Prevalence and determinants of post-traumatic stress disorder in patients with schizophrenia 2 years after an earthquake in Turkey

Int J Psychiatry Med. 2024 Jan;59(1):65-82. doi: 10.1177/00912174231180467. Epub 2023 Jun 5.

Abstract

Objectives: High rates of post-traumatic stress disorder (PTSD) have been observed in earthquake survivors many years after the event. However, its prevalence among patients with schizophrenia is largely unknown. This study, which was conducted two years after the 2020 Elazığ earthquake, sought to identify risk factors for earthquake-related PTSD among patients with schizophrenia and healthy subjects.

Methods: Adult patients with schizophrenia (N = 103) and healthy subjects (N = 103) who had survived the earthquake were recruited from affected areas in the Eastern Anatolian Region of Turkey, Elazığ. A detailed questionnaire of earthquake-related risk factors, the Brief Coping Orientation to Problems Experienced (Brief COPE), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Clinician-Administered PTSD scale for DSM-V (CAPS-5) scale were administered to participants.

Results: Twelve percent of the patients with schizophrenia and 25% of the healthy subjects had earthquake-related PTSD diagnoses two years after the 2020 Elazığ earthquake. Healthy subjects had a significantly higher rate of earthquake-related PTSD when compared to patients with schizophrenia. Religious coping, self-blaming, less emotional support seeking, and going to a safer place on the night of the earthquake were found to be associated with PTSD in patients with schizophrenia. History of traumatic events, self-blaming, and less social support from family were found to be associated with a PTSD diagnosis in healthy subjects.

Conclusions: The earthquake in Turkey created a situation such that significant symptoms of PTSD remained present at two years following the event in both patients diagnosed with schizophrenia and healthy subjects. Patients with schizophrenia have different risk factors for the development of PTSD when compared with healthy subjects. Clinical interventions should consider risk factors, coping strategies, and perceived social support when seeking to prevent earthquake-related PTSD.

Keywords: coping strategies; earthquake; earthquake-related PTSD; perceived social support; post-traumatic stress disorder; schizophrenia.

MeSH terms

  • Adult
  • Earthquakes*
  • Humans
  • Prevalence
  • Risk Factors
  • Schizophrenia* / epidemiology
  • Stress Disorders, Post-Traumatic* / diagnosis
  • Stress Disorders, Post-Traumatic* / epidemiology
  • Stress Disorders, Post-Traumatic* / psychology
  • Turkey / epidemiology