Over-time changes in PTSD and depression among children surviving the 1999 Istanbul earthquake

To follow-up on child and adolescent victims with full criteria of PTSD and depression, and to examine the impact of treatment.

One to two months following a 7.4-magnitude quake in Turkey, 160 students were examined by self-report questionnaire, psychiatric interview, clinician-administered post-traumatic stress disorder scale (CAPS), and depression and anxiety inventories. At baseline, 96 students were diagnosed with PTSD, and 49 had comorbid depression with anxiety symptoms. After 18-20 months, 74 of 96 students were found and reassessed by psychiatric interview and CAPS; 25 had been treated with cognitive-behavioral therapy (CBT) and pharmocotherapy, and 49 did not have any treatment. Binary logistic regression was used to identify significant predictors of persistent PTSD. Variables entered included pre-quake, quake and post-quake factors, having co-morbid depression upon initial interview, receipt of drug therapy, and number of months of CBT.

At follow-up, many had symptoms of PTSD with anxiety, but only 14 subjects met the full criteria of PTSD, and four students had major depression with anxiety symptoms. Only one variable--having been in serious personal danger during the quake (e.g., trapped in the house or under rubble)--was significantly associated with being symptomatic at follow-up.

Regardless of receipt of treatment, diagnoses of PTSD and depression were much reduced. More research is needed about resiliency factors.