Yakşi Neşe, Eroğlu Mehtap
Faculty of Medicine, Department of Public Health, Amasya University, Amasya, Turkey.
Department of Child and Adolescent Psychiatry, Hatay Training and Research Hospital, Hatay, Turkey.
Arch Public Health. 2024 Nov 1;82(1):199. doi: 10.1186/s13690-024-01434-x.
Earthquakes are potentially traumatic natural disasters due to their destructive nature, and huge impacts, producing scenes of horror, undesirable and uncontrollable results. Children are affected mainly by earthquakes not only physically but also psychologically. We aimed to evaluate the rates of probable PTSD and related factors in children and adolescents after the February 6 Kahramanmaras earthquake.
In this cross-sectional study, 246 children and adolescents were included. The research was conducted in Hatay, one of the most affected provinces, between 06/07/2023-06/08/2023. Sociodemographic form, Children's Depression Inventory, Children's Posttraumatic Response Reaction Index, Screen for Child Anxiety Related Emotional Disorders, Child and Youth Resilience Measure and Social Support Appraisals Scale for Children were applied by face-to-face survey method.
The median age of the participants was 12 (8-18). 133 (54%) of the participants were girls. Probable depression rate was 98%, and probable anxiety disorder rate was 63%. Probable mild, moderate, severe and very severe PTSD rates were 18%, 29%, 43% and 8%, respectively. The probable severe PTSD rate was higher in children who were injured in the earthquake (p = 0.032), who received outpatient treatment (p = 0.016), and who saw people trapped under the collapse (p = 0.012). Also, the children whose sleep routines have changed post-earthquake were found to have more probable severe PTSD (p < 0.001). Access time to the potable water supply (p = 0.045), toilet facilities (p = 0.045), shelter facilities (p = 0.004), heating facilities (p = 0.001), clothing supply (p < 0.001) and healthcare services (p = 0.009) were found to be associated with probable severe PTSD right after the earthquake. In the fifth month of the earthquake, inadequate meeting of clothing needs (p = 0.018), educational services (p = 0.028) and social activity opportunities (p < 0.001) were significantly associated with probable severe PTSD. In the multivariate analysis, the risk of probable severe PTSD was increased 2.9 times in those with post-earthquake sleep changes (p = 0.001) and 11.1 times in those with probable anxiety disorders (p < 0.001). Also, it has been shown that each unit increase in the APP-family score reduces probable severe PTSD risk by 2% (p = 0.002).
In the current study, the rates of probable PTSD, depression and anxiety disorders were considerably high. Probable anxiety disorder and sleep disturbance were significant predictors of probable severe PTSD. On the other hand, social support from family was found to be a significant protective factor for severe PTSD risk. We conclude that the lack of meeting needs that increase the risk of probable severe PTSD differs in the acute and subacute phases.
地震因其具有破坏性、巨大影响以及带来恐怖场景、不良和不可控的后果，是潜在的创伤性自然灾害。儿童不仅在身体上，而且在心理上都会受到地震的影响。我们旨在评估2月6日卡赫拉曼马拉什地震后儿童和青少年中可能患创伤后应激障碍（PTSD）的比率及相关因素。
在这项横断面研究中，纳入了246名儿童和青少年。研究于2023年7月6日至2023年8月6日在受灾最严重的省份之一哈塔伊进行。通过面对面调查方法应用社会人口学表格、儿童抑郁量表、儿童创伤后反应指数、儿童焦虑相关情绪障碍筛查量表、儿童和青少年复原力测量量表以及儿童社会支持评估量表。
参与者的中位年龄为12岁（8 - 18岁）。133名（54%）参与者为女孩。可能患抑郁症的比率为98%，可能患焦虑症的比率为63%。可能患轻度、中度、重度和极重度PTSD的比率分别为18%、29%、43%和8%。在地震中受伤的儿童（p = 0.032）、接受门诊治疗的儿童（p = 0.016）以及看到有人被困在废墟下的儿童（p = 0.012）中，可能患重度PTSD的比率更高。此外，地震后睡眠习惯改变的儿童被发现更有可能患重度PTSD（p < 0.001）。地震后获得饮用水供应（p = 0.045）、厕所设施（p = 0.045）、避难设施（p = 0.004）、供暖设施（p = 0.001）、衣物供应（p < 0.001）和医疗服务（p = 0.009）的时间被发现与地震后可能患重度PTSD有关。在地震后的第五个月，衣物需求（p = 0.018）、教育服务（p = 0.028）和社会活动机会（p < 0.001）的满足不足与可能患重度PTSD显著相关。在多变量分析中，地震后睡眠改变的人患可能患重度PTSD的风险增加2.9倍（p = 0.001），可能患焦虑症的人增加11.1倍（p < 0.001）。此外，已表明APP - 家庭得分每增加一个单位，可能患重度PTSD的风险降低2%（p = 0.002）。
在当前研究中，可能患PTSD、抑郁症和焦虑症的比率相当高。可能患焦虑症和睡眠障碍是可能患重度PTSD的重要预测因素。另一方面，来自家庭的社会支持被发现是重度PTSD风险的重要保护因素。我们得出结论，增加可能患重度PTSD风险的需求未得到满足的情况在急性期和亚急性期有所不同。
