Long-term psychological consequences of the 1999 Kocaeli earthquake

Abstract

The present study examined the rates of posttraumatic stress disorder (PTSD) and depression and associated risk factors in the 1999 Kocaeli earthquake survivors in Turkey. A group of 586 survivors from 3 prefabricated housing sites in the epicenter region was assessed using the Screening Instrument for Traumatic Stress in Earthquake Survivors and the Fear and Avoidance Questionnaire. The estimated rates of PTSD and major depression were 39% and 18%, respectively. Traumatic stress symptoms related to more intense fear during the earthquake, female gender, older age, participation in rescue work, loss of friends and neigbours and past history of psychiatric illness. Depression related to death of a family member, being single, divorced or widowed, female gender and family history of psychiatric illness. Overall, survivors feared and avoided a mean of 10 earthquake-related situations. Phobic avoidance of buildings and related activities and more severe depressive symptoms related to more interference with social, occupational and family functioning. Subjective distress, disability in functioning, more severe depressive symptoms related to seeking psychological care. Finally, a factor analysis of the Traumatic Stress Symptom Checklist failed to replicate the DSM-IV PTSD symptom clusters. Overall, these results point to the need of implementing effective national mental health care policies for psychological care of survivors of earthquake. Furthermore, they suggest that possible differences in symptom profiles following different traumatic events in different socio-cultural settings would need to be taken into account in future revisions of the DSM-IV.