The incidence of post-traumatic stress disorder among survivors after earthquakes:a systematic review and meta-analysis


Background:
Post-traumatic stress disorder (PTSD) is a common psychological disorder caused by unusual threats or catastrophic events. Little is known about the combined incidence of PTSD after earthquakes. This study aimed at evaluating the combined incidence of PTSD among survivors after earthquakes using systematic review and meta-analysis.

Methods:
The electronic databases of PubMed, Embase, Web of Science and PsycARTICLES were searched for relevant articles in this study. Loney criteria were used to assess the quality of eligible articles. The combined incidence of PTSD was estimated by using the Freeman-Tukey double arcsine transformation method. Subgroup analyses were conducted using the following variables: the time of PTSD assessment, gender, educational level, marital status, damage to one’s house, bereavement, injury of body and witnessing death.

Results:
Forty-six eligible articles containing 76,101 earthquake survivors met the inclusion criteria, of which 17,706 were diagnosed as having PTSD. Using a random effects model, the combined incidence of PTSD after earthquakes was 23.66 %. Moreover, the combined incidence of PTSD among survivors who were diagnosed at not more than 9 months after earthquake was 28.76 %, while for survivors who were diagnosed at over nine months after earthquake the combined incidence was 19.48 %. A high degree of heterogeneity (I2 = 99.5 %, p<0.001) was observed in the results, with incidence ranging from 1.20 to 82.64 %. The subgroup analyses showed that the incidence of PTSD after earthquake varied significantly across studies in relation to the time of PTSD assessment, gender, educational level, damage to one’s house, bereavement, injury of body and witnessing death. However, stratified analyses could not entirely explain the heterogeneity in the results.

Conclusions:
Given the high heterogeneity observed in this study, future studies should aim at exploring more possible risk factors for PTSD after earthquakes, especially genetic factors. In spite of that, the results of this study suggest that nearly 1 in 4 earthquake survivors are diagnosed as having PTSD. Therefore, the local government should plan effective psychological interventions for earthquake survivors.

Keywords:
Post-traumatic stress disorder, Earthquake, Incidence, Systematic review, Meta-analysis


Autoři: Wenjie Dai 1;  Long Chen 1,2;  Zhiwei Lai 1;  Yan Li 1;  Jieru Wang 1,3;  Aizhong Liu 1*
Působiště autorů: Department of Epidemiology and Health Statistics, School of Xiangya Public Health, Central South University, Changsha, China. 1;  Zhuhai Center for Disease Control and Prevention, Zhuhai, China. 2;  Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, USA. 3
Vyšlo v časopise: BMC Psychiatry 2016, 16:188
Kategorie: Research Article
prolekare.web.journal.doi_sk: 10.1186/s12888-016-0891-9

© 2016 The Author(s).
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
The electronic version of this article is the complete one and can be found online at: https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-016-0891-9

Souhrn

Background:
Post-traumatic stress disorder (PTSD) is a common psychological disorder caused by unusual threats or catastrophic events. Little is known about the combined incidence of PTSD after earthquakes. This study aimed at evaluating the combined incidence of PTSD among survivors after earthquakes using systematic review and meta-analysis.

Methods:
The electronic databases of PubMed, Embase, Web of Science and PsycARTICLES were searched for relevant articles in this study. Loney criteria were used to assess the quality of eligible articles. The combined incidence of PTSD was estimated by using the Freeman-Tukey double arcsine transformation method. Subgroup analyses were conducted using the following variables: the time of PTSD assessment, gender, educational level, marital status, damage to one’s house, bereavement, injury of body and witnessing death.

Results:
Forty-six eligible articles containing 76,101 earthquake survivors met the inclusion criteria, of which 17,706 were diagnosed as having PTSD. Using a random effects model, the combined incidence of PTSD after earthquakes was 23.66 %. Moreover, the combined incidence of PTSD among survivors who were diagnosed at not more than 9 months after earthquake was 28.76 %, while for survivors who were diagnosed at over nine months after earthquake the combined incidence was 19.48 %. A high degree of heterogeneity (I2 = 99.5 %, p<0.001) was observed in the results, with incidence ranging from 1.20 to 82.64 %. The subgroup analyses showed that the incidence of PTSD after earthquake varied significantly across studies in relation to the time of PTSD assessment, gender, educational level, damage to one’s house, bereavement, injury of body and witnessing death. However, stratified analyses could not entirely explain the heterogeneity in the results.

Conclusions:
Given the high heterogeneity observed in this study, future studies should aim at exploring more possible risk factors for PTSD after earthquakes, especially genetic factors. In spite of that, the results of this study suggest that nearly 1 in 4 earthquake survivors are diagnosed as having PTSD. Therefore, the local government should plan effective psychological interventions for earthquake survivors.

Keywords:
Post-traumatic stress disorder, Earthquake, Incidence, Systematic review, Meta-analysis


Zdroje

1. Dell'Osso L, Carmassi C, Massimetti G, Daneluzzo E, Di Tommaso S, Rossi A. Full and partial PTSD among young adult survivors 10 months after the L'Aquila 2009 earthquake: Gender differences. J Affect Disord. 2011;131(1-3):79–83. doi:10.1016/j.jad.2010.11.023.

2. Zhang W, Jiang X, Ho KW, Wu D. The presence of post-traumatic stress disorder symptoms in adolescents three months after an 8.0 magnitude earthquake in southwest China. J Clin Nurs. 2011;20(21-22):3057–69. doi:10.1111/j.1365-2702.2011.03825.x.

3. Zhang W, Liu H, Jiang X, Wu D, Tian Y. A longitudinal study of posttraumatic stress disorder symptoms and its relationship with coping skill and locus of control in adolescents after an earthquake in China. PLoS One. 2014;9(2):e88263. doi:10.1371/journal.pone.0088263.

4. Neria Y, Nandi A, Galea S. Post-traumatic stress disorder following disasters: a systematic review. Psychol Med. 2008;38(4):467–80. doi:10.1017/s0033291707001353.

5. Zhang Z, Ran MS, Li YH, Ou GJ, Gong RR, Li RH, et al. Prevalence of posttraumatic stress disorder among adolescents after the Wenchuan earthquake in China. Psychol Med. 2012;42(8):1687–93. doi:10.1017/S0033291711002844.

6. Zhang Y, Ho SM. Risk factors of posttraumatic stress disorder among survivors after the 512 wenchuan earthquake in China. PLoS One. 2011;6(7): e22371. doi:10.1371/journal.pone.0022371.

7. Dell'Osso L, Carmassi C, Massimetti G, Stratta P, Riccardi I, Capanna C, et al. Age, gender and epicenter proximity effects on post-traumatic stress symptoms in L'Aquila 2009 earthquake survivors. J Affect Disord. 2013;146(2):174–80. doi:10.1016/j.jad.2012.08.048.

8. Celebi Oncu E, Wise AM. The effects of the 1999 Turkish earthquake on young children: analyzing traumatized children's completion of short stories. Child Dev. 2010;81(4):1161–75. doi:10.1111/j.1467-8624.2010.01460.x.

9. Chan CL, Wang CW, Ho AH, Qu ZY, Wang XY, Ran MS, et al. Symptoms of posttraumatic stress disorder and depression among bereaved and nonbereaved survivors following the 2008 Sichuan earthquake. J Anxiety Disord. 2012;26(6):673–9. doi:10.1016/j.janxdis.2012.05.002.

10. Loney PL, Chambers LW, Bennett KJ, Roberts JG, Stratford PW. Critical appraisal of the health research literature: prevalence or incidence of a health problem. Chronic Dis Can. 1998;19(4):170–6.

11. Edmondson D, Richardson S, Fausett JK, Falzon L, Howard VJ, Kronish IM. Prevalence of PTSD in Survivors of Stroke and Transient Ischemic Attack: A Meta-Analytic Review. PLoS One. 2013;8(6):e66435. doi:10.1371/journal.pone.0066435.

12. Chen L, Liu A. The Incidence of Posttraumatic Stress Disorder After Floods: A Meta-Analysis. Disaster Med Public Health Prep. 2015;9(3):329–33. doi:10.1017/dmp.2015.17.

13. Udomratn P. Mental health and the psychosocial consequences of natural disasters in Asia. Int Rev Psychiatry. 2008;20(5):441–4. doi:10.1080/09540260802397487.

14. Galea S, Nandi A, Vlahov D. The epidemiology of post-traumatic stress disorder after disasters. Epidemiol Rev. 2005;27:78–91. doi:10.1093/epirev/mxi003.

15. Ma X, Liu X, Hu X, Qiu C, Wang Y, Huang Y, et al. Risk indicators for posttraumatic stress disorder in adolescents exposed to the 5.12 Wenchuan earthquake in China. Psychiatry Res. 2011;189(3):385–91. doi:10.1016/j.psychres.2011.02.016.

16. Armenian HK, Morikawa M, Melkonian AK, Hovanesian AP, Haroutunian N, Saigh PA, et al. Loss as a determinant of PTSD in a cohort of adult survivors of the 1988 earthquake in Armenia: implications for policy. Acta Psychiatr Scand. 2000;102(1):58–64.

17. Liu A, Tan H, Zhou J, Li S, Yang T, Wang J, et al. An epidemiologic study of posttraumatic stress disorder in flood victims in Hunan China. Can J Psychiatry. 2006;51(6):350–4.

18. Tolin DF, Foa EB. Sex differences in trauma and posttraumatic stress disorder: a quantitative review of 25 years of research. Psychol Bull. 2006; 132(6):959–92. doi:10.1037/0033-2909.132.6.959.

19. Lilly MM, Pole N, Best SR, Metzler T, Marmar CR. Gender and PTSD: What can we learn from female police officers? J Anxiety Disord. 2009;23(6):767–74. doi:10.1016/j.janxdis.2009.02.015.

20. Priebe S, Grappasonni I, Mari M, Dewey M, Petrelli F, Costa A. Posttraumatic stress disorder six months after an earthquake: findings from a community sample in a rural region in Italy. Soc Psychiatry Psychiatr Epidemiol. 2009; 44(5):393–7. doi:10.1007/s00127-008-0441-y.

21. Koenen KC, Nugent NR, Amstadter AB. Gene-environment interaction in posttraumatic stress disorder: review, strategy and new directions for future research. Eur Arch Psychiatry Clin Neurosci. 2008;258(2):82–96. doi:10.1007/s00406-007-0787-2.

22. Wu HC, Chou P, Chou FH, Su CY, Tsai KY, Ou-Yang WC, et al. Survey of quality of life and related risk factors for a Taiwanese village population 3 years post-earthquake. Aust N Z J Psychiatry. 2006;40(4):355–61.

23. Chou FH, Su TT, Chou P, Ou-Yang WC, Lu MK, Chien IC. Survey of psychiatric disorders in a Taiwanese village population six months after a major earthquake. J Formos Med Assoc. 2005;104(5):308–17.

24. Flores EC, Carnero AM, Bayer AM. Social capital and chronic post-traumatic stress disorder among survivors of the 2007 earthquake in Pisco Peru. Soc Sci Med. 2014;101:9–17. doi:10.1016/j.socscimed.2013.11.012.

25. Kadak MT, Nasiroǧlu S, Boysan M, Aydin A. Risk factors predicting posttraumatic stress reactions in adolescents after 2011 Van earthquake. Compr Psychiatry. 2013;54(7):982–90. doi:10.1016/j.comppsych.2013.04.003.

26. Zhou X, Song H, Hu M, Li X, Cai Y, Huang G, et al. Risk factors of severity of post-traumatic stress disorder among survivors with physical disabilities one year after the Wenchuan earthquake. Psychiatry Res. 2015;228(3):468–74. doi:10.1016/j.psychres.2015.05.062.

27. Önder E, Tural Ü, Aker T, Kiliç C, Erdoǧan S. Prevalence of psychiatric disorders three years after the 1999 earthquake in Turkey: Marmara Earthquake Survey (MES). Soc Psychiatry Psychiatr Epidemiol. 2006;41(11):868–74.

28. Başoǧlu M, Kiliç C, Şalcioǧlu E, Livanou M. Prevalence of posttraumatic stress disorder and comorbid depression in earthquake survivors in Turkey: An epidemiological study. J Trauma Stress. 2004;17(2):133–41.

29. Zhang LP, Zhao Q, Luo ZC, Lei YX, Wang Y, Wang PX. Prevalence and risk factors of posttraumatic stress disorder among survivors five years after the "Wenchuan" earthquake in China. Health Qual Life Outcomes. 2015;13:75. doi:10.1186/s12955-015-0247-z.

30. Kun P, Han S, Chen X, Yao L. Prevalence and risk factors for posttraumatic stress disorder: A cross-sectional study among survivors of the Wenchuan 2008 earthquake in China. Depress Anxiety. 2009;26(12):1134–40. doi:10.1002/da.20612.

31. Roussos A, Goenjian AK, Steinberg AM, Sotiropoulou C, Kakaki M, Kabakos C, et al. Posttraumatic stress and depressive reactions among children and adolescents after the 1999 earthquake in Ano Liosia Greece. Am J Psychiatr. 2005;162(3):530–7.

32. Cénat JM, Derivois D. Long-term outcomes among child and adolescent survivors of the 2010 Haitian earthquake. Depress Anxiety. 2015;32(1):57–63. doi:10.1002/da.22275.

33. Fu Y, Chen Y, Wang J, Tang X, He J, Jiao M, et al. Analysis of prevalence of PTSD and its influencing factors among college students after the Wenchuan earthquake. Child and Adolescent Psychiatry and Mental Health. 2013;7(1):1. doi:10.1186/1753-2000-7-1.

34. Hsu CC, Chong MY, Yang P, Yen CF. Posttraumatic stress disorder among adolescent earthquake victims in Taiwan. J Am Acad Child And Adolescent Psychiatry. 2002;41(7):875–81. doi:10.1097/00004583-200207000-00022.

35. Jia X, Ying L, Zhou X, Wu X, Lin C. The effects of extraversion, social support on the posttraumatic stress disorder and posttraumatic growth of adolescent survivors of the Wenchuan earthquake. PLoS One. 2015;10(3): e0121480. doi:10.1371/journal.pone.0121480.

36. Tian Y, Wong TKS, Li J, Jiang X. Posttraumatic stress disorder and its risk factors among adolescent survivors three years after an 8.0 magnitude earthquake in China. BMC Public Health. 2014;14:1073. doi:10.1186/1471-2458-14-1073.

37. Wang R, Wang L, Li Z, Cao C, Shi Z, Zhang J. Latent structure of posttraumatic stress disorder symptoms in an adolescent sample one month after an earthquake. J Adolesc. 2013;36(4):717–25. doi:10.1016/j.adolescence.2013.05.008.

38. Zhang J, Zhu S, Du C, Zhang Y. Posttraumatic stress disorder and somatic symptoms among child and adolescent survivors following the Lushan earthquake in China: A six-month longitudinal study. J Psychosom Res. 2015;79(2):100–6. doi:10.1016/j.jpsychores.

39. Gokcen C, Sahingöz M, Annagür BB. Does a non-destructive earthquake cause posttraumatic stress disorder? A cross-sectional study. Eur Child Adolesc Psychiatry. 2013;22(5):295–9. doi:10.1007/s00787-012-0348-8.

40. Chan CL, Wang CW, Qu Z, Lu BQ, Ran MS, Ho AH, et al. Posttraumatic Stress Disorder Symptoms Among Adult Survivors of the 2008 Sichuan Earthquake in China. J Trauma Stress. 2011;24(3):295–302. doi:10.1002/jts.20645.

41. Fan F, Zhang Y, Yang Y, Mo L, Liu X. Symptoms of posttraumatic stress disorder, depression, and anxiety among adolescents following the 2008 Wenchuan earthquake in China. J Trauma Stress. 2011;24(1):44–53. doi:10.1002/jts.20599.

42. Guo J, Wu P, Tian D, Wang X, Zhang W, Zhang X, et al. Post-traumatic Stress Disorder among adult survivors of the Wenchuan Earthquake in China: A repeated cross-sectional study. J Anxiety Disord. 2014;28(1):75–82. doi:10.1016/j.janxdis.2013.12.001.

43. Jia Z, Shi L, Duan G, Liu W, Pan X, Chen Y, et al. Traumatic experiences and mental health consequences among child survivors of the 2008 Sichuan earthquake: a community-based follow-up study. BMC Public Health. 2013;13:104. doi:10.1186/1471-2458-13-104.

44. Ying LH, Wu XC, Lin CD, Chen C. Prevalence and predictors of posttraumatic stress disorder and depressive symptoms among child survivors 1 year following the Wenchuan earthquake in China. Eur Child Adolesc Psychiatry. 2013;22(9):567–75. doi:10.1007/s00787-013-0400-3.

45. Xu J, Song X. Posttraumatic stress disorder among survivors of the Wenchuan earthquake 1 year after: Prevalence and risk factors. Compr Psychiatry. 2011;52(4):431–7. doi:10.1016/j.comppsych.2010.08.002.

46. Ali M, Farooq N, Bhatti MA, Kuroiwa C. Assessment of prevalence and determinants of posttraumatic stress disorder in survivors of earthquake in Pakistan using Davidson trauma scale. J Affect Disord. 2012;136(3):238–43. doi:10.1016/j.jad.2011.12.023.

47. Ayub M, Poongan I, Masood K, Gul H, Ali M, Farrukh A, et al. Psychological morbidity in children 18 months after Kashmir Earthquake of 2005. Child Psychiatry Hum Dev. 2012;43(3):323–36. doi:10.1007/s10578-011-0267-9.

48. Cénat JM, Derivois D. Assessment of prevalence and determinants of posttraumatic stress disorder and depression symptoms in adults survivors of earthquake in Haiti after 30 months. J Affect Disord. 2014;159:111–7. doi:10.1016/j.jad.2014.02.025.

49. Gigantesco A, Mirante N, Granchelli C, Diodati G, Cofini V, Mancini C, et al. Psychopathological chronic sequelae of the 2009 earthquake in L'Aquila, Italy. J Affect Disord. 2013;148(2-3):265–71. doi:10.1016/j.jad.2012.12.006.

50. Liu ZY, Yang YF, Ye YL, Zeng ZQ, Xiang YJ, Yuan P. One-year follow-up study of post-traumatic stress disorder among adolescents following the Wen-Chuan earthquake in China. Biosci Trends. 2010;4(3):96–102.

51. Naeem F, Ayub M, Masood K, Gul H, Khalid M, Farrukh A, et al. Prevalence and psychosocial risk factors of PTSD: 18 months after Kashmir earthquake in Pakistan. J Affect Disord. 2011;130(1-2):268–74. doi:10.1016/j.jad.2010.10.035.

52. Parvaresh N, Bahramnezhad A. Post-traumatic stress disorder in Bamsurvived students who immigrated to Kerman, four months after the earthquake. Arch Iran Med. 2009;12(3):244–9.

53. Takeda T, Tadakawa M, Koga S, Nagase S, Yaegashi N. Relationship between dysmenorrhea and posttraumatic stress disorder in Japanese high school students 9 months after the Great East Japan Earthquake. J Pediatr Adolesc Gynecol. 2013;26(6):355–7. doi:10.1016/j.jpag.2013.06.020.

54. Wang B, Ni C, Chen J, Liu X, Wang A, Shao Z, et al. Posttraumatic stress disorder 1 month after 2008 earthquake in China: Wenchuan earthquake survey. Psychiatry Res. 2011;187(3):392–6.

55. Wang L, Cao C, Wang R, Qing Y, Zhang J, Zhang XY. PAC1 receptor (ADCYAP1R1) genotype is associated with PTSD's emotional numbing symptoms in Chinese earthquake survivors. J Affect Disord. 2013;150(1):156–9. doi:10.1016/j.jad.2013.01.010.

56. Wang W, Fu W, Wu J, Ma XC, Sun XL, Huang Y, et al. Prevalence of PTSD and depression among junior middle school students in a rural town far from the epicenter of the Wenchuan Earthquake in China. PLoS One. 2012; 7(7):e41665. doi:10.1371/journal.pone.0041665.

57. Wen J, Shi YK, Li YP, Yuan P, Wang F. Quality of life, physical diseases, and psychological impairment among survivors 3 years after Wenchuan earthquake: A population based survey. PLoS One. 2012;7(8):e43081. doi:10.1371/journal.pone.0043081.

58. Zhang Z, Shi Z, Wang L, Liu M. One year later: Mental health problems among survivors in hard-hit areas of the Wenchuan earthquake. Public Health. 2011;125(5):293–300. doi:10.1016/j.puhe.2010.12.008.

59. Zhang Z, Wang W, Shi Z, Wang L, Zhang J. Mental Health Problems among the Survivors in the Hard-Hit Areas of the Yushu Earthquake. PLoS One. 2012;7(10):e46449. doi:10.1371/journal.pone.0046449.

60. Hou FS, Li T, Li J, Hu XQ, Liu ZY, Yuan P. The effects of demographic features on differences in sensitivity between PCL-C and SCL-90 scores in a follow-up study in secondary school students in the Wenchuan earthquake region. Biomed Environ Sci. 2011;24(6):642–8. doi:10.3967/0895-3988.2011.06.008.

61. Lau JT, Yu X, Zhang J, Mak WW, Choi KC, Lui WW, et al. Psychological distress among adolescents in Chengdu, Sichuan at 1 month after the 2008 Sichuan earthquake. J Urban Health. 2010;87(3):504–23. doi:10.1007/s11524-010-9447-3.

62. Liu X, Yang Y, Yuan P, Zhang X, Han Y, Cao Y, et al. A study of the relationship between mental health and menstrual abnormalities in female middle school students from postearthquake Wenchuan. Biosci Trends. 2010;4(1):4–8.

63. Ying L, Wu X, Lin C, Jiang L. Traumatic severity and trait resilience as predictors of posttraumatic stress disorder and depressive symptoms among adolescent survivors of the Wenchuan earthquake. PLoS One. 2014;9(2):e89401. doi:10.1371/journal.pone.0089401.

64. Kun P, Tong X, Liu Y, Pei X, Luo H. What are the determinants of post-traumatic stress disorder: Age, gender, ethnicity or other? Evidence from2008 Wenchuan earthquake. Public Health. 2013;127(7):644–52. doi:10.1016/j.puhe.2013.04.018.

65. Sezgin U, Punamäki RL. Earthquake trauma and causal explanation associating with PTSD and other psychiatric disorders among South East Anatolian women. J Affect Disord. 2012;141(2-3):432–40. doi:10.1016/j.jad.2012.03.005.

Štítky
Psychiatria
Prihlásenie
Zabudnuté heslo

Nemáte účet?  Registrujte sa

Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa