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Lee H, Kim Y. Trajectories of quality of life among disaster victims: A national longitudinal study. Int Nurs Rev 2024. [PMID: 38953470 DOI: 10.1111/inr.13015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 06/10/2024] [Indexed: 07/04/2024]
Abstract
AIM This study categorized quality-of-life trajectories among disaster victims in South Korea and identified the characteristics and predictors of each trajectory. BACKGROUND Disaster victims experience tremendous physical and mental distress, which has a long-term impact on their quality of life. METHODS We conducted a cross-sectional study using data obtained from the fourth Long-term Survey on the Change of Life of Disaster Victims conducted from 2017 to 2019. The study included 257 participants who experienced a typhoon, earthquake, or fire and completed the three-year follow-up. Latent transition analysis was used to identify the potential class of quality-of-life trajectories among disaster victims. Independent t tests, χ2 tests, and logistic regression were used to identify the predictors of quality-of-life trajectories. RESULTS Two latent quality-of-life classes were identified: persistent low-level and persistent high-level. Factors associated with the persistent high-level trajectory included higher education level, no injury/disease from the disaster, better subjective health status, higher social support, and lower social maladjustment. DISCUSSION Quality of life early after a disaster is maintained throughout subsequent years; early and active support following disasters is essential to promote its rapid improvement. CONCLUSION Targeted educational programs in disaster-prone areas are recommended to bolster resilience among individuals with lower education. Moreover, governmental and institutional efforts are needed to support victims who lack resources for disaster recovery. IMPLICATIONS FOR NURSING AND HEALTH POLICY There is a need to establish community-based social support systems and enhance nurses' disaster response capabilities to support vulnerable groups, with such interventions tailored to reflect disaster-affected victims' unique characteristics and needs, along with ongoing research and evaluation for continuous improvements to nursing practice and disaster response.
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Affiliation(s)
- Haeyoung Lee
- Red Cross College of Nursing, Chung-Ang University, Seoul, South Korea
| | - Yujeong Kim
- College of Nursing, Research Institute of Nursing Innovation, Kyungpook National University, Daegu, South Korea
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Holliday R, Krishnamurti LS, Jordan SE, Sia MA, Brenner LA, Monteith LL. The Health and Social Impacts of the Maui Wildfires: Post-Disaster Care from a Sociocultural Lens. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2024; 83:85-87. [PMID: 38456158 PMCID: PMC10915863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Affiliation(s)
- Ryan Holliday
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, Aurora, CO (RH, LSK, LAB, LLM)
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO (RH, LAB, LLM)
- Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO (RH, LAB, LLM)
| | - Lauren S Krishnamurti
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, Aurora, CO (RH, LSK, LAB, LLM)
| | - Shiloh E Jordan
- VA Pacific Islands Health Care System, Honolulu, HI (SEJ, MAS)
| | - Marissa A Sia
- VA Pacific Islands Health Care System, Honolulu, HI (SEJ, MAS)
| | - Lisa A Brenner
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, Aurora, CO (RH, LSK, LAB, LLM)
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO (RH, LAB, LLM)
- Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO (RH, LAB, LLM)
| | - Lindsey L Monteith
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, Aurora, CO (RH, LSK, LAB, LLM)
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO (RH, LAB, LLM)
- Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO (RH, LAB, LLM)
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Reifels L, Krysinska K, Andriessen K. Suicide prevention during disasters and public health emergencies: a systematic review. Front Public Health 2024; 12:1338099. [PMID: 38379672 PMCID: PMC10876787 DOI: 10.3389/fpubh.2024.1338099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 01/24/2024] [Indexed: 02/22/2024] Open
Abstract
Background Disasters and public health emergencies increasingly affect populations around the world, posing significant wide-ranging challenges for societies as well as for effective public health and suicide prevention. Intervention research is essential to inform evidence-based responses. Yet, despite evident public concern and growing research interest in heightened suicide risks and impacts, little is known about effective suicide prevention interventions in these contexts. We conducted a systematic review to examine the outcomes of suicide prevention strategies implemented in disasters and public health emergencies. Methods We searched five databases (Medline, Embase, PsycINFO, Web of Science, PTSDpubs) from inception to December 2022 for peer-reviewed quantitative studies that reported relevant intervention outcomes (changes in the frequency of suicide, suicide attempts, self-harm) for populations affected by disasters and public health emergencies. We assessed the quality of eligible studies using the Quality Assessment Tool for Quantitative Studies, and distilled review findings through narrative synthesis. The study protocol was registered with PROSPERO (CRD42021276195). Results Ten eligible and mostly observational studies were included in this review, which examined a range of universal, selective, and indicated interventions. Three of five studies of interventions in public health emergencies indicated the potential effectiveness and buffering effects of generic disaster related mental health support, access to urban parks, as well as the beneficial role of video-enabled tablets in facilitating treatment access and outcomes. Similarly, three of five studies of interventions in disaster contexts provided evidence of the beneficial role of universal economic security measures, national gun laws and buy back schemes, and volunteer-delivered mental health support. Overall, four of six studies with favorable outcomes examined interventions specifically deployed in disaster or public health emergency contexts, whereas two studies examined ongoing existing interventions. Three studies, respectively, of suicide prevention focused interventions or generic interventions reported favorable outcomes. The quality of included studies was variable, with two studies being rated as 'strong', four studies rated as 'moderate', and four studies rated as 'weak'. Conclusion Notwithstanding the limited scope and variable quality of published evidence, our review findings highlight the breadth of interventions that have been applied in such contexts with some success. There is a need for further research on effective interventions and intervention adaptations to inform evidence-based suicide prevention responses to disasters and public health emergencies. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021276195, PROSPERO ID CRD42021276195.
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Affiliation(s)
- Lennart Reifels
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
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Rahmani M, Silverman AL, Thompson A, Pumariega A. Youth Suicidality in the Context of Disasters. Curr Psychiatry Rep 2023; 25:587-602. [PMID: 37768444 DOI: 10.1007/s11920-023-01454-4] [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] [Accepted: 09/05/2023] [Indexed: 09/29/2023]
Abstract
PURPOSE OF REVIEW The purpose of this review is to summarize the current literature regarding youth suicidality (suicidal ideation, suicidal behavior, and completed suicide) in the context of disasters. RECENT FINDINGS There are fewer studies that examine the effect of disasters on suicidality specifically in children and youth than studies that focus on adults or general population. Numerous studies have reported on the effect of disasters on youth mental health in general without zeroing in on suicide risk. Some variables that have shown to increase suicide risk in children and youth after disasters include female gender, age at the time of disaster exposure, dependence on adults, attachments to places and caregivers, family functioning, and vulnerability to mistreatment. Several studies have demonstrated that youth suicidality fluctuates in response to disasters, at times increasing immediately post-disaster and at other times decreasing immediately post-disaster followed by an increase later. Exposure to natural disasters (e.g., earthquakes, typhoons, hurricanes, wildfires, and extremes of temperature and humidity), man-made disasters (e.g., armed conflict, global warming, and pollution), and unique disasters (e.g., the COVID-19 pandemic) have had significant impact on suicidality in children and adolescents. Although there are several promising interventions to mitigate the post-disaster suicide risk among youth, there is no consensus on a single intervention that is superior to others. More research is needed to study youth suicide risk in the context of disasters and develop culturally appropriate and evidence-based interventions.
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Affiliation(s)
- Mariam Rahmani
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, USA.
| | - Andrew L Silverman
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, USA
| | - Andrew Thompson
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, USA
| | - Andres Pumariega
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, USA
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Shakya M, Singh R, Arya KD, Rure D. Sociodemography, pattern, and response inhibition in suicide survivors: A case-control study. Ind Psychiatry J 2023; 32:S93-S99. [PMID: 38370971 PMCID: PMC10871401 DOI: 10.4103/ipj.ipj_202_23] [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: 01/06/2023] [Revised: 06/11/2023] [Accepted: 07/22/2023] [Indexed: 02/20/2024] Open
Abstract
Introduction Suicide is a global phenomenon. Psychiatric disorders are estimated to contribute to a large proportion of suicides; however, impulsive suicide is also common. Among the ages of 15-29 years, suicide was the second leading cause of death worldwide and has been hypothesized to have reduced response inhibition and decision-making abilities as contributing factors, which directly relate to impaired executive functioning and suicidal behavior. Aim This study aimed to study sociodemography, method, and pattern of suicide, and response inhibition in suicide survivors. Material and Methods A case-control study was designed in a tertiary medical center in Madhya Pradesh using convenient sampling of suicide survivors and controls from the general population over 3 months. Data collection was semi-structured pro forma, and response inhibition was assessed using the Stroop test. Statistical analysis was performed using IBM Statistical Package for the Social Sciences (SPSS) Windows version 25.0. Independent-samples Student's t-test, Chi-square test, and Mann-Whitney U-test were used for analyzing means of continuous data, nominal data, and ordinal data, respectively. The level of significance was at P < 0.05. Result A total of 126 suicide survivors and 99 controls were assessed after the end of the study period. Age (mean age for cases 25.4 ± 9.16; controls 23 ± 7.9), gender (F ~ M), and socioeconomic status were used to match cases and controls. 85.7% of suicide survivors had no history of suicide, but the majority had precipitating factors. Anomic suicide was the most common type, and poisoning was the most common method of suicide. Response inhibition between cases and control was significantly different. Conclusion The majority of suicide attempts were impulsive in youth, with no gender discrimination. Response inhibition seemed to play a role in a suicide attempt.
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Affiliation(s)
- Makhan Shakya
- Department of Psychiatry, Shyam Sham Medical College, Rewa, Madhya Pradesh, India
| | - Rajesh Singh
- Department of Psychiatry, Government Medical College, Datia, Madhya Pradesh, India
| | - Kapil Dev Arya
- Department of Psychiatry, Government Medical College, Ratlam, Madhya Pradesh, India
| | - Daisy Rure
- Department of Psychiatry, RD Gardi Medical College, Ujjain, Madhya Pradesh, India
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Identification of Risk Factors for Suicide and Insights for Developing Suicide Prevention Technologies: A Systematic Review and Meta-Analysis. HUMAN BEHAVIOR AND EMERGING TECHNOLOGIES 2023. [DOI: 10.1155/2023/3923097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
Suicide is a termite that engulfs close to seven hundred thousand people worldwide each year. Existing work on risk factors that predict suicide lacks statistical associations, does not consider most countries, and has a wide range of risk factor domains. The goal of this systematic review and meta-analysis is to enhance our current understanding of suicidality by identifying risk factors that are most strongly associated with suicide and their impact on developing technological interventions for suicide prevention. A search strategy was carried out on four databases: (1) PsycINFO, (2) IEEE Xplore, (3) the ACM Digital Library, and (4) PubMed, and twenty-five studies were included based on the inclusion criteria. Factors statistically associated with suicide are any diagnosed mental disorder, adverse life events, past suicide attempts, low education level, loneliness or high levels of isolation, bipolar disorder, depression, multiple chronic health conditions, family history of suicide, sexual trauma, and being female. Domain-wise, comorbid disorders, and behavior-related risk factors are most strongly associated with suicide. We present a new hierarchical model of risk factors for suicide that advances our understanding of suicide and its causes. Finally, we present open research directions and considerations for developing suicide prevention technologies.
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Pediatric Suspected Suicides and Nonfatal Suicide Attempts Reported to United States Poison Control Centers Before and During the COVID-19 Pandemic. J Med Toxicol 2023; 19:169-179. [PMID: 36877430 PMCID: PMC9987373 DOI: 10.1007/s13181-023-00933-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 02/03/2023] [Accepted: 02/14/2023] [Indexed: 03/07/2023] Open
Abstract
INTRODUCTION This study investigated the characteristics and compared the trends of pediatric suspected suicide and nonfatal suicide attempts reported to United States (US) poison control centers (PCCs) before and during the first year of the COVID-19 pandemic. METHODS An interrupted time series analysis using an ARIMA model was conducted to evaluate the trends of suspected suicides and nonfatal suicide attempts among children 6-19 years old reported to the National Poison Data System during March 2020 through February 2021 (pandemic period) compared with March 2017 through February 2020 (pre-pandemic period). RESULTS The annual number of cases of suspected suicides and nonfatal suicide attempts increased by 4.5% (6095/136,194) among children 6-19 years old during March 2020 through February 2021 compared with the average annual number during the previous three pre-pandemic years. There were 11,876 fewer cases than expected from March 2020 to February 2021, attributable to a decrease in cases during the initial three pandemic months. The average monthly and average daily number of suspected suicides and nonfatal suicide attempts among children 6-12 years old and 13-19 years old was higher during school months than non-school months and weekdays than weekends during both the pre-pandemic and pandemic periods. CONCLUSIONS There was a greater than expected decrease in the number of suspected suicides and nonfatal suicide attempts among children 6-19 years old reported to US PCCs during the early pandemic months, followed by an increase in cases. Recognizing these patterns can help guide an appropriate public health response to similar future crises.
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Chen XY, Wang D, Liu X, Shi X, Scherffius A, Fan F. Cumulative stressful events and mental health in young adults after 10 years of Wenchuan earthquake: the role of social support. Eur J Psychotraumatol 2023; 14:2189399. [PMID: 36942927 PMCID: PMC10035950 DOI: 10.1080/20008066.2023.2189399] [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] [Indexed: 03/23/2023] Open
Abstract
ABSTRACTBackground: After a natural disaster, stressful events often continue to accumulate, affecting individuals in a different manner than the original disaster never occurred. However, few studies have examined these associations, the cumulative impacts of stressful events on mental health outcomes, and the role of social support. This study examined the prospective association between cumulative stressful events and mental health problems and the role of social support in young adults.Methods: 695 participants provided available data on earthquake exposure, childhood maltreatment, other negative life events, and social support at baseline. Depressive symptoms and posttraumatic stress disorder were assessed at baseline and 10 years after the earthquake (T10y). A cumulative stressful events index was used to evaluate the levels of cumulative stressful events. Linear regressions were used to explore the predictive effects.Results: Of 695 participants, 41.3%, 28.5%, and 7.9% reported one, two, and three stressful events, respectively. The associations between cumulative stressful events and mental health problems at T10y presented a dose-response pattern: those who experienced three events had the highest risk of mental health problems, followed by those who experienced two events and those who reported one event. Additionally, higher social support partially reduced the negative impact of cumulative stressful events on mental health.Conclusions: Cumulative stressful events are associated with mental health problems 10 years later in young earthquake survivors. Social support could reduce the negative impact, but its protective role disappears when stressful events accumulate at the highest level. These findings highlight the importance of assessing the cumulative impacts of stressful events and social support available to young disaster survivors and intervening to prevent worse mental health outcomes.
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Affiliation(s)
- Xiao-Yan Chen
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, People's Republic of China
| | - Dongfang Wang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, People's Republic of China
| | - Xianchen Liu
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, USA
| | - Xuliang Shi
- College of Education, Hebei University, Baoding, People's Republic of China
| | - Andrew Scherffius
- Department of Microbiology and Immunology, Montana State University, Bozeman, MT, USA
| | - Fang Fan
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, People's Republic of China
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Kim Y, Lee E. The Suicidal Ideation of Disaster Victims: A Nationwide Cross-Sectional Study. Psychol Res Behav Manag 2023; 16:905-914. [PMID: 36974039 PMCID: PMC10039656 DOI: 10.2147/prbm.s405667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/09/2023] [Indexed: 03/29/2023] Open
Abstract
Purpose Various natural and human made disasters occur worldwide. This study aimed to identify the factors affecting suicidal ideation in victims of disasters such as typhoons, heavy rainfall, fires, and earthquakes. Methods Data were obtained from a long-term survey on life changes among disaster victims conducted in 2019 by the National Disaster Management Research Institute. The study included 2234 victims of natural and social disasters occurring in Korea between 2012 and 2018. Suicidal ideation was assessed using the Korean version of the Composite International Diagnostic Interview developed by the World Health Organization. The participants' demographic characteristics, disaster-related characteristics, physical characteristics, psychological characteristics, and social characteristics were analyzed as the influencing factors. The data were analyzed using the chi-square test, t-test, and logistic regression. Results Of the 2234 subjects in this study, 32 were disaster victims who had experienced suicidal ideation, accounting for 1.4%. The results showed that the factors affecting suicidal ideation included disaster-related injury/disease, depression, and social support. The odds ratio of suicidal ideation was higher when there was injury/disease (OR=1.89, 95% CI=0.07-0.48), with higher depression levels (OR=1.31, 95% CI=1.18-1.47) and with lower social support (OR=0.94, 95% CI=0.90-0.99). Conclusion This study identifies the significant influencing factors of suicidal ideation in disaster victims, which were as follows: disaster-related injury or disease, depression, and social support. Our study's findings would contribute to screening high-risk groups of suicidal ideation and developing effective support, interventions, and suicide prevention programs for disaster victims. Furthermore, to prevent suicide and promote the healthy recovery of disaster victims, mental health care services aimed at suicide prevention should be reinforced and the victims should be provided with psychological support and treatment without financial burden.
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Affiliation(s)
- Yujeong Kim
- College of Nursing, Research Institute of Nursing Science, Kyungpook National University, Daegu, Republic of Korea
- Correspondence: Yujeong Kim, College of Nursing, Kyungpook National University, 680 Gukchabosangro, Jung-Gu, Daegu, 41944, Republic of Korea, Tel +82-10-6311-5383, Fax +82-53-421-2758, Email
| | - Eunmi Lee
- Department of Nursing, Hoseo University, Asan, Republic of Korea
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Kwon HJ, Leem J, Kim DW, Kwon CY, Kim SH. Effect of acupuncture on patients with major psychiatric disorder and related symptoms caused by earthquake exposure: Protocol for a scoping review of clinical studies. PLoS One 2023; 18:e0281207. [PMID: 36706118 PMCID: PMC9882882 DOI: 10.1371/journal.pone.0281207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 01/11/2023] [Indexed: 01/28/2023] Open
Abstract
Earthquakes have the greatest destructive effect among all natural disasters. Posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and anxiety disorder (AD) are major psychiatric disorders (MPD) that can be triggered by exposure to earthquakes. Conventional treatments such as pharmacological treatments have several limitations. Acupuncture therapy as a complementary integrative medicine may be an effective alternative treatment for these limitations. This study aimed to identify the status of the clinical evidence regarding acupuncture therapy for earthquake survivors with MPD. We will follow the scoping review process as previously described. The study question is as follows: "Which types of clinical research designs, study types, study durations, adverse events, and clinical outcomes have been reported regarding acupuncture therapy for MPD in earthquake survivors?" Medline, Excerpta Medica dataBASE, Cochrane Central Register of Controlled Trials, Web of Science, Scopus, Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature, PsycArticles databases, and Chinese, Korean, and Japanese databases will be comprehensively searched electronically from their inception to November 2022. Data from the included studies will be collected and descriptively analyzed in relation to our research question. We will collate, synthesize, and summarize the extracted data according to the analytical framework of a scoping review. The protocol will conform with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extensions of Scoping Reviews to ensure the clarity and completeness of our reporting in the whole phase of the scoping review (Protocol registration: https://osf.io/wfru7/). The findings of this scoping review will provide fundamental data that will help researchers identify appropriate research questions and design further studies on the use of acupuncture for MPD management in earthquake survivors. These results will be helpful for developing disaster site-specific research protocols for future clinical trials on this topic.
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Affiliation(s)
- Hui-Ju Kwon
- College of Korean Medicine, Daegu Haany University, Gyeongsan-si, Gyeongsangbuk-do, Republic of Korea
| | - Jungtae Leem
- College of Korean Medicine, Wonkwang University, Iksan, Republic of Korea
| | - Da-Woon Kim
- Department of Neuropsychiatry of Korean Medicine, Pohang Korean Medicine Hospital Affiliated to Daegu Haany University, Pohang-si, Gyeongsangbuk-do, Republic of Korea
| | - Chan-Young Kwon
- Department of Oriental Neuropsychiatry, Dong-Eui University College of Korean Medicine, Busan, Korea
| | - Sang-Ho Kim
- Department of Neuropsychiatry of Korean Medicine, Pohang Korean Medicine Hospital Affiliated to Daegu Haany University, Pohang-si, Gyeongsangbuk-do, Republic of Korea
- * E-mail:
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Ornell F, Benzano D, Borelli WV, Narvaez JCDM, Moura HF, Passos IC, Sordi AO, Schuch JB, Kessler FHP, Scherer JN, von Diemen L. Differential impact on suicide mortality during the COVID-19 pandemic in Brazil. REVISTA BRASILEIRA DE PSIQUIATRIA (SAO PAULO, BRAZIL : 1999) 2022; 44:628-634. [PMID: 35839315 PMCID: PMC9851756 DOI: 10.47626/1516-4446-2022-2581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 03/12/2022] [Indexed: 02/01/2023]
Abstract
OBJECTIVES To compare suicide rates observed in Brazil after the onset of the COVID-19 pandemic with the estimated rate based on suicide deaths between 2010 and 2020, and identify sociodemographic variables associated with this outcome. METHODS Ecological time-series study. Data were obtained from Brazilian Unified Health System Department of Information Technology (DATASUS), with the structural break of the data set in March 2020. The number of actual suicides observed and the number of expected suicides if there were no COVID-19 pandemic were analyzed through bayesian structural time series modeling. RESULTS The overall incidence of suicides in Brazil remained stable after the start of the COVID-19 pandemic compared to what would be expected. However, there was a significant increase in suicide deaths among women (6.9%) and older adult (9.1%). Analysis by macro-regions of the country showed significant increases in suicide deaths in the Center-West (7.4%), Northeast (5.7%), and Southeast (10%). Stratified analyses revealed differences according to age, sex, education, and skin color. CONCLUSIONS Despite stability in the overall number of suicides, this phenomenon occurs heterogeneously among different population groups and regions of Brazil. Rates have increased in populations with a history of poor access to health, which may have been more severely impacted by the pandemic.
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Affiliation(s)
- Felipe Ornell
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil,Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Faculdade de Medicina, UFRGS, Porto Alegre, RS, Brazil,Correspondence: Felipe Ornell, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Centro de Pesquisa em Álcool e Drogas, Rua Ramiro Barcelos, 2350, Santa Cecilia, CEP 90410-004, Porto Alegre, RS, Brazil. E-mail:
| | - Daniela Benzano
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil,Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Faculdade de Medicina, UFRGS, Porto Alegre, RS, Brazil
| | | | | | - Helena Ferreira Moura
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil,Departamento de Clínica Médica, Faculdade de Medicina, Universidade de Brasília, Brasília, DF, Brazil
| | - Ives Cavalcante Passos
- Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Faculdade de Medicina, UFRGS, Porto Alegre, RS, Brazil
| | - Anne Orgler Sordi
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Jaqueline Bohrer Schuch
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil,Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Faculdade de Medicina, UFRGS, Porto Alegre, RS, Brazil
| | - Felix Henrique Paim Kessler
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil,Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Faculdade de Medicina, UFRGS, Porto Alegre, RS, Brazil
| | - Juliana Nichterwitz Scherer
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil,Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Faculdade de Medicina, UFRGS, Porto Alegre, RS, Brazil,Programa de Pós-Graduação em Saúde Coletiva, Universidade do Vale do Rio dos Sinos, São Leopoldo, RS, Brazil
| | - Lisia von Diemen
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil,Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Faculdade de Medicina, UFRGS, Porto Alegre, RS, Brazil
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Zarowsky Z, Rashid T. Resilience and Wellbeing Strategies for Pandemic Fatigue in Times of Covid-19. INTERNATIONAL JOURNAL OF APPLIED POSITIVE PSYCHOLOGY 2022; 8:1-36. [PMID: 36196257 PMCID: PMC9523176 DOI: 10.1007/s41042-022-00078-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 09/05/2022] [Indexed: 11/29/2022]
Abstract
The COVID-19 pandemic is truly one of the greatest collective health crises in history which have altered our life and living. For years, people have felt fatigued from following public health directives such as social distancing, wearing masks, washing hands frequently, and working or studying remotely without in-person interactions. In this paper, we explore strategies for resilience and wellbeing which can mitigate pandemic-caused stress and behavioural fatigue. We start with individual level strategies including reworking stress appraisals, the importance of psychological flexibility, reducing loneliness through adaptive online platform use, optimizing familial relationships when living in close quarters for a prolonged period, reducing symptoms of burnout and using adaptive distractions, using specific evidence-based resilience strategies. We discuss specific considerations which tap on our shared identities and shared responsibilities which can enhance a sense of community, especially for individuals from marginalized backgrounds and how suicide risks can be minimized.
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Affiliation(s)
- Zachary Zarowsky
- Department of Psychology, University of Toronto Scarborough, 1265 Military Trial, Toronto, ON M1C 1A4 Canada
| | - Tayyab Rashid
- Department of Psychology, University of Toronto Scarborough, 1265 Military Trial, Toronto, ON M1C 1A4 Canada
- Centre for Wellbeing Science, Melbourne Graduate School of Education, Melbourne, Australia
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Orui M. Suicide and Suicide Prevention Activities Following the Great East Japan Earthquake 2011: A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191710906. [PMID: 36078620 PMCID: PMC9518051 DOI: 10.3390/ijerph191710906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 08/31/2022] [Accepted: 08/31/2022] [Indexed: 05/30/2023]
Abstract
BACKGROUND Since the Great East Japan Earthquake (GEJE), numerous studies have been conducted, but no comprehensive review study has been carried out. Thus, this literature review aimed to examine how the GEJE might affect suicide and suicidal behaviors from a long-term perspective. METHODS For the literature review, a search of electronic databases was carried out to find articles written in English and in Japanese that were related to suicide and its risk factors, as well as suicide prevention activities following the GEJE. Thirty-two articles were then selected for the review. RESULTS There were several findings, as follows: (1) gender differences in suicide rates in the affected area: nationwide, the suicide rates in men showed a delayed increase, whereas suicide rates in women increased temporarily immediately after the GEJE; (2) the suicide rates increased again in the recovery phase; (3) the background of the suicides was linked to both disaster-related experiences, and indirect reasons pertaining to the GEJE; and (4) intensive intervention combined with a high-risk and community-focused approach could prevent suicides following the disaster. CONCLUSIONS Although further accumulation of knowledge about suicide and suicide prevention is essential, these findings can contribute to response, recovery, and preparedness in relation to future disasters.
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Affiliation(s)
- Masatsugu Orui
- Sendai City Mental Health and Welfare Center, Sendai 980-0845, Japan; ; Tel.: +81-24-547-1180
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
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Giner L, Vera-Varela C, de la Vega D, Zelada GM, Guija JA. Suicidal Behavior in the First Wave of the COVID-19 Pandemic. Curr Psychiatry Rep 2022; 24:1-10. [PMID: 35080711 PMCID: PMC8790944 DOI: 10.1007/s11920-022-01312-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/15/2021] [Indexed: 12/23/2022]
Abstract
PURPOSE OF REVIEW Since the declaration of the COVID-19 pandemic, there have been numerous social changes to try to contain the spread of the disease. These sudden changes in daily life have also changed the way we relate to others, in addition to creating a climate of uncertainty and fear. Therefore, the objective of this review is to compile published data of the consequences of suicidal behavior in the first months from the onset of the pandemic. RECENT FINDINGS The analysis reflects a concern about issues related to suicide since the beginning of the pandemic. A large number of online surveys have been released and have provided data on relatively large populations. The percentage of the population with suicidal ideation in that period seems to be approximately 5-15%. Many studies associate suicidal ideation with being young, female, and presence of sleep problems. Surveys of healthcare workers do not seem to indicate a higher prevalence of suicidal ideation compared to the general population. The incidence of suicide attempts seen in emergency departments did not seem to change, while the number of visits for other issues, unrelated to suicide, did decrease. The few studies on completed suicide do not indicate an increase in incidence in these first 6 months since March 2020, when the WHO declared the start of the pandemic. It does not seem that there have been major changes in the figures related to suicidal behavior in the studies from the first wave of the COVID-19 pandemic, although it is still too early to know the consequences it will have long term. The social and economic damages resulting from the pandemic will certainly take a long time to recover.
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Affiliation(s)
- Lucas Giner
- Department of Psychiatry, Universidad de Sevilla, Seville, Spain.
| | | | - Diego de la Vega
- Department of Psychiatry, Universidad de Sevilla, Seville, Spain ,Unidad de Hospitalización de Salud Mental. Unidad de Gestión Clínica de Salud Mental del Hospital Virgen Macarena. Servicio Andaluz de Salud, Seville, Spain
| | - Giovani M. Zelada
- Internal Medicine/Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX USA
| | - Julio A. Guija
- Department of Psychiatry, Universidad de Sevilla, Seville, Spain ,Instituto de Medicina Legal Y Ciencias Forenses de Sevilla, Seville, Spain
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15
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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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Long-term observation of mortality among inpatients evacuated from psychiatric hospitals in Fukushima prefecture following the Fukushima nuclear disaster. Sci Rep 2021; 11:14651. [PMID: 34282221 PMCID: PMC8289941 DOI: 10.1038/s41598-021-94152-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 07/06/2021] [Indexed: 11/23/2022] Open
Abstract
The debate regarding the need for hospital evacuation and the evacuation distance remains rather chaotic. Furthermore, the relationship between hospital evacuation and the prognoses of psychiatric inpatients has not yet been investigated. We aimed to reveal the association between the long-term prognosis of psychiatric inpatients evacuated immediately following the Fukushima Daiichi Nuclear Power Plant accident and their backgrounds. In this retrospective cohort study, 777 psychiatric inpatients who were immediately evacuated from their hospitals following the accident were included for analysis. Survival time was the primary outcome. We conducted univariable and multivariable analyses to examine the associations between mortality and linear distance of evacuation and different backgrounds, including psychiatric/physical traits. Univariable analysis showed that the estimated survival time among patients was significantly associated with their evacuation distance. A multivariable analysis showed that a longer evacuation distance had a significantly lower hazard ratio (HR) and resulted in lower mortality. In contrast, older patients with physical complications of respiratory disease (International Statistical Classification of Diseases and Related Health Problems 10th revision, J00–99) and genitourinary disease (N00–99) showed a significantly higher HR and had a higher mortality than patients without these complications. To prevent death among elderly psychiatric inpatients with physical comorbidities during disasters, the evacuation destination should be determined taking into consideration the evacuees’ tolerance for long-distance transportation and the availability of post-evacuation care in the destination hospitals.
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Suicide and Health Crisis in Extremadura: Impact of Confinement during COVID-19. TRAUMA CARE 2021. [DOI: 10.3390/traumacare1010004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Because of its impact on social well-being, mental health, and financial security, the COVID-19 health crisis may increase the risk of suicide. This study’s objective was to determine what impact the period of confinement might have had on the incidence of deaths by suicide (DBS) in the Extremadura region (Spain). Cases registered in the Institutes of Legal Medicine and Forensic Science (IMLyCFs) from January 2015 to December 2020 were collected. Intra- and interannual comparisons were made of the suicide rates in the periods of confinement (March–June) and postconfinement (July–October) of 2020 with those of the preceding 5 years. After seasonally adjusting the data by means of a time series analysis, rate ratios (RRs) were calculated together with their 95% confidence intervals (CI). There were no significant differences between the suicide rates of 2020 and the mean of the preceding 5 years (RR = 0.94; CI: 0.56–1.55), and neither did any differences seen in the intra-annual analysis from the period of confinement to postconfinement reach statistical significance (RR = 0.74; CI: 0.45–1.20). It is necessary to strengthen vigilance during and after the crisis and ensure that assistance mechanisms are in place to prevent an increase in suicides.
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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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Chen Y, Lam C, Deng H, Ko KY. Changes Over Time in Post-traumatic Stress Disorder Among Children Who Survived the 2008 Wenchuan Earthquake and Predictive Variables. Front Psychiatry 2021; 12:691765. [PMID: 34630174 PMCID: PMC8492922 DOI: 10.3389/fpsyt.2021.691765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 08/18/2021] [Indexed: 02/05/2023] Open
Abstract
Background: This study examines changes over time in post-traumatic stress disorder (PTSD) among children who survived the 2008 Wenchuan earthquake and the relevant predictive variables. Methods: A total of 203 children and adolescents were investigated 24 months after the earthquake, and 151 children and adolescents completed the 1-year follow-up study. Participants completed the Children's Revised Impact of Event Scale (CRIES-13), the Center for Epidemiologic Studies Depression Scale (CES-D) and the Connor-Davidson Resilience Scale (CD-RISC). Hierarchical linear regression analysis was used to evaluate the predictors of changes in PTSD severity. Results: Eighty percent of the children still had some PTSD symptoms 2 years after the Wenchuan earthquake, and 66.25% of the children had symptoms that lasted 3 years. In the model predicting PTSD symptom severity, the loss of family members and child burial explained a significant 21.9% of the variance, and depression explained a significant 16.7% of the variance. In the model predicting changes in PTSD severity, the change scores for resilience and depression explained a significant 18.7% of the variance, and cognitive behavioral therapy (CBT) explained a significant 33.6% of the variance. Conclusions: PTSD symptoms in children and adolescents can persist for many years after trauma. In addition to using psychological interventions to improve PTSD symptoms, improvements in depression and resilience should also be considered.
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Affiliation(s)
- Ying Chen
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Chow Lam
- Department of Psychology, Illinois Institute of Technology, Chicago, IL, United States
| | - Hong Deng
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Kam Ying Ko
- Hong Kong Youth Foundation, Hong Kong, China
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