title: Ongoing adverse mental health impact of the earthquake sequence in Christchurch, New Zealand.
abstract: OBJECTIVE
  In September 2010 Christchurch, New Zealand, was struck by a 7.1 magnitude earthquake, followed by a prolonged sequence of significant aftershocks including a fatal aftershock in February 2011. Christchurch City has experienced widespread damage, ongoing disruption and building demolitions resulting in many difficulties for the residents of the Christchurch area. We explore what impact the earthquakes have had on the mental and physical health of a random sample of 50-year-olds who live in the Christchurch area.
  
  
  METHODS
  The 295 participants were selected from the electoral rolls for participation in the CHALICE study, a longitudinal study of ageing. Self-reported health status was assessed using the standardised Short Form 36 version 2 health survey (SF-36v2), a 36-item questionnaire, and results from the eight subscales compared to a national health survey. Mood disorders were assessed and the results were compared to other local and national studies.
  
  
  RESULTS
  Since the onset of the earthquakes and throughout the study period, participating middle-aged Christchurch residents have mean SF-36v2 scores significantly lower than population norms in the mental health, vitality, social functioning and role-emotional subscales (Cohen's d ranged from -0.270 to -0.357, all p < 0.001), while there was no evidence of reduced physical health. Rates of current major depressive disorder were 7.5% in the earthquake survivors compared to 5.1% and 3.7% in other historical, local and national surveys. Similarly, bipolar disorder prevalence was 2.8% in the earthquake survivors compared to 2.2% and 1.4% in other studies.
  
  
  CONCLUSIONS
  Eighteen months after the first earthquake the significant adverse impact on mental health clearly continues. The ongoing provision of additional mental health services and consideration of these adverse mental health effects in relation to other social policies remains necessary and fundamental.
authors.affiliation: Department of Psychological Medicine, University of Otago, Christchurch, New Zealand janet.spittlehouse@otago.ac.nz.
authors.forename: Janet K
authors.initials: JK
authors.lastname: Spittlehouse
authors.affiliation: Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.
authors.forename: Peter R
authors.initials: PR
authors.lastname: Joyce
authors.affiliation: Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.
authors.forename: Esther
authors.initials: E
authors.lastname: Vierck
authors.affiliation: School of Health Sciences, University of Canterbury, New Zealand The University of Queensland, School of Nursing and Midwifery, Brisbane, Australia.
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Schluter
authors.affiliation: Biostatistics and Computational Biology Unit, University of Otago, Christchurch, New Zealand.
authors.forename: John F
authors.initials: JF
authors.lastname: Pearson
mesh_terms: D001714:Bipolar Disorder / Q000453:epidemiology / Q000209:etiology; D003865:Major Depressive Disorder / Q000453:epidemiology / Q000209:etiology; D004190:Disasters; D055866:Earthquakes; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000209:etiology*; D008603:Mental Health / Q000706:statistics & numerical data; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D015995:Prevalence; D011795:Surveys and Questionnaires
keywords: Health impact; SF-36; bipolar disorder; depression; earthquakes; mental health; physical health; self-reported health status