Earthquake disaster of Pakistan caused massive destruction. Survivors have experienced several recurrent aftershocks since then. Many of them measured above 5. Data was collected from various agencies including WHO, Turkish Red Crescent, Canadian team of relief and some other NGOs working with earth quake hit communities in NWFP and Azad Kashmir. Diagnosis was made using semi-structured interviews. The objective of this paper is to measure the impact of neurobiological and socio cultural underpinnings.

Data analyses of women (1056), men (281) and children (204) indicate high prevalence of anxiety disorders including PTSD (853 women, 153 men) and depression (73 women, 31 men). Results vary from the observations made from other disasters. Sex ratio shows huge difference in prevalence between males and females. The major factors responsible are loss of life and property and uncertainty regarding future, harsh weather and repeated tremors.

Patients with PTSD have dysregulation of HPA axis response. This alteration is more pronounced in case of women. Studies show that estrogen plays important role in the genesis of disease. Dexamethasone suppression test also indicates greater dysregulation of glucocorticoid receptor. Studies reveal predisposition in women for PTSD and depression.

Women and children were affected most because most of them were at home and in schools. Hence, large number of women sustained more physical injuries and psychiatric consequences.

In our study depression came out to be more prevalent in females. This can be explained as comorbidity of PTSD and because of its own dynamics.