Negative effects of Syria’s earthquake 2023 in Aleppo city

Negative effects of Syria’s earthquake 2023 in Aleppo city | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Negative effects of Syria’s earthquake 2023 in Aleppo city Dina Zidan, Mohammad Lala, Rajwah Jbili, Ghina Najaty, Noura Zidan This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3829419/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Earthquakes are unexpected and destructive disasters that can cause massive destruction and huge losses of life. Often, the survivors may suffer severe psychological symptoms. With the lack of related studies in the psychological field after the natural disaster that happened in Aleppo city, Syria. So, there must be a concentrated study that focuses on affected people and their feeling after treating them with anti-depressants. In our work, two questionnaires have distributed among 40 individuals that agreed on participating in this study. The questions have focused on the effect of anti-depressants API and Placebo medicines in minimizing post-traumatic stress disorder (PTSD) symptoms. Our results have shown that people who given placebo were less percentages of fear after three months from the first questionnaire. Benefits of taking anti-depressants by time with continuing treatment, which is why placebo succeeded more than anti-depressants in this study. Clinical Pharmacology Placebo Anti-depressants API PTSD Aleppo earthquake 2023 Figures Figure 1 Figure 2 Figure 3 Introduction Earthquake is one kind of natural disaster that causes a large loss of life and properties. Over 60,000 persons reported dead in Turkey and Syria because of earthquakes in March 2023 [ 1 ]. Both, the mental health of the victims and those around them impacted by traumatic experiences. Post-traumatic stress disorder (PTSD) is one of the main anxiety illnesses brought on by the catastrophe. People may experience a crippling mental illness, if they are subjected to a traumatic incident, such the recent coronavirus 2019 (COVID-19) or the earthquakes in Turkey and Syria in 2023. Studying the impact of Meaning of Life (ML) factor, following catastrophic occurrences, like the recent earthquakes in Turkey and Syria in 2023, can offer deep insight into the psychological processes that promote resilience and recovery among university students by concentrating on the importance of social support and ML. In addition, social support (SS), which refers to the resources supplied by others that can use to cope with stressors, it has demonstrated to be protective factor against mental health concerns [ 2 ]. SS may offer materials, emotional, and informational resources to help people can deal with stressors and may have a significant role in preventing the onset of PTSD. The SS scale provides insights into the role of social and family networks in fostering resilience and coping mechanisms, making it a valuable instrument for examining the significance of these networks during times of crisis [ 3 – 4 ]. The consequences of earthquakes on people's psychological have attracted more attention in recent decades. Research on the aftermath of disasters suggests that a large number of victims may have a clinically significant symptomatic reaction because of exposed to stressful events, the degree of loss, social disarray, and a lack of support from the community. Many studies on mental health issues associated to earthquakes published in Asian nations, gradually introducing PTSD and its diagnostic criteria. To the best of our knowledge, no such research has examined bout the prevalence of PTSD symptoms or the perceived severity of social stress among Syrians in the wake of the 2023 earthquakes in Turkey and Syria. However, our present study aims to add a new insight to the body of literature by investigating the prevalence of PTSD symptoms and perceived social support (SS) among Aleppo residents following the 2023’s earthquake that struck Turkey and Syria [ 4 ]. Post-traumatic stress disorders (PTSD Over the last four decades, a variety of psychopathologies have been linked to disasters; however, prior systematic reviews have shown that, all the psychopathologies associated with disasters, the PTSD are the most extensively researched and likely the most common [ 5 – 7 ]. PTSD is more likely to manifest them following a significant disaster [ 8 – 10 ]. A number of conclusions drawn from earlier researches on the psychological effects of natural disasters, including the prevalence of PTSD, which can range from 2–67% [ 11 ]. Although, a few researches have looked at the course of PTSD after natural disasters, the prevalence of PTSD reported in early studies following natural disasters was often lower than that reported in studies following technical or human-caused disasters [ 5 – 10 ]. A number of studies have also reported an increase in the prevalence of PTSD over time. Longitudinal studies of natural catastrophes have shown a decline in the disorder's prevalence with time [ 12 – 16 ]. Numbers of researches have demonstrated that PTSD symptoms are prevalent in earthquake survivors [ 17 – 22 ], with confirmed rates of PTSD in these survivors ranging from 10–87%. [ 5 , 22 – 25 ]. The chance of developing PTSD consistently linked to a larger degree of exposure to a disaster [ 6 , 9 – 11 ]. After period (six weeks to ten months), the prevalence rates of PTSD among Chi-Chi earthquake victims range from 7.9–21.7%. [ 25 – 28 ]. According to earlier research, survivors of the 1999 earthquake in Turkey had PTSD rates ranging from 39–63% [ 23 , 28 – 29 ], and short-term therapy treatments were suggested [ 30 ]. After, an earthquake, children and adolescents have the PTSD at rates ranging from 21–70% [ 31 – 33 ]. The studies have indicated the female sex with lesser education [ 5 , 11 , 34 – 37 ], and a lack of social support [ 5 , 20 , 31 – 32 ] were common risk factors for post-earthquake PTSD. The greatest predictor of PTSD was thought to be the survivors' level of dread during the earthquake [ 23 , 30 – 33 ]. People who feel high levels of fear during earthquakes can get PTSD even from relatively small ones [ 37 ]. Furthermore, new research indicates that being a member of an ethnic minority has a strong correlation with PTSD [ 38 – 50 ]. All age groups affected by the conditions, but each different age group can respond differently. Two main factors contributed to the development of post-traumatic stress disorder in addition to wars [ 50 ]. Placebo treatment It is difficult to define "placebo" in a way that makes sense inside. In contrast to "real" treatment, a placebo typically understood to be inert and generic. However, it is evident that placebos work has good impact and useful. Regarding, non-specificity, its meaning in relation to placebo is not very apparent, but it likely means, other thing, an ill-defined or imprecise mode of action or an influence on multiple conditions. The term "placebo" has a specific, albeit restrictive, definition in placebo-controlled medication efficacy studies, which provide the majority of the evidence on placebo response in depression. A placebo is a pharmacologically inert capsule or injection. The improvement that takes place in the group that receives a placebo known as the placebo effect or response. However, in double-blind clinical experiments, participants receiving a placebo receive far more than just an inert pill. The common therapy elements in all conceivable treatment scenarios directed toward them. These include the desire for and expectation of progress as well as the zeal, diligence, and dedication of clinicians. Antidepressant clinical trial participants also receive attention, positive regard, encouragement, mobilization of hope, and the chance to articulate their distress, to varied degrees depending on the therapy context and physician. Is there any benefit to use a placebo over a "wait and see" strategy, other than the passage of time? As far as I know, no research has explicitly been tested the efficacy of placebo pills versus time alone in treating depression. However, three different lines of evidence—none of which is conclusive or devoid of bias-converge to imply that receiving a placebo relieves symptoms more than receiving no treatment at all [ 51 ]. Zoloft sertraline: In several nations, SSRIs have been available for sale since more than 15 years. Fluvoxamine, fluoxetine, sertraline, paroxetine, and citalopram are the five SSRIs that currently marketed. Due to a variety of reasons, these medications have completely changed the way that anxiety and depression are treated. First, there are significantly less safety issues with SSRIs than other conventional drugs, including as possible dependence, cardiotoxicity, and overdose mortality. Second, patients find SSRIs tolerable due to their good side effect profiles, which enhance patient compliance with therapy. Lastly, it seems that there are numerous therapeutic uses for SSRIs. These medications used to treat depression and dysthymia as well as a variety of anxiety disorders. Their usefulness in treating eating disorders, PMDD, and drug dependence treatment go even beyond treating depression and anxiety. While SSRIs frequently thought to be interchangeable, there are distinctions in their efficacy evidence and adverse effect profiles that might help clinicians choose the right medication. An FDA-approved selective serotonin reuptake inhibitor (SSRI) called sertraline (Zoloft®), it used to treat depression, panic disorder, OCD, and PTSD. The method of action of sertraline, like other SSRIs, involves boosting serotonin availability in the central nervous system [ 52 ]. Materials and Methods Study design and population Samples collected between 5/30/2023 and 6/9/2023 in shelter centers in the Syria by means of electronic questionnaire that created by the research team and published among the population on social networking sites. The samples analyzed on a daily basis, and the sample selection method was convenience-sampling size. Our sample study consists of 40 individual, who meet the inclusion and exclusion criteria. As, the research design was of the type of cross-sectional study, the sample size was determined taking into account the confidence interval (95%) and the 5% confidence interval (margin of error ± 5%). Participants who did not give us sufficient or illogical information excluded. In addition, children and elderly people excluded. Adults (Males and females) of all ages who exposed to the earthquake and who followed news of its occurrence on social media sites were included, depending on their educational level and standard of living. The electronic questionnaire published through networking with Red Crescent volunteers in Aleppo, which facilitated the questionnaire’s access to those affected. Sample techniques and Data collection: In this study, 40 participants were included. The previous earthquake in Aleppo affected those individuals. The survey spread in Arabic Language. Data were collected using structured questionnaires. The survey has performed twice, the first; people answered the questions before taking Placebo or Zoloft sertraline. The first one contained 15 questions, while the second one contained 5 questions. All participants willingly volunteered to participate in the study. Data management and analysis: The Microsoft Excel 2022 employed for the purpose of generating figures and conducting preliminary analysis, in order to compare the effects of both medicines over people who affected by the earthquake. Ethics approval and consent to participate: Approval of the work obtained from the College of Pharmacy at ASPU. The questionnaire includes information that participants must read before answering the questionnaire and emphasizes the privacy and confidentiality of the data and participants. The information sheet also includes contact details and a brief overview. Each questionnaire have a digital code and stored with our principal investigator. The information sheet stored separately. The study does not cause any physical, psychological or social for any of the participants, it does not require them to disclose any information of a sensitive nature, as well as participants did not receive any payment for participating in the survey. Results Our 40 participants answered all the questions of both surveys, all the data illustrated in the Tables below: Table (1) the acquired data related to questionnaire sheet 1. Question First survey Gender Females 57.5% Males 42.5% Economic status Good 60% Moderate 12.5% Bad 27.5% Marital Status Married 70% Single 30% Educational status Post-grad 82.5% Under-grad 10% School or none 7.5% Previous experience in earthquakes Yes 50% No 50% Staying under rubble Yes 5% No 95% Feeling during earthquake Panic 55% Extreme fear 30% Mild fear 20% None 5% Fear remaining Month or less 42.5% Two months 27.5% 3 months 30% Need for taking sedative Yes 17.5% No 82.5% Psychotherapy sessions Yes 2.5% No 97.5% Social support Yes 42.5% No 57.5% Death of loved ones Yes 12.5% No 87.5% Hyper vigilance Yes 57.5% No 42.5% Loss of concentration Yes 70% No 30% Reviving the event Yes 70% No 30% Table (2) the acquired data related to questionnaire sheet 2. Question Feeling after taking medicines Relaxation 35% Calmness 25% Nothing 40% Remaining of fear Yes 22.5% No 77.5% Decreasing in fear Yes 80% No 20% Recovery after taking medicines Yes 77.5% No 22.5% Discussion This study presents information on the prevalence of PTSD following the earthquake in Turkey and Syria. Additionally, it sheds light on potential interventions aimed at improving the overall mental health of Syrian people in Aleppo, it’s the first study that compare two groups of people who were given an antidepressant medication and a placebo. A questionnaires were conducted on 40 participants, before and after taking the medication in order to find out whether the effects of exposure to such incidents had diminished or not. The largest percentage of participants were females in both questionnaires, at a rate of 57.5%, while the percentage of males was about 42.5%, with the age group between 30-40 years predominant at 45%, followed by the age group from 18-30 years at a rate of 25%, and the age group from 50-60 at a rate 18%, then the age group of 40-50% by 12%. This study differed from a previous study conducted in 2023 on the earthquake in Syria and Turkey, where the majority percentage was for the age group of 20-30 years [4]. Sertraline has been linked to improvements on the majority of efficacy metrics and demonstrated to lower the mean weekly frequency of panic attacks [52]. When compared to men, women seemed to experience the sertraline impact more strongly. The study lacked the power to adequately investigate gender disparities [52]. Furthermore, sertraline showed a noteworthy enhancement in the quality of life metrics [52]. Longer term studies of sertraline in patients with psychological disorders have found that benefits are maintained with continued treatment. Studies have found that sertraline (50–200 mg) is more effective than placebo for the treatment of psychological disorders, with a trend towards greater efficacy with higher dosages [52]. The amount of sertraline drug was 50 mg, which accounts for the placebo's superiority over the sertraline drug because the sertraline amount was insufficient to outweigh the placebo's effects. Three month medication regimen allowed sertraline ample time to have the desired benefits on depressed individuals. The act of swallowing a pill could potentially enhance the therapeutic outcome of a placebo. Studies on the impact of pill consumption on depression in general are lacking. Some evidence indicates that taking pills by themselves may have an impact on general health [51]. The notion that pills represent the doctor's curing ability in our culture linked to the apparent health benefits of pill consumption. The psychological advantages of a pill's symbolic significance enhanced by conditioning effects stemming from favorable prior experiences with medication [51]. This can explain the results of our current study, as the results of the second questionnaire showed that the majority of people (77.5%) who benefited from the drug were those who benefited after taking the placebo, as the feeling of fear and anxiety disappeared by a large percentage of about 80%. Certain patients are more likely to improve when treated with a placebo, according to studies on the placebo response in depression. Episode duration is the most reliable and consistent indicator of placebo response. The placebo response drops to less than 30% for patients who have been depressed for more than a year, whereas, it hovers around 50% for those who have been depressed for less than three months [51]. The National Institute of Mental Health Treatment of Depression Collaborative Research Program, which is the largest and most well-known controlled treatment trial, found that, when compared to cognitive therapy and antidepressant medications, placebo was the most successful way to treat depressed participants [53]. Finally, the results of this study have explained how placebo drugs can play on psychological side, in addition to time that can treat some of the bad memories among individuals. Conclusion In this study, two questionnaires statements distributed among 40 individuals that agreed on participating in studying the role of the ML after traumatic events, like the recent earthquakes of Turkey and Syria in 2023. The questionnaires were conducted, before and after taking the medication in order to find out whether the effects of exposure to such incidents had diminished or not. The distributed questions have concentrated on the effect of anti-depressants API and Placebo medicines in minimizing Post-traumatic stress disorder (PTSD) symptoms. Our results have shown that people who used placebo have shown less percentages of fear after three months from the first questionnaire. Benefits from taking anti-depressants maintained with continued treatments Declarations Ethics approval and consent to participate The Research Ethics Committee at Al-Sham Private University approved the study protocol. Verbal informed consent was obtained from each participant prior to participation. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards Consent for publication Not applicable. Availability of data and materials: All data related to this paper’s conclusion are available and stored by the authors. All data are available from the corresponding author on a reasonable request. Conflict of interest: The authors declare that they have no conflict of interest. Funding: This research received no specific grant from ASPU or any other funding agency in the public, commercial or non-pro t sectors. Acknowledgments We are thankful to the Syrian Private University for their support. References WHO. Syria/Turkey Earthquakes Situation Report #7, March 8, 2023. 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Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. Journal of consulting and clinical psychology , 74 (4), p.658. Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3829419","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":264750684,"identity":"0ad468f1-c2f0-46ec-a1ee-8e7333d3a251","order_by":0,"name":"Dina Zidan","email":"","orcid":"","institution":"Faculty of Pharmacy, Al-Sham Private University, Damascus, Syria","correspondingAuthor":false,"prefix":"","firstName":"Dina","middleName":"","lastName":"Zidan","suffix":""},{"id":264750685,"identity":"efad7d7f-2bf9-49e2-909c-4ff14b354dda","order_by":1,"name":"Mohammad Lala","email":"","orcid":"","institution":"Faculty of Pharmacy, Al-Sham Private University, Damascus, Syria","correspondingAuthor":false,"prefix":"","firstName":"Mohammad","middleName":"","lastName":"Lala","suffix":""},{"id":264750686,"identity":"279b8dae-a99e-40b6-810c-2d4e9dbaee12","order_by":2,"name":"Rajwah Jbili","email":"","orcid":"","institution":"Faculty of Pharmacy, Al-Sham Private University, Damascus, Syria","correspondingAuthor":false,"prefix":"","firstName":"Rajwah","middleName":"","lastName":"Jbili","suffix":""},{"id":264750687,"identity":"43544125-388b-4bba-978b-0f5c476f5186","order_by":3,"name":"Ghina Najaty","email":"","orcid":"","institution":"Faculty of Dentistry, Al-Sham Private University, Damascus, Syria","correspondingAuthor":false,"prefix":"","firstName":"Ghina","middleName":"","lastName":"Najaty","suffix":""},{"id":264750688,"identity":"7dcc1686-f85e-4bf2-968f-2bd9ea5fdd4b","order_by":4,"name":"Noura Zidan","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA+ElEQVRIiWNgGAWjYPACCcYGBsbGxz8qgGxm5gZitTA3GzOcAWlhJEoLA1AZe5s0YxuUjQ+Ys/eYffjxx0K2f3Zjm3ThvNpo/naglh8V23Bqsew5Yzyzh0fCeMadg83WM7cdz51xmLGBsefMbZxaDG7kGDPwSEgkNtxIbLzBu+1YbgNQCzNjG34tjH8MJBLn30hskOCdcyx3PjFamHkSJBI33EhskuZtqMndQFDLmWPFzDIHJIw33khsNpxx7EDuRqCWg3j9crx5M+ObP3Wy826kP3zwoaYud975wwcf/KjArQUdHAaTB4hWDwR1pCgeBaNgFIyCEQIAZ5FgpXT9NFwAAAAASUVORK5CYII=","orcid":"","institution":"Faculty of Dentistry, Al-Sham Private University, Damascus, Syria","correspondingAuthor":true,"prefix":"","firstName":"Noura","middleName":"","lastName":"Zidan","suffix":""}],"badges":[],"createdAt":"2024-01-02 11:52:55","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-3829419/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3829419/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":49136113,"identity":"e114cd51-0b51-41cc-90e6-777ab4b47ff4","added_by":"auto","created_at":"2024-01-03 17:15:08","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":162919,"visible":true,"origin":"","legend":"\u003cp\u003ethe rate of healing after taking the medicine.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-3829419/v1/df5d506f2eb9594bf101eb3b.png"},{"id":49136112,"identity":"b309f144-7a24-4111-94d0-5e2e57623a66","added_by":"auto","created_at":"2024-01-03 17:15:08","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":165108,"visible":true,"origin":"","legend":"\u003cp\u003ethe rate of individuals benefited from the medicine.\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-3829419/v1/0fd92400c0ebe25a7007a5e3.png"},{"id":49136114,"identity":"2e207aee-9c2f-4b16-bbee-fb24cffceec3","added_by":"auto","created_at":"2024-01-03 17:15:09","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":167470,"visible":true,"origin":"","legend":"\u003cp\u003ethe rate of individuals not benefited from the medicine.\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-3829419/v1/1ad6c31b206a8c24aaf81152.png"},{"id":49136715,"identity":"46ee959f-0993-47c8-8ece-aa904e4729fe","added_by":"auto","created_at":"2024-01-03 17:23:09","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":578979,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3829419/v1/4544f304-49c6-4536-b5e7-936a3b9c1da0.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eNegative effects of Syria’s earthquake 2023 in Aleppo city\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eEarthquake is one kind of natural disaster that causes a large loss of life and properties. Over 60,000 persons reported dead in Turkey and Syria because of earthquakes in March 2023 [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Both, the mental health of the victims and those around them impacted by traumatic experiences. Post-traumatic stress disorder (PTSD) is one of the main anxiety illnesses brought on by the catastrophe. People may experience a crippling mental illness, if they are subjected to a traumatic incident, such the recent coronavirus 2019 (COVID-19) or the earthquakes in Turkey and Syria in 2023.\u003c/p\u003e \u003cp\u003eStudying the impact of Meaning of Life (ML) factor, following catastrophic occurrences, like the recent earthquakes in Turkey and Syria in 2023, can offer deep insight into the psychological processes that promote resilience and recovery among university students by concentrating on the importance of social support and ML. In addition, social support (SS), which refers to the resources supplied by others that can use to cope with stressors, it has demonstrated to be protective factor against mental health concerns [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. SS may offer materials, emotional, and informational resources to help people can deal with stressors and may have a significant role in preventing the onset of PTSD. The SS scale provides insights into the role of social and family networks in fostering resilience and coping mechanisms, making it a valuable instrument for examining the significance of these networks during times of crisis [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe consequences of earthquakes on people's psychological have attracted more attention in recent decades. Research on the aftermath of disasters suggests that a large number of victims may have a clinically significant symptomatic reaction because of exposed to stressful events, the degree of loss, social disarray, and a lack of support from the community. Many studies on mental health issues associated to earthquakes published in Asian nations, gradually introducing PTSD and its diagnostic criteria.\u003c/p\u003e \u003cp\u003eTo the best of our knowledge, no such research has examined bout the prevalence of PTSD symptoms or the perceived severity of social stress among Syrians in the wake of the 2023 earthquakes in Turkey and Syria. However, our present study aims to add a new insight to the body of literature by investigating the prevalence of PTSD symptoms and perceived social support (SS) among Aleppo residents following the 2023\u0026rsquo;s earthquake that struck Turkey and Syria [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e\n\u003ch3\u003ePost-traumatic stress disorders (PTSD\u003c/h3\u003e\n\u003cp\u003eOver the last four decades, a variety of psychopathologies have been linked to disasters; however, prior systematic reviews have shown that, all the psychopathologies associated with disasters, the PTSD are the most extensively researched and likely the most common [\u003cspan additionalcitationids=\"CR6\" citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. PTSD is more likely to manifest them following a significant disaster [\u003cspan additionalcitationids=\"CR9\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. A number of conclusions drawn from earlier researches on the psychological effects of natural disasters, including the prevalence of PTSD, which can range from 2\u0026ndash;67% [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Although, a few researches have looked at the course of PTSD after natural disasters, the prevalence of PTSD reported in early studies following natural disasters was often lower than that reported in studies following technical or human-caused disasters [\u003cspan additionalcitationids=\"CR6 CR7 CR8 CR9\" citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. A number of studies have also reported an increase in the prevalence of PTSD over time. Longitudinal studies of natural catastrophes have shown a decline in the disorder's prevalence with time [\u003cspan additionalcitationids=\"CR13 CR14 CR15\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eNumbers of researches have demonstrated that PTSD symptoms are prevalent in earthquake survivors [\u003cspan additionalcitationids=\"CR18 CR19 CR20 CR21\" citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e], with confirmed rates of PTSD in these survivors ranging from 10\u0026ndash;87%. [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan additionalcitationids=\"CR23 CR24\" citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. The chance of developing PTSD consistently linked to a larger degree of exposure to a disaster [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan additionalcitationids=\"CR10\" citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. After period (six weeks to ten months), the prevalence rates of PTSD among Chi-Chi earthquake victims range from 7.9\u0026ndash;21.7%. [\u003cspan additionalcitationids=\"CR26 CR27\" citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. According to earlier research, survivors of the 1999 earthquake in Turkey had PTSD rates ranging from 39\u0026ndash;63% [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e], and short-term therapy treatments were suggested [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. After, an earthquake, children and adolescents have the PTSD at rates ranging from 21\u0026ndash;70% [\u003cspan additionalcitationids=\"CR32\" citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. The studies have indicated the female sex with lesser education [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan additionalcitationids=\"CR35 CR36\" citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e], and a lack of social support [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e] were common risk factors for post-earthquake PTSD. The greatest predictor of PTSD was thought to be the survivors' level of dread during the earthquake [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan additionalcitationids=\"CR31 CR32\" citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. People who feel high levels of fear during earthquakes can get PTSD even from relatively small ones [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]. Furthermore, new research indicates that being a member of an ethnic minority has a strong correlation with PTSD [\u003cspan additionalcitationids=\"CR39 CR40 CR41 CR42 CR43 CR44 CR45 CR46 CR47 CR48 CR49\" citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e]. All age groups affected by the conditions, but each different age group can respond differently. Two main factors contributed to the development of post-traumatic stress disorder in addition to wars [\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e].\u003c/p\u003e\n\u003ch3\u003ePlacebo treatment\u003c/h3\u003e\n\u003cp\u003eIt is difficult to define \"placebo\" in a way that makes sense inside. In contrast to \"real\" treatment, a placebo typically understood to be inert and generic. However, it is evident that placebos work has good impact and useful. Regarding, non-specificity, its meaning in relation to placebo is not very apparent, but it likely means, other thing, an ill-defined or imprecise mode of action or an influence on multiple conditions. The term \"placebo\" has a specific, albeit restrictive, definition in placebo-controlled medication efficacy studies, which provide the majority of the evidence on placebo response in depression. A placebo is a pharmacologically inert capsule or injection. The improvement that takes place in the group that receives a placebo known as the placebo effect or response. However, in double-blind clinical experiments, participants receiving a placebo receive far more than just an inert pill. The common therapy elements in all conceivable treatment scenarios directed toward them. These include the desire for and expectation of progress as well as the zeal, diligence, and dedication of clinicians. Antidepressant clinical trial participants also receive attention, positive regard, encouragement, mobilization of hope, and the chance to articulate their distress, to varied degrees depending on the therapy context and physician. Is there any benefit to use a placebo over a \"wait and see\" strategy, other than the passage of time? As far as I know, no research has explicitly been tested the efficacy of placebo pills versus time alone in treating depression. However, three different lines of evidence\u0026mdash;none of which is conclusive or devoid of bias-converge to imply that receiving a placebo relieves symptoms more than receiving no treatment at all [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e].\u003c/p\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eZoloft sertraline:\u003c/h2\u003e \u003cp\u003eIn several nations, SSRIs have been available for sale since more than 15 years. Fluvoxamine, fluoxetine, sertraline, paroxetine, and citalopram are the five SSRIs that currently marketed. Due to a variety of reasons, these medications have completely changed the way that anxiety and depression are treated. First, there are significantly less safety issues with SSRIs than other conventional drugs, including as possible dependence, cardiotoxicity, and overdose mortality. Second, patients find SSRIs tolerable due to their good side effect profiles, which enhance patient compliance with therapy. Lastly, it seems that there are numerous therapeutic uses for SSRIs. These medications used to treat depression and dysthymia as well as a variety of anxiety disorders. Their usefulness in treating eating disorders, PMDD, and drug dependence treatment go even beyond treating depression and anxiety. While SSRIs frequently thought to be interchangeable, there are distinctions in their efficacy evidence and adverse effect profiles that might help clinicians choose the right medication. An FDA-approved selective serotonin reuptake inhibitor (SSRI) called sertraline (Zoloft\u0026reg;), it used to treat depression, panic disorder, OCD, and PTSD. The method of action of sertraline, like other SSRIs, involves boosting serotonin availability in the central nervous system [\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e"},{"header":"Materials and Methods","content":"\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eStudy design and population\u003c/h2\u003e \u003cp\u003eSamples collected between 5/30/2023 and 6/9/2023 in shelter centers in the Syria by means of electronic questionnaire that created by the research team and published among the population on social networking sites. The samples analyzed on a daily basis, and the sample selection method was convenience-sampling size.\u003c/p\u003e \u003cp\u003eOur sample study consists of 40 individual, who meet the inclusion and exclusion criteria. As, the research design was of the type of cross-sectional study, the sample size was determined taking into account the confidence interval (95%) and the 5% confidence interval (margin of error\u0026thinsp;\u0026plusmn;\u0026thinsp;5%). Participants who did not give us sufficient or illogical information excluded. In addition, children and elderly people excluded. Adults (Males and females) of all ages who exposed to the earthquake and who followed news of its occurrence on social media sites were included, depending on their educational level and standard of living.\u003c/p\u003e \u003cp\u003eThe electronic questionnaire published through networking with Red Crescent volunteers in Aleppo, which facilitated the questionnaire\u0026rsquo;s access to those affected.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eSample techniques and Data collection:\u003c/h2\u003e \u003cp\u003eIn this study, 40 participants were included. The previous earthquake in Aleppo affected those individuals. The survey spread in Arabic Language. Data were collected using structured questionnaires. The survey has performed twice, the first; people answered the questions before taking Placebo or Zoloft sertraline. The first one contained 15 questions, while the second one contained 5 questions. All participants willingly volunteered to participate in the study.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eData management and analysis:\u003c/h2\u003e \u003cp\u003eThe Microsoft Excel 2022 employed for the purpose of generating figures and conducting preliminary analysis, in order to compare the effects of both medicines over people who affected by the earthquake.\u003c/p\u003e \u003c/div\u003e\n\u003ch2\u003eEthics approval and consent to participate:\u003c/h2\u003e\u003cp\u003eApproval of the work obtained from the College of Pharmacy at ASPU. The questionnaire includes information that participants must read before answering the questionnaire and emphasizes the privacy and confidentiality of the data and participants. The information sheet also includes contact details and a brief overview. Each questionnaire have a digital code and stored with our principal investigator. The information sheet stored separately. The study does not cause any physical, psychological or social for any of the participants, it does not require them to disclose any information of a sensitive nature, as well as participants did not receive any payment for participating in the survey.\u003c/p\u003e "},{"header":"Results","content":"\u003cp\u003eOur 40 participants answered all the questions of both surveys, all the data illustrated in the Tables below:\u003c/p\u003e \u003cp\u003eTable\u0026nbsp;(1) the acquired data related to questionnaire sheet 1.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Taba\" border=\"1\"\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQuestion\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c5\" namest=\"c2\"\u003e \u003cp\u003eFirst survey\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e \u003cb\u003eGender\u003c/b\u003e \u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemales 57.5%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMales 42.5%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e \u003cb\u003eEconomic status\u003c/b\u003e \u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGood 60%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eModerate 12.5%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eBad 27.5%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e \u003cb\u003eMarital Status\u003c/b\u003e \u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMarried 70%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSingle 30%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e \u003cb\u003eEducational status\u003c/b\u003e \u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePost-grad 82.5%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eUnder-grad 10%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSchool or none 7.5%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e \u003cb\u003ePrevious experience in earthquakes\u003c/b\u003e \u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes 50%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo 50%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e \u003cb\u003eStaying under rubble\u003c/b\u003e \u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes 5%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo 95%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e \u003cb\u003eFeeling during earthquake\u003c/b\u003e \u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePanic 55%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eExtreme fear 30%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMild fear 20%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNone 5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e \u003cb\u003eFear remaining\u003c/b\u003e \u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMonth or less 42.5%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eTwo months 27.5%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3 months 30%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e \u003cb\u003eNeed for taking sedative\u003c/b\u003e \u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes 17.5%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo 82.5%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e \u003cb\u003ePsychotherapy sessions\u003c/b\u003e \u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes 2.5%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo 97.5%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e \u003cb\u003eSocial support\u003c/b\u003e \u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes 42.5%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo 57.5%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e \u003cb\u003eDeath of loved ones\u003c/b\u003e \u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes 12.5%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo 87.5%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e \u003cb\u003eHyper vigilance\u003c/b\u003e \u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes 57.5%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo 42.5%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e \u003cb\u003eLoss of concentration\u003c/b\u003e \u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes 70%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo 30%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e \u003cb\u003eReviving the event\u003c/b\u003e \u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes 70%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo 30%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;(2) the acquired data related to questionnaire sheet 2.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabb\" border=\"1\"\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQuestion\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e \u003cb\u003eFeeling after taking medicines\u003c/b\u003e \u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRelaxation 35%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCalmness 25%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNothing 40%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e \u003cb\u003eRemaining of fear\u003c/b\u003e \u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes 22.5%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo 77.5%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e \u003cb\u003eDecreasing in fear\u003c/b\u003e \u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes 80%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo 20%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e \u003cb\u003eRecovery after taking medicines\u003c/b\u003e \u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes 77.5%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo 22.5%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e "},{"header":"Discussion","content":"\u003cp\u003eThis study presents information on the prevalence of PTSD following the earthquake in Turkey and Syria. Additionally, it sheds light on potential interventions aimed at improving the overall mental health of Syrian people in Aleppo, it\u0026rsquo;s the first study that compare two groups of people who were given an antidepressant medication and a placebo.\u003c/p\u003e\n\u003cp\u003eA questionnaires were conducted on\u0026nbsp;40 participants,\u0026nbsp;before and after taking the medication in order to find out whether the effects of exposure to such incidents had diminished or not. The largest percentage of participants were females in both questionnaires, at a rate of 57.5%, while the percentage of males was about 42.5%, with the age group between 30-40 years predominant at 45%, followed by the age group from 18-30 years at a rate of 25%, and the age group from 50-60 at a rate 18%, then the age group of 40-50% by 12%. This study differed from a previous study conducted in 2023 on the earthquake in Syria and Turkey, where the majority percentage was for the age group of 20-30 years [4].\u003c/p\u003e\n\u003cp\u003eSertraline has been linked to improvements on the majority of efficacy metrics and demonstrated to lower the mean weekly frequency of panic attacks [52]. When compared to men, women seemed to experience the sertraline impact more strongly. The study lacked the power to adequately investigate gender disparities [52]. Furthermore, sertraline showed a noteworthy enhancement in the quality of life metrics [52].\u003c/p\u003e\n\u003cp\u003eLonger term studies of sertraline in patients with psychological disorders have found that benefits are maintained with continued treatment. Studies have found that sertraline (50\u0026ndash;200 mg) is more effective than placebo for the treatment of psychological disorders, with a trend towards greater efficacy with higher dosages [52]. The amount of sertraline drug was 50 mg, which accounts for the placebo\u0026apos;s superiority over the sertraline drug because the sertraline amount was insufficient to outweigh the placebo\u0026apos;s effects. Three month medication regimen allowed sertraline ample time to have the desired benefits on depressed individuals.\u0026nbsp;The act of swallowing a pill could potentially enhance the therapeutic outcome of a placebo. Studies on the impact of pill consumption on depression in general are lacking. Some evidence indicates that taking pills by themselves may have an impact on general health [51]. The notion that pills represent the doctor\u0026apos;s curing ability in our culture linked to the apparent health benefits of pill consumption. The psychological advantages of a pill\u0026apos;s symbolic significance enhanced by conditioning effects stemming from favorable prior experiences with medication [51].\u0026nbsp;This can explain the results of our current study, as the results of the second questionnaire showed that the majority of people (77.5%) who benefited from the drug were those who benefited after taking the placebo, as the feeling of fear and anxiety disappeared by a large percentage of about 80%.\u003cspan dir=\"RTL\"\u003e\u0026nbsp;\u003c/span\u003eCertain patients are more likely to improve when treated with a placebo, according to studies on the placebo response in depression. Episode duration is the most reliable and consistent indicator of placebo response. The placebo response drops to less than 30% for patients who have been depressed for more than a year, whereas, it hovers around 50% for those who have been depressed for less than three months [51].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe National Institute of Mental Health Treatment of Depression Collaborative Research Program, which is the largest and most well-known controlled treatment trial, found that, when compared to cognitive therapy and antidepressant medications, placebo was the most successful way to treat depressed participants [53].\u003c/p\u003e\n\u003cp\u003eFinally, the results of this study have explained how placebo drugs can play on psychological side, in addition to time that can treat some of the bad memories among individuals.\u0026nbsp;\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn this study, two questionnaires statements distributed among 40 individuals that agreed on participating in\u0026nbsp;studying the\u0026nbsp;role of the ML after traumatic events, like the recent earthquakes of Turkey and Syria in 2023.\u0026nbsp;The questionnaires were conducted,\u0026nbsp;before and after taking the medication in order to find out whether the effects of exposure to such incidents had diminished or not.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e The distributed questions have concentrated on the effect of anti-depressants API and Placebo medicines in minimizing Post-traumatic stress disorder (PTSD) symptoms. Our results have shown that people who used placebo have shown less percentages of fear after three months from the first questionnaire. Benefits from taking anti-depressants maintained with continued treatments\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe Research Ethics Committee at Al-Sham Private University approved the study protocol. Verbal informed consent was obtained from each participant prior to participation. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll data related to this paper\u0026rsquo;s conclusion are available and stored by\u0026nbsp;the authors. All data are available from the corresponding author on a reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interest:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research received no specific grant from ASPU or any other funding agency in the public, commercial or non-pro t sectors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe are thankful to the Syrian Private University for their support.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eWHO. Syria/Turkey Earthquakes Situation Report #7, March 8, 2023. Available online: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://reliefweb.int/report/syrian-arabrepublic/syriaturkey-earthquakes-situation-report-7-march-8-2023\u003c/span\u003e\u003cspan address=\"https://reliefweb.int/report/syrian-arabrepublic/syriaturkey-earthquakes-situation-report-7-march-8-2023\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e, (accessed on 25 May 2023).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eThoits, P.A. Mechanisms linking social ties and support to physical and mental health. J. Health Soc. Behav. 2011, \u003cem\u003e52\u003c/em\u003e, 145\u0026ndash;161. [CrossRef]\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKokai, M., Fujii, S., Shinfuku, N. and Edwards, G., 2004. Natural disaster and mental health in Asia. Psychiatry and clinical neurosciences, \u003cem\u003e58\u003c/em\u003e(2), pp.110\u0026ndash;116.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlfuqaha, O.A., Al-Masarwah, U.M., Farah, R.I., Yasin, J.A., Alkuttob, L.A., Muslieh, N.I., Hammouri, M., Jawabreh, A.E., Aladwan, D.A., Barakat, R.O. and Alshubbak, N.A.H., 2023. The impact of Turkey and Syria earthquakes on university students: posttraumatic stress disorder symptoms, meaning in life, and social support. \u003cem\u003eBehavioral Sciences\u003c/em\u003e, \u003cem\u003e13\u003c/em\u003e(7), p.587.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNorris F.H.,FriedmanM. J.,Watson P. J., Byrne C. M., Diaz E. ,Kaniasty K.60,000 disaster victims speak: Part I. Anempirical review of the empirical literature,1981\u0026ndash;2001. Psychiatry 2002;65:207\u0026ndash;39.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGalea S.,Nandi A. ,Vlahov D. The epidemiology of post-traumatic stress disorder after disasters. Epidemiol Rev. 2005;27:78\u0026ndash;91.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNeriaY.,Gross R., Marshall R.9/11:Mental health in the wake of terrorist attacks. NewYork: Cambridge University Press;2006.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSprang G., Post disaster stress following the Oklahoma City bombing in survivors. J. Interpers Violence1999;14:169\u0026ndash;83.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDavid D., Mellman T. A., Mendoza L. M., Kulick Bell R. ,Ironson G.,Schneiderman N. Psychiatric morbidity following Hurricane Andrew., J. Trauma Stress1996; 9:607\u0026ndash;12.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNorris F. H. Epidemiology of trauma: frequency and impact of diffe-rent potentially traumatic events on different demographic groups. 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Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. \u003cem\u003eJournal of consulting and clinical psychology\u003c/em\u003e, \u003cem\u003e74\u003c/em\u003e(4), p.658.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Faculty of Pharmacy, Al-Sham Private University, Damascus, Syria","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Placebo, Anti-depressants, API, PTSD, Aleppo earthquake, 2023","lastPublishedDoi":"10.21203/rs.3.rs-3829419/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3829419/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eEarthquakes are unexpected and destructive disasters that can cause massive destruction and huge losses of life. Often, the survivors may suffer severe psychological symptoms. With the lack of related studies in the psychological field after the natural disaster that happened in Aleppo city, Syria. So, there must be a concentrated study that focuses on affected people and their feeling after treating them with anti-depressants. In our work, two questionnaires have distributed among 40 individuals that agreed on participating in this study. The questions have focused on the effect of anti-depressants API and Placebo medicines in minimizing post-traumatic stress disorder (PTSD) symptoms. Our results have shown that people who given placebo were less percentages of fear after three months from the first questionnaire. Benefits of taking anti-depressants by time with continuing treatment, which is why placebo succeeded more than anti-depressants in this study.\u003c/p\u003e","manuscriptTitle":"Negative effects of Syria’s earthquake 2023 in Aleppo city","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-01-03 17:15:04","doi":"10.21203/rs.3.rs-3829419/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"2d6018aa-b817-4009-8cb3-01a53e3c97bd","owner":[],"postedDate":"January 3rd, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":27896797,"name":"Clinical Pharmacology"}],"tags":[],"updatedAt":"2024-01-03T17:15:04+00:00","versionOfRecord":[],"versionCreatedAt":"2024-01-03 17:15:04","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3829419","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3829419","identity":"rs-3829419","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}