The catastrophic earthquakes that struck Kahramanmaraş in 2023 unleashed a wave of destruction unprecedented in recent history, devastating communities and displacing tens of thousands. In the eye of this calamity, Hatay Province emerged as the region most profoundly impacted, burdened with extensive infrastructure collapse and a humanitarian crisis of immense scale. Survivors of this seismic disaster found themselves compelled to inhabit temporary shelters, where the scars of trauma are not just physical but deeply psychological. Recent research published in BMC Psychiatry delves into the mental health repercussions for these displaced individuals, with a particular focus on the prevalence of post-traumatic stress disorder (PTSD) and depression.
This comprehensive study conducted by Yilmaz and Erdem employs a cross-sectional, population-based design to survey 400 adult survivors of the 2023 earthquakes residing in temporary shelter zones within Hatay’s central districts. Using a rigorous multistage cluster sampling technique, the researchers collected a blend of sociodemographic data, individual earthquake experiences, and psychiatric histories through self-administered questionnaires, ensuring a broad and representative sample of the affected population.
The assessment of PTSD leveraged the well-validated PTSD Checklist for DSM-5 (PCL-5), a standardized diagnostic instrument widely used in trauma research for its sensitivity to core symptoms such as intrusive memories, avoidance behaviors, negative cognitions, and hyperarousal. In parallel, depressive symptoms were quantified via the Beck Depression Inventory, an established psychological tool recognized for its reliability in detecting and gauging the severity of depressive states.
Results from this research underscore a distressing reality. Nearly one-third of participants—29.0%—met diagnostic criteria suggestive of PTSD, while a larger cohort, 38.8%, exhibited significant depressive symptoms. These findings illuminate a critical and often underappreciated dimension of disaster aftermaths: the pervasive and enduring psychological impact which can persist long after the physical danger has subsided.
Notably, the study meticulously identifies several robust risk factors that elevate the susceptibility to PTSD among survivors. Unemployment emerged as a potent predictor, increasing the odds of PTSD by more than two-and-a-half times. The economic upheaval following the disaster likely compounds psychological distress, as job loss deepens feelings of insecurity and helplessness.
Loss of a family member during the earthquake—arguably one of the most shattering experiences—also markedly heightened the risk of PTSD, emphasizing the profound grief intertwined with trauma. This loss not only exacts an emotional toll but underscores the fractured social bonds survivors must attempt to reconstruct amid chaos.
Pre-existing psychiatric diagnoses prior to the earthquake were found to double the likelihood of developing PTSD, a finding consistent with broader trauma literature that recognizes mental health vulnerabilities as key determinants of post-disaster psychological outcomes. This highlights the imperative for health systems to prioritize mental health screening and support in disaster response protocols, particularly for individuals with known psychiatric histories.
Substance use behaviors such as alcohol consumption and smoking were also significant contributors, with odds ratios indicating a meaningful increase in PTSD risk. These patterns may reflect maladaptive coping mechanisms, wherein survivors turn to substances in an effort to self-medicate distressing symptoms, inadvertently exacerbating mental health deterioration.
Moreover, the subjective experience of extreme fear during the earthquakes themselves was associated with more than double the risk for PTSD. The intensity of fear not only captures immediate physiological responses to trauma but also relates to how traumatic memories are encoded, potentially influencing the persistence and intrusion of distressing recollections.
The implications of this research extend beyond epidemiological insight. They call for urgent implementation of large-scale psychosocial interventions tailored to the unique stressors and vulnerabilities of earthquake survivors in temporary shelters. Mental health services need to be integrated into disaster recovery plans with targeted efforts to address unemployment, substance misuse, and trauma-informed care, enhancing the resilience of affected populations.
This study further underscores the necessity of a multidisciplinary approach encompassing social support, psychological counseling, and community rebuilding endeavors. Early identification of high-risk individuals through screening protocols based on the highlighted risk factors can facilitate timely intervention, potentially mitigating the chronicity of PTSD and depression in post-disaster contexts.
Given the substantial prevalence rates reported, these findings demand action not only from local health authorities but also from global humanitarian organizations. They illuminate a crucial gap between immediate emergency relief and sustained mental health care, reminding the international community that the invisible wounds of disaster are as urgent as the visible ones.
In conclusion, the investigation by Yilmaz and Erdem offers a sobering yet essential insight into the post-earthquake psychological landscape in Hatay Province. The confluence of trauma exposure, socioeconomic disruption, and pre-existing vulnerabilities paint a complex picture that challenges health systems to evolve beyond survival-oriented responses towards holistic recovery frameworks. Addressing PTSD and depression in disaster-affected populations is indispensable for restoring individual well-being and community resilience amid the shadows of catastrophe.
Subject of Research: Post-traumatic stress disorder and depression prevalence and risk factors among earthquake survivors living in temporary shelters after the 2023 Kahramanmaraş earthquakes.
Article Title: Post-traumatic stress disorder in earthquake survivors living in temporary shelter areas in Hatay central districts: a cross-sectional study.
Article References:
Yilmaz, E., Erdem, M. Post-traumatic stress disorder in earthquake survivors living in temporary shelter areas in Hatay central districts: a cross-sectional study. BMC Psychiatry 25, 461 (2025). https://doi.org/10.1186/s12888-025-06919-9
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