title: Mental health problems among survivors in hard-hit areas of the 5.12 Wenchuan and 4.20 Lushan earthquakes.
abstract: BACKGROUND
  Earthquake exposure has often been associated with psychological distress. However, little is known about the cumulative effect of exposure to two earthquakes on psychological distress and in particular, the effect on the development of post-traumatic stress disorder (PTSD), anxiety and depression disorders.
  
  
  OBJECTIVE
  This study explored the effect of exposure on mental health outcomes after a first earthquake and again after a second earthquake.
  
  
  METHODS
  A population-based mental health survey using self-report questionnaires was conducted on 278 people in the hard-hit areas of Lushan and Baoxing Counties 13-16 months after the Wenchuan earthquake (Sample 1). 191 of these respondents were evaluated again 8-9 months after the Lushan earthquake (Sample 2), which struck almost 5 years after the Wenchuan earthquake.
  
  
  RESULTS
  In Sample 1, the prevalence rates for PTSD, anxiety and depression disorders were 44.53, 54.25 and 51.82%, respectively, and in Sample 2 the corresponding rates were 27.27, 38.63 and 36.93%. Females, the middle-aged, those of Tibetan nationality, and people who reported fear during the earthquake were at an increased risk of experiencing post-traumatic symptoms.
  
  
  CONCLUSIONS
  Although the incidence of PTSD, anxiety and depression disorders decreased from Sample 1 to Sample 2, the cumulative effect of exposure to two earthquakes on mental health problems was serious in the hard-hit areas. Therefore, it is important that psychological counseling be provided for earthquake victims, and especially those exposed to multiple earthquakes.
authors.affiliation: a School of Business, Sichuan University , Chengdu , China.
authors.forename: Zongtang
authors.initials: Z
authors.lastname: Xie
authors.affiliation: a School of Business, Sichuan University , Chengdu , China.
authors.forename: Jiuping
authors.initials: J
authors.lastname: Xu
authors.affiliation: a School of Business, Sichuan University , Chengdu , China.
authors.forename: Zhibin
authors.initials: Z
authors.lastname: Wu
mesh_terms: D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders / Q000453:epidemiology; D003866:Depressive Disorder / Q000453:epidemiology; D004190:Disasters; D055866:Earthquakes; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Lushan earthquake; PTSD; Wenchuan earthquake; anxiety; depression