Loss as a determinant of PTSD in a cohort of adult survivors of the 1988 earthquake in Armenia: implications for policy


Dr. Haroutune K. Armenian, The Johns Hopkins University, School of Hygiene and Public Health, Department of Epidemiology, 615 N. Wolfe Street, Baltimore, Maryland 21205 USA. Telephone: 410–955–8720
Fax: 410–614–8883, e-mail: harmenia@jhsph.edu


Objective: To study the relationship of post-traumatic stress disorder (PTSD) to severity of the disaster experience.

Method: A sample of 1785 adult participants of an epidemiological study initiated in the immediate aftermath of the 1988 earthquake in Armenia were interviewed about 2 years following the disaster based on the NIMH DIS-Disaster Supplement. All 154 cases of pure PTSD were compared with 583 controls without symptoms satisfying psychiatric diagnoses of interest.

Results: PTSD cases included more persons from areas with the worst destruction. Having the highest level of education compared to lowest (OR 0.6 [95% CI 0.4–0.9]), being accompanied at the moment of the earthquake (OR 0.6 [95% CI 0.4–0.9]) and making new friends after the earthquake (OR 0.6 [95% CI 0.5–0.8]) were protective for PTSD. PTSD risk increased with the total amount of loss to the family (OR for highest level of loss 4.1 [95% CI 2.3–7.5]).

Conclusion: Based on this large population sample, we believe that early support to survivors with high levels of loss may reduce PTSD following earthquakes.