Post-Traumatic and Psychiatric Symptoms among Young Earthquake Survivors in Primary Care Camp Hospital

Abstract

Earthquakes have been found to be associated with increased prevalence of psychiatric disorders: Post-traumatic Stress Disorder (PTSD) with a diagnosis range of 1.5%-74%, depression, anxiety and sleep disorders and substance abuse. Risk factors are varied: exposure to the earthquake, closeness to the epicenter, disruption of social network, financial loss, female sex, low educational level, etc. PTSD diagnosis is difficult because people unconsciously neglect traumatic history and ignore consequences. Between April 6 th 2009 and September 2009, 323 young survivors aged between 18 and 30 years were screened for PTSD symptoms at the S.M.I.L.E., a psychiatric service for young people at the L'Aquila Camp Hospital. The screening assessment consisted of: a socio-demographic schedule with questions about earthquake experience, the General Health Questionnaire-12 items (GHQ-12), Impact Event Scale-Revised (IES-R) and Semi-structured Clinical Interview Diagnosis II (SCID-II). Regarding psychiatric morbidity, 44.2% and 37.4% had respectively moderate and high stress levels. Female gender and unemployment were significantly correlated (p<.001) with stress level and Obsessive-Compulsive (OC) trait. After screening assessment, the 66.7% (N=215) of total sample showed a positive post-traumatic symptomatology with 13.8% of PTSD diagnosis. Obsessive-Compulsive trait, female gender, destruction of housing and high level of stress (GHQ ≥ 20) were significant predictors for a PTSD diagnosis when compared with subjects positive for PTSD symptomatology but without a PTSD diagnosis according to DSM-IV criteria. Personality features must be considered important risks for post-traumatic consequences: OC trait was significantly associated with a high score on the GHQ-12 (≥20) and is a significant predictor of PTSD symptoms (“re-experiencing” dimension). Houses destroyed, gender and unemployed were also important risk factors. Our study confirms that a natural disaster produces high levels of mental disorders with significant long-term risk of chronic impairment, such as the development of a PTSD diagnosis (13.8%) with enormously costly consequences for the mental health care system and society. This should be a high priority in a public health program.