Psychopathology and Treatment After Earthquakes

psyhopathologyandtreatmentaftearthquake-1-0-24-kapak

Mental Health Consequences of Earthquakes in Various Countries

Selen Tütüncü

İstanbul Health and Technology University Faculty of Economics, Administrative and Social Sciences, Department of Psychology, İstanbul, Türkiye

Tütüncü S. Mental Health Consequences of Earthquakes in Various Countries. Hızlı Sayar G., Çınaroğlu M ed. Psychopathology and Treatment After Earthquakes. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.45-55.

ABSTRACT

Earthquakes are among the most devastating natural disasters, causing significant loss of life, widespread destruction of infrastructure, and long-term psychological and physical impacts on survivors. These events, which often occur without warning, pose a global public health concern due to their suddenness, uncontrollability, and large-scale effects. Unlike other events, earthquakes represent an ongoing series of impacts, with their effects continuing long after the immediate danger has passed, sometimes lasting for years. The psychological consequences, in particular, can persist for months and may even outlast physical injuries caused by the disaster. This chapter explores the mental health consequences of major earthquakes with high fatality rates in various countries, with a particular focus on post-traumatic stress disorder, depression, and anxiety symptoms. The mental health effects of earthquakes on populations in China, Haiti, Iran, Japan, Nepal, Pakistan, Syria, and Turkey are specif- ically analyzed. Earthquakes are handled differently in various countries, depending on the resources available and the interventions that can be made. In developing countries, earthquakes are especially challenging because health systems are often overwhelmed by the large number of people needing help for trauma. This chapter explores how earthquakes affect mental health and what factors can help protect and support people during recovery, with a focus on different countries. Overall, the need for global cooperation in addressing the mental health impacts of natural disasters, particularly in less-developed regions, where resources and infrastructure are limited are emphasized.

Keywords: Disasters; Earthquakes; Mental health; Post-traumatic stress disorder; Anxiety; Depression

Referanslar

  1. Ben-Ezra M. Traumatic events take their toll on mental health. Nature. 2004;430(7000):611-1. [Crossref]  [PubMed]
  2. Altindag A, Ozen S, Sir A. One-year follow-up study of posttraumatic stress disorder among earthquake survivors in Turkey. Compr Psychiatry. 2005 Sep-Oct;46(5):328-33. [Crossref]  [PubMed]
  3. Farooqui M, Quadri SA, Suriya SS, et al. Posttraumatic stress disorder: A serious post-earthquake complication. Trends Psychiatry Psychother. 2017;39(2):135-143. [Crossref]  [PubMed]
  4. Wu Z, Xu J, He L. Psychological consequences and associated risk factors among adult survivors of the 2008 Wenchuan earthquake. BMC Psychiatry. 2014;14:126. [Crossref]  [PubMed]  [PMC]
  5. Carr VJ, Lewin TJ, Webster RA, Kenardy JA. A synthesis of the findings from the Quake Impact Study: A two-year investigation of the psychosocial sequelae of the 1989 Newcastle earthquake. Social Psychiatry. 1997;32(2):123-136. [Crossref]  [PubMed]
  6. Schnurr P P, Green B L. Trauma and health: Physical health consequences of exposure to extreme stress. Journal of Health Psychology. 2004;10(9):734-736. [Crossref]
  7. Tang, B., Deng, Q., Glik, D., Dong, J., & Zhang, L. (2017). A Meta-Analysis of Risk Factors for Post-Traumatic Stress Disorder (PTSD) in Adults and Children after Earthquakes. International Journal of Environmental Research and Public Health, 14(12), 1537. [Crossref]  [PubMed]  [PMC]
  8. American Psychiatric Association. Trauma and Stressor-Related Disorders. In: Diagnostic and Statistical Manual of Mental Disorders. 5th ed., text revision; 2022. [Crossref]
  9. Neria Y, Nandi A, Galea S. Post-traumatic stress disorder following disasters: A systematic review. Psychol Med. 2008;38(4):467-480. [Crossref]  [PubMed]  [PMC]
  10. Galea S, et al. Psychological sequelae of the September 11 terrorist attacks in New York City. N Engl J Med. 2002;346(13):982-987. [Crossref]  [PubMed]
  11. Manzoor S, Ali M. Disaster and mental health: A need for multi-pronged approach. IAHRW Int J Soc Sci Rev. 2018;6(1):160-164. [Link]
  12. Zhang Z, Shi Z, Wang L, Liu M. One year later: Mental health problems among survivors in hard-hit areas of the Wenchuan earthquake. Public Health. 2011;125(5):293-300. [Crossref]  [PubMed]
  13. Wang B, Ni C, Chen J, Liu X, Wang A, Shao Z, et al. Posttraumatic stress disorder 1 month after 2008 earth-quake in China: Wenchuan earthquake survey. Psychiatry Res. 2011;187(3):392-6. [Crossref]  [PubMed]
  14. Kun P, Han S, Chen X, Yao L. Prevalence and risk factors for post-traumatic stress disorder: A cross-sectional study among survivors of the Wenchuan 2008 earthquake in China. Depress Anxiety. 2009;26(12):1134-1140. [Crossref]  [PubMed]
  15. Wang L, Zhang Y, Wang W, Shi Z, Shen J, Li M, et al. Symptoms of posttraumatic stress disorder among adult survivors three months after the Sichuan earthquake in China. J Trauma Stress 2009;22:444e50. [Crossref]  [PubMed]
  16. Wang XL, Tan J, Wen SL, Gan ZY, Li LJ, Shan H, et al. Mental health status of victims of Wenchuan earthquake and affecting factors. J Sun Yat-Sen Univ 2008;29:367e71. [Link]
  17. Wen J, Shi YK, Li YP, Yuan P, Wang F. Quality of life, physical diseases, and psychological impairment among survivors 3 years after Wenchuan earthquake: a population based survey. PLoS One. 2012;7(8):e43081. [Crossref]  [PubMed]  [PMC]
  18. Kalantar Motamedi MH, Sagafinia M, Ebrahimi A, Shams E, Kalantar Motamedi M. Major earthquakes of the past decade (2000-2010): A comparative review of various aspects of management. Trauma Mon. 2012;17(1):219-229. [Crossref]  [PubMed]  [PMC]
  19. Cenat JM, Derivois D. Assessment of prevalence and determinants of posttraumatic stress disorder and depression symptoms in adult survivors of earthquake in Haiti after 30 months. J Affect Disord. 2014;159:111-117. [Crossref]  [PubMed]
  20. Cénat JM, McIntee SE, Blais-Rochette C. Symptoms of posttraumatic stress disorder, depression, anxiety, and other men- tal health problems following the 2010 earthquake in Hai- ti: A systematic review and meta-analysis. J Affect Disord. 2020;273:55-85. [Crossref]  [PubMed]
  21. Silvestre, G., Anacréon, P., Théodore, M., Silvestre, E., Garcia-Dubus, E., 2014. Risk factors for posttraumatic stress disorder in Haitian students. Psychology 05, 849-858. [Crossref]
  22. Ramazi H, Soltani Jigheh H. The Bam (Iran) Earthquake of December 26, 2003: From an engineering and seismological point of view. J Asian Earth Sci. 2006;27(5):576-584. [Crossref]
  23. Hagh-Shenas H, Goodarzi MA, Farajpoor M, Zamyad A. Posttraumatic stress disorder among survivors of Bam earthquake 40 days after the event. East Mediterr Health J. 2006;12(Suppl 2):S118-125. [Link]
  24. Ripoll Gallardo A, Pacelli B, Alesina M, Serrone D, Iacutone G, Faggiano F, Della Corte F, Allara E. Medium- and long-term health effects of earthquakes in high-income countries: a systematic review and meta-analysis. Int J Epidemiol.2018 Aug 1;47(4):1317-1332. [Crossref]  [PubMed]
  25. Yokoyama, Y., Otsuka, K., Kawakami, N., Kobayashi, S., Ogawa, A., Tannno, K., ... & Sakata, K. (2014). Mental health and related factors after the Great East Japan earthquake and tsunami. PloS one, 9(7), e102497. [Crossref]  [PubMed]  [PMC]
  26. Ando S, Kuwabara H, Araki T, Kanehara A, Tanaka S, Morishima R, Kondo S, Kasai K. Mental health problems in a community after the Great East Japan Earthquake in 2011: A systematic review. Harv Rev Psychiatry. 2017;25(1):15-28. [Crossref]  [PubMed]
  27. Kino S, Aida J, Kondo K, Kawachi I. Persistent mental health impacts of disaster: Five-year follow-up after the 2011 Great East Japan earthquake and tsunami. J Psychiatr Res. 2021;136:452-459. [Crossref]  [PubMed]  [PMC]
  28. Basnyat B, Tabin C, Nutt C, Farmer P. Post-earthquake Nepal: the way forward. Lancet Glob Health. 2015 Dec;3(12):e731-e732. [Crossref]  [PubMed]
  29. Schwind, J. S., Norman, S. A., Brown, R., Frances, R. H., Koss, E., Karmacharya, D., & Santangelo, S. L. (2019). Association Between Earthquake Exposures and Mental Health Outcomes in Phulpingdanda Village After the 2015 Nepal Earthquakes. Community Mental Health Journal. [Crossref]  [PubMed]
  30. Ehring T, Razik S, Emmelkamp PM. Prevalence and predictors of posttraumatic stress disorder, anxiety, depression, and burnout in Pakistani earthquake recovery workers. Psychi- atry Res. 2011;185(1-2):161-166. [Crossref]  [PubMed]
  31. Soqia J, Ghareeb A, Hadakie R, et al. The mental health impact of the 2023 earthquakes on the Syrian population: cross-sectional study. BJPsych Open. 2024;10(1):e1. [Crossref]  [PubMed]  [PMC]
  32. Aker AT. 1999 Marmara Depremleri: epidemiyolojik bulgular ve toplum ruh sağlığı uygulamaları üzerine bir gözden geçirme. Turk Psikiyatri Derg. 2006;17(3):204-212. [Link]
  33. Livanou M, Başoğlu M, Salcıoğlu E, et al. Traumatic stress responses in treatment-seeking earthquake survivors in Turkey. J Nerv Ment Dis. 2002;190:816-823. [Crossref]  [PubMed]
  34. Başoğlu M, Şalcıoğlu E, Livanou M. Traumatic stress responses in earthquake survivors in Tur- key. J Trauma Stress. 2002;15(3):269-276. [Crossref]  [PubMed]
  35. Onder E, Tural U, Aker T, Kiliç C, Erdoğan S. Prevalence of psychiatric disorders three years after the 1999 earthquake in Turkey: Marmara Earthquake Survey (MES). Soc Psychiatry Psychiatr Epidemiol. 2006;41(11):868-874. [Crossref]  [PubMed]
  36. Ekici ÖK. 6 Şubat 2023 depremleri. TÜBİTAK Bilim ve Teknik Dergisi. Available from: [Link]
  37. Ministry of Interior of the Republic of Turkey. February 08, 2024. Available from: [Link]
  38. Çıtak Ş. Psychological Experiences and Risk Factors in Earthquakes. J Fam Couns Educ. 2023;8(2):116-134. [Crossref]
  39. Aslan B, Önal Ö. Prevalence of probable post-traumatic stress disorder among survivors of the 2023 earthquakes in Türkiye. East Mediterr Health J. 2024;30(9):622-631. [Crossref]  [PubMed]
  40. Tanrikulu, A. B., & Kayaoglu, K. (2024). Prevalence and determinants of probable posttraumatic stress disorder among university students eight months after the 2023 Kahramanmaras earthquake doublet. Dusunen Adam: Journal of Psychiatry & Neurological Sciences, 37(2). [Crossref]
  41. Bland SH, O'Leary ES, Farinaro E, et al. Social network disturbances and psychological distress following earthquake evacuation. J Nerv Ment Dis. 1997;185(3):188-195. [Crossref]  [PubMed]
  42. Xu J, Song X. Posttraumatic stress disorder among survivors of the Wenchuan earthquake 1 year after: prevalence and risk factors. Compr Psychiatry. 2011;52(4):431-7. [Crossref]  [PubMed]
  43. Xu, J., Dai, J., Rao, R., & Xie, H. (2016). The association between exposure and psychological health in earthquake survivors from the Longmen Shan Fault area: the mediating effect of risk perception. BMC Public Health, 16(1). [Crossref]  [PubMed]  [PMC]
  44. Cerdá M, Paczkowski M, Galea S, Nemethy K, Peán C, Desvarieux M. Psychopathology in the aftermath of the Haiti earthquake: A population-based study of posttraumatic stress disorder and major depression. Depress Anxiety. 2013;30:413-424. [Crossref]  [PubMed]  [PMC]
  45. McFarlane AC, Williams R. Mental health services required after disasters: Learning from the lasting effects of disasters. Depress Res Treat. 2012;2012:970194. [Crossref]  [PubMed]  [PMC]
  46. Yacoubian, V. V., & Hacker, F. J. (1989). Reactions to disaster at a distance: The first week after the earthquake in Soviet Armenia. Bulletin of the Menninger Clinic, 53(4), 331-339. [PubMed]
  47. Kino S, Aida J, Kondo K, Kawachi I. Long-Term Trends in Mental Health Disorders after the 2011 Great East Japan Earthquake and Tsunami. JAMA Netw Open. 2020;3:e2013437. [Crossref]  [PubMed]  [PMC]
  48. Gordon KH, Bresin K, Dombeck J, Routledge C, Wonderlich JA. The impact of the 2009 Red River Flood on interpersonal risk factors for suicide. Crisis. 2011;32(1):52-55. [Crossref]  [PubMed]
  49. Shakespeare-Finch JE, Green J. Social support promotes psychological well-being following a natural disaster. In: Australia & New Zealand Disaster & Emergency Management Conference. AST Management Pty Ltd; 2013:210-229. [Link]
  50. Shang F, Kaniasty K, Cowlishaw S, Wade D, Ma H, Forbes D. Social support following a natural disaster: A longitudinal study of survivors of the 2013 Lushan earthquake in China. Psychiatry Research. 2019;273:641-646. [Crossref]  [PubMed]
  51. Jeanet Sinding Bentzen. Acts of God? Religiosity and Natural Disasters Across Subnational World Districts. Econ J. 2019;129(622):2295-2321. [Crossref]
  52. Kölves KE, Kölves K, De Leo D. Natural disasters and suicidal behaviours: A systematic literature review. J Affect Disord. 2013;146(1):1-14. [Crossref]  [PubMed]
  53. Ramalho, R., Ersönmez, R., Kına, İ., Keçeci, İ., Apparao, R., Koh, E. B. Y., & Coskun, B. (2024). Improving mental health response in earthquake-prone regions: recommendations following the recent earthquake in Türkiye. BJPsych International, 1-3. [Crossref]
  54. Davidson JR, McFarlane AC. The extent and impact of mental health problems after disaster. J Clin Psychiatry. 2006;67(Suppl 2):9-14. [PubMed]
  55. Kokai M, Fujii S, Shinfuku N, Edwards G. Natural disaster and mental health in Asia. Psychiatry Clin Neurosci. 2004;58(2):110-116. [Crossref]  [PubMed]
  56. Ursano RJ, Fullerton CS, Norwood AE. Psychiatric dimensions of disaster: patient care, community consultation, and preventive medicine. Harvard Rev. Psychiatry 1995; 3: 196-209. [Crossref]  [PubMed]