to determine the respondents’ characteristics, including their age, education, occupation, income, and a description of the PTSD condition. Results: The results show that the majority of respondents experienced severe PTSD (70.43%). Most of the respondents (35.65%) were between the ages of 37 and 46, were senior high school graduates (40%), were unemployed (74%), and had earnings of < 2,500,000 (85.22%). Three variables that affect PTSD are education with a p-value of 0.03 < 0.05, job/occupation with a p-value of 0.02 < 0.05, and income with a p-value of 0.03 < 0.05. Conclusion: Women who are elderly, have a low level of education, are unemployed, and have low income are more vulnerable to experiencing PTSD.

Are older adults also at higher psychological risk from COVID-19?

OBJECTIVE

Given the lack of information on the psychological impact of COVID-19 on people aged ≥60, we aimed to describe their psychological responses to this pandemic and lockdown situation and compare them with those under 60 years of age.

METHODS

Secondary analysis of a larger online cross-sectional study designed to determine the psychological impact of the COVID-19 pandemic and lockdown across Spain. We analyzed a total of 1690 respondents aged ≥60 years and compared them with 13,363 respondents under 60 years of age. We employed the Depression, Anxiety, and Stress Scale and the Impact of Event Scale to evaluate psychological responses.

RESULTS

In all, 52.6% of women and 34.3% of men were found to be probable cases of any emotional distress (p < 0.001). In both sexes, the most common psychological response was avoidance behavior (34.7% and 23.8%, respectively), followed by depression (28.5 and 14.2%). Older women and men were considered probable cases of any emotional distress less often than younger ones (women: 52.6% vs. 72.3%, p < 0.001; men: 34.3% vs. 50.6%, p < 0.001). Finally, the results of the binary logistic regression showed that only depressive and stress responses are psychological factors associated with age group [age ≥ 60 years, O.R. = 0.617 (95% CI = 0.501 - 0.759) and 0.437 (95% CI = 0.334 - 0.573), respectively].

CONCLUSION

Contrary to our hypothesis and despite the high percentage of emotional distress we found in older adults, especially women, they are actually at lower risk of developing depressive and stress consequences from COVID-19 and lockdown than those under 60 years of age. That said, we believe our results highlight the need for expert guidance in this age group, especially older women living alone.

Longitudinal Changes in Posttraumatic Stress Disorder After Resettlement Among Yazidi Female Refugees Exposed to Violence

IMPORTANCE

Posttraumatic stress disorder (PTSD) is highly prevalent among refugees surviving mass atrocities, especially among women. Longitudinal studies investigating factors associated with PTSD course are essential to enable adequate treatment yet widely lacking.

OBJECTIVE

To identify longitudinal changes in PTSD severity and posttraumatic coping among severely traumatized female refugees as well as risk and protective factors for PTSD course.

DESIGN, SETTING, AND PARTICIPANTS

This prospective cohort study took place in 14 German cities in the context of a humanitarian admission program that resettled 1000 especially vulnerable women and children from northern Iraq to Germany. Approximately 400 adult beneficiaries of the humanitarian admission program were eligible for the study. At baseline, a total of 116 of the 400 beneficiaries (29.0%) participated, with 96 (82.8%) of these women participating in the follow-up assessment. The study included a baseline assessment conducted 2 years after resettlement (September 1, 2017, to January 12, 2018) and a 1-year follow-up (August 29, 2018, to January 15, 2019).

EXPOSURES

Violence and/or captivity during the 2014 genocide in northern Iraq by the so-called Islamic State.

MAIN OUTCOMES AND MEASURES

Posttraumatic stress disorder severity and coping strategies were assessed in interpreter-aided interviews using the Impact of Event Scale-Revised.

RESULTS

A total of 116 women (mean [SD] age, 32.2 [8.2] years; 115 [99.1%] Yazidi; 1 [0.9%] Christian) participated at baseline. According to the Impact of Event Scale-Revised, a high PTSD severity was found (mean [SD] raw sum score, 60.88 [15.75] of 88, with higher scores indicating greater distress), with no significant change over time. Helpful coping strategies included prayer, belief in collective strength, and belief in personal strength. Earlier symptoms of intrusions (β = 0.389, P = .007) and longer captivity (β = 0.218, P = .02) were identified as being associated with PTSD severity 1 year later. Longer captivity was associated with PTSD aggravation over time (β = 0.227, P = .04). Posttraumatic strengthening in faith (β = -0.206, P = .05) and in social relationships (β = -0.221, P = .03) were associated with a reduction in PTSD symptoms.

CONCLUSIONS AND RELEVANCE

These findings suggest that female refugee survivors of genocide are at high risk for severe and chronic PTSD beyond the initial years of resettlement. The findings provide suggestions for mental health care specialized for particularly vulnerable populations.

Long-term effects of housing damage on survivors' health in rural China: Evidence from a survey 10 Years after the 2008 Wenchuan earthquake

BACKGROUND

Disaster experiences have long-term health effects. However, less is known about the pathways of the association between disaster experiences and people's long-term health. We aimed to examine the long-term (10-year) effect of housing damage in the 2008 Wenchuan earthquake on survivors' health and to explore the pathways of the long-term effect.

METHODS

We used data from a survey conducted in 2018 in rural areas affected by the 2008 Wenchuan earthquake. The survey collected information on housing damage caused by the earthquake from survivors aged 18 years old or above. Our primary outcome was dichotomous self-rated health in 2018. We considered decreased living standards and debt burden as mediators. To examine the long-term effect of housing damage on health, we performed multivariable binary logistic regression models. We also performed mediation analyses using the "KHB-method".

RESULTS

Compared with no/slight damage, serious damage (odds ratio (OR): 1.50, 95% confidence interval (CI): 1.11,2.04) and collapse (OR: 1.57, 95% CI: 1.13,2.18) were associated with a higher risk of poor health. Decreased living standards and debt burden mediated 8.49% and 4.79%, respectively, of the association between serious damage and poor health and 10.64% and 6.10%, respectively, of the association between collapse and poor health.

CONCLUSION

Housing damage in a natural disaster is a long-term risk for survivors' health. Long-term policies and interventions are necessary to protect and promote the health of survivors who experience housing damage. In addition to house reconstruction assistance, policies and interventions can be designed to promote living standards and financial situations to protect survivors' health.

Early Psychological Correlates Associated With COVID-19 in A Spanish Older Adult Sample

OBJECTIVE

Main aims of the study are to examine the early psychological correlates associated with the COVID-19 pandemic and lockdown on the mental health of a Spanish older adult sample and to analyze the influence of past mental disorder (PMD) and current mental disorder (CMD) on those correlates.

METHODS

Cross-sectional study based on an online snowball recruiting questionnaire. Psychological correlates assessed with the Depression, Anxiety, and Stress Scale (DASS-21) and Impact of Event Scale (IES). Binary and multinomial logistic regression models were used to identify risk and protective factors.

RESULTS

Final sample included 2,194 individuals aged 60 years or more (mean age [SD]: 65.62 [5.05]; females: 1,198 [54.6%]). There were 342 (15.6%) individuals who reported a PMD and 162 (7.4%) who reported a CMD. Avoidant (32.1%) and depressive (25.6%) styles were the most prevalent, regardless of mental health status. Main risk factors for negative affectivity were female gender and history CMD or PMD. However, job stability and the ability to enjoy free time were generally associated with better outcomes. No differences were found in psychological correlates between those with no lifetime history of mental disorder versus PMD on the DASS-21 or IES. However, CMD was associated with higher anxiety scores on the DASS-21 (odds ratio: 1.838, p < .001).

CONCLUSION

Regardless of mental status, avoidant and depressive styles were the most prevalent in this older adult sample. Main protective factor in all subgroups was the ability to enjoy free time, whereas the main risk factors were being female and current or past history of mental disorder.