Recovery from post-earthquake psychopathology among survivors of the 1988 Armenian earthquake 23 years after the event

Abstract

Background: A significant proportion of disaster survivors develop mental disorders. However, studies evaluating determinants for long-term recovery from psychopathology are scarce. This study identifies factors associated with recovery from post-disaster psychopathologies among 1988 Armenian earthquake survivors. Methods: This is part of a longitudinal epidemiologic study among survivors of the 1988 Spitak earthquake. A nested cohort of 544 subjects was assessed in 1991 and 2012. Subjects had one-or-more baseline psychopathologies, including depression, PTSD, and anxiety disorder. Based on our 2012 psychological assessment, individuals formed two groups: those who recovered from all psychopathologies and those who did not. The associations of socio-demographic characteristics and earthquake-related and life-time experiences with recovery from psychopathologies were explored using multivariable logistic regression. Results: About 60% of individuals with one-or-more psychopathologies in 1991 were free of psychopathology in 2012. After controlling for confounders, we found access to healthcare services (OR=1.80, CI: 1.21-2.68) and perceived average/high socioeconomic status during the 10 years following the earthquake (OR=1.64, CI: 1.12-2.39) were positively associated with recovery. Each additional negative stressful life event decreased the likelihood of recovery from psychopathologies (OR=0.88, CI: 0.80-0.97). Those with severe financial/material losses had 61% lower odds of recovery (OR=0.39, CI: 0.19-0.78). Among those with severe losses, post-earthquake financial/material support contributed to recovery (OR=5.57, CI: 2.01-14.85). Discussion: Earthquake-related losses have long-lasting negative impacts on the mental health of survivors. Post-disaster adversities and harsh living conditions aggravate the sequel of psychopathology among victims. Timely financial/material support and access to healthcare services helps recovery, particularly for those experiencing severe losses.