Two large earthquakes in 2015 caused widespread destruction in Nepal. This study aimed to examine frequency
of common mental health and psychosocial problems and their correlates following the earthquakes.
Methods. A stratified multi-stage cluster sampling design was employed to randomly select 513 participants (aged 16
and above) from three earthquake-affected districts in Nepal: Kathmandu, Gorkha and Sindhupalchowk, 4 months after
the second earthquake. Outcomes were selected based on qualitative preparatory research and included symptoms of
depression and anxiety (Hopkins Symptom Checklist-25); post-traumatic stress disorder (PTSD Checklist-Civilian); hazardous
alcohol use (AUDIT-C); symptoms indicating severe psychological distress (WHO-UNHCR Assessment
Schedule of Serious Symptoms in Humanitarian Settings (WASSS)); suicidal ideation (Composite International
Diagnostic Interview); perceived needs (Humanitarian Emergency Settings Perceived Needs Scale (HESPER)); and functional
impairment (locally developed scale).
Results. A substantial percentage of participants scored above validated cut-off scores for depression (34.3%, 95% CI
28.4–40.4) and anxiety (33.8%, 95% CI 27.6–40.6). Hazardous alcohol use was reported by 20.4% (95% CI 17.1–24.3) and
10.9% (95% CI 8.8–13.5) reported suicidal ideation. Forty-two percent reported that ‘distress’ was a serious problem in
their community. Anger that was out of control (symptom from the WASSS) was reported by 33.7% (95% CI 29.5–38.2).
Fewer people had elevated rates of PTSD symptoms above a validated cut-off score (5.2%, 95% CI 3.9–6.8), and levels of
functional impairment were also relatively low. Correlates of elevated symptom scores were female gender, lower caste
and greater number of perceived needs. Residing in Gorkha and Sindhupalchowk districts and lower caste were also
associated with greater perceived needs. Higher levels of impaired functioning were associated with greater odds of
depression and anxiety symptoms; impaired functioning was less strongly associated with PTSD symptoms.