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

Objective  To follow-up on child and adolescent victims with full criteria of PTSD and depression, and to examine the impact of treatment. Method  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. Results  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. Conclusion  Regardless of receipt of treatment, diagnoses of PTSD and depression were much reduced. More research is needed about resiliency factors.