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      A meta-analysis of risk factors for depression in adults and children after natural disasters

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          Abstract

          Background

          A number of studies have shown a range of negative psychological symptoms (e.g. depression) after exposure to natural disasters. The aim of this study was to determine risk factors for depression in both children and adults who have survived natural disasters.

          Methods

          Four electronic databases (PubMed, Embase, Web of Science, and PsychInfo) were used to search for observational studies (case–control, cross-sectional, and cohort studies) about depression following natural disasters. The literature search, study selection, and data extraction were conducted independently by two authors. Thirty-one articles were included in the study, of which twenty included adult participants and eleven included child participants. Summary estimates were obtained using random-effects models. Subgroup analysis, sensitivity analysis, and publication bias tests were performed on the data.

          Results

          The prevalence of depression after natural disasters ranged from 5.8% to 54.0% in adults and from 7.5% to 44.8% in children. We found a number of risk factors for depression after exposure to natural disasters. For adults, the significant predictors were being female ;not married;holding religious beliefs; having poor education; prior trauma; experiencing fear, injury, or bereavement during the disaster; or losing employment or property, suffering house damage as a result of the disaster. For children, the significant predictors were prior trauma; being trapped during the disaster; experiencing injury, fear, or bereavement during the disaster; witnessing injury/death during the disaster; or having poor social support.

          Conclusions

          The current analysis provides evidence of risk factors for depression in survivors of natural disasters. Further research is necessary to design interventions to improve the mental health of survivors of natural disasters.

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          Most cited references41

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          60,000 disaster victims speak: Part I. An empirical review of the empirical literature, 1981-2001.

          Results for 160 samples of disaster victims were coded as to sample type, disaster type, disaster location, outcomes and risk factors observed, and overall severity of impairment. In order of frequency, outcomes included specific psychological problems, nonspecific distress, health problems, chronic problems in living, resource loss, and problems specific to youth. Regression analyses showed that samples were more likely to be impaired if they were composed of youth rather than adults, were from developing rather than developed countries, or experienced mass violence (e.g., terrorism, shooting sprees) rather than natural or technological disasters. Most samples of rescue and recovery workers showed remarkable resilience. Within adult samples, more severe exposure, female gender, middle age, ethnic minority status, secondary stressors, prior psychiatric problems, and weak or deteriorating psychosocial resources most consistently increased the likelihood of adverse outcomes. Among youth, family factors were primary. Implications of the research for clinical practice and community intervention are discussed in a companion article (Norris, Friedman, and Watson, this volume).
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            Psychiatric comorbidity in children after the 1988 earthquake in Armenia.

            To determine current rates of posttraumatic stress disorder (PTSD), depressive disorder, and separation anxiety disorder (SAD) among children 1 1/2 years after the 1988 earthquake in Armenia; to determine current rates of comorbid PTSD and depressive disorder; and to assess the contribution of exposure, gender, loss of family members, and loss of residence. Two hundred eighteen school-age children from three cities at increasing distances from the epicenter were evaluated using the Child Posttraumatic Stress Disorder Reaction Index, the Depression Self-Rating Scale, and the section on SAD from the Diagnostic Interview for Children and Adolescents. On the basis of these evaluations, high rates of current PTSD, depressive disorder, and their co-occurrence were found among victims residing in the two heavily impacted cities. SAD was comparatively less frequent, although symptoms of SAD had been pervasive throughout the region. Severity of posttraumatic stress and depressive reactions were highly correlated. Extent of loss of family members was independently correlated with each. After a catastrophic natural disaster, children are at risk for comorbid PTSD and secondary depression. Based on the findings, an interactive model is proposed of postdisaster psychopathology. Early clinical intervention is recommended to prevent chronic posttraumatic stress reactions and secondary depression.
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              Symptoms of posttraumatic stress disorder, depression, and anxiety among adolescents following the 2008 Wenchuan earthquake in China.

              This study examined the symptoms of posttraumatic stress disorder (PTSD), anxiety, and depression among 2,250 adolescents 6 months after the 2008 Wenchuan earthquake in China. Results showed that 15.8%, 40.5%, and 24.5% of participants reported clinical symptoms of PTSD, anxiety, and depression, respectively. Posttraumatic stress disorder, anxiety, and depression were highly comorbid. Risk factors for symptoms of the 3 disorders were female gender, older age, and earthquake disaster exposure. In addition, the interaction effects of residence (urban/rural) and number of siblings of study subjects on symptoms of the 3 disorders were examined. Implications of findings on intervention and prevention of mental health problems among adolescents after experiencing earthquake disasters are discussed. Copyright © 2011 International Society for Traumatic Stress Studies.
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                Author and article information

                Contributors
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central
                1471-2458
                2014
                19 June 2014
                : 14
                : 623
                Affiliations
                [1 ]Institute of Military Health Management, Second Military Medical University, 800 Xiangyin Rd, Shanghai 200433, China
                Article
                1471-2458-14-623
                10.1186/1471-2458-14-623
                4077641
                24941890
                7f1d5212-81f3-429c-a056-39986a7be970
                Copyright © 2014 Tang et al.; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 12 November 2013
                : 13 June 2014
                Categories
                Research Article

                Public health
                depression,risk factors,children,adults,natural disasters
                Public health
                depression, risk factors, children, adults, natural disasters

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