Traumatic stress responses in treatment-seeking earthquake survivors in Turkey.

This study examined the incidence of posttraumatic stress disorder (PTSD) and depression in 1,027 earthquake survivors who were consecutively referred to a community center at a mean of 14 months after the August 1999 earthquake in Turkey. Seventy-seven percent of referrals were women. The estimated rates of PTSD and major depression were 63% and 42%, respectively. More severe PTSD symptoms related to greater fear during the earthquake, female gender, lower education, loss of friends, shorter time since the earthquake, and material loss. More severe depression symptoms related to female gender, longer time since the earthquake, lower educational level, loss of a family member, and past psychiatric illness. In conclusion, long-term public mental health policies are needed for postearthquake psychological problems. These policies need to take into account the risk factors for traumatic stress and the gender differences in referral patterns. The differential stressor-response relationship may have important implications for treatment.