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Some clinical characteristics of children who survived the Marmara earthquakes
Turkay Demir1, Demet Eralp Demir, Leyla Alkas
1Department of Child and Adolescent Psychiatry, Bakirköy State Hospital for Psychiatric and Neurological Disorders, Istanbul, Turkey. tdemir@isbank.net.tr
Insights
Children experiencing the 1999 Marmara earthquakes often developed emotional and behavioral issues. Post-traumatic stress disorder (PTSD), acute stress disorder (ASD), and adjustment disorder were common diagnoses, particularly for those with significant losses or home damage.
Area of Science:
- Child and Adolescent Psychiatry
- Trauma Psychology
- Disaster Mental Health
Background:
- The 1999 Marmara earthquakes caused widespread devastation and loss of life in Turkey.
- Natural disasters significantly impact the emotional and behavioral well-being of children.
- Child psychiatric services are crucial for addressing trauma-related disturbances post-disaster.
Purpose of the Study:
- To investigate the relationship between specific variables and psychiatric diagnoses in children affected by the Marmara earthquakes.
- To identify risk factors associated with emotional and behavioral disturbances in pediatric populations post-natural disaster.
- To understand the prevalence of adjustment disorder, acute stress disorder (ASD), and post-traumatic stress disorder (PTSD) in earthquake-affected children.
Main Methods:
- Retrospective review of medical records of 321 children and adolescents (ages 2-15) treated between August 1999 and February 2000.
- Evaluation of variables including gender, age, earthquake experience location, loss of relatives/friends, bodily injuries, and residential damage.
- Analysis of diagnostic data for adjustment disorder, ASD, and PTSD.
Main Results:
- No significant relationship was found between gender and diagnosis.
- Younger children were more frequently diagnosed with adjustment disorder.
- Significant losses (relatives, friends) and severe residential damage were associated with higher rates of ASD and PTSD.
- Adjustment disorder (38%) was the most common diagnosis, followed by PTSD (25.5%) and ASD (16.5%).
Conclusions:
- Children and adolescents are particularly vulnerable to severe emotional-behavioral disturbances following natural disasters.
- The study highlights a high frequency of ASD and PTSD, and underscores adjustment disorder as a prevalent pediatric response to trauma.
- Factors such as loss and property damage are critical indicators for increased risk of trauma-related psychiatric conditions in children.
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.
