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Prevalence of psychiatric disorders three years after the 1999 earthquake in Turkey: Marmara Earthquake Survey (MES)

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Abstract

Background

The objective of the study is to describe the community prevalence of psychiatric disorder, mainly posttraumatic stress disorder (PTSD) and Major Depressive Disorder (MDD) 3 years after a devastating earthquake.

Methods

Three years after the Marmara Earthquake, 683 individuals from the epicentre were randomly selected to form a representative sample and were assessed with Composite International Diagnostic Interview (CIDI), General Health Questionnaire (GHQ), Traumatic Stress Symptom Checklist (TSSC) and Beck Depression Inventory (BDI).

Results

The 36 months prevalence of PTSD and MDD after the Marmara Earthquake were 19.2% and 18.7% respectively. The current prevalence of PTSD and MDD in the affected community was found to be 11.7% and 10.5%, respectively. PTSD and MDD were the most prevalent disorders after the disaster and showed a decrease over time. However, only 38.9% of the PTSD cases identified at any time over the 3 years were in remission at the 3rd-year. The co-occurrence of MDD with PTSD resulted in a decrease in the rate of recovery from PTSD. MDD was also the most prevalent disorder accompanying PTSD. Of all the subjects 37.5% with PTSD still met the MDD criteria at the 3rd year postearthquake.

Conclusions

In comparison with the data from pre-earthquake national mental health profile, the present study showed that the prevalence of MDD, panic disorder, OCD, GAD, social phobia and special phobias were still higher in the affected region 3 years after the earthquake.

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References

  • Alarcon RD, Glover SG, Deering CG (1999) The cascade model: an alternative to comorbidity in the pathogenesis of posttraumatic stress disorder. Psychiatry 62:114–124

    PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  • Armenian HK, Morikawa M, Melkonian AK, Hovanesian AP, Akiskal K, Akiskal HS (2002) Risk factors for depression in survivors of the 1988 earthquake in Armenia. J Urban Health 79:373–382

    PubMed  Google Scholar 

  • Başoğlu M, Kılıç C, Şalcıoğlu E, Livanou M (2004) Prevalence of posttraumatic stress disorder and comorbid depression in earthquake survivors in Turkey: an epidemiological study. J Trauma Stress 17:133–141

    Article  PubMed  Google Scholar 

  • Başoğlu M, Şalcıoğlu E, Livanou M, Ozeren M, Aker T, Kilic C, et al. (2001) A study of the validity of a screening instrument for traumatic stress in earthquake survivors in Turkey. J Trauma Stress 14:491–509

    Article  PubMed  Google Scholar 

  • Başoğlu M, Şalcıoğlu E, Livanou M (2002) Traumatic stress responses in earthquake survivors in Turkey. J Trauma Stress 15:269–276

    Article  PubMed  Google Scholar 

  • Brady KT, Killeen TK, Brewerton T, Lucerini S (2000) Comorbidity of psychiatric disorders and posttraumatic stress disorder. J Clin Psychiatr 61(Suppl 7):22–32

    Google Scholar 

  • Breslau N, Davis GC, Andreski P, Peterson E (1991) Traumatic events and posttraumatic stress disorder in an urban population of young adults. Arch Gen Psychiatry 48:216–222

    PubMed  CAS  Google Scholar 

  • Breslau N, Davis GC, Peterson EL, Schultz L (1997) Psychiatric sequelae of posttraumatic stress disorder in women. Arch Gen Psychiatry 54:81–87

    PubMed  CAS  Google Scholar 

  • Breslau N, Davis GC, Peterson EL, Schultz LR (2000) A second look at comorbidity in victims of trauma: the posttraumatic stress disorder—major depression connection. Biol Psychiatry 48:902–909

    Article  PubMed  CAS  Google Scholar 

  • Cao H, Mcfarlane AC, Klimidis S (2003) Prevalence of psychiatric disorder following the 1988 Yun Nan (China) earthquake: the first 5-month period. Soc Psychıatry Psychıatr Epıdemıol 38:204–212

    PubMed  Google Scholar 

  • Carr VJ, Lewin TJ, Webster RA, Hazell PL, Kenardy JA, Carter GL (1995) Psychosocial sequelae of the 1989 Newcastle earthquake: I. Community disaster experiences and psychological morbidity 6 months post-disaster. Psychol Med 25:539–555

    PubMed  CAS  Google Scholar 

  • Carr VJ, Lewin TJ, Webster RA, Kenardy JA (1997) A synthesis of the findings from the quake impact study: a two-year investigation of the psychosocial sequelae of the 1989 Newcastle earthquake. Soc Psychıatry Psychıatr Epıdemıol 32:123–136

    PubMed  CAS  Google Scholar 

  • Davidson JRT, Hughes D, Blazer DG, George LK (1991) Posttraumatic stress disorder in the community: an epidemiological study. Psychol Med 21:713–721

    Article  PubMed  CAS  Google Scholar 

  • Deering CG, Glover SG, Ready D, Eddleman HC, Alarcon RD (1996) Unique patterns of comorbidity in posttraumatic stress disorder from different sources of trauma. Compr Psychiatry 37:336–346

    Article  PubMed  CAS  Google Scholar 

  • Duggan C, Gunn J (1995) Medium-term course of disaster victims. A naturalistic follow-up. Br J Psychiatry 167:228–232

    Article  PubMed  CAS  Google Scholar 

  • Goenjian AK, Najarian LM, Pynoos RS, Steinberg AM, Manoukian G, Tavosian A, et al. (1994) Posttraumatic stress disorder in elderly and younger adults after the 1988 earthquake in Armenia. Am J Psychiatry 151:895–901

    PubMed  CAS  Google Scholar 

  • Goenjian AK, Steinberg AM, Najarian LM, Fairbanks LA, Tashjian M, Pynoos RS (2000) Prospective study of posttraumatic stress, anxiety, and depressive reactions after earthquake and political violence. Am J Psychiatry 157:911–916

    Article  PubMed  CAS  Google Scholar 

  • Goldberg DP, Williams P (1988) A user’s guide to the general health questionnaire. NFR/Nelson Publishing Company, Windsor, United Kingdom

    Google Scholar 

  • Government Planning Organization (1999) Retrieved from the World Wide Web: http://www.basbakanlik.gov.tr/deprem/dptdepremraporu.doc , December 20

  • Hisli N (1989) A study on validity of Beck depression inventory. Psikoloji Derg 6:118–122 (Turkish)

    Google Scholar 

  • Karanci AN, Rustemli A (1995) Psychological consequences of the 1992 Erzincan (Turkey) earthquake. Disasters 19:8–18

    PubMed  CAS  Google Scholar 

  • Kessler RC, Sonnega A, Bromet E, Hughes M, Nelson CB (1995) Posttraumatic stress disorder in the National comorbidity survey. Arch Gen Psychiatry 52:1048–1060

    PubMed  CAS  Google Scholar 

  • Kılıç C, Göğüş A. Composite International Diagnostic Interview: CIDI (Turkish version). Ankara: Hacettepe University Psychiatry Department; The Collaboration with World Health Organization Centre Release, Nurol Press, 1997. (Turkish)

  • Kılıç C, Ulusoy M (2003) Psychological effects of the November 1999 earthquake in Turkey: an epidemiological study. Acta Psychiatr Scand 108:232–238

    Article  PubMed  Google Scholar 

  • Kılıç C (1996) General health questionnaire: the study of reliability and validity. Türk Psikiyatri Derg 7:3–9 (Turkish)

    Google Scholar 

  • Kılıç C (1998) Results from the adult sample. In: Erol N, Kılıç C, Ulusoy M, Keçeci M, Şimşek Z (eds) Mental health profile of Turkey main report. Ministry of Health Publications, Ankara, pp 77–93

    Google Scholar 

  • Lai TJ, Chang CM, Connor KM, Lee LC, Davidson JRT (2004) Full and partial PTSD among earthquake survivors in rural Taiwan. J Psychiatr Res 38:313–322

    Article  PubMed  Google Scholar 

  • Livanou M, Başoğlu M, Şalcıoğlu E, Kalendar D (2002) Traumatic stress responses in treatment-seeking earthquake survivors in Turkey. J Nerv Ment Dis 190:816–823

    Article  PubMed  Google Scholar 

  • Mcfarlane AC, Papay P (1992) Multiple diagnoses in posttraumatic stress disorder in the victims of a natural disaster. J Nerv Ment Dis 180:498–504

    Article  PubMed  CAS  Google Scholar 

  • Mcmillen JC, North CS, Smith EM (2000) What parts of PTSD are normal: Intrusion, avoidance or arousal? Data from the Northridge, California, Earthquake. J Trauma Stress 13:57–75

    Article  PubMed  CAS  Google Scholar 

  • Mollica RF, Mclanes K, Sarajlic N, Lavelle J, Sarajlic I, Massagli MP (1999) Disability associated with psychiatric comorbidity and health status in Bosnian refugees living in Croatia. J Am Med Assoc 282:433–439

    Article  CAS  Google Scholar 

  • National Earthquake Information Center (2000) Earthquakes with 1,000 or more deaths from 1900. Retrieved from World Data Center Web site: http://wwwneic.cr.usgs.gov/neis/eqlists/eqsmajr.html , February 14

  • Norris FH, Friedman MJ, Watson PJ, Byrne CM, Diaz E, Kaniasty K (2002) 60,000 disaster victims speak: Part I. An empirical review of the empirical literature, 1981–2001. Psychiatry 65:207–239

    PubMed  Google Scholar 

  • Peters L, Andrews G, Cottler LB, Chatterjı S, Janca A, Smeets R (1996) The composite international diagnostic interview post-traumatic stress disorder module: preliminary data. Int J Methods Psychiatr Res 6:167–174

    Article  Google Scholar 

  • Şalcıoğlu E, Başoğlu M, Livanou M (2003) Long-term psychological outcome for non-treatment-seeking earthquake survivors in Turkey. J Nerv Ment Dis 191:154–160

    Article  PubMed  Google Scholar 

  • Shalev AY, Freedman S, Peri T, Brandes D, Sahar T, Orr SP, Pitman RK (1998) Prospective study of posttraumatic stress disorder and depression following trauma. Am J Psychiatry 155:630–637

    PubMed  CAS  Google Scholar 

  • Sharan P, Chaudhary G, Kavathekar SA, Saxena S (1996) Preliminary report of psychiatric disorders in survivors of a severe earthquake. Am J Psychiatry 153:556–558

    PubMed  CAS  Google Scholar 

  • Tural Ü, Coşkun B, Önder E, Çorapçıoğlu A, Yıldız M, Kesepara C, Karakaya I, Aydın M, Erol A, et al. (2004) Psychological consequences of the 1999 earthquake in Turkey. J Trauma Stress 17: 451–459

    Article  PubMed  Google Scholar 

  • Tural Ü, Tolun HGA, Karakaya I, Erol A, Yıldız M, Erdoğan S (2001) Predictors of current comorbid psychiatric disorders with posttraumatic stress disorder in earthquake survivors. Türk Psikiyatri Derg 12:175–183 (Turkish)

    Google Scholar 

  • Wang X, Gao L, Shinfuku N, Zhang H, Zhao C, Shen Y (2000) Longitudinal study of earthquake-related PTSD in a randomly selected community sample in North China. Am J Psychiatry 157:1260–1266

    Article  PubMed  CAS  Google Scholar 

  • World Health Organization (1992) Mental health and behavioral disorders. In: International classification of diseases. 10th revision. Geneva, Switzerland: World Health Organization, pp 311–387

Download references

Acknowledgements

The authors wish to thank Dr. Carol North for her helpful comments. This study was funded by the Directorates of Kocaeli Province and was partly presented at 39th Turkish National Psychiatric Meeting (2003) and awarded with “The best research of the year” reward by Turkish Psychiatric Association.

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Authors and Affiliations

  1. Dept. of Psychiatry, Medical Faculty of Kocaeli University, Kocaeli, Turkey

    Emin Önder MD, Ümit Tural MD & Tamer Aker MD

  2. Centre for Psychological Trauma, Kocaeli University, Kocaeli, Turkey

    Emin Önder MD & Tamer Aker MD

  3. Kocaeli Üniversitesi Tıp Fakültesi, Psikiyatri Bölümü, 41380, Umuttepe, Kocaeli, Turkey

    Tamer Aker MD

  4. Dept. of Psychiatry, Medical Faculty of Abant İzzet Baysal University, Bolu, Turkey

    Cengiz Kılıç MD

  5. Dept. of Public Health, Medical Faculty of Kocaeli University, Kocaeli, Turkey

    Sarper Erdoğan MD

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  1. Emin Önder MD
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  2. Ümit Tural MD
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  3. Tamer Aker MD
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  4. Cengiz Kılıç MD
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  5. Sarper Erdoğan MD
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Correspondence to Tamer Aker MD.

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Önder, E., Tural, Ü., Aker, T. et al. Prevalence of psychiatric disorders three years after the 1999 earthquake in Turkey: Marmara Earthquake Survey (MES). Soc Psychiat Epidemiol 41, 868–874 (2006). https://doi.org/10.1007/s00127-006-0107-6

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  • DOI: https://doi.org/10.1007/s00127-006-0107-6

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