Citation

Jha A, Shakya S, Zang Y, Pathak N, Pradhan PK, Bhatta KR, Sthapit S, Niraula S, Nehete R. Indian J. Psychiatry 2017; 59(3): 320-327.

Affiliation

Hertfordshire Partnership University NHS Foundation Trust, Hertfordshire, UK.

Copyright

(Copyright © 2017, Medknow Publications)

DOI

10.4103/psychiatry.IndianJPsychiatry_236_16

PMID

29085091

PMCID

PMC5659082

Abstract

CONTEXT: In April 2015, a major earthquake struck northern regions of Nepal affecting one-third of the population, and many suffered mental health problems. AIMS: This study aimed to conduct a preliminary investigation of prevalence and feasibility of brief therapy for posttraumatic stress disorder (PTSD) among earthquake survivors. SETTINGS AND DESIGN: This is an exploratory cross-sectional study of prevalence and feasibility of brief trauma-focused therapy for PTSD among survivors 3 and 11 months after the earthquake in affected areas near Kathmandu.

METHODOLOGY: A team of local nonspecialist mental health volunteers was trained to identify survivors with PTSD using the PTSD checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (PCL-5) (cutoff score 38). They were trained to deliver either shortened versions of narrative exposure therapy (NET)-revised or group-based control-focused behavioral treatment (CFBT).

RESULTS: Altogether, 333 survivors were surveyed (130 in July 2015 and 203 in March 2016) with PCL-5 as the screening instrument, using the cutoff score of 38 or more for diagnosing PTSD. A PTSD prevalence of 33% was noted in 2015 and 28.5% in 2016. This drop of 4.5% prevalence in the intervening 8 months suggests that a significant number of survivors are still suffering from PTSD. Most participants were female, aged 40 or above, married, and poorly educated. Compared to the brief (four sessions) individual NET-revised, a group-based CFBT was found more acceptable and affordable.

CONCLUSIONS: PTSD is common following earthquake trauma, and if untreated, survivors continue to suffer for a long time. Management of PTSD should be included in future disaster management plans.

Language: en

Keywords

Control-focused behavioral treatment; Nepal; earthquake; narrative exposure therapy; posttraumatic stress disorder