title: Mental health problems among children and adolescents experiencing two major earthquakes in remote mountainous regions: A longitudinal study.
abstract: Millions of children were exposed to major earthquake in China, with serious psychological and developmental consequences. To obtain accurate rate of post-disaster related disorder and identify predictors may help inform post-disaster rescue and rehabilitation efforts. The present longitudinal study explored correlations of demographic and socioeconomic characteristics of juvenile survivors of the Ya'an and Wenchuan earthquakes in China with their trajectories of post-disaster related disorder.
  
  
  
  A total of 435 Chinese children and adolescents who survived the 2013 Ya'an earthquake were recruited from six primary, secondary and high schools in Baoxing County. All survivors were assessed at 12months after the disaster, when a trained psychiatrist assessed mental health problems in a face-to-face structured interview, and 153 survivors were followed up at 30months after the earthquake via telephone.
  
  
  
  The 12-month assessment indicated a post-traumatic stress disorder (PTSD) prevalence of 43.9% as well as depression (20.9%) or the criteria for both PTSD and depression (18.2%) and the other disorder (0.9%). The 30-month assessment indicated that 15.7% of subjects met the criteria for PTSD, 21.6% met the criteria for depression. No subjects met the criteria for other affective or anxiety disorders. Significant predictors of PTSD and depression were death in the family, previous earthquake experience, a poor parent-child relationship and economic pressure or poverty.
  
  
  
  Clinical interview face to face is quite different from via telephone and the attrition rate in the longitudinal cohort is high, which would directly affect our results of the assessment.
  
  
  
  PTSD and depression may be as prevalent and persistent in disaster victims in China as elsewhere, and high co-comorbidities remain poorly understood. Although many adolescents recover over time, some exhibit chronic, delayed-onset PTSD and depression, especially those with poor relationships with their parents or those living in precarious economic conditions. Family-based therapy may be needed to support child and adolescent trauma survivors in order to prevent mental illness.
authors.affiliation: Institute of Emergency Management and Reconstruction in Post-disaster, Sichuan University, Chengdu, China; Centre for Educational and Health Psychology, Sichuan University, Chengdu, China; Mental Health Center, State Key Lab of Biotherapy, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Wanjie
authors.initials: W
authors.lastname: Tang
authors.affiliation: Institute of Emergency Management and Reconstruction in Post-disaster, Sichuan University, Chengdu, China.
authors.forename: Jingdong
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Institute of Emergency Management and Reconstruction in Post-disaster, Sichuan University, Chengdu, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Lu
authors.affiliation: Mental Health Center, State Key Lab of Biotherapy, West China Hospital, Sichuan University, Chengdu, China; School of Post-disaster Reconstruction and Management, Sichuan University, Chengdu, China.
authors.forename: Tingting
authors.initials: T
authors.lastname: Yan
authors.affiliation: Department of Neurology, Sichuan Academy of Medical Sciences and Sichuan Provincial People' Hospital, Chengdu, China.
authors.forename: Lijuan
authors.initials: L
authors.lastname: Wang
authors.affiliation: Mental Health Center, State Key Lab of Biotherapy, West China Hospital, Sichuan University, Chengdu, China. Electronic address: zhang2000jun200@163.com.
authors.forename: Jun
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Institute of Emergency Management and Reconstruction in Post-disaster, Sichuan University, Chengdu, China. Electronic address: xujiuping@scu.edu.cn.
authors.forename: Jiuping
authors.initials: J
authors.lastname: Xu
mesh_terms: D000293:Adolescent; D002648:Child; D002681:China / Q000453:epidemiology; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D004190:Disasters; D055866:Earthquakes; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health; D010287:Parent-Child Relations; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D017741:Survivors / Q000523:psychology