title: Acute stress-related psychological impact in children following devastating natural disaster, the Sikkim earthquake (2011), India.
abstract: BACKGROUND
  Psychological stress following natural disaster is common. Despite several earthquakes in India, data on evaluation of acute stress among the child victims in the early postdisaster period is scarce. Immediately following a devastating earthquake (6.9 Richter) at Sikkim on September, 18 2011, many children attended North Bengal Medical College, the nearest government tertiary care institution, with unusual stress symptoms.
  
  
  OBJECTIVE
  Evaluation of acute stress symptoms in children in the immediate postearthquake period.
  
  
  METHODS
  This was a cross-sectional study done over 4 weeks and includes all the children from 1 to 12 years presenting with unusual physical or behavioral symptoms. Those with major injuries requiring admission were excluded. They were divided into two age groups. For older children (8-12 years) the 8-item Children Impact of Event Scale (CIES) was used for screening of stress. Unusual symptoms were recorded in younger children (1-8 years) as CIES is not validated < 8 years.
  
  
  RESULTS
  A total of 84 children (2.66%) out of 3154 had stress symptoms. Maximum attendance was noted in first 3 days (65.47%) and declined gradually. In children ≥ 8 years, 48.78% had psychological stress, which was statistically significant on CIES scores without any gender predilection. Static posturing (41.86%), sleeplessness (32.55%), anorexia (9.30%), recurrent vomiting (13.95%), excessive crying (13.95%), or night-awakenings (4.65%) were found in younger children (n = 43) and three required admission.
  
  
  CONCLUSIONS
  This study represent the first Indian data showing statistically significant psychological impact in older children (8-12 years) and various forms of physical stress symptoms in young children (1-8 years) following earthquake.
authors.affiliation: Department of Pediatric Medicine, North Bengal Medical College, Darjeeling, India.
authors.forename: Rakesh
authors.initials: R
authors.lastname: Mondal
authors.forename: Sumantra
authors.initials: S
authors.lastname: Sarkar
authors.forename: Indira
authors.initials: I
authors.lastname: Banerjee
authors.forename: Avijit
authors.initials: A
authors.lastname: Hazra
authors.forename: Debabrata
authors.initials: D
authors.lastname: Majumder
authors.forename: Tapas
authors.initials: T
authors.lastname: Sabui
authors.forename: Sudip
authors.initials: S
authors.lastname: Dutta
authors.forename: Abhisek
authors.initials: A
authors.lastname: Saren
authors.forename: Partha
authors.initials: P
authors.lastname: Pan
keywords: Acute stress symptoms; disaster; earthquake; physical symptom; psychological impact