Over-time changes in PTSD and depression among children surviving the 1999 Istanbul earthquake.
OBJECTIVE
To follow-up on child and adolescent victims with full criteria of PTSD and depression, and to examine the impact of treatment.


METHODS
One to two months following a 7.4-magnitude quake in Turkey, 160 students were examined by self-report questionnaire, psychiatric interview, clinician-administered post-traumatic stress disorder scale (CAPS), and depression and anxiety inventories. At baseline, 96 students were diagnosed with PTSD, and 49 had comorbid depression with anxiety symptoms. After 18-20 months, 74 of 96 students were found and reassessed by psychiatric interview and CAPS; 25 had been treated with cognitive-behavioral therapy (CBT) and pharmocotherapy, and 49 did not have any treatment. Binary logistic regression was used to identify significant predictors of persistent PTSD. Variables entered included pre-quake, quake and post-quake factors, having co-morbid depression upon initial interview, receipt of drug therapy, and number of months of CBT.


RESULTS
At follow-up, many had symptoms of PTSD with anxiety, but only 14 subjects met the full criteria of PTSD, and four students had major depression with anxiety symptoms. Only one variable--having been in serious personal danger during the quake (e.g., trapped in the house or under rubble)--was significantly associated with being symptomatic at follow-up.


CONCLUSIONS
Regardless of receipt of treatment, diagnoses of PTSD and depression were much reduced. More research is needed about resiliency factors.
Eksi
Aysel
A
Institute of Child Health, Istanbul University, Istanbul, Turkey.
Braun
Kathryn L
KL
D000223:Adaptation, Psychological; D000293:Adolescent; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology* / Q000523:psychology; D004190:Disasters; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008016:Life Change Events; D008297:Male; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology*; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology*; D017741:Survivors / Q000523:psychology / Q000706:statistics & numerical data*; D014421:Turkey / Q000453:epidemiology; D014947:Wounds and Injuries; D055815:Young Adult