Prevalence and risk factors of chronic Post-Traumatic Stress Disorder in children and adolescents after the 2012 earthquake affecting the province of Modena (Northern Italy).

Introduction: Post-traumatic stress disorder (PTSD) is the most frequent psychological disorder occurring after natural disasters. Some cases have a chronic, unremitting course causing long term health impacts and relevant social costs. On May 2012, two earthquakes of high Richter magnitude hit Modena (Italy), causing 27 deaths, several hundred of injured citizen and more than 15000 homeless. The aim of this study was to investigate the prevalence of chronic PTSD in children and adolescents, two extremely sensitive subpopulations, and to identify individual and social predictive risk and protective factors Methods: A cross-sectional study approved by Ethical Committee was conducted. Subjects aged 9-14, providing a written informed consent, were recruited from local schools, randomly selected from the earthquake area (EA) and an extra-earthquake area (EEA), with similar demographic and geographic characteristics. The UCLA-PTSD Index for DSM-IV was used to assess PTSD in students; risk/protective factors were investigated using a traumatic exposure checklist and the Strengths and Difficulties Questionnaire. Parental psychopathology was assessed by Symptom Checklist-90-R. Results: 683 students (2% of residents) and 1161 parents were enrolled. Overall, 9 subjects (1.3%) showed chronic PTSD symptoms. Most (8) were living in EA. The risk of suffering from PTSD symptoms was higher in girls, older students and subjects most directly affected by earthquake. Distressing factors no earthquake-related appeared predictive of distress as well. Further, psychopathological symptoms in parents were significantly associated with high PTSD scores in children. Conclusions: PTSD prevalence appeared lower than observed in similar studies. However, anxiety and depressive symptoms were widespread and correlate with several predictive factors. We hope that our findings will help planning future preventive and supportive effective public health interventions in similar distressing situations.