Dysfunction and Post-Traumatic Stress Disorder in Fracture Victims 50 Months after the Sichuan Earthquake

Jun Ni,Jan D Reinhardt,Xianmin Zeng,Hong Jin,Jianan Li,Ling Li,Mingyue Xiao,Xia Zhang,Anthony E Kline

doi:10.1371/journal.pone.0077535

Abstract

BackgroundThis study aimed to evaluate the effectiveness of a rehabilitation intervention on physical dysfunction (PDF) and post-traumatic stress disorder (PTSD) in fracture victims 50 months after the Sichuan earthquake of 2008 and to identify risk factors for PTSD.MethodsThis is a retrospective cohort study. Four hundred and fifty-nine earthquake-related fracture victims from Mianzhu city, Sichuan Province who did not qualify for disability pension participated. Two hundred and forty-five subjects received regular rehabilitation and 214 did not. Muscle strength, joint range of motion (ROM),sensory function, and sit-to-stand balance capacity were evaluated to assess PDF. The PTSD Checklist-Civilian Version (PCL-C) was administered to screen for PTSD. An ordinary least square regression was used to predict PTSD, and a logistic regression was used to predict PDF. In addition a Least Angle Regression (LARS) was carried out for PTSD to study the effects of rehabilitation and PDF at the same time.ResultsUnadjusted and adjusted group differences in physical dysfunction (p<0.01) and PTSD prevalence (p<0.05) were significant in favor of the rehabilitation group. In addition, being female, average or above family income, having witnessed death and fearfulness were found risk factors for PTSD symptoms 50 months after the earthquake. Both PDF and rehabilitation were selected predictors by LARS demonstrating opposite effects.ConclusionPDF and PTSD were significantly reduced by the rehabilitation intervention. Future medical intervention strategies should consider rehabilitation in order to assist survivors in dealing with both physical and psychological effects of natural disaster.

Highlights

On May 12, 2008, an earthquake of magnitude 8.0 on the Richter Scale struck the densely populated Sichuan Province, in southwestern China
In order to exclude effects from differing degrees of impairment on post-traumatic stress disorder (PTSD), we selected fracture victims who had well recovered from bodily injury, i.e. at least did not qualify for disability pension
Based on retrospective information gathered from the victims in personal interviews, subjects were divided into two groups: a rehabilitation group that had reported to have received regular institution-based rehabilitation therapy and a control group that had not

Summary

Introduction

On May 12, 2008, an earthquake of magnitude 8.0 on the Richter Scale struck the densely populated Sichuan Province, in southwestern China. The Sichuan earthquake affected 46 million people resulting in 87,476 deaths, over 350,000 persons injured, leaving many physical and mental health problems in the affected area [1,2]. Past research has demonstrated a clear relationship between natural disasters and mental health problems [4,5,6,7]. Studies on the impact of the Sichuan earthquake on the mental health of survivors reported prevalence rates of post-traumatic stress disorder (PTSD) ranging from 9.4% to 45.5% [8,9]. This study aimed to evaluate the effectiveness of a rehabilitation intervention on physical dysfunction (PDF) and post-traumatic stress disorder (PTSD) in fracture victims 50 months after the Sichuan earthquake of 2008 and to identify risk factors for PTSD

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Methods

Results

Conclusion