Effectiveness of psychological interventions for adult survivors of the 2023 Kahramanmaraş earthquakes: a systematic review and meta-analysis.

Background: The February 6, 2023 Kahramanmaraş earthquakes were among the most devastating disasters in Türkiye's history, leaving millions affected and exposing survivors to elevated risks of post-traumatic stress disorder (PTSD), depression, and anxiety. While numerous psychological interventions have been deployed in the aftermath, their effectiveness for this population has not been systematically evaluated. Objective: This study synthesized evidence on the effectiveness of psychological interventions delivered to adult survivors of the Kahramanmaraş earthquakes, with a focus on PTSD, depression, and anxiety outcomes. Methods: A systematic review and meta-analysis was conducted in accordance with PRISMA guidelines and registered on PROSPERO (CRD420251102991). Eligible studies were randomized or quasi-experimental trials assessing structured psychological interventions (e.g., trauma-focused cognitive behavioral therapy [TF-CBT], psychoeducation, spiritually integrated approaches, telepsychiatry, and virtual reality-based programs) among earthquake-exposed adults. Primary outcomes were PTSD, depression, and anxiety, measured with validated instruments. Random-effects models were used to pool effect sizes. Results: Nine peer-reviewed studies (N = 435 participants) were identified. Interventions included TF-CBT, Islamic TF-CBT, spiritually oriented logotherapy, VR-based trauma therapy, CBT-based psychoeducation, and telepsychiatry. Meta-analyses indicated large pooled effects favoring interventions: PTSD (Hedges' g = -2.6, 95% CI [-4.0, -1.3]), depression (g = -1.27, 95% CI [-1.73, -0.81]), and anxiety (g = -1.18, 95% CI [-1.55, -0.82]). Benefits were consistent across individual, group, and online formats. Culturally adapted approaches appeared to produce meaningful improvements, although the evidence is limited. Follow-up assessments across studies ranged widely (1-12 months). Short-term follow-up data (1-3 months) generally indicated maintained symptom reductions, whereas evidence from longer-term follow-up (6-12 months) was limited to a small number of studies and should therefore be interpreted cautiously. Conclusion: Structured psychological interventions-especially trauma-focused CBT, culturally adapted therapies, and psychoeducation-significantly alleviated PTSD, depression, and anxiety among adult survivors of the Kahramanmaraş earthquakes. Group-based and telehealth modalities proved feasible and effective, expanding access when in-person services were disrupted. Despite promising results, evidence remains limited by small sample sizes, heterogeneity, and short follow-up. Future research should address long-term outcomes, functional recovery, and broader populations, including children and first responders. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251102991, identifier CRD42025837569.