Preventive and Therapeutic Mental Health Care after the Earthquake- Expert Opinion from the Psychiatric Association of Turkey

Investigation of Posttraumatic Stress and Depression Symptoms in Children Who Experienced the Kahramanmaraş Earthquake

BACKGROUND

Trauma is important in the etiology of many problems including childhood anxiety, somatization, hostility and sleep disturbance.

AIMS

This research was conducted to examine the posttraumatic stress and depression symptoms of children who experienced the Kahramanmaraş earthquakes in Türkiye.

METHODS

The research, designed as a descriptive and relational type, was conducted with 636 children in the 10 to 18 age group who experienced the earthquake. Data were obtained through the Child Information Form, the Child Posttraumatic Stress Disorder Reaction Index (CPTSD-RI), and the Depression Inventory for Children.

RESULTS

According to the scale scores, 100% of the children had depression symptoms, while 23% had severe trauma and 77% had very severe posttraumatic stress symptoms. It was revealed that children's posttraumatic stress reactions explained 71% of their depression (p < .001). It has been determined that the most important triggers affecting children's posttraumatic stress reactions are being trapped under debris and the problems they experience in reaching shelter and assistance (B: -3.706; B: -1.547; B: 3.969).

CONCLUSIONS

It was determined that there was a strong relationship between posttraumatic stress reactions and depression symptoms of children who experienced the earthquake. It has been observed that the experiences of children during and after the earthquake can have an impact on their trauma situations.

Virtual Reality Supported Intervention Program for Trauma Symptoms of Individuals Who Experienced an Earthquake: An Effectiveness Study

Introduction

This study aimed to develop an effective virtual reality (VR)-based intervention program to improve trauma symptoms of survivors of the 2023 Kahramanmaraş earthquake.

Methods

In line with this aim, the sample of the study consisted of 34 earthquake survivors aged 15-72 years (mean: 38.09, standard deviation (SD): 15.09) who were directly affected by the Kahramanmaraş earthquake on February 6, 2023. A five-stage intervention program (normalization, reinterpretation, creating a safe place, developing problem-focused coping strategies, and social support) was applied to 17 participants (mean: 36.88, SD: 13.65), who constituted the intervention group, using VR technology. All participants assigned to the intervention group received the intervention, which included normalization, reinterpreting the earthquake, creating a safe place, problem-focused coping, and increasing social support, one time in a standardized manner. In the stages of reinterpretation, creating a safe place and problem-focused coping VR technology was used and, the stages of normalization and increasing social support were carried out with psychotherapeutic work involving one-to-one interaction between the researcher and the participant. The five-stage intervention program started to be implemented 51 days after the February 6 Kahramanmaraş earthquakes and all stages of the intervention were completed within seven days. Measurements were taken from the participants at two different times: pre-intervention pre-test and post-intervention post-test. The 17 participants in the control group (mean: 39.29, SD: 16.75) were placed on a waiting list. Data were collected using the "Sociodemographic Information Form", "Posttraumatic Growth Inventory", "Scale for Determining the Level of Post-Earthquake Trauma" and "Ways of Coping Scale".

Results

Before the intervention, the groups were controlled in terms of posttraumatic growth, post-earthquake trauma level, fatalistic coping, social support-seeking coping, and helplessness style coping levels and no difference was observed between them (p>0.05). After the intervention, it was found that the posttraumatic growth and social support-seeking coping scores of the earthquake survivors who received VR-supported intervention were significantly higher than the scores of the control group, and the post-earthquake trauma level, fatalistic coping and helplessness style coping scores were significantly lower than the control group scores (p<0.05). As a result of the in-group analyses, it is seen that the post-traumatic growth, social support-seeking coping and problem-focused coping scores of the intervention group participants after the VR-supported intervention increased statistically significantly compared to the pre-intervention, while the post-earthquake trauma level, fatalistic coping and helplessness style coping scores decreased statistically significantly compared to the pre-intervention (p<0.05). However, it is seen that the scores of the control group participants from all other scales of the Ways of Coping Scale, except for the fatalistic coping subscale, did not change statistically significantly (p>0.05).

Conclusion

As a result of the analysis, it is seen that the VR-supported intervention program developed is effective in improving the trauma symptoms of earthquake survivors. The rapid and statistically significant reduction in the trauma levels of earthquake survivors as a result of the developed intervention shows that the relevant intervention can be applied in other trauma areas and suggested for further studies.

Chronotype influences on posttraumatic stress disorder induced by the twin earthquakes in Turkey: A cross-sectional study among medical students

This study aimed to investigate the correlation between chronotypes and posttraumatic stress disorder (PTSD) symptoms in medical students affected by earthquakes in Kahramanmaraş, Turkey, while elucidating if the PTSD manifestation varies among different chronotypes four months post-disaster. The study encompassed 193 medical students, subjected to the sociodemographic data form, the Morningness-Eveningness Questionnaire (MEQ) and the PTSD Checklist for DSM-5 (PCL-5). The results indicated that students identified as "evening types" reported significantly elevated PCL-5 scores (p < 0.001) relative to "morning" and "intermediate" types. According to PCL-5 scores, 43.5% of the participants exhibited PTSD, with a higher occurrence among the evening types. Multivariable linear regression analysis revealed that lower MEQ scores independently correlated with elevated PTSD symptoms (β = -0.1389 [95% CI = -0.273 - -0.0048], p = 0.042), suggesting the potential of eveningness as a risk factor for PTSD post-disaster. These findings could enhance our understanding of PTSD, aid the development of preventive strategies, and underscore the importance of considering chronotypes. Further expansive, population-based studies with a longitudinal design are necessary to better understand the relationship between PTSD and the circadian system.

The earthquakes in Turkey and their effects on nursing and community health

BACKGROUND

Severe damage was experienced in 10 provinces in Turkey, and the north of Syria, with the earthquakes that hit Kahramanmaraş at midnight and afternoon on February 6, 2023.

AIM

The authors aimed to give brief information to the international nursing community about the situation related to earthquakes in the aspects of nurses.

CONCLUSION

These earthquakes caused traumatic processes in the affected regions. Many people, including nurses and other healthcare professionals, died or were injured. The results demonstrated that the required preparedness had not been applied. Nurses went to these areas voluntarily or on assignment and cared for individuals with injured. The universities in the country passed to distance education because of the shortage of safe places for victims. This situation also negatively influenced nursing education and clinical practice by interrupting in-person education one more time after the COVID-19 pandemic.

IMPLICATIONS FOR NURSING AND NURSING POLICY

Since the outcomes show a need for well-organized health and nursing care, policymakers may consider getting nurses' contributions to the disaster preparedness and management policy-making processes.

Emergence Agitation with Earthquake-Related Traumatic Stress Symptoms After Intravenous Sedation

Sedation with intravenous anesthetics is a sedation method that is often preferred during minor surgical procedures for anxious patients. Among the anesthetic agents used are drugs such as midazolam and ketamine, which can cause psychiatric symptoms such as loss of control over the behavior of the person (disinhibition) or dissociation. In people with high anxiety levels, a paradoxical rise of anxiety may rarely occur with midazolam, and emergence agitation or delirium may occur after anesthesia with ketamine. Post-traumatic stress disorder is a known risk factor for emergence agitation. Accompanying traumatic stress symptoms are reported to have persisted for a long time in the case reports of emergence agitation with a past history of trauma. It is aimed to discuss the importance of traumatic stress symptoms in sedation management in the post-earthquake period by presenting a case with increased anxiety and emergence agitation with acute stress symptoms such as re-experiencing the earthquake after sedation with intravenous anesthetics for a local surgical procedure immediately after experiencing the Kahramanmaraş earthquake on February 6 in Turkey. Keywords: Earthquakes, intravenous anesthetics, emergence, psychomotor agitation, acute stress disorder, post-traumatic stress disorder.