Prediction of sleep quality and insomnia severity by psychological disorders and acute stress among earthquake survivors in Sarpol-e Zahab, Iran, 2017


1 Sleep Disorders Research Center; Department of Neurology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran

2 Department of Educational Science, Farhangian University, Sanandaj, Iran

3 Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran

4 Department of Epidemiology, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran

5 Sleep Disorders Research Center; Department of Psychiatry, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran


Background: Psychological and health outcomes of natural disasters such as earthquakes affect survivors and health services for a long time. In the present study, posttraumatic stress disorders (PTSD), symptoms of psychopathology, sleep quality, and insomnia disorder were investigated among survivors of earthquake occurred at the Western Iran on November 12, 2017. Materials and Methods: This study was conducted on 1031 adult participants from rural and urban areas of Sarpol-e Zahab, a city in Kermanshah Province (Western Iran), who suffered from mental health problems due to the earthquake, a magnitude-7.3 quake, occurred in the Western Iran in 2017. Participants completed the Symptom Checklist 90, Insomnia Severity Index, Pittsburgh Sleep Quality Index, and Self-Rating Scale for PTSD. Data were analyzed using Pearson correlation and multivariate regression analysis by Statistical Package for Social Sciences Software (Version 21). Results: A positive correlation was observed between insomnia severity and all psychopathological symptoms. There was a positive correlation between sleep quality and somatization, obsessive–compulsive disorder, depression, and psychoticism. In addition, acute stress was positively correlated with insomnia severity and sleep quality. Conclusion: According to the results of the present study, it is recommended that psychological disorders in earthquake victims be considered to enhance their sleep quality.


1. Başoğlu M, Salcioğlu E, Livanou M. Traumatic stress responses in earthquake survivors in Turkey. J Trauma Stress 2002;15:269‑76. 
2. Thapa K. Mental health in post‑earthquake Nepal. Nepal J Epidemiol 2015;5:520‑1. 
3. Matthieu MM, Ivanoff A. Using stress, appraisal, and coping theories in clinical practice: Assessments of coping strategies after disasters. Brief Treat Crisis Interv 2006;6:337-48. 
4. Caltabiano ML, Sarafino EP. Health Psychology: Biopsychosocial Interactions. An Australian Perspective. New York: John Wiley and Sons; 2002. 
5. Parvaresh N, Bahramnejad A. Posttraumatic stress disorder in earthquake‑stricken students residing in Kerman four months after the earthquake. Iran J Psychiatry Clin Psychol 2006;12:165‑8. 
6. Dejkam M. PTSD among Victims of North Earthquake. Alameh Tabatabaei University; 1991. 
7. Farooqui M, Quadri SA, Suriya SS, Khan MA, Ovais M, Sohail Z, et al. Posttraumatic stress disorder: A serious post‑earthquake complication. Trends Psychiatry Psychother 2017;39:135‑43. 
8. Geng F, Zhou Y, Liang Y, Fan F. A longitudinal study of recurrent experience of earthquake and mental health problems among Chinese adolescents. Front Psychol 2018;9:1259. 
9. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM‑5®). Washington, DC: American Psychiatric Pub; 2013. 
10. Lemma S, Gelaye B, Berhane Y, Worku A, Williams MA. Sleep quality and its psychological correlates among university students in Ethiopia: A cross‑sectional study. BMC Psychiatry 2012;12:237. 
11. Nyer M, Farabaugh A, Fehling K, Soskin D, Holt D, Papakostas GI, et al. Relationship between sleep disturbance and depression, anxiety, and functioning in college students. Depress Anxiety 2013;30:873‑80. 
12. Karami J, Momeni K, Alimoradi F. Prediction of sleep quality based on stress, depression and anxiety with role of mediator cognitive emotion regulation strategies in pregnant women. Iran J Obstet Gynecol Infertil 2016;19:1‑10. 
13. Beyrami M, Alizadeh Goradel J, Ansarhosein S, Ghahraman Moharrampour N. Comparing sleep quality and general health among the elderly living at home and at nursing home. Iran J Ageing 2014;8:47‑55. 
14. Golabi S. A comparative studi of prevalence of parasomnia among male and female students. J Urmia Nurs Midwifery Fac 2009;6:205‑9. 
15. Tang W, Xu D, Li B, Lu Y, Xu J. The relationship between the frequency of suicidal ideation and sleep disturbance factors among adolescent earthquake victims in China. Gen Hosp Psychiatry 2018;55:90‑7. 
16. Black JM, Hawks JH, Keene AM. Medical‑Surgical Nursing: Clinical Management for Positive Outcomes. St. Louis, Mo: Saunders Elsevier; 2009. 17. Khodadadi N, Ghanbari A, Yosefzadeh S, Meskini F, Asgari F, Koochaki Nejad L. Astudy on acute stress, post‑traumatic stress disorder and quality of life in injured accident survivors admitted to Rasht Porsina hospital during 2009‑10. KAUMS J (FEYZ) 2011;14:520‑5. 
18. Derogatis LR, Lipman R, Covi L. SCL‑90. Administration, Scoring and Procedures Manual‑I for the R (Revised) Version and Other Instruments of the Psychopathology Rating Scales Series. Chicago: Johns Hopkins University School of Medicine; 1977. 
19. Derogatis LR, Cleary PA. Confirmation of the dimensional structure of the SCL‐90: A study in construct validation. J Clin Psychol 1977;33:981‑9. 
20. Anisi J, Akbari F, Madjian M, Atashkar M, Ghorbani Z. Standardization of Mental Disorders Symptoms Checklist 90 Revised (SCL‑90‑R) in Army Staffs; 2011. 
21. Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The pittsburgh sleep quality index: A new instrument for psychiatric practice and research. Psychiatry Res 1989;28:193‑213. 
22. Farrahi J, Nakhaee N, Sheibani V, Garrusi B, Amirkafi A. Psychometric properties of the Persian version of the pittsburgh sleep quality index addendum for PTSD (PSQI‑A). Sleep Breath 2009;13:259‑62. 
23. Farrahi Moghaddam J, Nakhaee N, Sheibani V, Garrusi B, Amirkafi A. Reliability and validity of the Persian version of the Pittsburgh sleep quality index (PSQI‑P). Sleep Breath 2012;16:79‑82. 
24. Nazifi M, Mokarami H, Akbaritabar A, Kalte HO, Rahi A. Psychometric properties of the Persian translation of Pittsburgh sleep quality index. Health Scope 2014;3:e15547. 
25. Bastien CH, Vallières A, Morin CM. Validation of the insomnia severity index as an outcome measure for insomnia research. Sleep Med 2001;2:297‑307. 
26. Sadeghniiat‑Haghighi K, Montazeri A, Khajeh‑Mehrizi A, Nedjat S, Aminian O. The insomnia severity index: Cross‑cultural adaptation and psychometric evaluation of a Persian version. Qual Life Res 2014;23:533‑7. 
27. Yazdi Z, Sadeghniiat‑Haghighi K, Zohal MA, Elmizadeh K. Validity and reliability of the Iranian version of the insomnia severity index. Malays J Med Sci 2012;19:31‑6. 
28. Zhou P, Zhang Y, Wei C, Liu Z, Hannak W. Acute stress disorder as a predictor of posttraumatic stress: A longitudinal study of Chinese children exposed to the Lushan earthquake. Psych J 2016;5:206‑14. 
29. Yuan KC, Ruo Yao Z, Zhen Yu S, Xu Dong Z, Jian Zhong Y, EdwardsJG, et al. Prevalence and predictors of stress disorders following two earthquakes. Int J Soc Psychiatry 2013;59:525‑30. 
30. Casacchia M, Bianchini V, Mazza M, Pollice R, Roncone R. Acute stress reactions and associated factors in the help‑seekers after the L’aquila earthquake. Psychopathology 2013;46:120‑30. 
31. Hosseini F, Fasihi Harandi T, Kazemi M, Rezaeian M, Hosseini R. The relationship between sleep quality and general health of nurses in Rafsanjan university of medical sciences in 2012. J Rafsanjan Univ Med Sci 2013;12:843‑54. 
32. Shamshri M, Moshki M, Mogharab M. The survey of sleep quality and its relationship to mental health of hospital nurses. Iran Occup Health 2014;11:96‑104. 
33. Hayashino Y, Yamazaki S, Takegami M, Nakayama T, Sokejima S, Fukuhara S. Association between number of comorbid conditions, depression, and sleep quality using the Pittsburgh sleep quality index: Results from a population‑based survey. Sleep Med 2010;11:366‑71. 
34. Baglioni C, Spiegelhalder K, Lombardo C, Riemann D. Sleep and emotions: A focus on insomnia. Sleep Med Rev 2010;14:227‑38. 
35. Lund HG, Reider BD, Whiting AB, Prichard JR. Sleep patterns and predictors of disturbed sleep in a large population of college students. J Adolesc Health 2010;46:124‑32.