Prevalence of PTSD and Depression among Junior Middle School Students in a Rural Town Far from the Epicenter of the Wenchuan Earthquake in China

Wei Wang,Yi Huang,Wei Fu,Kenji Hashimoto,Xian-Cang Ma,Jin Wu,Xue-Li Sun,Cheng-Ge Gao,Takeo Yoshikawa

doi:10.1371/journal.pone.0041665

Abstract

ContextOn May12th 2008, a devastating earthquake measuring 8.0 on the Richter scale, struck Wenchuan county and surrounding areas in China. The prevalence of mental illness among children and adolescents in a rural town far from the earthquake epicenter is unknown.ObjectiveTo assess the prevalence of posttraumatic stress disorder (PTSD) and depression among junior middle school students in a rural town Ningqiang county, 327 km from the earthquake epicenter.Design, Setting, and ParticipantsA population-based mental health survey was conducted in March, 2009.Main Outcome MeasureSurvey Self-designed General Condition Survey Scale, Children's Revised Impact of Event Scale (CRIES-13), and the Depression Self-rating Scale for Children (DSRSC) were used to sample 1,841 junior middle school students in Ningqiang county, ten months after the Wenchuan earthquake.ResultsThe prevalence rate of a high-risk for PTSD was 28.4%, with 32.7% among females, 23.8% among males (female vs. male, p<0.001), 38.6% in the severe exposure group and 24.3% in the mild exposure group (severe vs. mild exposure, p<0.001). For depressive symptoms, the overall prevalence was 19.5%, with 24.0% among females, 14.7% among males, 24.5% in the severe exposure group and 17.5% in the mild exposure group (female vs. male, p<0.001; severe vs. mild exposure, p<0.001, respectively). In multivariate analysis, factors such as “having felt despair”, or “danger” and “having own house destroyed or damaged” were significantly associated with PTSD symptoms. Female gender and delayed evacuation in females, and earthquake related experiences in males were significantly associated with depression.ConclusionTraumatic events experienced during the earthquake were significantly associated with symptoms of PTSD and depression in children and adolescents, ten months after the Wenchuan earthquake. These data highlight a need for mental health services for children and adolescents in rural areas, far from earthquake epicenters.

Highlights

It is well established that natural disasters, such as earthquakes lead to increased prevalence of mental illness in the range of 5 to 40%, this prevalence is dependent upon the disaster severity and population exposure [1,2,3,4]
Our results suggest that severe exposure was an important factor for the prevalence of Post-traumatic stress disorder (PTSD), and that there is a gender difference in the ability to cope with stress after natural disasters
This study showed a high prevalence of PTSD and depression among junior middle school students in a rural area, 10 months after the Wenchuan earthquake

Summary

Introduction

It is well established that natural disasters, such as earthquakes lead to increased prevalence of mental illness in the range of 5 to 40%, this prevalence is dependent upon the disaster severity and population exposure [1,2,3,4]. On May 12, 2008, a devastating earthquake measuring 8.0 on the Richter scale, occurred in the Wenchuan county of Sichuan Province, in southwest China (Figure 1). This earthquake was the most destructive natural disaster in modern Chinese history. Some reports show that children and adolescents are more susceptible to mental health problems after catastrophic events, such as earthquakes, debate still exists over these findings [10,11,12,13] It is, important to study the mental health of children and adolescents in disaster areas, in order to provide appropriate mental health support for survivors of natural disasters

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Discussion

Conclusion