Earthquake-related PTSD: A follow-up study in prevalence, comorbidity, quality of life, and biological correlates

Abstract

Disasters, both natural and man made, affect millions of people around the worldeach year. Breslau et al. (1991) estimated that 6%-7% of the US population wasexposed to disaster or physical or psychological trauma every year. Wang et al.(2000) showed that natural disasters affect an average of approximately 200 millionpeople in China each year, killing several thousands. Two of the most recent anddevastating traumatic events were the 9/11 terrorism attack that occurred in theUSA in 2001 and the tsunami disaster in South Asia in 2004. Most studies havefound evidence of psychiatric disorders among residents of affected areas after disasters,including posttraumatic stress disorder (PTSD), major depressive episode(MDE), sleep and anxiety disorders, and substance abuse (Goenjian et al. 2000;Green et al. 1992; Maj et al. 1989; McFarlane and Papay 1992; Rubonis and Bickman1991). MDE and PTSD are the most common disaster-related psychiatric diagnoses,and are strongly associated with each other (Chang et al. 2003; Chou et al.2003; Goenjian et al. 2000; Green et al. 1992; McFarlane and Papay 1992). The reportedPTSD incidence in various studies has ranged from 6%-74% (Breslau et al.1991; Carr et al. 1995; Chang et al. 2002, 2003; Chen et al. 2001a; Chou et al. 2003;Hsu et al. 2002; Kuo et al. 2003; Tainaka et al. 1998; Papadatos et al. 1990; Yang etal. 2003), occurring predominantly in women (Chang et al. 2003; Chou et al. 2003).PTSD can be triggered by a variety of traumatic events (e.g., earthquake; EQ) andhas been found to be associated with the development of all other psychiatric disor- ders examined (Brady et al. 2000; Chou et al. 2003; Goenjian et al. 2000). However,Krause (1987) argued that careful consideration must be given to the time intervalbetween the occurrence of a stressful situation and data acquisition, as well as thelength of time that is required for symptoms to abate. The meaning attributed to atraumatic event is the product of a complex interaction that is based on the eventitself, personal histories and future expectations, and biological factors, all combiningto produce the psychiatric impairment or disorder (Ursano et al. 1992).