The incidence of post-traumatic stress disorder among survivors after earthquakes:a systematic review and meta-analysis

Abstract

BackgroundPost-traumatic stress disorder (PTSD) is a common psychological disorder caused by unusual threats or catastrophic events. Little is known about the combined incidence of PTSD after earthquakes. This study aimed at evaluating the combined incidence of PTSD among survivors after earthquakes using systematic review and meta-analysis.MethodsThe electronic databases of PubMed, Embase, Web of Science and PsycARTICLES were searched for relevant articles in this study. Loney criteria were used to assess the quality of eligible articles. The combined incidence of PTSD was estimated by using the Freeman-Tukey double arcsine transformation method. Subgroup analyses were conducted using the following variables: the time of PTSD assessment, gender, educational level, marital status, damage to one’s house, bereavement, injury of body and witnessing death.ResultsForty-six eligible articles containing 76,101 earthquake survivors met the inclusion criteria, of which 17,706 were diagnosed as having PTSD. Using a random effects model, the combined incidence of PTSD after earthquakes was 23.66 %. Moreover, the combined incidence of PTSD among survivors who were diagnosed at not more than 9 months after earthquake was 28.76 %, while for survivors who were diagnosed at over nine months after earthquake the combined incidence was 19.48 %. A high degree of heterogeneity (I2 = 99.5 %, p<0.001) was observed in the results, with incidence ranging from 1.20 to 82.64 %. The subgroup analyses showed that the incidence of PTSD after earthquake varied significantly across studies in relation to the time of PTSD assessment, gender, educational level, damage to one’s house, bereavement, injury of body and witnessing death. However, stratified analyses could not entirely explain the heterogeneity in the results.ConclusionsGiven the high heterogeneity observed in this study, future studies should aim at exploring more possible risk factors for PTSD after earthquakes, especially genetic factors. In spite of that, the results of this study suggest that nearly 1 in 4 earthquake survivors are diagnosed as having PTSD. Therefore, the local government should plan effective psychological interventions for earthquake survivors.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-016-0891-9) contains supplementary material, which is available to authorized users.

Reduced local segregation of single‐subject gray matter networks in adult PTSD

“…Its lifetime prevalence is 6.8% of the adult population (Kessler et al, 2005), and it occurs in 24% of individuals after severe stressors such as occur in military veterans and earthquake survivors (Dai et al, 2016). Its lifetime prevalence is 6.8% of the adult population (Kessler et al, 2005), and it occurs in 24% of individuals after severe stressors such as occur in military veterans and earthquake survivors (Dai et al, 2016).…”

Evaluation of a Group-Based Resilience Intervention for Typhoon Haiyan Survivors

“…Although many survivors are able to recover after a disaster, there are those who experience difficulty in recovering and are at risk for developing post-traumatic stress disorder (PTSD). Meta-analytic studies report the prevalence of PTSD ranges from 19.5-28% among earthquake victims (Dai, Chen, Lai, Wang, & Liu, 2016), 11.5-16% among flood victims (Chen & Liu, 2015), and 15-24% across disaster victims in general (Utzon-Frank et al, 2014).Mental health and/or psychosocial support (MHPSS) interventions are particularly salient among communities located in the Pacific Rim Ring of Fire, who regularly contend with earthquakes, tsunamis, typhoons, floods, and bushfires (Paton, 2009). In the past 100 years, nine of ten of the worst natural disasters occurred in Asia (Udomratn, 2008).…”

“…Although many survivors are able to recover after a disaster, there are those who experience difficulty in recovering and are at risk for developing post-traumatic stress disorder (PTSD). Meta-analytic studies report the prevalence of PTSD ranges from 19.5-28% among earthquake victims (Dai, Chen, Lai, Wang, & Liu, 2016), 11.5-16% among flood victims (Chen & Liu, 2015), and 15-24% across disaster victims in general (Utzon-Frank et al, 2014).…”

Longitudinal interplays of estrogen receptor alpha gene rs9340799 with social‐environmental factors on post‐traumatic stress disorder in Chinese Han adolescents after Wenchuan earthquake

“…In studies about 2008 Wenchuan earthquake, the prevalence of PTSD was reported to range from 1.3 to 62.8% among survivors of this earthquake (Hong & Efferth, ). These great variations across previous studies may be partly explained by the differences in diagnostic tools, sampling frames, study designs, and the time of PTSD assessments, gender, and other factors (Dai et al, ; Hong & Efferth, ). For example, the prevalence of PTSD in adolescents ranged from 8.8 to 21.0% at 6 months (Fan, Long, Zhou, Zheng, & Liu, ; Fan, Zhang, Yang, Mo, & Liu, ; Liu et al, , ; Zhang et al, ), from 1.3 to 40.1% at 12 months (Fan et al, ; Fu et al, ; Jia, Ying, Zhou, Wu, & Lin, ; Jin, Xu, Liu, & Liu, ; Liu et al, , 2011; Ying, Wu, Lin, & Chen, ; Zhang et al, ), form 1.6 to 13.5% at 18 months (Fan et al, ; Zhang et al, ) after the earthquake.…”

“…Nevertheless, great variations of PTSD prevalence have been documented across the previous investigations. A meta‐analysis towards 46 articles on 16 different destructive earthquakes occurred between 1999 and 2013 indicated that the incidence of PTSD after the included earthquakes ranged from 1.20 to 82.64% (Dai et al, ). Even after a specific earthquake, there were still huge variations of PTSD prevalence recorded.…”