Evaluation of Psychosocial Conditions of Dentistry Students After the Earthquake

Öz

This study aimed to evaluate the psychosocial conditions of dentistry students after the earthquake that struck Türkiye on February 6, 2023, affecting eleven provinces and approximately 15 million people. The research investigated the disaster's impact on students’ mental health and its potential implications for academic performance. A total of 405 clinical dentistry students from both earthquake-affected and unaffected areas participated in the study. Participants were divided into two groups based on their earthquake exposure status. Data were collected via the Depression, Anxiety, and Stress Scale-21 (DASS-21) using an online questionnaire and analyzed using the Mann-Whitney U and independent t-tests. Results were considered statistically significant at a p-value of ≤0.05. A total of 405 students (243 females, 162 males, mean age: 23.15 ± 1.37 years) completed the questionnaire. Students in the earthquake-affected group exhibited significantly higher scores for depression (23.35), anxiety (17.40), and stress (19.72) compared to those in the unaffected group (p<0.001). Gender differences were significant across all parameters, with female participants scoring significantly higher than their male counterparts, except for depression scores in the affected group (p>0.05). These findings underscore the profound impact of natural disasters on students’ psychosocial well-being and highlight the urgent need for targeted mental health support initiatives. Investigating the psychosocial conditions of dentistry students may become increasingly relevant for their well-being during times of crisis such as natural disasters.

Anahtar Kelimeler

• Anxiety
• dentistry students
• depression
• earthquake
• stress

Deprem Sonrası Diş Hekimliği Öğrencilerinin Psikososyal Durumlarının Değerlendirilmesi

Öz

Bu çalışma, 6 Şubat 2023 tarihinde Türkiye'de on bir ili ve yaklaşık 15 milyon kişiyi etkileyen deprem sonrasında diş hekimliği öğrencilerinin psikososyal durumlarını değerlendirmeyi amaçlamıştır. Araştırma, felaketin öğrencilerin ruh sağlığı üzerindeki etkisini ve akademik performanslarına olası yansımalarını incelemektedir. Depremden etkilenen ve etkilenmeyen bölgelerden toplam 405 klinik diş hekimliği öğrencisi çalışmaya katılmıştır. Katılımcılar, depremden etkilenme durumlarına göre iki gruba ayrılmış, veriler Depresyon, Anksiyete ve Stres Ölçeği-21 (DASS-21) çevrimiçi anketi kullanılarak toplanmış ve Mann-Whitney U ile bağımsız t-testleri ile analiz edilmiştir. Sonuçlar, p değeri ≤0.05 düzeyinde istatistiksel olarak anlamlı kabul edilmiştir. Toplam 405 öğrenci (243 kadın, 162 erkek, ortalama yaş: 23.15 ± 1.37 yıl) anketi tamamlamıştır. Depremden etkilenen öğrenciler, etkilenmeyen öğrencilere göre anlamlı derecede daha yüksek depresyon (23.35), anksiyete (17.40) ve stres (19.72) skorları göstermiştir (p<0.001). Tüm parametrelerde cinsiyet farklılıkları anlamlı bulunmuş; kadın öğrenciler, etkilenen grupta depresyon hariç olmak üzere tüm DASS skorlarını sürekli olarak daha yüksek bildirmiştir (p>0.05). Bu bulgular, doğal afetlerin öğrencilerin psikososyal iyi oluşu üzerindeki ciddi etkisini vurgulamakta ve ruh sağlığı destek girişimlerine duyulan ihtiyacı ortaya koymaktadır. Doğal afet zamanlarında diş hekimliği öğrencilerinin psikososyal durumlarının incelenmesi, onların iyi oluşu için giderek daha önemli hale gelebilir.

Anahtar Kelimeler

• Anksiyete
• diş hekimliği öğrencileri
• depresyon
• deprem
• stres

Kaynakça

1. Orak Y, Orak F, Gocer S, Doganay M. Earthquake in Türkiye: impact on health services and infection threats. J ClinPract Res. 2023;45(6):549-557. doi:10.14744/cpr.2023.59244.
2. Şenol Balaban M, Doğulu C, Akdede N, et al. Emergency response, and community impact after February 6, 2023 Kahramanmaraş Pazarcık and Elbistan Earthquakes: reconnaissance findings and observations on affected region in Türkiye. Bull Earthquake Eng. 2025;23(3):1053-1081. doi:10.1007/s10518-024-01867-3.
3. Kocoglu E, Demir FB, Oteles UU, Ozeren E. Post-Earthquake Trauma Levels of University Students Evaluation: Example of 6 February Kahramanmaras Earthquake. High Educ Stud. 2023;13(2):121-127. doi:10.5539/hes.v13n2p121.
4. Eroglu CN, KeskinTunç S, Isik M, Elasan S. Prevalence of Posttraumatic Stress Disorder and Depression among the Individuals within Faculty of Dentistry, who Experienced Earthquake and who did not, and the Relation with Temporomandibular Joint Disorders. Van Med J. 2017;24(2):94-100. doi:10.5505/vtd.2017.58066.
5. Stallman HM. Psychological distress in university students: A comparison with general population data. Aust Psychol. 2010;45(4):249-257. doi:10.1080/00050067.2010.482109.
6. Alzahem AM, Van der Molen HT, Alaujan AH, Schmidt HG, Zamakhshary MH. Stress amongst dental students: a systematic review. Eur J Dent Educ. 2011;15(1):8-18. doi:10.1111/j.1600-0579.2010.00640.x.
7. Uraz A, Tocak YS, Yozgatligil C, Cetiner S, Bal B. Psychological well–being, health, and stress sources in Turkish dental students. J Dent Educ. 2013;77(10):1345-1355. doi:10.1002/j.0022-0337.2013.77.10.tb05609.x.
8. Hakami Z, Khanagar SB, Vishwanathaiah S, et al. Psychological impact of the coronavirus disease 2019 (COVID‐19) pandemic on dental students: a nationwide study. J Dent Educ. 2021;85(4):494-503. doi:10.1002/jdd.12470.

9. Santabarbara J, Idoiaga N, Ozamiz-Etxebarria N, Bueno-Notivol J. Prevalence of anxiety in dental students during the COVID-19 outbreak: A meta-analysis. Int J Environ Res Public Health. 2021;18(20):10978. doi:10.3390/ijerph182010978.
10. Elani HW, Allison PJ, Kumar RA, Mancini L, Lambrou A, Bedos C. A systematic review of stress in dental students. J Dent Educ. 2014;78(2):226-242. doi:10.1002/j.0022-0337.2014.78.2.tb05673.x.
11. Jowkar Z, Masoumi M, Mahmoodian H. Psychological stress and stressors among clinical dental students at Shiraz School of Dentistry, Iran. Adv Med EducPract. Published online 2020:113-120. doi:10.2147/AMEP.S236758.
12. Lovibond SH. Manual for the Depression Anxiety Stress Scales. Psychology Foundation: Sydney, Australia,1995. doi:10.1016/0005-7967(94)00075-U.
13. Stormon N, Ford PJ, Kisely S, Bartle E, Eley DS. Depression, anxiety and stress in a cohort of Australian dentistry students. Eur J Dent Educ. 2019;23(4):507-514. doi:10.1111/eje.12459.
14. Odriozola-González P, Planchuelo-Gómez Á, Irurtia MJ, de Luis-García R. Psychological effects of the COVID-19 outbreak and lockdown among students and workers of a Spanish university. Psychiatry Res. 2020; 290:113108. doi: 10.1016/j.psychres.2020.113108.
15. Yilmaz O, Boz H, Arslan A. Depresyon Anksiyete Stres Ölçeğinin (Dass 21) Türkçe Kisa Formunun Geçerlilik-Güvenilirlik Çalişmasi. J Financ Econ Soc Stud. 2017;2(2):78-91. https://dergipark.org.tr/en/pub/ fesa/issue/30912/323190.
16. Alhajj MN, Khader Y, Murad AH, et al. Perceived sources of stress amongst dental students: A multicountry study. Eur J Dent Educ. 2018;22(4):258-271. doi:10.1111/eje.12350.
17. Shehada MR, Alfakhry G, Jamous I, Aljoujou AA, Abdul_hak M. Major Stress Sources Amongst Dental Students at Damascus University, Syria. Int Dent J. 2023;73(2):205-211. doi:10.1016/j.identj.2022.03.005.
18. Abdulrazzaq MM, Adnan MM, Al-Ani ZTA. Psychological stress among dental students at al-iraqia university after corona virus pandemic. Ind J Forensic Med Toxicol. 2020;14(3):2397-2401. doi:10.37506/ijfmt.v14i3.10795.
19. Koufatzidou M, Koletsi D, Basdeki EI, Pandis N, Polychronopoulou A. Paediatricians’ awareness on orthodontic problems and related conditions-a national survey. Prog Orthod. 2019;20:1-6. doi:10.1186/s40510-019-0285-x.
20. Basudan S, Binanzan N, Alhassan A. Depression, anxiety and stress in dental students. Int J Med Educ. 2017;8:179. doi:10.5116/ijme. 5910.b961.
21. Frese C, Wolff D, Saure D, Staehle HJ, Schulte A. Psychosocial impact, perceived stress and learning effect in undergraduate dental students during transition from pre‐clinical to clinical education. Eur J Dent Educ. 2018;22(3):e555-e563. doi:10.1111/eje.12352.
22. Iwadare Y, Usami M, Ushijima H, et al. Changes in traumatic symptoms and sleep habits among junior high school students after the Great East Japan Earthquake and Tsunami. Sleep Biol Rhythms. 2014; 12:53-61. doi:10.1111/sbr.12047.
23. Marijanović I, Kraljević M, Buhovac T, et al. Use of the Depression, Anxiety and Stress Scale (DASS-21) questionnaire to assess levels of depression, anxiety, and stress in healthcare and administrative staff in 5 oncology institutions in Bosnia and Herzegovina during the 2020 COVID-19 pandemic. Med Sci Monit. 2021;27:81-93. doi:10.12659/MSM.930812.
24. Lee E, Lee H. Disaster awareness and coping: Impact on stress, anxiety, and depression. Perspect Psychiatr Care. 2019;55(2):311-318. doi:10.1111/ppc.12351.
25. Niitsu K, Watanabe-Galloway S, Sayles H, Houfek J, Rice M. A pilot study of the psychological impact of the great East Japan earthquake and tsunami. J Am Psychiatr Nurses Assoc. 2014;20(3):194-202. doi:10.1177/1078390314536615.
26. Tokpinar A, Yilmaz S, Yilmaz H, Degermenci M. Investigation of the Opinions of the First-Year Students of Dentistry Who Go to Online Education on Anatomy Education After the Kahramanmaraş Earthquake. Med Records. 2023;5(3):603-607. doi:10.37990/medr.1318386.
27. Boduc E. The Effect of Distance Learning Anatomy Lesson on Dentistry Students in Natural Disasters such as Earthquakes. Turkish J Dent Res. 2023;2(2):191-197. doi:10.58711/turkishjdentres.vi.1337613.
28. Prinz P, Hertrich K, Hirschfelder U, de Zwaan M. Burnout, depression and depersonalisation–psychological factors and coping strategies in dental and medical students. GMS Z Med Ausbild. 2012;29(1). doi:10.3205/zma000780.
29. Abbasi S, Mubeen N, Ayub T, Khan M, Abbasi Z, Baig N. Comparison of stress levels among medical and dental students in the clinical years of training and their coping strategies. J Pak Med Assoc. 2020;70(6):1006-1008. doi:10.5455/JPMA.294959.
30. Shamsuddin K, Fadzil F, Ismail WSW, et al. Correlates of depression, anxiety and stress among Malaysian university students. Asian J Psychiatr. 2013;6(4):318-323. doi: 10.1016/j.ajp.2013.01.014.
31. Silverstein ST, Kritz‐Silverstein D. A longitudinal study of stress in first‐year dental students. J Dent Educ. 2010;74(8):836-848. doi:10.1002/j.0022-0337.2010.74.8.tb04940.x.
32. Radeef AS, Faisal GG. Stressors and their association with symptoms of depression, anxiety and stress in dental students. Makara J Health Res. 2018;22(2):58-62. doi:10.7454/msk.v22i2.9064.
33. Al-Shayea EI. Perceived depression anxiety and stress among saudi postgraduate orthodontic students: A multi-institutional survey. Pak Oral Dental J. 2014;34(2):296-303. https://applications.emro.who.int/imemrf/Pak_Oral_Dent_J/Pak_Oral_Dent_J_2014_34_2_296_303.pdf.
34. Witruk E, Lee Y, Riyono B, Kumara A, Otto K. Dealing with earthquake disaster on Java 2006: A comparison of affected and non-affected people. Anima Indones Psychol J. 2014;29(3):121-135. https://journal.ubaya.ac.id/index.php/jpa/article/view/4267.
35. Yang L, Zhang J, Choi Y, et al. Peritraumatic distress and its relationship to appliance-related orthodontic emergencies in orthodontic patients during the COVID-19 lockdown in Shanghai, China: a cross-sectional study. BMJ Open. 2025;15(8):e095959. doi:10.1136/bmjopen-2024-095959.
36. Pazderka H, Brown MRG, Agyapong VIO, et al. Collective trauma and mental health in adolescents: a retrospective cohort study of the effects of retraumatization. Front Psychiatry. 2021;12:682041. doi:10.3389/fpsyt.2021.682041.
37. Wu YL, Lin TW, Lam J, Wang SSC, Lo HHM. Resilience, coping strategies, and disaster experience: a path analysis of preparedness and avoidance in Taiwan. BMC Public Health. 2025;25(1):200. doi:10.1186/s12889-025-21361-y.
38. Gao W, Ping S, Liu X. Gender differences in depression, anxiety, and stress among college students: a longitudinal study from China. J Affect Disord. 2020;263:292-300. doi:10.1016/j.jad.2019.11.121.
39. Naz N, Iqbal S, Mahmood A. Stress, anxiety and depression among the dental students of university college of medicine and dentistry Lahore; Pakistan. Pak J Med Health Sci. 2017;11(4):1277-1281. https://www.pjmhsonline.com/2017/oct_dec/pdf/1277.pdf.