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The narrative epidemiology of L'Aquila 2009 earthquake

  • M. Casacchia (a1), R. Pollice (a1) and R. Roncone (a1)


The authors describe their experience working and living in L'Aquila, where at 3.32 a.m., early in the morning of 6 April 2009, a 6.3 Richter magnitude earthquake caused serious damages to this 13th century town (with a population of 72 000 and a health district of 103 788), in the mountainous Abruzzo region and to several medieval hill villages in the surrounding areas: 309 residents were killed, over 1600 were injured, 66 000 residents were displaced, and, the centre of L'Aquila, the main historical and artistic centre of Abruzzo, was totally destroyed.

Here is described the work done at the Psychiatric Unit of the General Hospital of L'Aquila and in the University. The Authors report the incidence rate of Acute Stress Disorder (ASD) in help-seekers (full ASD 4.9%, and partial ASD 39.3%), and of post-traumatic stress disorder (PTSD) found in different samples of population (range 12–37.5). The authors express their consideration about which real-world variables can reflect the population distress and the naturalistic process of recovery in such natural disasters. After the earthquake they hypothesize that a lot of residents had found their way to recover through ‘writing, telling the story’, by analogy with what narrative medicine asserts, thus estimating the positive effect of ‘emotional disclosure’ on health. A large number of materials (books, web-blogs, videos) were produced by residents and a database of memories was implemented. The suffering and struggle to recover in the aftermaths of a traumatic experience often yields remarkable transformations and positive growth. From this point of view, the authors underline the increased virtual relationships of residents through Facebook, to cope with the loss of previous social relationships, to get information about recreational opportunities, or to get organized for public events, despite their displacement. Many collective demonstrations were organized and showed the will to actively participate to the processes of reconstruction of the civil and scientific life of the town. The authors stress the need to prevent natural disasters, instead of preventing mental disorders following natural disasters, reporting that seven Italian seismologists and scientists are on trial for manslaughter, accused to have failed to evaluate the true risks of L'Aquila earthquake.

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Corresponding author

*Address for correspondence: Professor R. Roncone, Department of Health Sciences, Psychiatric Unit, University of L'Aquila, Via Vetoio, Loc. Coppito, I-67100 L'Aquila, Italy. (Email:


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American Psychiatric Association (2000) Diagnostic and Statistical Manual of Mental Disorders (4th Revised Edition). American Psychiatric Press: Washington, DC.
Calhoun, LG, Tedeschi, RG (2006). Handbook of Posttraumatic Growth: Research and Practice, Erlbaum: Mahwah, NJ.
Casacchia, M (2010). Interview to the Italian newpaper ‘Il Centro’, 10 April 2010.
Casacchia, M, Bianchini, V, Mazza, M, Pollice, R, Roncone, R. Predictive factors of acute stress disorder among help-seekers following the L'Aquila earthquake. Psychopathology.
Cepeda, MS, Chapman, CR, Miranda, N, Sanchez, R, Rodriguez, CH, Restrepo, AE, Ferrer, LM, Linares, RA, Carr, DB (2008). Emotional disclosure through patient narrative may improve pain and well-being: results of a randomized controlled trial in patients with cancer pain. Journal of Pain and Symptom Management 35, 623631.
Charon, R (2001). The patient-physician relationship. Narrative medicine: a model for empathy, reflection, profession, and trust. Journal of American Medical Association 286, 18971902.
Charon, R (2004). Narrative and medicine. New England Journal of Medicine 350, 862864.
Chen, CC, Yeh, TL, Yang, YK, Chen, SJ, Lee, IH, Fu, LS, Yeh, CY, Hsu, HC, Tsai, WL, Cheng, SH, Chen, LY, Si, YC (2001). Psychiatric morbidity and post-traumatic symptoms among survivors min the early stage following the 1999 earthquake in Taiwan. Psychiatry Research 105, 1322.
Dabner, N (2011). ‘Breaking ground’ in the use of social media: a case study of a university earthquake response to inform educational design with Facebook. Internet and Higher Education 15, 6978. Available online 25 June 2011.
Dell'Osso, L, Carmassi, C, Massimetti, G, Daneluzzo, E, Di Tommaso, S, Rossi, A (2011 a). Full and partial PTSD among young adult survivors 10 months after the L'Aquila 2009 earthquake: gender differences. Journal of Affective Disorders 131, 7983.
Dell'Osso, L, Carmassi, C, Massimetti, G, Conversano, C, Daneluzzo, E, Riccardi, I, Stratta, P, Rossi, A (2011 b). Impact of traumatic loss on post-traumatic spectrum symptoms in high school students after the L'Aquila 2009 earthquake in Italy. Journal of Affective Disorders 134, 5964.
Farinosi, M, Trerè, E (2010). Inside the ‘People of the Wheelbarrows’: participation between online and offline dimension in the post-quake social movement. Journal of Community Informatics 6, Available online 18 November 2011 from
Francis, ME, Pennebaker, JW (1992). Putting stress into words: the impact of writing on physiological, absentee, and self-reported emotional well-being measures. American Journal of Health Promotion 6, 280287.
Frisina, PG, Borod, JC, Lepore, SJ (2004). A meta-analysis of the effects of written emotional disclosure on the health outcomes of clinical populations. Journal of Nervous and Mental Disease 192, 629634.
Giordani Paesani, N, Malavolta, M, Verni, L, Bianchini, V, Colatei, M, De Lauretis, I, Santini, I, Tosone, A, D'Onofrio, S, Pollice, R, Evangelista, P, Nenna, G, Roncone, R (2011 a). Impatto del sisma su una popolazione afferente presso il Nucleo di Cure Primarie dell'Aquila: aspetti biologici e psicosociali. Giornale Italiano di Psicopatologia 17 (Suppl. 1), 201.
Giordani Paesani, N, De Lauretis, I, Bianchini, V, Di Mauro, S, Pollice, R, Roncone, R (2011 b). PTSD e stili di coping negli studenti universitari esposti al terremoto dell'Aquila. Giornale Italiano di Psicopatologia 17 (Suppl. 1),200.
Graf, MC, Gaudiano, BA, Geller, PA (2008). Written emotional disclosure: a controlled study of the benefits of expressive writing homework in outpatient psychotherapy. Psychotherapy Research 18, 389399.
Hall, S (2011). Scientists on trials: at fault? Nature 477, 264269.
Horan, WP, Ventura, J, Kopelowicz, JMA, Wirshing, D, Christian-Herman, J, Foy, D, Liberman, RP (2007). Stress and coping responses to a natural disaster in people with schizophrenia. Psychiatry Research 151, 7786.
Jin, H, Lanouette, NM, Mudaliar, S, Henry, R, Folsom, DP, Khandrika, S, Glorioso, DK, Jeste, DV (2009). Association of posttraumatic stress disorder with increased prevalence of metabolic syndrome. Journal of Clinical Psychopharmacology 29, 210215.
Katz, CL, Pellegrino, L, Pandya, A, Ng, A, DeLisi, LE (2002). Research on psychiatric outcomes and interventions subsequent to disasters: a review of the literature. Psychiatry Research 110, 201217.
Kiliç, C, Ulusoy, M (2003). Psychological effects of the November 1999 earthquake in Turkey: an epidemiological study. Acta Psychiatrica Scandinavica 108, 232238.
Kiliç, C, Aydin, I, Taşkintuna, N, Ozçürümez, G, Kurt, G, Eren, E, Lale, T, Ozel, S, Zileli, L (2006). Predictors of psychological distress in survivors of the 1999 earthquakes in Turkey: effects of relocation after the disaster. Acta Psychiatrica Scandinavica 114, 194202.
Kiliç, C, Kiliç, EZ, Aydin, IO (2011). Effect of relocation and parental psychopathology on earthquake survivor-children's mental health. Journal of Nervous and Mental Disease 199, 335341.
Mollica, RF, Wyshak, G, de Marneffe, D, Khuon, F, Lavelle, J (1987). Indochinese versions of the Hopkins Symptom Checklist-25: a screening instrument for the psychiatric care of refugees. American Journal of Psychiatry 144, 497500.
Mollica, RF, Caspi-Yavin, Y, Bollini, P, Truong, T, Tor, S, Lavelle, J (1992). The Harvard Trauma Questionnaire. Validating a cross-cultural instrument for measuring torture, trauma, and posttraumatic stress disorder in Indochinese refugees. Journal of Nervous and Mental Disease 180, 111116.
Mollica, RF, Lavelle, J, Rossi, A, Roncone, R, Muscettola, G, Pollice, R, Palumbo, W, Evangelista, P, Casacchia, M (2011). Il progetto aquilano ‘Salute e benessere dopo l'aprile 2009′: la formazione del medico di famiglia nelle situazioni di emergenza e negli eventi traumatici. Giornale Italiano di Psicopatologia 17 (Suppl. 1),92.
Mueser, KT, Rosenberg, SD, Rosenberg, JH (2009). Treatment of Posttraumatic Stress Disorder in Special Populations. American Psychological Association: Washington, DC.
Najarian, LM, Goenjian, AK, Pelcovitz, D, Mandel, F, Najarian, B (2001). The effect of relocation after a natural disaster. Journal of Traumatic Stress 14, 511526.
Pennebaker, JW (1999). The effects of traumatic disclosure on physical and mental health: the values of writing and talking about upsetting events. International Journal of Emergency Mental Health 1, 918.
Pennebaker, JW, Barger, SD, Tiebout, J (1989). Disclosure of traumas and health among Holocaust survivors. Psychosomatic Medicine 51, 577589.
Pollice, R, Bianchini, V, Conti, MC, Mazza, M, Roncone, R, Casacchia, M (2010). Cognitive impairment and perceived stress in schizophrenic inpatients with post-traumatic stress disorder. European Journal of Inflammation 8, 211219.
Pollice, R, Bianchini, V, Marola, V, Verni, L, Di Mauro, S, Ussorio, D, Cavicchio, A, Ortenzi, R, Roncone, R, Casacchia, M (2011 a). Post-traumatic and psychiatric symptoms among young earthquake survivors in primary care camp hospital. European Journal of Inflammation 9, 3944.
Pollice, R, Bianchini, V, Roncone, R, Casacchia, M (2011 b). Marked increase in substance use among young people after L'Aquila earthquake. European Child and Adolescent Psychiatry 20, 429430.
Priebe, S, Grappasonni, I, Mari, M, Dewey, M, Petrelli, F, Costa, A (2009). Post-traumatic stress disorder six months after an earthquake: findings from a community sample in a rural region in Italy. Social Psychiatry and Psychiatric Epidemiology 44, 393397.
Roncone, R, Pollice, R, Mazza, M, Ussorio, D, Casacchia, M (2011). Gender differences and quake exposure, displacement, and coping as predictors of psychological distress following the April 2009 earthquake in L'Aquila, Italy. 4th World Congress on Women's Mental Health, 16–19 March 2011, Madrid, Spain. Poster Proceedings, section “Political and sociocultural aspects of women's mental health”, page 6.
Rossi, A, Maggio, R, Riccardi, I, Allegrini, F, Stratta, P (2011). A quantitative analysis of antidepressant and antipsychotic prescriptions following an earthquake in Italy. Journal of Traumatic Stress 24, 129132.
Smith Fawzi, MC, Murphy, E, Pham, T, Lin, L, Poole, C, Mollica, RF (1997). The validity of screening for post-traumatic stress disorder and major depression among Vietnamese former political prisoners. Acta Psychiatrica Scandinavica 95, 8793.
Smorti, A, Pananti, B, Rizzo, A (2010). Autobiography as tool to improve lifestyle, well being, and self-narrative in patients with mental disorders. Journal of Nervous and Mental Disease 198, 564571.
Smyth, JM (1998). Written emotional expression: effect sizes, outcome types, and moderating variables. Journal of Consulting and Clinical Psychology 66, 174184.
Stratta, P, Rossi, A (2010). Subjective adjustment of individuals with psychiatric disorders in the aftermath of the L'Aquila earthquake. American Journal of Psychiatry 167, 352353.
Tedeschi, RG, Calhoun, LG (1996). The posttraumatic growth Inventory: measuring the positive legacy of trauma. Journal of Traumatic Stress 9, 455471.
Walsh, F (2007). Traumatic loss and major disasters: strengthening family and community resilience. Family Process 46, 207227.
Weiss, T, Skelton, K, Phifer, J, Jovanovic, T, Gillespie, CF, Smith, A, Umpierrez, G, Bradley, B, Ressler, KJ (2011). Posttraumatic stress disorder is a risk factor for metabolic syndrome in an impoverished urban population. General Hospital Psychiatry 33, 135142.
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