Investigation of Suicide Attempt, Impulsivity, Psychological Pain and Depression in Earthquake Survivors Affected by the February 6, 2023 Kahramanmaraş Centered Earthquake

Öz

Background: Our aim was to examine the prediction of impulsivity, psychological pain, depression and anxiety levels in individuals who survived the Kahramanmaraş earthquake to be in the group with a history of suicide attempt. Materials and Methods: Between August 2023 and February 2024, 36 earthquake survivors who attempted suicide were selected to be included in a case group at a psychiatric clinic. Simultaneously, a control group of 36 earthquake survivors, who had not received a psychiatric diagnosis and were matched with the case group in terms of age and gender, was formed Results: 63.9% of the patients who attempted suicide were females. Individuals in the case group experienced more loss of relatives in the earthquake than the control group (p=0.002). In the case group, there was a positive correlation between the non-planning subscale and BDI (Beck Depression Inventory) and Psychache Scale (PS) (r=0.691, p<0.001, r= 0.370 p=0.026, respectively). When analyzed in terms of whether the suicide act was related to the earthquake or not, there was less suicide history and method difference in the cases of earthquake-related suicide (p=0.006, p=0.029, respectively). According to logistic regression analysis, high psychological pain symptom severity predicts that earthquake survivors are in the group with a history of suicide attempt (OR=1.50, 95% CI: 1.17-1.94, p=0.01). Conclusions: Post-earthquake survivors with symptoms of depression, impulsivity, anxiety and psychological pain should be closely monitored for suicide risk and psychosocial interventions should be provided.

Anahtar Kelimeler

• Depression
• Earthquake
• Impulsivity
• Suicide
• Psychache

6 Şubat 2023 Kahramanmaraş Merkezli Depremlerden Etkilenen Depremzedelerde İntihar Girişimi, Dürtüsellik, Psikolojik Acı ve Depresyonun Araştırılması

Öz

Amaç: 6 Şubat 2023 tarihli Kahramanmaraş merkezli depremlerden etkilenen depremzedelerden inti-har girişimi olan grupta bulunmayı öngören dürtüsellik, psikolojik acı, depresyon ve anksiyete düzeyleri-ni incelemekti. Materyal ve Metod: Ağustos 2023 ile Şubat 2024 arasında, intihar girişiminde bulunan 36 depremzede, bir psikiyatri kliniğinde vaka grubuna dahil edilmek üzere seçildi. Aynı zamanda, vaka grubu ile yaş ve cinsiyet açısından eşleştirilen ve psikiyatrik tanı almamış 36 depremzeden oluşan bir kontrol grubu oluşturuldu. Devamında her bir depremzede yarı yapılandırılmış sosyodemografik ve klinik veri formu, Beck Depresyon Ölçeği (BDÖ), Beck Anksiyete Ölçeği (BAÖ), Psikolojik Acı Ölçeği (PAÖ) ve Barratt Dürtüsellik Ölçeğini (BDÖ) doldurdu. Bulgular: İntihar girişiminde bulunan hastaların %63.9'u kadındı. Vaka grubundaki bireyler, kontrol gru-buna göre depremde daha fazla akraba kaybı yaşadı (p=0,002). Vaka grubunda, plan yapmama alt ölçeği ile BDÖ ve PAÖ arasında pozitif bir korelasyon vardı (sırasıyla r=0,691, p<0,001, r=0,370 p=0,026). İnti-har eyleminin depremle ilgili olup olmadığı açısından analiz edildiğinde, depremle ilgili intiharlarda daha az intihar geçmişi ve yöntem farkı olduğu gözlemlendi (sırasıyla p=0,006, p=0,029). Lojistik regres-yon analizine göre, yüksek PAÖ şiddeti, depremzedelerin intihar girişimi geçmişine sahip olma grubunda yer alacağını öngörmektedir (OR = 1,50, %95 CI: 1,17-1,94, p=0,01). Sonuç: Depresyon, dürtüsellik, anksiyete ve psikolojik acı belirtileri gösteren deprem sonrası hayatta kalanlar, intihar riski açısından yakından izlenmeli ve psikososyal müdahaleler sağlanmalıdır.

Anahtar Kelimeler

• Depresyon
• Deprem
• Dürtüsellik
• İntihar
• Psikolojik acı

Kaynakça

1. 1. Kahramanmaras and Hatay Earthquakes Report. Presidency of the Republic of Turkey, Presidency of Strategy and Budget 2023, March 17. Retrieved December 13, 2023, from https://www.sbb.gov.tr/wp-content/uploads/2023/03/2023- 2023 Kahramanmaras and Hatay Earthquakes Report.pdf
2. 2. Bertinelli L, Mahé C, Strobl E. Earthquakes and mental health. World Development. 2023; 169:106283. https://doi.org/10.1016/j.worlddev.2023.106283
3. 3. Makwana N. Disaster and its impact on mental health: A narrative review. Journal of family medicine and primary ca-re. 2019; 8(10):3090. https://doi.org/10.4103%2Fjfmpc.jfmpc_893_19
4. 4. Tang W, Lu Y, Xu J. Post-traumatic stress disorder, anxiety and depression symptoms among adolescent earthquake vic-tims: comorbidity and associated sleep-disturbing factors. Social Psychiatry and Psychiatric Epidemiology. 2018; 53:1241-1251. https://doi.org/10.1007/s00127-018-1576-0
5. 5. Chou FHC, Wu HC, Chou P, Su CY, Tsaı KY, Chao SS, et al. Epidemiologic psychiatric studies on post‐disaster impact among Chi‐Chi earthquake survivors in Yu‐Chi. Taiwan. Psyc-hiatry and Clinical Neurosciences. 2007; 61(4):370-378. https://doi.org/10.1111/j.1440-1819.2007.01688.x
6. 6. Bartels SA, VanRooyen MJ. Medical complications associated with earthquakes. The Lancet. 2012; 379(9817):748-757. https://doi.org/10.1016/S0140-6736(11)60887-8.
7. 7. Osaki Y, Otsuki H, Imamoto A, Kinjo A, Fujii M, Kuwabara Y, et al. Suicide rates during social crises: Changes in the suicide rate in Japan after the Great East Japan earthquake and du-ring the COVID-19 pandemic. Journal of psychiatric research. 2021; 140:39-44.
8. 8. Matsubayashi T, Sawada Y, Ueda M. Natural disasters and suicide: Evidence from Japan. Social science & medicine. 2013; 82:126-133. https://doi.org/10.1016/j.socscimed.2012.12.021

9. 9. World Health Organization. Suicide in the world: global he-alth estimates (No. WHO/MSD/MER/19.3). World Health Organization. 2019
10. 10. Alabi AA. Management of self-harm, suicidal ideation and suicide attempts. S Afr Fam Pract. 2022; 64(1):e1-e4. https://orcid.org/0000-0003-0430-9171
11. 11. Jahangiri K, Yousefi K, Mozafari A, Sahebi A. The prevalence of suicidal ideation after the earthquake: A systematic review and meta-analysis. Iranian journal of public health. 2020; 49(12):2330. https:// doi.org/10.18502%2Fijph.v49i12.4815
12. 12. Lim M, Lee S, Park JI. Differences between Impulsive and Non-Impulsive Suicide Attempts among Individuals Treated in Emergency Rooms of South Korea. Psychiatry Investigation. 2016; 13(4):389-96. https://doi.org/10.4306%2Fpi.2016.13.4.389
13. 13. Simon OR, Swann AC, Powell KE, Potter LB, Kresnow MJ, O'Carroll PW. Characteristics of impulsive suicide attempts and attempters. Suicide Life Threatening Behaviour. 2001; 32(1 Suppl):49-59.
14. 14. Grant JB, Batterham PJ, McCallum SM, Werner-Seidler A, Calear AL. Specific anxiety and depression symptoms are risk factors for the onset of suicidal ideation and suicide attempts in youth. Journal of affective disorders. 2023; 327:299-305. https://doi.org/10.1016/j.jad.2023.02.024
15. 15. Shneidman ES. Commentary: Suicide as psychache. Journal of Nervous and Mental Disease 1993
16. 16. Patterson AA, Holden RR. Psychache and suicide ideation among men who are homeless: a test of Shneidman’s model. Suicide and Life‐Threatening Behavior. 2012; 42(2):147-156. https://doi.org/10.1111/j.1943-278X.2011.00078.x
17. 17. Orbach I, Mikulincer M, Gilboa-Schechtman E, Sirota P. Men-tal pain and its relationship to suicidality and life meaning. Suicide and Life-Threatening Behavior. 2003; 33(3):231-241.
18. 18. Schwind JS, Formby CB, Santangelo SL, Norman SA, Brown R, Hoffman Frances R, et al. Earthquake exposures and mental health outcomes in children and adolescents from Phulping-danda village, Nepal: a cross-sectional study. Child and ado-lescent psychiatry and mental health. 2018; 12:1-9. https://doi.org/10.1186/s13034-018-0257-9
19. 19. Cénat JM, McIntee SE, Blais-Rochette C. Symptoms of postt-raumatic stress disorder, depression, anxiety and other men-tal health problems following the 2010 earthquake in Haiti: A systematic review and meta-analysis. Journal of affective di-sorders. 2020; 273:55-85. https://doi.org/10.1016/j.jad.2020.04.046
20. 20. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh, J. An inventory for measuring depression. Archives of general psychiatry. 1961; 4(6):561-571. https://doi.org/10.1001/archpsyc.1961.01710120031004
21. 21. Hisli N. Beck Depresyon Ölçeği’nin bir Türk örnekleminde geçerlilik ve güvenilirliği. Psikoloji Dergisi. 1988; 6(22):118-122.
22. 22. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. Journal of consulting and clinical psychology. 1988; 56(6):893.
23. 23. Ulusoy M, Sahin NH, Erkmen H. Turkish version of the Beck Anxiety Inventory: psychometric properties. Journal of cogni-tive psychotherapy. 1998; 12(2):163.
24. 24. Shneidman ES. Conceptual contribution: The psychological pain assessment scale. Suicide and life-threatening behavior. 1999; 29(4):287.
25. 25. Demirkol ME, Güleç H, Çakmak S, Namli Z, Güleç M, Güçlü N, et al. Reliability and validity study of the Turkish Version of the Psychache Scale. Anatolian Journal of Psychiatry/Anadolu Psikiyatri Dergisi. 2018; 19(Special issue.1):14-20. http://dx.doi.org/10.5455/apd.292935
26. 26. Güleç H, Tamam L, Turhan M, Karakuş G, Zengin M, Stanford MS. Psychometric Properties of the Turkish Version of the Barratt Impulsiveness Scale-11. Klinik Psikofarmakoloji Bul-teni. 2008; 18(4):251-258.
27. 27. Krug EG, Kresnow MJ, Peddicord JP, Dahlberg LL, Powell KE, Crosby AE, et al. Suicide after natural disasters. New England Journal of Medicine. 1998; 338(6):373-378. http://dx.doi.org/10.1056/NEJM199802053380607
28. 28. Kõlves K, Kõlves KE, De Leo D. Natural disasters and suicidal behaviours: a systematic literature review. Journal of affecti-ve disorders. 2013; 146(1):1-14. https://doi.org/10.1016/j.jad.2012.07.037
29. 29. Matsubayashi T, Kamada T. The Great East Japan Earthquake and suicide: The long-term consequences and underlying mechanisms. Preventive medicine. 2021; 153:106755. https://doi.org/10.1016/j.ypmed.2021.106755
30. 30. Stratta P, Capanna C, Riccardi I, Carmassi C, Piccinni A, Dell'Osso L, et al. Suicidal intention and negative spiritual coping one year after the earthquake of L'Aquila (Italy). Journal of affective disorders. 2012; 136(3):1227-1231. https://doi.org/10.1016/j.jad.2011.10.006
31. 31. Vehid HE, Alyanak B, Eksi A. Suicide ideation after the 1999 earthquake in Marmara, Turkey. The Tohoku
32. journal of expe-rimental medicine. 2006; 208(1):19-24. https://doi.org/10.1620/tjem.208.19
33. 32. Jafari H, Heidari M, Heidari S, Sayfouri N. Risk factors for suicidal behaviours after natural disasters: a systematic re-view. The Malaysian journal of medical sciences: MJMS. 2020; 27(3):20. https:// doi.org/10.21315%2Fmjms2020.27.3.3
34. 33. Nishio A, Akazawa K, Shibuya F, Abe R, Nushida H, Ueno Y, et al. Influence on the suicide rate two years after a devastating disaster: a report from the 1995 Great Hanshin‐Awaji Earthquake. Psychiatry and Clinical Neurosciences. 2009; 63(2):247-250. https://doi.org/10.1111/j.1440-1819.2009.01942.x
35. 34. Guo J, He H, Fu M, Han Z, Qu Z, Wang X, et al. Suicidality associated with PTSD, depression, and disaster recovery sta-tus among adult survivors 8 years after the 2008 Wenchuan earthquake in China. Psychiatry research. 2017; 253:383-390. https://doi.org/10.1016/j.psychres.2017.04.022
36. 35. Cherry KE, Calamia MR, Elliott EM, McKneely KJ, Nguyen QP, Loader CA, et al. Religiosity and social support predict resi-lience in older adults after a flood. The International Journal of Aging and Human Development. 2023; 96(3):285-311. https://doi.org/10.1177/00914150221088543
37. 36. Chou YJ, Huang N, Lee CH, Tsai SL, Tsay JH, Chen LS, et al. Suicides after the 1999 Taiwan earthquake. International jo-urnal of epidemiology. 2003; 32(6):1007-1014. https://doi.org/10.1093/ije/dyg296
38. 37. Martikainen P, Valkonen T. Mortality after the death of a spouse: rates and causes of death in a large Finnish co-hort. American journal of public health. 1996; 86(8_Pt_1):1087-1093. https://doi.org/10.2105/AJPH.86.8_Pt_1.1087
39. 38. Yang CH, Xirasagar S, Chung HC, Huang YT, Lin HC. Suicide trends following the Taiwan earthquake of 1999: empirical evidence and policy implications. Acta Psychiatrica Scandina-vica. 2005; 112(6):442-448. https://doi.org/10.1111/j.1600-0447.2005.00603.x
40. 39. Safarpour H, Sohrabizadeh S, Malekyan L, Safi-Keykaleh M, Pirani D, Daliri S, et al. Suicide death rate after disasters: a meta-analysis study. Archives of suicide research. 2022; 26(1):14-27. https://doi.org/10.1080/13811118.2020.1793045
41. 40. Brown LA, Fernandez CA, Kohn R, Saldivia S, Vicente B. Pre-disaster PTSD as a moderator of the relationship between natural disaster and suicidal ideation over time. Journal of af-fective disorders. 2018; 230:7-14. https://doi.org/10.1016/j.jad.2017.12.096
42. 41. Nock MK, Borges G, Bromet EJ, Alonso J, Angermeyer M, Beautrais A, et al. Cross-national prevalence and risk factors for suicidal ideation, plans and attempts. The British journal of psychiatry. 2008; 192(2):98-105. https://doi.org/10.1192/bjp.bp.107.040113
43. 42. Ran MS, Zhang Z, Fan M, Li RH, Li YH, Ou GJ, et al. Risk factors of suicidal ideation among adolescents after Wenchuan earthquake in China. Asian journal of psychiatry. 2015; 13:66-71. https://doi.org/10.1016/j.ajp.2014.06.016
44. 43. Baca–Garcia E, Diaz–Sastre C, García Resa E, Blasco H, Braquehais Conesa D, Oquendo MA, et al. Suicide attempts and impulsivity. European archives of psychiatry and clinical neuroscience. 2005; 255:152-156. https://doi.org/10.1007/s00406-004-0549-3
45. 44. Öğüt Ç, Başar K, Karahan S. Impulsivity in depression: its relation to suicidality. Journal of Psychiatric Practice. 2023; 29(3):189-201. https://doi.org/10.1097/PRA.0000000000000712
46. 45. Arnberg FK, Gudmundsdóttir R, Butwicka A, Fang F, Lichtens-tein P, Hultman CM, et al. Psychiatric disorders and suicide attempts in Swedish survivors of the 2004 southeast Asia tsunami: a 5 year matched cohort study. The Lancet Psychi-atry. 2015; 2(9):817-824. https://doi.org/10.1016/S2215-0366(15)00124-8
47. 46. Lee K, Cho Y, Kim D. The Relationship Between Depression, Perceived Social Support, and Suicide Risk in Natural Disaster Survivors. Psychıatry And Clınıcal Psychopharmacology. 2021; 31(4):442-448. https://doi.org/10.5152/pcp.2021.21082
48. 47. Gray JA. The psychophysiological basis of introversion-extraversion. Behaviour research and therapy. 1970; 8(3):249-266. https://doi.org/10.1016/0005-7967(70)90069-0
49. 48. Cáceda R, Durand D, Cortes E, Prendes-Alvarez S, Moskovciak T, Harvey PD, et al. Impulsive choice and psychological pain in acutely suicidal depressed patients. Psychosomatic Medicine. 2014; 76(6):445-451. https://doi.org/10.1097/PSY.0000000000000075
50. 49. Levi-Belz Y, Gvion Y, Horesh N, Fischel T, Treves I, Or E, et al. Mental pain, communication difficulties, and medically seri-ous suicide attempts: A case-control study. Archives of Suici-de Research. 2014; 18(1):74-87. https://doi.org/10.1080/13811118.2013.809041
51. 50. Bender TW, Gordon KH, Bresin K, Joiner Jr TE. Impulsivity and suicidality: The mediating role of painful and provocative experiences. Journal of affective disorders. 2011; 129(1-3):301-307. https://doi.org/10.1016/j.jad.2010.07.023
52. 51. Shioiri T, Nishimura A, Nushida H, Tatsuno Y, Tang SW. The Kobe earthquake and reduced suicide rate in Japanese males. Archives of general psychiatry. 1999; 56(3):282-283. https://doi.org/10.1001/archpsyc.56.3.282