Mental Health Risk and Associated Factors in the Aftermath of the 2015 Earthquake in Nepal: A Systematic Literature Review.

Abstract

Background: In 2015, Nepal was struck by two massive earthquakes with magnitudes over the 7.0 Richter Scale, imposing short- and long-term mental health risks. This review aims to: (a) evaluate mental health risk among the earthquake survivors; and, (b) identify factors that influence it. Methods: The following databases: Scopus and PubMed were searched to identify studies published from 2015 to July 2020 on the mental health risk among the Nepali populations. Inclusion criteria were: (a) primary research related to mental health after the 2015 earthquakes in Nepal, (b) English language articles, (c) access to full-text literature, and (d) studies conducted on the general population of Nepal. Exclusion criteria were: (a) newspaper articles or other forms of popular media, (b) grey records and reviews or, (c) studies carried out among patients in a clinical setting. Key features and risk of bias factors were extracted from each study to obtain necessary characteristics for further analysis of results. Results: The initial search produced 134 articles, however, a total, 14 studies fulfilled the inclusion criteria and were explored for this review. Ten of these articles were obtained from established databases, and four additional studies were obtained from other sources. Findings indicate that post-traumatic stress was mostly present among earthquake survivors with rates varying from 4.9% to 51%. Mental health risks for children and adolescent were mostly high with rates greater than 23% across studies. However, the adult prevalence rate for mental health risk was lower than that of children and adolescents, with most rates across studies lower than 20%. Socio-demographic factors (such as gender and age) and methodological heterogeneities such as variations in study design and mental health tools used to assess rates were associated factors that potentially influenced the findings. Conclusion: Mental health risks are present among earthquake survivors in Nepal. Various factors have been identified as potential mental health risk rate influencers including sex, with females presenting as the higher at-risk group for mental health relative to males. Methodological issues such as a wide range of mental health assessment instruments employed across studies can potentially impact rates.