This study examined the incidence of posttraumatic stress disorder (PTSD) and depression in 586 earthquake survivors living in prefabricated housing sites a mean of 20 months after the 1999 earthquake in Turkey. The estimated rates of PTSD and major depression were 39% and 18%, respectively. More severe PTSD symptoms related to greater fear during the earthquake, female gender, older age, participation in rescue work, having been trapped under rubble, and personal history of psychiatric illness. More severe depression symptoms related to older age, loss of close ones, single marital status, past psychiatric illness, previous trauma experience, female gender, and family history of psychiatric illness. These findings suggest that catastrophic earthquakes have long-term psychological consequences, particularly for survivors with high levels of trauma exposure. These findings lend further support to the need for long-term mental health care policies for earthquake survivors. Outreach service delivery programs are needed to access non-treatment-seeking survivors with chronic PTSD.

This study examined the prevalence of posttraumatic stress disorder (PTSD) and depression 14 months after the earthquake in Turkey in 2 randomly selected samples from the epicenter (n = 530) and a suburb of Istanbul 100 km from the epicenter (n = 420). The rates of PTSD and depression comorbid with PTSD were, respectively, 23 and 16% at the epicenter and 14 and 8% in Istanbul. The strongest predictor of traumatic stress symptoms was fear during the earthquake, whereas predictions with female gender, past psychiatric illness, damage to home, participation in rescue work, past trauma, and loss of close ones were significant but weak. Our findings suggest that devastating earthquakes have long-term psychological effects. Psychological interventions reducing fear may improve PTSD in survivors.

In an attempt to develop a brief treatment for disaster survivors, the present study examined the effectiveness of a single session of modified behavioral treatment in earthquake-related posttraumatic stress disorder. Fifty-nine earthquake survivors in Turkey were randomized into either single-session modified behavioral treatment (SSBT) designed to enhance sense of control over earthquake-related fears or waiting list control condition (WL). The WL group received SSBT after a second baseline assessment. Follow-ups were at weeks 6, 12, 24, and at 1-2 years posttreatment. Significant treatment effects were found on all measures at posttreatment. The improvement rate was 49% at week 6; it rose to 80% by week 12, 85% by week 24, and 83% by the 1-2-year follow-up. Brief behavioral treatment has promise as a cost-effective intervention for disaster survivors.