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Post-traumatic stress disorder, anxiety and depression symptoms among adolescent earthquake victims: comorbidity and associated sleep-disturbing factors

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Abstract

Purpose

Our study aimed to examine the prevalence of psychiatric symptoms and their comorbidity and correlation with sleep problems among adolescent survivors 3 years after the 2013 Ya’an earthquake.

Methods

A representative sample of 6132 adolescent students was analysed from 11 primary and high schools in the three counties most severely affected by the earthquake. Students were invited to complete the Pittsburgh Sleep Quality Index, Children’s Revised Impact of Event Scale-13, Short Mood and Feelings Questionnaire, the Adolescent Self-Rating Life Events Checklist, and Screen for Child Anxiety-Related Emotional Disorders.

Results

Three years after this major earthquake, 1-month prevalence of mental health problems was 13.1% for PTSD, 37.3% for anxiety, and 19.8% for depression. Among the participants who reported PTSD, 71.5% also reported anxiety, and 49.7% also reported depression. At least half of those with any type of mental health problem reported concurrent sleeping problems. Specific sleep risk factors were independently associated with increased risk of PTSD, depression or anxiety. Girls were more likely than boys to exhibit symptoms of PTSD, depression or anxiety. Older adolescents were more likely to have depression and anxiety.

Conclusions

Mental health problems are prevalent with high comorbidity and are associated with sleep-related problems among adolescent survivors, even years after the occurrence of a major earthquake. Nightmares and difficulty initiating sleep are independently associated with PTSD. Insufficient sleep is independently associated with anxiety and depression. Sleep-related problems may be effective targets of preventive interventions, which may need to be optimised for gender and age.

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Acknowledgements

The authors thank all participants in this study. We also thank all of our research collaborators in Baoxing County, Tianquan County, Lushan County, and Ya’an City in the Sichuan province of China. This research was supported by the Major Bidding Program of the National Social Science Foundation of China (17ZDA286), the Program of the National Social Science Foundation of China (18BSH121) and a project of the Propaganda Department of the People’s Republic of China (2016zybw03).

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Authors and Affiliations

  1. Institute of Emergency Management and Post-disaster Reconstruction, Sichuan University, No. 24, South Section 1, Yihuan Road Wuhou District, 610065, Chengdu, China

    Wanjie Tang, Yi Lu & Jiuping Xu

  2. Centre for Educational and Health Psychology, Sichuan University, Chengdu, China

    Wanjie Tang

  3. Mental Health Center, State Key Lab of Biotherapy, West China Hospital, Sichuan University, Chengdu, China

    Wanjie Tang

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  1. Wanjie Tang
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  2. Yi Lu
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  3. Jiuping Xu
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Correspondence to Jiuping Xu.

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Tang, W., Lu, Y. & Xu, J. Post-traumatic stress disorder, anxiety and depression symptoms among adolescent earthquake victims: comorbidity and associated sleep-disturbing factors. Soc Psychiatry Psychiatr Epidemiol 53, 1241–1251 (2018). https://doi.org/10.1007/s00127-018-1576-0

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