Abstract

Disasters such as earthquakes can lead to adverse psychological outcomes in vulnerable individuals with severe mental illness (SMI). This study aims to investigate how the course of disease and post-traumatic stress disorder (PTSD) symptoms in individuals with SMI are associated with caregiver-related outcomes, including caregiver burden, depression, anxiety, and stress levels. The study included 60 patients who were being followed at the Community Mental Health Center (CMHC) before the earthquake and agreed to participate in the study, along with their caregivers. Patients with SMI were assessed using the Brief Psychiatric Rating Scale (BPRS), the Post-Traumatic Stress Disorder Checklist (PCL-5), the General Health Questionnaire (GHQ-12), and the Clinical Global Impression Scale (CGI). Caregivers were evaluated using the Zarit Burden Interview (ZBI) and the Depression Anxiety Stress Scale – Short Form (DASS-21). Of the cases, 42 (70%) were male, 34 (56.7%) were single, and 30 (50%) were unable to access antipsychotic medication after the earthquake. The BPRS score of individuals who were hospitalized following an episode (62.3±10.9) was significantly higher than those who were not hospitalized (36.8±15.2) (t=4.268, p=.001). The PCL-5 score was found to have a positive and moderately significant correlation with both the ZBI (r=.41, p=.001) and the DASS-21 (r=.38, p=.003). The BPRS score showed a significant positive correlation with both ZBI (r=.37, p=.004) and DASS-21 scores (r=.42, p=.001). In conclusion, the worsening clinical course and increased PTSD symptoms in individuals with SMI following the earthquake were significantly associated with increased psychological burden, depression, and anxiety in caregivers. These findings underscore the multidimensional support needs of both patients and their caregivers.

Key words: Severe mental illness, schizophrenia, earthquake, posttraumatic stress disorder, caregiver