Post-Traumatic Stress Disorder, Sleep Problems and Nutritional Status after the 7.8 and 7.5 Magnitude Earthquakes in Kahramanmaraş, Türkiye: A Cross-Sectional Study

Abstract

Objective: This study aimed to evaluate post-traumatic stress disorder (PTSD), depression, stress, anxiety levels, sleep problems, and nutritional status among earthquake survivors. Materials and Methods: This cross-sectional study was conducted nine months after the 2023 Kahramanmaraş earthquakes with 201 adult earthquake survivors, including 87 men and 114 women, with a mean age of 29.46 ± 12.19 years. An online questionnaire including demographic characteristics, the Impact of Event Scale (IES-R), Depression Anxiety Stress Scale, the PTSD Symptom-Self Report Scale (PSS-SR), Insomnia Severity Index (ISI), and food frequency questionnaire was performed. Participants self-reported their height and body weight before and after the earthquake. The scales were correlated and compared with gender. Results: According to the PSS-SR classification, 58.3% of participants had severe and 11.9% had extremely severe PTSD symptoms. Additionally, 51.2% experienced extremely severe anxiety, and 75.6% had insomnia. There was a moderate positive correlation between IES-R and stress (r: 0.634, p<0.001), anxiety (r: 0.589, p<0.001), depression (r: 0.610, p<0.001), ISI (r: 0.492, p<0.001), and PSS-SR (r: 0.696, p<0.001). Nutrient intake was adequate according to the RDA, but there were significant differences in body weight and body mass index before and after the earthquake (p<0.001). Conclusion: The earthquakes significantly affected survivors, leading to a high burden of psychiatric disorders. It is essential to strengthen public health services in this area.

Keywords

• Earthquakes
• insomnia
• nutritional status
• post-traumatic
• stress disorders

Kahramanmaraş, Türkiye'de 7.8 ve 7.5 Büyüklüğündeki Depremler Sonrası Travma Sonrası Stres Bozukluğu, Uyku Sorunları ve Beslenme Durumu: Kesitsel Bir Çalışma

Öz

Amaç: Bu çalışmada depremzedelerde travma sonrası stres bozukluğu (TSSB), depresyon, stres, anksiyete düzeyleri, uyku sorunları ve beslenme durumunun değerlendirilmesi amaçlanmıştır. Materyal ve Metot: Bu kesitsel çalışma, 2023 Kahramanmaraş depremlerinden dokuz ay sonra, yaş ortalaması 29,46 ± 12,19 yıl olan 87 erkek ve 114 kadın olmak üzere 201 yetişkin depremzede ile gerçekleştirilmiştir. Demografik özellikler, Olay Etkisi Ölçeği (IES-R), Depresyon Anksiyete Stres Ölçeği, TSSB Belirtileri Ölçeği-Kendini Değerlendirme (TSSBÖ-KD), Uykusuzluk Şiddeti İndeksi (UŞİ) ve besin tüketim sıklığını içeren online bir anket uygulanmıştır. Katılımcıların beyanı ile depremden önce ve sonra boy ve vücut ağırlıkları alındı. Ölçekler ilişkilendirildi ve cinsiyetler arası karşılaştırıldı. Sonuçlar: TSSBÖ-KD sınıflandırmasına göre, katılımcıların %58.3'ü şiddetli ve %11,9'u çok şiddetli TSSB semptomlarına sahiptir. Ayrıca, %51,2'si çok şiddetli anksiyete ve %75,6'sı uykusuzluk yaşamaktadır. IES-R ile stres (r: 0,634, p<0,001), anksiyete (r: 0,589, p<0,001), depresyon (r: 0,610, p<0,001), UŞİ (r: 0,492, p<0,001) ve TSSBÖ-KD (r: 0,696, p<0,001) arasında orta düzeyde pozitif bir korelasyon bulunmuştur. Besin alımı RDA'ya göre yeterlidir, ancak deprem öncesi ve sonrasında vücut ağırlığı ve beden kütle indeksinde anlamlı farklılıklar vardır (p<0.001). Sonuç: Depremler hayatta kalanları önemli ölçüde etkilemiş ve yüksek psikiyatrik bozukluk yüküne yol açmıştır. Bu alanda halk sağlığı hizmetlerinin güçlendirilmesi elzemdir.

Anahtar Kelimeler

• Beslenme durumu
• depremler
• stres bozuklukları
• travma sonrası
• uykusuzluk

References

1. 1. Fotiou K, Argyriou AV, Alatza S, et al. Impact assessment of the catastrophic earthquakes of 6 February 2023 in Türkiye and Syria via the exploitation of satellite datasets. In Ninth International Conference on Remote Sensing and Geoinformation of the Environment (RSCy2023). 2023;12786:475-487.
2. 2. Cambaz MD, Turhan F, Yılmazer M, Kekovalı K, Necmioğlu Ö, Kalafat D. An Investigation on the Evaluation of Regional Earthquake Tsunami Monitoring Center (RETMC) Seismic Network and Catalogue. Yerbilimleri. 2019;40(1):110-135. doi:10.17824/yerbilimleri.500472
3. 3. Kalafat D, Zülfikar AC, Akcan SO. Seismicity of Türkiye and real-time seismology applications in determining earthquake hazard. Academic Platform Journal of Natural Hazards and Disaster Management. 2021;2(2):96-111. doi:10.52114/apjhad.1039670
4. 4. Halpaap F, Rondenay S, Liu Q, Millet F, Ottemöller L. Toward Waveform‐Based Characterization of Slab & Mantle Wedge (SAM) Earthquakes. J Geophys Res Solid Earth. 2021;126(9):e2020JB021573. doi:10.1029/2020JB021573
5. 5. Radell ML, Hamza EA, Moustafa AA. Depression in post-traumatic stress disorder. Rev Neurosci. 2020;31(7):703-722. doi:10.1515/revneuro-2020-0006
6. 6. Jia Z, Tian W, Liu W, Cao Y, Yan J, Shun Z. Are the Elderly More Vulnerable to Psychological Impact of Natural Disaster? A Population-Based Survey of Adult Survivors of the 2008 Sichuan Earthquake. BMC Public Health. 2010;10:172. doi:10.1186/1471-2458-10-172
7. 7. Neria Y, Nandi A, Galea S. Post-Traumatic Stress Disorder Following Disasters: A Systematic Review. Psychol Med. 2008;38:467-480. doi:10.1017/S0033291707001353
8. 8. Flores EC, Carnero AM, Bayer AM. Social Capital and Chronic Post-Traumatic Stress Disorder among Survivors of the 2007 Earthquake in Pisco, Peru. Soc Sci Med. 2014;101:9-17. doi:10.1016/j.socscimed.2013.11.012

9. 9. Stefańska E, Wendołowicz A, Kowzan U, Konarzewska B, Szulc A, Ostrowska L. Does the usual dietary intake of patients with depression require vitamin-mineral supplementation? Psychiatr Pol. 2014;48:75-88.
10. 10. Yokomichi H, Matsubara H, Ishikuro M, et al. Impact of the Great East Japan Earthquake on body mass index, weight, and height of infants and toddlers: an infant survey. J Epidemiol. 2018;28(5):237-244. doi:10.2188/jea.JE20170006
11. 11. Raut NK, Pokhrel K. Impact of Natural Disaster on Health of Children: Empirical Evidence from Nepal’s Earthquake. Economic Journal of Nepal. 2022;45(3-4):1-22. doi:10.3126/ejon.v45i3-4.63145
12. 12. Çorapçıoğlu A, Yargıç İ, Geyran P, Kocabaşoğlu N. Olayların etkisi ölçeği (IES-R) Türkçe versiyonunun geçerlik ve güvenirliği. New/Yeni Symposium Journal. 2006;44:14-22.
13. 13. Sarıçam H. The psychometric properties of Turkish version of Depression Anxiety Stress Scale-21 (DASS-21) in health control and clinical samples. JCBPR. 2018;7(1):19-30. doi: 10.5455/JCBPR.274847
14. 14. Aydın A, Barut Y, Kalafat T, Boysan M, Beşiroğlu L. Travma Sonrası Stres Bozukluğu Belirtileri Ölçeği-kendini değerlendirme (TSSBÖ-KD) Türkçe formunun psikometrik özellikleri. Anadolu Psikiyatri Dergisi. 2012;13:125-130.
15. 15. Boysan M, Güleç M, Beşiroğlu L, Kalafat T. Uykusuzluk Şiddeti İndeksi’nin Türk örneklemindeki psikometrik özellikleri. Anadolu Psikiyatri Dergisi. 2010;11:248-252.
16. 16. T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü, Sağlıklı Beslenme ve Hareketli Hayat Dairesi Başkanlığı. Türkiye Beslenme Rehberi 2022. 1st ed. Ankara, Türkiye; 2022:324-325.
17. 17. Dai W, Chen L, Lai Z, Li Y, Wang J, Liu A. The Incidence of Post-Traumatic Stress Disorder among Survivors after Earthquakes: A Systematic Review and Meta-Analysis. BMC Psychiatry. 2016;16:188. doi:10.1186/s12888-016-0891-9
18. 18. Cairo JB, Dutta S, Nawaz H, Hashmi S, Kasl S, Bellido E. The Prevalence of Posttraumatic Stress Disorder among Adult Earthquake Survivors in Peru. Disaster Med. Public Health Prep. 2010;4:39-46.
19. 19. Xi Y, Yu H, Yao Y, Peng K, Wang Y, Chen R. Post-traumatic stress disorder and the role of resilience, social support, anxiety and depression after the Jiuzhaigou earthquake: A structural equation model. Asian J Psychiatr. 2020;49:101958. doi: 10.1016/j.ajp.2020.101958
20. 20. Valladares-Garrido MJ, Zapata-Castro LE, Peralta CI, et al. Post-traumatic stress disorder after the 6.1 magnitude earthquake in Piura, Peru: a cross-sectional study. Int J Environ Res Public Health. 2022;19(17):11035. doi: 10.3390/ijerph191711035
21. 21. Marthoenis M, Ilyas A, Sofyan H, Schouler-Ocak M. Prevalence, comorbidity and predictors of post-traumatic stress disorder, depression, and anxiety in adolescents following an earthquake. Asian J Psychiatr. 2019;43:154-159. doi: 10.1016/j.ajp.2019.05.030
22. 22. Duan W, Guo P, Gan P. Relationships among trait resilience, virtues, post-traumatic stress disorder, and post-traumatic growth. PloS One. 2015;10(5):e0125707. doi: 10.1371/journal.pone.0125707
23. 23. Ataya J, Soqia J, Ataya J, et al. Sleep quality and mental health differences following Syria-Türkiye earthquakes: A cross-sectional study. Int J Soc Psychiatry. 2024;70(4):700-708. doi: 10.1177/00207640231223432
24. 24. Yabe Y, Hagiwara Y, Sekiguchi T, et al. Sleep Disturbance Is Associated with New Onset and Continuation of Lower Back Pain: A Longitudinal Study among Survivors of the Great East Japan Earthquake. Tohoku J Exp Med. 2018;246(1):9-14. doi: 10.1620/tjem.246.9
25. 25. Tempesta D, Curcio G, De Gennaro L, Ferrara M. Long-term impact of earthquakes on sleep quality. PLoS One. 2013;8(2):e55936. doi: 10.1371/journal.pone.0055936
26. 26. Colvonen PJ, Straus LD, Stepnowsky C, McCarthy MJ, Goldstein LA, Norman SB. Recent advancements in treating sleep disorders in co-occurring PTSD. Curr Psychiatry Rep. 2018;20(7):48. doi: 10.1007/s11920-018-0916-9
27. 27. Ohayon MM, Shapiro CM. Sleep disturbances and psychiatric disorders associated with posttraumatic stress disorder in the general population. Compr Psychiatry. 2000;41(6):469-478. doi: 10.1053/comp.2000.16568
28. 28. Geng F, Liang Y, Li Y, et al. Bidirectional associations between insomnia, posttraumatic stress disorder, and depressive symptoms among adolescent earthquake survivors: a longitudinal multiwave cohort study. Sleep. 2019;42(11):zsz162. doi: 10.1093/sleep/zsz162.
29. 29. Gerstner RM, Lara-Lara F, Vasconez E, Viscor G, Jarrin JD, Ortiz-Prado E. Earthquake-related stressors associated with suicidality, depression, anxiety and post-traumatic stress in adolescents from Muisne after the earthquake 2016 in Ecuador. BMC Psychiatry. 2020;20(1):347. doi: 10.1186/s12888-020-02759-x