Full and partial PTSD among earthquake survivors in rural Taiwan.

In 1999, a major earthquake struck central Taiwan. Ten months after the earthquake, survivors were surveyed to examine the background factors of demographics and exposure that are associated with posttraumatic stress disorder (PTSD) and subthreshold posttraumatic stress disorder (PTSS) and to investigate the relationships between other psychiatric problems and PTSD and PTSS following the earthquake. Subjects (n=252) randomly selected from two rural communities near the epicenter of the earthquake were interviewed to obtain the following information: demographic characteristics; extent of earthquake exposure; severity of posttraumatic stress symptoms; other psychiatric morbidity; and other morbidity-related factors, including general mental health, disability, stress vulnerability, social support, and wellbeing. Three diagnostic groups were identified with regard to trauma-related symptoms: full PTSD, partial PTSD (PTSS), and non-PTSD. Prevalence rates were calculated and bivariate and multivariate comparisons adjusted for age, sex and education were performed. The prevalence rates for PTSD (n=26) and PTSS (n=48) were 10.3% and 19.0%, respectively. The PTSD and PTSS groups differed significantly from non-PTSD on most variables, with greater likelihood of the following: female gender; total trauma exposure; generalized anxiety disorder; suicidality; any other axis I disorder; general psychopathology, disability; and impaired wellbeing. Few differences were observed between the PTSD and PTSS groups, although greater likelihood for major depression, trauma-related loss of life, and impaired stress vulnerability were noted in the PTSD group. In conclusion, PTSD and PTSS are commonly observed following earthquake exposure and are associated with similarly high levels of psychosocial impairment.

[1]  J. Jesberger,et al.  The relationship between smooth pursuit performance, motion perception and sustained visual attention in patients with schizophrenia and normal controls , 1997, Psychological Medicine.

[2]  D. Spiegel,et al.  Dissociative reactions to the San Francisco Bay Area earthquake of 1989. , 1993, The American journal of psychiatry.

[3]  K. Krishnan,et al.  Screening for Trauma History on an Inpatient Affective-Disorders Unit: A Pilot Study , 1997 .

[4]  H. J. Friedsam,et al.  Reactions of Older Persons to Disaster-caused Losses: An Hypothesis of Relative Deprivation , 1961 .

[5]  N. Asukai,et al.  Post‐traumatic symptoms among younger and elderly evacuees in the early stages following the 1995 Hanshin‐Awaji earthquake in Japan , 1996, Acta psychiatrica Scandinavica.

[6]  N. Breslau,et al.  Sex differences in posttraumatic stress disorder. , 1997, Archives of general psychiatry.

[7]  P. Sharan,et al.  Preliminary report of psychiatric disorders in survivors of a severe earthquake. , 1996, The American journal of psychiatry.

[8]  D. Kaloupek,et al.  Comorbid Psychiatric Disorders in PTSD , 1997, Annals of the New York Academy of Sciences.

[9]  D J Nutt,et al.  Consensus statement on posttraumatic stress disorder from the International Consensus Group on Depression and Anxiety. , 2000, The Journal of clinical psychiatry.

[10]  L. Fairbanks,et al.  Prospective study of posttraumatic stress, anxiety, and depressive reactions after earthquake and political violence. , 2000, The American journal of psychiatry.

[11]  R. Kessler,et al.  Posttraumatic stress disorder: the burden to the individual and to society. , 2000, The Journal of clinical psychiatry.

[12]  R. Mcfarland Post-Traumatic Stress Disorder and Concurrent Psychiatric Illness , 1985 .

[13]  S. Nolen-Hoeksema,et al.  A prospective study of depression and posttraumatic stress symptoms after a natural disaster: the 1989 Loma Prieta Earthquake. , 1991, Journal of personality and social psychology.

[14]  L. Fairbanks,et al.  Posttraumatic stress disorder in elderly and younger adults after the 1988 earthquake in Armenia. , 1994, The American journal of psychiatry.

[15]  D. Weiss,et al.  The prevalence of lifetime and partial post-traumatic stress disorder in vietnam theater veterans , 1992 .

[16]  L. Gao,et al.  Longitudinal study of earthquake-related PTSD in a randomly selected community sample in north China. , 2000, The American journal of psychiatry.

[17]  J. Davidson,et al.  Assessment of a new self-rating scale for post-traumatic stress disorder , 1997, Psychological Medicine.

[18]  Elizabeth M. Smith,et al.  What Parts of PTSD Are Normal: Intrusion, Avoidance, or Arousal? Data from the Northridge, California, Earthquake , 2000, Journal of traumatic stress.

[19]  J. Nolan,et al.  Epidemiology of trauma. , 1999, Journal of the Indian Medical Association.

[20]  J. Davidson,et al.  Davidson Trauma Scale (DTS): Normative scores in the general population and effect sizes in placebo‐controlled SSRI trials , 2002, Depression and anxiety.

[21]  G. Canino,et al.  The Impact of Disaster on Mental Health: Prospective and Retrospective Analyses , 1990 .

[22]  F H Norris,et al.  Epidemiology of trauma: frequency and impact of different potentially traumatic events on different demographic groups. , 1992, Journal of consulting and clinical psychology.

[23]  D. Sheehan,et al.  The Anxiety Disease , 1984 .

[24]  M. Stein,et al.  Full and partial posttraumatic stress disorder: findings from a community survey. , 1997, The American journal of psychiatry.

[25]  A. Taylor,et al.  One-year prospective follow-up of motor vehicle accident victims. , 1996, Behaviour research and therapy.

[26]  P. Williams,et al.  The design and development of a screening questionnaire (CHQ) for use in community studies of mental disorders in Taiwan , 1986, Psychological Medicine.

[27]  L. Robins,et al.  Post-traumatic stress disorder in the general population. Findings of the epidemiologic catchment area survey. , 1987, The New England journal of medicine.

[28]  P. Williams,et al.  Internal consistency and factor structure of the Chinese Health Questionnaire , 1990, Acta psychiatrica Scandinavica.

[29]  I. Carlier,et al.  Partial posttraumatic stress disorder (PTSD): the issue of psychological scars and the occurrence of PTSD symptoms. , 1995, The Journal of nervous and mental disease.

[30]  R. Bootzin,et al.  Effects of the 1989 San Francisco earthquake on frequency and content of nightmares. , 1992, Journal of abnormal psychology.

[31]  Masahiro Morikawa,et al.  Loss as a determinant of PTSD in a cohort of adult survivors of the 1988 earthquake in Armenia: implications for policy , 2000, Acta psychiatrica Scandinavica.

[32]  P. Schnurr,et al.  Premilitary MMPI scores as predictors of combat-related PTSD symptoms. , 1993, The American journal of psychiatry.

[33]  N. Breslau,et al.  Risk factors for PTSD-related traumatic events: a prospective analysis. , 1995, The American journal of psychiatry.

[34]  J. Davidson,et al.  Functional Impairment and Utilization of Services Associated With Posttraumatic Stress in the Community , 1999, Journal of traumatic stress.

[35]  D. Sheehan,et al.  The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. , 1998, The Journal of clinical psychiatry.

[36]  G. Wilkinson,et al.  Validation of 30- and 12-item versions of the Chinese Health Questionnaire (CHQ) in patients admitted for general health screening , 1989, Psychological Medicine.

[37]  M. Taylor,et al.  Posttraumatic stress disorder and concurrent psychiatric illness: a preliminary report. , 1983, The American journal of psychiatry.

[38]  D. Takeuchi,et al.  An epidemiological study of neurasthenia in Chinese-Americans in Los Angeles. , 1997, Comprehensive psychiatry.

[39]  R. Kessler,et al.  Posttraumatic stress disorder in the National Comorbidity Survey. , 1995, Archives of general psychiatry.