Skip to main content
Top
Published in: European Child & Adolescent Psychiatry 2/2010

01-02-2010 | Original Contribution

Some clinical characteristics of children who survived the Marmara earthquakes

Authors: Turkay Demir, Demet Eralp Demir, Leyla Alkas, Mazlum Copur, Burak Dogangun, Levent Kayaalp

Published in: European Child & Adolescent Psychiatry | Issue 2/2010

Login to get access

Abstract

The Marmara earthquakes occurred in the Marmara Region (North West) of Turkey in 1999 and resulted in a death toll of approximately 20,000. This paper investigates the relationships between diagnoses and certain variables in children who developed emotional and/or behavioral disturbances in the aftermath of the Marmara earthquakes and were subsequently seen at a child psychiatry outpatient clinic. The variables evaluated are gender, age, the location where the earthquake was experienced, and the degree of losses, bodily injuries, and damage to the residence. Medical records of 321 children and adolescents ranging in age from 2 to 15 years who presented at the clinic due to problems associated with the earthquake between August 1999 and February 2000 were reviewed. Of the patients, 25.5% were diagnosed with post-traumatic stress disorder (PTSD), 16.5% with acute stress disorder (ASD) and 38% with adjustment disorder. No relationship is found between gender and diagnosis. Younger age groups tended to be diagnosed with adjustment disorder. Those who had lost relatives, friends or neighbors were more frequently diagnosed with ASD or PTSD. The same was true for children whose residence was heavily damaged. Children and adolescents constitute the age group that is most severely affected by natural disasters and display significant emotional–behavioral disturbances. The frequency of ASD and PTSD found in our study is considerably high. Although rarely mentioned in the literature, adjustment disorder appears to be one of the most common reactions of children to trauma.
Literature
1.
go back to reference American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association, Washington, DC American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association, Washington, DC
2.
go back to reference Araki K, Nakane Y, Ohta Y, Kawasaki N (1998) The nature of psychiatric problems among disaster victims. Psychiatry Clin Neurosci 52(Suppl):317–319 Araki K, Nakane Y, Ohta Y, Kawasaki N (1998) The nature of psychiatric problems among disaster victims. Psychiatry Clin Neurosci 52(Suppl):317–319
3.
go back to reference Asarnow J, Glynn S, Pynoos R, Nahum J, Guthrie D, Cantwell D, Franklin B (1999) When the earth stops shaking: earthquake sequelae among children diagnosed for pre-earthquake psychopathology. J Am Acad Child Adolesc Psychiatry 38:1016–1023CrossRefPubMed Asarnow J, Glynn S, Pynoos R, Nahum J, Guthrie D, Cantwell D, Franklin B (1999) When the earth stops shaking: earthquake sequelae among children diagnosed for pre-earthquake psychopathology. J Am Acad Child Adolesc Psychiatry 38:1016–1023CrossRefPubMed
4.
go back to reference Bal A, Jensen B (2007) Post-traumatic stress disorder symptom clusters in Turkish child and adolescent trauma survivors. Eur Child Adolesc Psychiatry 16:449–457CrossRefPubMed Bal A, Jensen B (2007) Post-traumatic stress disorder symptom clusters in Turkish child and adolescent trauma survivors. Eur Child Adolesc Psychiatry 16:449–457CrossRefPubMed
5.
go back to reference Breton JJ, Valla JP, Lambert J (1993) Industrial disaster and mental health of children and their parents. J Am Acad Child Adolesc Psychiatry 32:438–445CrossRefPubMed Breton JJ, Valla JP, Lambert J (1993) Industrial disaster and mental health of children and their parents. J Am Acad Child Adolesc Psychiatry 32:438–445CrossRefPubMed
6.
go back to reference Burke JD Jr, Moccia P, Borus JF, Burns BJ (1986) Emotional distress in fifth grade children ten months after a natural disaster. J Am Acad Child Psychiatry 25:536–541CrossRefPubMed Burke JD Jr, Moccia P, Borus JF, Burns BJ (1986) Emotional distress in fifth grade children ten months after a natural disaster. J Am Acad Child Psychiatry 25:536–541CrossRefPubMed
7.
go back to reference Diler RS, Avci A, Kulan E, Uzel M, Adiguzel L (1999) Assessment of outpatient referrals after Adana earthquake. 9th National Child and Adolescent Psychiatry Congress Book. CUY, Adana (Turkish) Diler RS, Avci A, Kulan E, Uzel M, Adiguzel L (1999) Assessment of outpatient referrals after Adana earthquake. 9th National Child and Adolescent Psychiatry Congress Book. CUY, Adana (Turkish)
8.
go back to reference Duggal HS, Berezkin G, John V (2002) PTSD and TV viewing of World Trade Center. J Am Acad Child Adolesc Psychiatry 41:494–495CrossRefPubMed Duggal HS, Berezkin G, John V (2002) PTSD and TV viewing of World Trade Center. J Am Acad Child Adolesc Psychiatry 41:494–495CrossRefPubMed
9.
go back to reference Garrison CZ, Bryant ES, Addy CL, Spurrier PG, Freedy JR, Kilpatrick DG (1995) Post-traumatic stress disorder in adolescents after Hurricane Andrew. J Am Acad Child Adolesc Psychiatry 34:1193–1201PubMed Garrison CZ, Bryant ES, Addy CL, Spurrier PG, Freedy JR, Kilpatrick DG (1995) Post-traumatic stress disorder in adolescents after Hurricane Andrew. J Am Acad Child Adolesc Psychiatry 34:1193–1201PubMed
10.
go back to reference Goenjian A (1993) A mental health relief programme in Armenia after the 1988 Earthquake. Br J Psychiatry 163:230–239CrossRefPubMed Goenjian A (1993) A mental health relief programme in Armenia after the 1988 Earthquake. Br J Psychiatry 163:230–239CrossRefPubMed
11.
go back to reference Goenjian AK, Pynoos RS, Steinberg AM, Najarian LM, Asarnow JR, Karayan I, Ghurabi M, Fairbanks LA (1995) Psychiatric comorbidity in children after the 1988 earthquake in Armenia. J Am Acad Child Adolesc Psychiatry 34:1174–1184CrossRefPubMed Goenjian AK, Pynoos RS, Steinberg AM, Najarian LM, Asarnow JR, Karayan I, Ghurabi M, Fairbanks LA (1995) Psychiatric comorbidity in children after the 1988 earthquake in Armenia. J Am Acad Child Adolesc Psychiatry 34:1174–1184CrossRefPubMed
12.
go back to reference Goenjian A, Stilwell BM, Steinberg AM, Fairbanks L, Galvin MR, Karayan I, Pynoos RS (1999) Moral development and psychopathological interference in conscience functioning among adolescents after trauma. J Am Acad Child Adolesc Psychiatry 38:376–384CrossRefPubMed Goenjian A, Stilwell BM, Steinberg AM, Fairbanks L, Galvin MR, Karayan I, Pynoos RS (1999) Moral development and psychopathological interference in conscience functioning among adolescents after trauma. J Am Acad Child Adolesc Psychiatry 38:376–384CrossRefPubMed
13.
go back to reference Goenjian AK, Molina L, Steinberg AM, Fairbanks LA, Alvarez ML, Goenjian HA, Pynoos RS (2001) Post-traumatic stress and depressive reactions among Nicaraguan adolescents after Hurricane Mitch. Am J Psychiatry 158:788–794CrossRefPubMed Goenjian AK, Molina L, Steinberg AM, Fairbanks LA, Alvarez ML, Goenjian HA, Pynoos RS (2001) Post-traumatic stress and depressive reactions among Nicaraguan adolescents after Hurricane Mitch. Am J Psychiatry 158:788–794CrossRefPubMed
14.
go back to reference Green BL, Korol M, Grace MC, Vary M, Leonard AC, Gleser G, Smitson-Cohen S (1991) Children and disaster: age, gender, and parental effects on PTSD symptoms. J Am Acad Child Adolesc Psychiatry 30:945–951PubMedCrossRef Green BL, Korol M, Grace MC, Vary M, Leonard AC, Gleser G, Smitson-Cohen S (1991) Children and disaster: age, gender, and parental effects on PTSD symptoms. J Am Acad Child Adolesc Psychiatry 30:945–951PubMedCrossRef
15.
go back to reference Green BL, Grace MC, Vary MG, Kramer TL, Gleser GC, Leonard AC (1994) Children of disaster in the second decade: a 17-year follow-up of Buffalo Creek survivors. J Am Acad Child Adolesc Psychiatry 33:71–79CrossRefPubMed Green BL, Grace MC, Vary MG, Kramer TL, Gleser GC, Leonard AC (1994) Children of disaster in the second decade: a 17-year follow-up of Buffalo Creek survivors. J Am Acad Child Adolesc Psychiatry 33:71–79CrossRefPubMed
16.
go back to reference Groome D, Soureti A (2004) Post-traumatic stress disorder and anxiety symptoms in children exposed to the 1999 Greek earthquake. Br J Psychol 95:387–397CrossRefPubMed Groome D, Soureti A (2004) Post-traumatic stress disorder and anxiety symptoms in children exposed to the 1999 Greek earthquake. Br J Psychol 95:387–397CrossRefPubMed
17.
go back to reference Howard WT, Loberiza FR, Pfohl BM, Thorne PS (1999) Initial results, reliability, and validity of a mental health survey of Mount Pinatubo disaster victims. J Nerv Ment Dis 187:661–672CrossRefPubMed Howard WT, Loberiza FR, Pfohl BM, Thorne PS (1999) Initial results, reliability, and validity of a mental health survey of Mount Pinatubo disaster victims. J Nerv Ment Dis 187:661–672CrossRefPubMed
18.
go back to reference Hsu CC, Chong MY, Yang P, Yen CF (2002) Post-traumatic stress disorder among adolescent earthquake victims in Taiwan. J Am Acad Child Adolesc Psychiatry 41:875–881CrossRefPubMed Hsu CC, Chong MY, Yang P, Yen CF (2002) Post-traumatic stress disorder among adolescent earthquake victims in Taiwan. J Am Acad Child Adolesc Psychiatry 41:875–881CrossRefPubMed
19.
go back to reference Karakaya I, Agaoglu B, Coskun A, Sismanlar SG, Yildiz Oc O (2004) The symptoms of PTSD, depression and anxiety in adolescent students three and a half years after the Marmara earthquake. Turk Psikiyatri Derg 15:257–263 (Turkish)PubMed Karakaya I, Agaoglu B, Coskun A, Sismanlar SG, Yildiz Oc O (2004) The symptoms of PTSD, depression and anxiety in adolescent students three and a half years after the Marmara earthquake. Turk Psikiyatri Derg 15:257–263 (Turkish)PubMed
20.
go back to reference Kassam-Adams N, Winston FK (2004) Predicting child PTSD: the relationship between acute stress disorder and PTSD in injured children. J Am Acad Child Adolesc Psychiatry 43:403–411CrossRefPubMed Kassam-Adams N, Winston FK (2004) Predicting child PTSD: the relationship between acute stress disorder and PTSD in injured children. J Am Acad Child Adolesc Psychiatry 43:403–411CrossRefPubMed
21.
go back to reference Kilic EZ, Uslu RI, Kerimoglu E (1999) Family factors associated with post-traumatic stress disorder symptoms in children. Cocuk ve Genclik Ruh Sagligi Dergisi 6:150–157 (Turkish) Kilic EZ, Uslu RI, Kerimoglu E (1999) Family factors associated with post-traumatic stress disorder symptoms in children. Cocuk ve Genclik Ruh Sagligi Dergisi 6:150–157 (Turkish)
22.
go back to reference Kilic EZ, Ozguven HD, Sayil I (2003) The psychological effects of parental mental health on children experiencing disaster: the experience of Bolu earthquake in Turkey. Fam Process 42:485–495CrossRefPubMed Kilic EZ, Ozguven HD, Sayil I (2003) The psychological effects of parental mental health on children experiencing disaster: the experience of Bolu earthquake in Turkey. Fam Process 42:485–495CrossRefPubMed
23.
go back to reference Kolaitis G, Kotsopoulos J, Tsiantis J, Haritaki S, Rigizou F, Zacharaki L, Riga E, Augoustatou A, Bimbou A, Kanari N, Liakopoulou M, Katerelos P (2003) Post-traumatic stress reactions among children following the Athens earthquake of September 1999. Eur Child Adolesc Psychiatry 12:273–280CrossRefPubMed Kolaitis G, Kotsopoulos J, Tsiantis J, Haritaki S, Rigizou F, Zacharaki L, Riga E, Augoustatou A, Bimbou A, Kanari N, Liakopoulou M, Katerelos P (2003) Post-traumatic stress reactions among children following the Athens earthquake of September 1999. Eur Child Adolesc Psychiatry 12:273–280CrossRefPubMed
24.
go back to reference Korol M, Green B, Gleser G (1999) Children’s responses to a nuclear waste disaster: PTSD symptoms and outcome prediction. J Am Acad Child Adolesc Psychiatry 38:368–375CrossRefPubMed Korol M, Green B, Gleser G (1999) Children’s responses to a nuclear waste disaster: PTSD symptoms and outcome prediction. J Am Acad Child Adolesc Psychiatry 38:368–375CrossRefPubMed
25.
go back to reference La Greca AM, Silverman WK, Vernberg EM, Prinstein MJ (1996) Symptoms of post-traumatic stress in children after Hurricane Andrew. J Consult Clin Psychol 64:712–723CrossRefPubMed La Greca AM, Silverman WK, Vernberg EM, Prinstein MJ (1996) Symptoms of post-traumatic stress in children after Hurricane Andrew. J Consult Clin Psychol 64:712–723CrossRefPubMed
26.
go back to reference La Greca AM, Silverman WK, Wasserstein SB (1998) Children’s predisaster functioning as a predictor of post-traumatic stress following Hurricane Andrew. J Consult Clin Psychol 66:883–892CrossRefPubMed La Greca AM, Silverman WK, Wasserstein SB (1998) Children’s predisaster functioning as a predictor of post-traumatic stress following Hurricane Andrew. J Consult Clin Psychol 66:883–892CrossRefPubMed
27.
go back to reference Lonigan CJ, Shannon MP, Taylor CM, Finch AJ Jr, Sallee FR (1994) Children exposed to disaster: II. Risk factors for the development of post-traumatic symptomatology. J Am Acad Child Adolesc Psychiatry 33:94–105CrossRefPubMed Lonigan CJ, Shannon MP, Taylor CM, Finch AJ Jr, Sallee FR (1994) Children exposed to disaster: II. Risk factors for the development of post-traumatic symptomatology. J Am Acad Child Adolesc Psychiatry 33:94–105CrossRefPubMed
28.
go back to reference McFarlane AC (1998) Recent life events and psychiatric disorder in children: the interaction with preceding extreme adversity. J Child Psychol Psychiatry 29:677–690CrossRef McFarlane AC (1998) Recent life events and psychiatric disorder in children: the interaction with preceding extreme adversity. J Child Psychol Psychiatry 29:677–690CrossRef
29.
go back to reference Meiser-Stedman R, Yule W, Smith P, Glucksman E, Dalgleish T (2005) Acute stress disorder and post-traumatic stress disorder in children and adolescents involved in assaults or motor vehicle accidents. Am J Psychiatry 162:1381–1383CrossRefPubMed Meiser-Stedman R, Yule W, Smith P, Glucksman E, Dalgleish T (2005) Acute stress disorder and post-traumatic stress disorder in children and adolescents involved in assaults or motor vehicle accidents. Am J Psychiatry 162:1381–1383CrossRefPubMed
30.
go back to reference Nader KO, Pynoos RS, Fairbanks LA, al-Ajeel M, al-Asfour A (1993) A preliminary study of PTSD and grief among the children of Kuwait following the Gulf crisis. Br J Clin Psychol 32:407–416PubMed Nader KO, Pynoos RS, Fairbanks LA, al-Ajeel M, al-Asfour A (1993) A preliminary study of PTSD and grief among the children of Kuwait following the Gulf crisis. Br J Clin Psychol 32:407–416PubMed
31.
go back to reference Neria Y, Handi A, Galea S (2008) Post-traumatic stress disorder following disasters: a systematic review. Psychol Med 38:467–480CrossRefPubMed Neria Y, Handi A, Galea S (2008) Post-traumatic stress disorder following disasters: a systematic review. Psychol Med 38:467–480CrossRefPubMed
32.
go back to reference Neuner F, Schauer E, Catani C, Ruf M, Elbert T (2006) Post-tsunami stress: a study of posttraumatic stress disorder in children living in three severely affected regions in Sri Lanka. J Trauma Stress 19:339–347CrossRefPubMed Neuner F, Schauer E, Catani C, Ruf M, Elbert T (2006) Post-tsunami stress: a study of posttraumatic stress disorder in children living in three severely affected regions in Sri Lanka. J Trauma Stress 19:339–347CrossRefPubMed
33.
go back to reference Papadatos Y, Nikou K, Potamianos G (1990) Evaluation of psychiatric morbidity following an earthquake. Int J Social Psychiatry 36:131–136CrossRef Papadatos Y, Nikou K, Potamianos G (1990) Evaluation of psychiatric morbidity following an earthquake. Int J Social Psychiatry 36:131–136CrossRef
34.
go back to reference Pfefferbaum B, Gurwitch RH, McDonald NB, Leftwich MJ, Sconzo GM, Messenbaugh AK, Schultz RA (2000) Post-traumatic stress among young children after the death of a friend or acquaintance in a terrorist bombing. Psychiatr Serv 51:386–388CrossRefPubMed Pfefferbaum B, Gurwitch RH, McDonald NB, Leftwich MJ, Sconzo GM, Messenbaugh AK, Schultz RA (2000) Post-traumatic stress among young children after the death of a friend or acquaintance in a terrorist bombing. Psychiatr Serv 51:386–388CrossRefPubMed
35.
go back to reference Pynoos RS, Goenjian A, Tashjian M, Karakashian M, Manjikian R, Manoukian G, Steinberg AM, Fairbanks LA (1993) Post-traumatic stress reactions in children after the 1988 Armenian earthquake. Br J Psychiatry 163:239–247CrossRefPubMed Pynoos RS, Goenjian A, Tashjian M, Karakashian M, Manjikian R, Manoukian G, Steinberg AM, Fairbanks LA (1993) Post-traumatic stress reactions in children after the 1988 Armenian earthquake. Br J Psychiatry 163:239–247CrossRefPubMed
36.
go back to reference Roussos A, Goenjian AK, Steinberg AM, Sotiropoulou C, Kakaki M, Kabakos C, Karagianni S, Manouras V (2005) Post-traumatic stress and depressive reactions among children and adolescents after the 1999 earthquake in Ano Liosia, Greece. Am J Psychiatry 162:530–537CrossRefPubMed Roussos A, Goenjian AK, Steinberg AM, Sotiropoulou C, Kakaki M, Kabakos C, Karagianni S, Manouras V (2005) Post-traumatic stress and depressive reactions among children and adolescents after the 1999 earthquake in Ano Liosia, Greece. Am J Psychiatry 162:530–537CrossRefPubMed
37.
go back to reference Scheeringa MS, Peebles CD, Cook CA, Zeanah CH (2001) Toward establishing procedural, criterion, and discriminant validity for PTSD in early childhood. J Am Acad Child Adolesc Psychiatry 40:52–60CrossRefPubMed Scheeringa MS, Peebles CD, Cook CA, Zeanah CH (2001) Toward establishing procedural, criterion, and discriminant validity for PTSD in early childhood. J Am Acad Child Adolesc Psychiatry 40:52–60CrossRefPubMed
38.
go back to reference Sener S, Ozdemir YD, Senol S, Karacan E, Kargın SE (1997) Preliminary report of stressor effects on adolescent survivors who are in dormitory living after Dinar earthquake. Cocuk ve Genclik Ruh Sagligi Dergisi 4:135–144 (Turkish) Sener S, Ozdemir YD, Senol S, Karacan E, Kargın SE (1997) Preliminary report of stressor effects on adolescent survivors who are in dormitory living after Dinar earthquake. Cocuk ve Genclik Ruh Sagligi Dergisi 4:135–144 (Turkish)
39.
go back to reference Shannon MP, Lonigan CJ, Finch AJ Jr, Taylor CM (1994) Children exposed to disaster: I. Epidemiology of post-traumatic symptoms and symptom profiles. J Am Acad Child Adolesc Psychiatry 33:80–93CrossRefPubMed Shannon MP, Lonigan CJ, Finch AJ Jr, Taylor CM (1994) Children exposed to disaster: I. Epidemiology of post-traumatic symptoms and symptom profiles. J Am Acad Child Adolesc Psychiatry 33:80–93CrossRefPubMed
40.
go back to reference Sharan P, Chaudhary G, Kavathekar SA, Saxena S (1996) Preliminary report of psychiatric disorders in survivors of a severe earthquake. Am J Psychiatry 153:556–558PubMed Sharan P, Chaudhary G, Kavathekar SA, Saxena S (1996) Preliminary report of psychiatric disorders in survivors of a severe earthquake. Am J Psychiatry 153:556–558PubMed
41.
go back to reference Shaw JA, Applegate B, Tanner S, Perez D, Rothe E, Campo-Bowen AE, Lahey BL (1995) Psychological effects of Hurricane Andrew on an elementary school population. J Am Acad Child Adolesc Psychiatry 34:1185–1192CrossRefPubMed Shaw JA, Applegate B, Tanner S, Perez D, Rothe E, Campo-Bowen AE, Lahey BL (1995) Psychological effects of Hurricane Andrew on an elementary school population. J Am Acad Child Adolesc Psychiatry 34:1185–1192CrossRefPubMed
42.
go back to reference Simons D, Silveira WR (1994) Post-traumatic stress disorder in children after television programmes. BMJ 308(6925):389–390PubMed Simons D, Silveira WR (1994) Post-traumatic stress disorder in children after television programmes. BMJ 308(6925):389–390PubMed
43.
go back to reference Swenson CC, Saylor CF, Powell MP, Stokes SJ, Foster KY, Belter RW (1996) Impact of a natural disaster on preschool children: adjustment 14 months after a hurricane. Am J Orthopsychiatry 66:122–130CrossRefPubMed Swenson CC, Saylor CF, Powell MP, Stokes SJ, Foster KY, Belter RW (1996) Impact of a natural disaster on preschool children: adjustment 14 months after a hurricane. Am J Orthopsychiatry 66:122–130CrossRefPubMed
44.
go back to reference Vernberg EM, Silverman WK, La Greca AM, Prinstein MJ (1996) Prediction of post-traumatic stress symptoms in children after Hurricane Andrew. J Abnorm Psychol 105:237–248CrossRefPubMed Vernberg EM, Silverman WK, La Greca AM, Prinstein MJ (1996) Prediction of post-traumatic stress symptoms in children after Hurricane Andrew. J Abnorm Psychol 105:237–248CrossRefPubMed
45.
go back to reference Vila G, Witkowski P, Tondini MC, Perez-Diaz F, Mouren-Simeoni MC, Jouvent R (2001) A study of post-traumatic disorders in children who experienced an industrial disaster in the Briey Region. Eur Child Adolesc Psychiatry 10:10–18CrossRefPubMed Vila G, Witkowski P, Tondini MC, Perez-Diaz F, Mouren-Simeoni MC, Jouvent R (2001) A study of post-traumatic disorders in children who experienced an industrial disaster in the Briey Region. Eur Child Adolesc Psychiatry 10:10–18CrossRefPubMed
Metadata
Title
Some clinical characteristics of children who survived the Marmara earthquakes
Authors
Turkay Demir
Demet Eralp Demir
Leyla Alkas
Mazlum Copur
Burak Dogangun
Levent Kayaalp
Publication date
01-02-2010
Publisher
D. Steinkopff-Verlag
Published in
European Child & Adolescent Psychiatry / Issue 2/2010
Print ISSN: 1018-8827
Electronic ISSN: 1435-165X
DOI
https://doi.org/10.1007/s00787-009-0048-1

Other articles of this Issue 2/2010

European Child & Adolescent Psychiatry 2/2010 Go to the issue