title: Posttraumatic stress and depressive reactions among children and adolescents after the 1999 earthquake in Ano Liosia, Greece.
abstract: OBJECTIVE
  This study evaluated the severity of posttraumatic stress and depressive reactions among children and adolescents 3 months after the 1999 earthquake in Ano Liosia, Greece, and additionally assessed the relationship of these reactions to objective and subjective features of earthquake exposure, sex, school level, postearthquake difficulties, death of a family member, and thoughts of revenge.
  
  
  METHODS
  This school-based study of 1,937 students was conducted in two differentially exposed cities (Ano Liosia, at the epicenter, and Dafni, 10 kilometers from the epicenter) with an earthquake exposure questionnaire, the UCLA Posttraumatic Stress Disorder (PTSD) Reaction Index, and the Depression Self-Rating Scale.
  
  
  RESULTS
  Endorsement of earthquake-related exposure items between the two cities was congruent with the extent of earthquake impact in each city. Median PTSD Reaction Index scores were significantly higher in Ano Liosia. The estimated rates of PTSD and clinical depression for both cities combined were 4.5% and 13.9%, respectively. Depression, subjective and objective earthquake-related experiences, and difficulties at home accounted for 41% of the variance in severity of PTSD reactions. PTSD score was the single most powerful variable predicting depression (36% of the variance), with only sex making a small but significant additional contribution.
  
  
  CONCLUSIONS
  This study demonstrated the feasibility of conducting large-scale school-based postdisaster mental health screening for planning intervention strategies. The present findings regarding PTSD and depression indicate the need to provide targeted specialized postdisaster mental health services to subgroups with significant levels of posttraumatic stress and depressive reactions after an earthquake of moderate intensity.
authors.affiliation: Attiki Child Psychiatric Hospital, Athens, Greece.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Roussos
authors.forename: Armen K
authors.initials: AK
authors.lastname: Goenjian
authors.forename: Alan M
authors.initials: AM
authors.lastname: Steinberg
authors.forename: Christina
authors.initials: C
authors.lastname: Sotiropoulou
authors.forename: Marina
authors.initials: M
authors.lastname: Kakaki
authors.forename: Christos
authors.initials: C
authors.lastname: Kabakos
authors.forename: Stavroula
authors.initials: S
authors.lastname: Karagianni
authors.forename: Vagelis
authors.initials: V
authors.lastname: Manouras
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001601:Bereavement; D002648:Child; D003695:Delivery of Health Care; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D004189:Disaster Planning; D004190:Disasters; D004644:Emotions; D005260:Female; D005500:Follow-Up Studies; D006115:Greece / Q000453:epidemiology; D006801:Humans; D008016:Life Change Events; D008297:Male; D008403:Mass Screening; D008605:Mental Health Services / Q000600:supply & distribution; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D012111:Residence Characteristics; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D013334:Students / Q000523:psychology / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires