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

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.

Keywords: Adolescents; Anxiety; Depression; Earthquake; PTSD; Sleep problems.