Mental Health Problems in a Community After the Great East Japan Earthquake in 2011: A Systematic Review

Development and validation of the Earthquake Obsession Scale

Earthquakes are natural disasters that are very destructive and whose timing is unknown. These disasters can have a very negative effect on people's mental health, and their effects can last for many years. This study examined the psychometric properties of a scale to measure earthquake obsession. Data were collected from adults living in different provinces of Türkiye (N = 732), who completed the new scale, Doomscrolling Scale, Death Distress Scale, and Mental Well-Being Scale. The Earthquake Obsession Scale (EOS) had a two-factor structure, good internal consistency reliability, and convergent and discriminant validity. Correlational analysis revealed that earthquake obsession was positively associated with doomscrolling and death anxiety, and negatively associated with well-being. Mediation analysis indicated that doomscrolling and death distress mediated the relationship between earthquake obsession and well-being. The results emphasized the potential of earthquake obsession to affect daily life negatively and revealed its relationship with psychological variables.

Associations between media exposure and mental health among children and parents after the Great East Japan Earthquake

Background: Exposure to natural disaster media coverage is associated with mental health problems, but its long-term impacts are still unclear. Also, no study has analysed the psychological impact of exposure to natural disaster media coverage among children who are generally sensitive to threatening events.Objective: We aimed to examine how television images of victims after the 2011 Great East Japan Earthquake were associated with mental health among children and their parents.Methods: In 2012, questionnaires for sociodemographic factors were distributed to 2053 families. Parents who provided written consent were contacted in 2013 and invited to provide information on mental health problems (outcome) and retrospectively provide information on television watching at the time of the earthquake (exposure). We used data from 159 parents who completed the survey as the final sample. We used a dichotomous variable to evaluate exposure to media coverage. Multivariable regression was used to examine the association between exposure to television images of victims and mental health, adjusting for potential confounders. Bias-corrected and accelerated bootstrap confidence intervals (CIs) were used.Results: Exposure to television images of victims was significantly associated with worse psychopathology among children (β, 1.51; 95% CI, 0.07-2.96) and greater psychological distress among their parents (β, 1.49; 95% CI, 0.28-2.70). Child psychopathology and parental psychological distress were significantly correlated (r = 0.36, p < .001).Conclusions: Exposure to television images of disaster victims may produce long-term impacts on mental health among children and their parents. To reduce the likelihood of mental health problems associated with disasters, clinicians may recommend reducing exposure to television images of victims.

Changes in substance use and engagement in gaming/gambling in persons with severe mental illness during the COVID-19 pandemic and earthquakes: a community study in two points

Introduction

External stressors, such as COVID-19 pandemic and earthquake, can cause an increase in substance use and addictive behavior in persons with severe mental illnesses (SMI). We analyzed the changes and predictors of substance use and addictive behavior in SMI during these double disasters in Croatia.

Methods

Questionnaires exploring the presence of substance or behavior addiction disorder, mental ill health [Depression Anxiety Stress Scales-21 (DASS-21), Insomnia Severity Index (ISI), Perceived Stress Scale (PSS), Obsessive-Compulsive Inventory-Revised], coping mechanisms, and perceived social support [Multidimensional Scale of Perceived Social Support (MSPSS)] were administered among 90 participants with SMI included in the RECOVER-E study in May/June 2020 (first COVID-19 wave, Zagreb earthquake) and in December 2020/January 2021 (second COVID-19 wave, Petrinja earthquake).

Results

In both time points, a major increase was observed in tobacco smoking (25.0%; 28.6%, respectively) predicted by discontinuation of antidepressants and higher DASS-21 score. Increased sedative use was observed (24.4%; 23.8%, respectively) predicted by higher PSS and ISI scores, lower MSPSS scores, antipsychotic discontinuation and not receiving community mental health team (CMHT) service.

Discussion

In persons with SMI during a double disaster special attention needs to be given to reducing mental-ill health and stress, providing social support and continuity of psychiatric care, through medications and CMHTs.

The Impact of Moderate Earthquakes on Antidepressant Prescriptions in Ulsan, South Korea: A Controlled Interrupted Time Series Analysis

BACKGROUND

In 2016, two consecutive moderate magnitude earthquakes occurred in Ulsan, South Korea. Therefore, we aimed to investigate the impact of earthquakes on the mental health of residents in Ulsan.

METHODS

We used data from the 2015-2017 Korean Health Insurance Review & Assessment Service National Patient Sample. We conducted an interrupted time series analysis using location-based controls. Changes in the number of antidepressants, benzodiazepines, and zolpidem prescriptions in Ulsan were compared to controls. Overall changes in weekly prescriptions 1 year after the first earthquake, compared to a non-earthquake scenario, were estimated.

RESULTS

In antidepressant prescriptions, the increase in trend after an earthquake was significantly higher than controls. However, the changes in benzodiazepines and zolpidem prescribing were not significant. Overall, the impact of the earthquake on weekly antidepressant prescriptions at 1 year was estimated as a 1.32 (95% CI, 1.18-1.56) rate ratio compared to the non-earthquake scenario. This corresponded to an increase of 1,989.7 (95% CI, 1,202.1-3,063.0) in the number of prescriptions. Among subgroups, the increase was highest among males aged 20-39 years.

CONCLUSION

The moderate earthquake in Ulsan was associated with an increase in antidepressant prescriptions. The increase in the male group aged 20-39 was the highest. The impact may vary according to the context of the population.

Mental health and resilience after the covid-19 pandemic: a multi-ethnic longitudinal survey

BACKGROUND

Longitudinal work on the impact of COVID-19 on population mental health and resilience beyond the first year of the pandemic is lacking. We aimed to understand how mental health and resilience evolved during the pandemic (2020) and two years later (2022) in a multi-ethnic Singaporean population. In addition, we assessed what characteristics were associated with mental health and resilience scores.

METHODS

We surveyed and analysed two balanced panel samples up to four times between 30th April 2020 and 11th July 2022. One panel assessed psychological distress (Kessler-10) and well-being (short Warwick Edinburgh Mental Well-being scale) n = 313, and one panel assessed resilience (10-item Connor-Davidson Resilience Scale©) n = 583. A linear panel regression model with random effects assessed the temporal patterns for psychological distress, well-being, and resilience.

RESULTS

Mean psychological distress scores (Kessler-10) were relatively stable over time and were not statistically significantly worse than baseline at any follow-up. Well-being scores improved over time and were significantly better than baseline by the third survey (22nd Jul-18th Aug 2020) (0.54 p = 0.007, Cohen's d 0.12). Scores had worsened by the last survey (27th June-11th July 2022) but were not significantly different from baseline 0.20 p = 0.30. Resilience scores declined over time. Scores at both follow-ups (14th Aug- 4th Sep 2020 and 27th June-11th July 2022) were statistically significantly lower than baseline: -1.69 p < 0.001 (Cohen's d 0.25) and -0.96 p = 0.006 (Cohen's d 0.14), respectively.

CONCLUSIONS

Our study joins a body of work measuring the longitudinal effects of COVID-19 on population mental health and resilience. While, the magnitude of the effect related to resilience decline is small, our findings indicate that particular attention should be given to ongoing population surveillance, with the aim of maintaining good health and well-being.

Investigation of the Relationship Between Mental Health Status and Sleep Patterns of Children Who Experienced the Kahramanmaraş Earthquake: Data From the Earthquake Region

BACKGROUND

The psychological conditions of children exposed to earthquakes, such as somatization, obsessive-compulsive, hostility, and paranoid thought, have not been adequately studied.

AIM

This study was conducted to examine the relationship between the mental states and sleep patterns of children who experienced the Kahramanmaraş earthquake.

METHOD

This is a descriptive, cross-sectional, and relational study that included 867 children from 11 provinces of Turkey affected by the earthquake that occurred in Kahramanmaraş on February 6th. The Child Follow-up Form, Mental Symptom Screening Scale, and Child Sleep Habits Scale were used to collect data.

RESULTS

The psychological symptoms (anxiety, depression, somatization, anger-hostility, obsessive-compulsive symptoms, interpersonal sensitivity, phobic anxiety, paranoid ideation, psychotic symptoms, and other issues) experienced by children after the earthquake explained 96.9% of their sleep disturbance. Some of the demographic characteristics, such as age, the status of experiencing loss in the earthquake, the survival status of their mother and father, the survival status of their siblings, the total number of losses after the earthquake, the total number of losses in the nuclear family, total hours spent under the rubble, the hours children waited for their father, mother, and siblings to come out of the rubble, accounted for 77.9% of the mental symptoms (SCL-90).

CONCLUSIONS

These results showed the importance of early recognition and treatment of sleep disturbances to prevent possible psychiatric disorders after children have been exposed to natural disasters. It is of great importance to evaluate the mental states of children after the earthquake and to apply appropriate psychiatric interventions.

Does disaster-related relocation impact mental health via changes in group participation among older adults? Causal mediation analysis of a pre-post disaster study of the 2016 Kumamoto earthquake

BACKGROUND

Disaster-related relocation is associated with depression and post-traumatic stress disorder, especially in older adults. Disaster-related relocation often deprives survivors of opportunities for social group participation, potentially deteriorating their mental health. On the contrary, the relocation could also be an opportunity for optimizing social relationships, ending/reducing unwanted participation. This study examined the potential mediation effects of changing participation for the link of disaster-related relocation to mental health.

METHODS

We analyzed a pre-post disaster dataset of functionally independent older adults from the Japan Gerontological Evaluation Study. Following the 2013 survey, a follow-up survey was conducted seven months after the 2016 Kumamoto earthquake (n = 828).

RESULTS

The causal mediation analyses indicated that compared to no relocation, the relative risk for experiencing major depressive episodes among those relocating to temporary housing was 3.79 [95% confidence interval: 1.70-6.64] (natural direct effect). By contrast, the relative risk for those renewing (either ceased or started) group participation was 0.60 [95% CI: 0.34-0.94] (natural indirect effect).

CONCLUSIONS

Optimization of social ties according to a renewal of group participation status might have protected older adults in temporary housing against depression.

Post-traumatic stress disorder and its associated factors among survivors of 2015 earthquake in Nepal

BACKGROUND

Natural disasters cause long term psychological consequences, especially post-traumatic stress disorders. It has been regarded as the most prevalent of psychiatric disorders after a natural disaster. The purpose of this study is to estimate the prevalence of Post-Traumatic Stress Disorder (PTSD) and determine its associated factors in adult survivors three years after the 2015 Nepal earthquake.

METHODS

A cross-sectional descriptive design was used where 1076 adults within the age range of 19-65 were randomly selected and interviewed from four adversely affected districts due to the 2015 earthquake. Instruments included a demographic questionnaire, an earthquake exposure questionnaire, the Oslo Social Support Scale (OSSS), and the Post-traumatic Stress Disorder Checklist-Civilian Version (PCL-C). Descriptive and inferential statistics were applied using Statistical Package for Social Science (SPSS) Version 16 for data analysis.

RESULTS

The prevalence of PTSD among earthquake survivors was 18.9%. The multivariate logistic regression showed that gender, ethnicity, education, occupation, social support and severity of damage to house and property were significantly associated with PTSD. Odds of having PTSD was 1.6 times higher among females (AOR = 1.6, 95% CI: 1.1-2.3) and nearly 2 times higher amongst illiterate survivors (AOR = 1.9, 95% CI: 1.2-2.8). Participants from the Janajati ethnic group and those who had a business occupation had a 50% lower risk of having PTSD. Around 39% of the participants had moderate social support and had 60% lower odds of having PTSD compared to those with poor social support (AOR = 0.4, 95%CI: 0.2-0.5, p < 0.001). Participants with medium and very high-level damage to personal property were more likely to have PTSD.

CONCLUSION

Post-traumatic stress disorder remained prevalent amongst survivors three years after the 2015 Nepal Earthquake. It is important to provide psychological and social support for survivors to decrease the health burden from PTSD. Socio-demographic characteristics such as females, farmers, those survivors who endured significant personal property damage were at higher risk.

The Suicidal Ideation of Disaster Victims: A Nationwide Cross-Sectional Study

Purpose

Various natural and human made disasters occur worldwide. This study aimed to identify the factors affecting suicidal ideation in victims of disasters such as typhoons, heavy rainfall, fires, and earthquakes.

Methods

Data were obtained from a long-term survey on life changes among disaster victims conducted in 2019 by the National Disaster Management Research Institute. The study included 2234 victims of natural and social disasters occurring in Korea between 2012 and 2018. Suicidal ideation was assessed using the Korean version of the Composite International Diagnostic Interview developed by the World Health Organization. The participants' demographic characteristics, disaster-related characteristics, physical characteristics, psychological characteristics, and social characteristics were analyzed as the influencing factors. The data were analyzed using the chi-square test, t-test, and logistic regression.

Results

Of the 2234 subjects in this study, 32 were disaster victims who had experienced suicidal ideation, accounting for 1.4%. The results showed that the factors affecting suicidal ideation included disaster-related injury/disease, depression, and social support. The odds ratio of suicidal ideation was higher when there was injury/disease (OR=1.89, 95% CI=0.07-0.48), with higher depression levels (OR=1.31, 95% CI=1.18-1.47) and with lower social support (OR=0.94, 95% CI=0.90-0.99).

Conclusion

This study identifies the significant influencing factors of suicidal ideation in disaster victims, which were as follows: disaster-related injury or disease, depression, and social support. Our study's findings would contribute to screening high-risk groups of suicidal ideation and developing effective support, interventions, and suicide prevention programs for disaster victims. Furthermore, to prevent suicide and promote the healthy recovery of disaster victims, mental health care services aimed at suicide prevention should be reinforced and the victims should be provided with psychological support and treatment without financial burden.

Long term mental health trajectories after disasters and pandemics: A multilingual systematic review of prevalence, risk and protective factors

The patterns of long-term psychological response after disasters and pandemics remain unclear. We aimed to determine the trajectories for post-traumatic stress symptoms (PTSS), depression and anxiety prevalence following disasters and pandemic exposure; and identify associated risk and protective factors. A systematic review of the English, Chinese, and Japanese longitudinal mental health literature was conducted. We searched Cochrane, MEDLINE, ProQuest, PsycINFO, PubMed, Web of Science, and CINAHL (English), CNKI and SINOMED (Chinese) and CiNii (Japanese) for studies published between January 2000 and May 2022. Following a pre-specified protocol (PROSPERO: CRD42020206424), conditional linear growth curve models and ANOVA analyses were conducted. The search identified 77,891 papers, with a final sample of 234: 206 English, 24 Chinese, and 4 Japanese-language papers. PTSS rates improved for all ages (p = .018, eta² = 0.035). In contrast, depression and anxiety prevalence remained elevated for years following exposure (p = .424, eta² = 0.019 and p = .051, eta² = 0.064, respectively), with significantly higher rates for children and adolescents (p < .005, eta² > 0.056). Earthquakes and pandemics were associated with higher prevalence of PTSS (p < .019, eta² > 0.019). Multi-level risk and protective factors were identified. The chronicity of mental health outcomes highlights a critical need for tailored, sustainable mental health services, particularly for children and adolescents, in disaster- and pandemic-affected settings.

Lessons learned from psychosocial support and mental health surveys during the 10 years since the Great East Japan Earthquake: Establishing evidence-based disaster psychiatry

Post-disaster mental health and psychosocial support have drawn attention in Japan after the 1995 Great Hanshin-Awaji Earthquake, with mental health care centers for the affected communities being organized. After the catastrophe, a reconstruction budget was allocated to organize mental health care centers to provide psychosocial support for communities affected by the 2007 Chūetsu offshore earthquake, the 2011 Great East Japan Earthquake, and the 2016 Kumamoto Earthquake. There were several major improvements in post-disaster mental health measures after the Great East Japan Earthquake. The Disaster Psychiatric Assistance Team system was organized after the earthquake to orchestrate disaster response related to the psychiatric health system and mental health of the affected communities. Special mental health care efforts were drawn to the communities affected by the nuclear power plant accident through Chemical, Biological, Radiological, Nuclear, and high yield Explosives, being succeeded by measures against the coronavirus pandemic. As another new movement after the Great East Japan Earthquake, the number of surveys involving communities affected by disasters has soared. More than 10 times the number of scientific publications were made in English during the decade following the Great East Japan Earthquake, compared with the previous decades. In this review, we examined the results and issues acquired in the 10 years since the Great East Japan Earthquake, proposing evidence-based disaster psychiatry as the direction of future mental health measures related to emergency preparedness and response.

PTSD and Depression 8 Years After the 2004 Tsunami in Sri Lanka

OBJECTIVES

To evaluate prevalence and risk factors of posttraumatic stress disorder (PTSD) and depression among directly exposed (DE) and indirectly or nonexposed (INE) populations in Sri Lanka 8 y after the Indian Ocean Tsunami in 2004.

METHODS

Population-based structured survey study was conducted among Sri Lankan adults living in 5 coastal districts, Hamboantha, Matara, Galle, Kalutara, and Colombo in 2012-2013. A total of 430 individuals, 325 in DE, 105 in INE, participated in the survey. DE and INE groups were compared for demographics and outcomes. Bivariate and multiple logistic regressions with backward selection were used to identify risk factors for partial PTSD and depression.

RESULTS

The prevalence of PTSD, partial PTSD and depression were 2.8%, 10.5%, and 18.8% in DE group, respectively. In multivariable analyses tsunami exposure, female gender, subjective physical health before the tsunami, previous trauma, and depression were significantly associated with partial PTSD. Female gender, high frequency of religious activity, previous trauma, social support, and PTSD were significantly associated with depression.

CONCLUSIONS

The psychological impacts of the tsunami did wane over time, but still present at lower rate even in 8 y. It is important to address these lingering sequelae and expand access to at risk individuals.

Depression, Insomnia, and Probable Post-Traumatic Stress Disorder among Survivors of the 2016 Kumamoto Earthquake and Related Factors during the Recovery Period Amidst the COVID-19 Pandemic

The aftereffects of the severe 2016 Kumamoto earthquake were complicated by the COVID-19 pandemic. This study aimed to identify mental health problems and related factors among survivors five years after the earthquake and clarify its long-term effects. A cross-sectional survey was conducted in 2020 among 19,212 survivors affected by the earthquake who moved from temporary to permanent housing. We analysed 8966 respondents (5135 women, 3831 men; mean age 62.25 ± 17.29 years). Logistic regression analysis was conducted to examine associations between mental health problems and socioeconomic factors. Prevalence rates of psychological distress, insomnia, and probable post-traumatic stress disorder were 11.9%, 35.2%, and 4.1%, respectively. Female gender (OR = 1.33, 95% CI = 1.13–1.57; OR = 1.21, 95% CI = 1.08–1.34; OR = 1.81, 95% CI = 1.41–2.32), public housing (OR = 2.14, 95% CI = 1.63–2.83; OR = 1.54, 95% CI = 1.26–1.88; OR = 2.41, 95% CI = 1.62–3.58), loneliness (OR = 9.08, 95% CI = 7.71–10.70; OR = 5.55, 95% CI = 4.90–6.30; OR = 3.52, 95% CI = 2.77–4.49), COVID-19-induced activity reduction (OR = 1.41, 95% CI = 1.19–1.66; OR = 1.86, 95% CI = 1.68–2.07; OR = 1.80, 95% CI = 1.40–2.31), and COVID-19-induced income reduction (OR = 1.33, 95% CI = 1.12–1.57; OR = 1.43, 95% CI = 1.28–1.59; OR = 1.92, 95% CI = 1.51–2.43) were significantly associated with mental health problems. These results suggest that gender, current housing, loneliness, and COVID-19 affected the survivors’ mental health during recovery.

Clinical Features of Patients With Heart Failure After the 2016 Kumamoto Earthquakes

OBJECTIVE

Acute and chronic stress after severe earthquakes can contribute to cardiovascular events, including heart failure (HF). On April 14, 2016, magnitude 7 earthquakes occurred in the Aso region in the western part of Japan. This study aimed to investigate the clinical characteristics of HF in this area after these earthquakes.

METHODS

We investigated the clinical characteristics and 1-y mortality rate of patients with HF. Nutritional status was evaluated with the Geriatric Nutritional Risk Index (GNRI) and the Prognostic Nutritional Index (PNI).

RESULTS

Among a total of 58 cardiovascular events, HF was the most frequently observed (n = 28). The mean age of individuals with HF was 85.5 y. The total incidence of HF was significantly higher compared with the average of the prior 2 y. Disaster influence on mental health was suggested by patient history in 20 patients (71%). The 1-y mortality rate among patients with HF was 50%. Among those who died, 93% had malnutrition status (GNRI <92 and /or PNI ≤38).

CONCLUSIONS

Our results demonstrated the poor prognosis of patients with HF following the disaster. The prevalence of malnutrition was high in those patients. Careful follow-up is necessary, especially for older people with frailty.

Gender differences in trajectories of mental health symptoms among Chinese earthquake survivors

BACKGROUND

Posttraumatic stress symptoms and depressive symptoms are prevalent after natural disasters. However, in a Chinese trauma context, little research examined the long-term trajectories of these two symptoms with a gender perspective.

METHODS

Data came from an 8-year longitudinal survey of 3522 Wenchuan earthquake adult survivors. We used multilevel growth-curve models to investigate the trajectories of PTSS and depressive symptoms; adopted conditional growth-curve models to explore the gender differences in trajectories together with gendered factors associated with mental health symptoms; conducted Chow tests to examine the significance of gender differences. Standardized coefficients, P values, and effect sizes were reported.

RESULTS

With covariates controlled, both linear (β = -1.33, p < 0.001, Cohen's d = 0.79) and quadratic effects (β = 1.03, p < 0.001, Cohen's d = 0.59) of time were significant in PTSS trajectory, whereas quadratic effect (β = 0.27, p < 0.001, Cohen's d = 0.14) in the declining depressive trajectory was clinically nonsignificant. Compared with men, women are at higher risk of PTSS (β = 0.12, p < 0.001, Cohen's d = 0.21) and depressive symptoms (β = 0.10, p < 0.001, Cohen's d = 0.20), but also with a faster-declining rate in PTSS within first five years after the disaster. No gender difference was found regarding depressive trajectory. Additionally, poor education and income associate with more PTSS in women, while sickness predicts severer depression in women and more PTSS in men.

CONCLUSIONS

This study proposes a gendered U-shape trajectory for PTSS and a declining depressive trajectory without gender difference. The findings of this study shed light on mental health intervention in future natural disasters.

The Effect of Post-Traumatic Stress Disorder on Women After The Earthquake in Central Sulawesi

Background: Posttraumatic stress disorder (PTSD) is a psychological disorder caused by uncommon occurrences such as threats or catastrophic events. Women are particularly susceptible to developing PTSD, as they have a range of threat perceptions. Purpose: The aim of this study was to examine the effect of PTSD on women survivor of the earthquake in the Sigi Biromaru sub-district of Central Sulawesi. Methods: This was a descriptive study conducted using a cross-sectional design. The population for this study were housewives who have been displaced by the earthquake and are currently residing in temporary shelters (Huntara) in a village located in the Sigi Biromaru sub-district. The instrument used in this study was the PTSD measurement questionnaire sheet. It was conducted from March to April 2020 and included a total of 115 participants. Univariate analysis was used to determine the respondents’ characteristics, including their age, education, occupation, income, and a description of the PTSD condition. Results: The results show that the majority of respondents experienced severe PTSD (70.43%). Most of the respondents (35.65%) were between the ages of 37 and 46, were senior high school graduates (40%), were unemployed (74%), and had earnings of < 2,500,000 (85.22%). Three variables that affect PTSD are education with a p-value of 0.03 < 0.05, job/occupation with a p-value of 0.02 < 0.05, and income with a p-value of 0.03 < 0.05. Conclusion: Women who are elderly, have a low level of education, are unemployed, and have low income are more vulnerable to experiencing PTSD.

Psychological Well-Being in Chinese College Students During the COVID-19 Pandemic: Roles of Resilience and Environmental Stress

Psychological well-being is an important indicator of well-being and has been found to be associated with a multitude of positive life outcomes. Using data collected from 1,871 Chinese college students from September 23 to October 5, 2020, this study examined students' psychological well-being during the COVID-19 pandemic and investigated how resilience and pandemic-related environmental stress may affect psychological well-being. Results showed that resilience had strong positive effects on psychological well-being during the pandemic. Meanwhile, environmental stress had a moderate effect and marginally reduced psychological well-being. The magnitudes of the estimates suggested that increasing resilience can effectively buffer the negative effect of environmental stress on psychological well-being.

Trajectories of peer relationship problems and emotional symptoms in children 5 years after a nuclear disaster: Fukushima Health Management Survey

The Fukushima Daiichi Nuclear Power Station (NPS) accident, which occurred in March 2011, is having long-term effects on children. About 3 years after the accident, we identified three patterns of peer relationship problems and four patterns of emotional symptoms using group-based trajectory modeling. As a result, we reported that different factors might be related to very severe trajectories of peer relationship problems and emotional symptoms. In this study, we used five waves of data from fiscal year (FY) 2011 to FY2015 from the Mental Health and Lifestyle Survey, a detailed survey of the Fukushima Health Management Survey started in FY2011. We analyzed 7013 residents within the government-designated evacuation zone (aged 6-12 years old as of 11 March 2011) with responses to all items of psychological distress in at least one wave from FY2011 and FY2015. We planned this study to describe the trajectories of peer relationship problems and emotional symptoms in children and to examine potential risks and protective factors over the 5 years following the NPS accident. We identified four patterns of peer relationship problems and five patterns of emotional symptoms using latent class growth analysis. For peer relationship problems, male sex, experiencing the NPS explosion and lack of exercise habits were associated with the severe trajectory group. For emotional symptoms, experiencing the NPS explosion, experiencing the tsunami disaster and lack of exercise habits were associated with the severe trajectory group. Exercise habits are very important for the mental health of evacuees after a nuclear disaster.

How Does Reciprocal Exchange of Social Support Alleviate Individuals' Depression in an Earthquake-Damaged Community?

There is ample evidence to indicate the direct effects of receiving social support on mental health during and after a disaster. However, the importance of reciprocal exchanges of social support (i.e., balanced receipt and provision of social support) in maintaining the mental health status of individuals is not widely recognized. Using equity theory and reciprocity norms as a conceptual base, we distinguished two types of social support, namely, emotional support and instrumental support, and examined the effects of reciprocal exchanges of types of support on depression in survivors of an earthquake-damaged community. To collect data, in 2019, a questionnaire survey was conducted among 295 survivors of the 2015 Gorkha Earthquake in a rural village in Nepal. Our results showed that the relationship between reciprocal exchange of support and depression varied depending on the types of support. The amount of emotional support received by the individual alleviated his/her depression only when accompanied by giving emotional support. By contrast, the net amount of instrumental support given by the individual increased his/her depression. The practical implications of the study are discussed.

Mental health consequences for survivors of the 2011 Fukushima nuclear disaster: a systematic review. Part 1: psychological consequences

To integrate scholastic literature regarding the prevalence and characteristics of the psychological consequences faced by survivors of the 2011 Fukushima earthquake/tsunami/nuclear disaster, we conducted a systematic review of survivor studies concerning the Fukushima disaster. In August 2019, four literature databases (PubMed, PsycINFO, Psychology and Behavioral Sciences Collection, and ICHUSHI) were used in the literature search. Peer-reviewed manuscripts reporting psychological consequences, either in English or Japanese, were selected. A total of 79 studies were selected for the review. Twenty-four studies (30.4%) were conducted as part of the Fukushima Health Management Survey-large-scale cohort study recruiting the residents of the entire Fukushima prefecture. Study outcomes were primarily nonspecific psychological distress, depressive symptoms, post-traumatic stress symptoms, and anxiety symptoms. The rates of high-risk individuals determined by the studies varied significantly owing to methodological differences. Nevertheless, these rates were mostly high (nonspecific psychological distress, 8.3%-65.1%; depressive symptoms, 12%-52.0%; and post-traumatic stress symptoms, 10.5%-62.6%). Many studies focused on vulnerable populations such as children, mothers of young children, evacuees, and nuclear power plant workers. However, few studies reported on the intervention methods used or their effect on the survivors. As a conclusion, high rates of individuals with psychological conditions, as well as a wide range of mental conditions, were reported among the Fukushima nuclear disaster survivors in the first 8 years after the disaster. These findings demonstrate the substantial impact of this compound disaster, especially in the context of a nuclear catastrophe.

Onset and remission of common mental disorders among adults living in temporary housing for three years after the triple disaster in Northeast Japan: comparisons with the general population

Background

People living in temporary housing for long periods after a disaster are at risk of poor mental health. This study investigated the post-disaster incidence and remission of common mental disorders among adults living in temporary housing for the 3 years following the 2011 Great East Japan Earthquake.

Methods

Three years after the disaster, face-to-face interviews were conducted with 1089 adult residents living in temporary housing in the disaster area, i.e., the shelter group, and a random sample of 852 community residents from non-disaster areas of East Japan. The World Health Organization Composite International Diagnostic Interview was used to diagnose DSM-IV mood, anxiety, and alcohol use disorders. Information on demographic variables and disaster experiences was also collected.

Results

Response rates were 49 and 46% for the shelter group and the community residents, respectively. The incidence of mood/anxiety disorder in the shelter group was elevated only in the first year post-disaster compared to that of the general population. The rate of remission for mood and anxiety disorders was significantly lower in the shelter group than in the community residents. The proportion seeking medical treatment was higher in the shelter group.

Conclusions

The onset of common mental disorders increased in the first year, but then levelled off in the following years among residents in temporary housing after the disaster. Remission from incident post-disaster mental disorders was slower in the shelter group than in the general population. Post-disaster mental health service could consider the greater incidence in the first year and prolonged remission of mental disorders among survivors with a long-term stay in temporary housing after a disaster.

Living in temporary housing and later psychological distress after the Great East Japan Earthquake of 2011: A cross-lagged panel model

Living in temporary housing is a risk factor for psychological distress after a natural disaster. As temporary housing is an essential resource for those affected by disasters, investigation of factors which potentially mediate living in temporary housing and psychological distress is needed. This is a cohort study in general population of areas affected by the Great East Japan Earthquake in 2011. Data were obtained from self-report questionnaires in annual health checks between 2014 and 2016 regarding residential situation (e.g., prefabricated or privately-rented temporary housing), psychological distress, sleep disturbances, social support, and covariates. Mediation effects of sleep disturbances and social support on the relationship between temporary housing and psychological distress were evaluated using a cross-lagged panel model during three time points. Among 3,116 participants in 2014, approximately 12% lived in prefabricated or privately-rented temporary housing. Living in prefabricated (β = 0.046, p = 0.031) and privately-rented temporary housing (β = 0.043, p = 0.042) predicted later psychological distress. There was no mediation effect by sleep disturbances (prefabricated temporary housing: β = 0.001, p = 0.620; privately-rented temporary housing: β = −0.001, p = 0.467) or social support (prefabricated temporary housing: β < 0.001, p = 0.748; privately-rented temporary housing: β < 0.001, p = 0.435). CLPM also showed no relationship between living in temporary housing and increased sleep problems or decreased social support. Mental health support may be required for residents who lived in prefabricated or privately-rented temporary housing three years after a natural disaster, whereas support focusing only on sleep disturbances or social support in residents who lived in temporary housing may not be enough to contribute to reducing psychological distress.

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This study investigated mediators on link temporary housing and distress following natural disaster.

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Living in prefabricated and privately-rented temporary housing was associated with distress.

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However, this link was not mediated by sleep disturbances or social support.

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Mental health support may be required for individuals who lived in temporary housing.

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Support focusing only on sleep disturbances or social support may not be enough to contribute to reducing distress.

Spatio-temporal distribution of negative emotions on Twitter during floods in Chennai, India, in 2015: a post hoc analysis

Background

Natural disasters are known to take their psychological toll immediately, and over the long term, on those living through them. Messages posted on Twitter provide an insight into the state of mind of citizens affected by such disasters and provide useful data on the emotional impact on groups of people. In 2015, Chennai, the capital city of Tamil Nadu state in southern India, experienced unprecedented flooding, which subsequently triggered economic losses and had considerable psychological impact on citizens. The objectives of this study are to (i) mine posts to Twitter to extract negative emotions of those posting tweets before, during and after the floods; (ii) examine the spatial and temporal variations of negative emotions across Chennai city via tweets; and (iii) analyse associations in the posts between the emotions observed before, during and after the disaster.

Methods

Using Twitter’s application programming interface, tweets posted at the time of floods were aggregated for detailed categorisation and analysis. The different emotions were extracted and classified by using the National Research Council emotion lexicon. Both an analysis of variance (ANOVA) and mixed-effect analysis were performed to assess the temporal variations in negative emotion rates. Global and local Moran’s I statistic were used to understand the spatial distribution and clusters of negative emotions across the Chennai region. Spatial regression was used to analyse over time the association in negative emotion rates from the tweets.

Results

In the 5696 tweets analysed around the time of the floods, negative emotions were in evidence 17.02% before, 29.45% during and 11.39% after the floods. The rates of negative emotions showed significant variation between tweets sent before, during and after the disaster. Negative emotions were highest at the time of disaster’s peak and reduced considerably post disaster in all wards of Chennai. Spatial clusters of wards with high negative emotion rates were identified.

Conclusions

Spatial analysis of emotions expressed on Twitter during disasters helps to identify geographic areas with high negative emotions and areas needing immediate emotional support. Analysing emotions temporally provides insight into early identification of mental health issues, and their consequences, for those affected by disasters.

Nurses' experience in providing care at shelters following natural hazards and disasters: a qualitative systematic review protocol

OBJECTIVE

The review will synthesize current evidence regarding the experiences of nurses who care for people living in shelters following natural hazards and disasters.

INTRODUCTION

Over the last decade, due to climate change and global warming, the damage caused by natural hazards and disasters like hurricanes, floods and heavy rainfall has been steadily growing. Following natural hazards and disasters, many who lose their homes reside in evacuation shelters for prolonged periods. The loss of medical infrastructure in disaster-stricken areas can result in evacuees' health being compromised and the spread of disease and/or infection. Under such circumstances, disaster relief nurses can play a critical role in supporting these victims. This review aims to provide useful information for nurses who are working in disaster shelters.

INCLUSION CRITERIA

The review will include qualitative studies examining experiences of nurses caring for people living in shelters following natural hazards and disasters, published in either English or Japanese. Studies published from 2000 to the present will be considered.

METHODS

The review will follow the meta-aggregation approach developed by JBI. Published and unpublished studies will be searched using major international databases and other relevant databases for gray literature in either English or Japanese. Two reviewers will independently appraise studies and extract qualitative data using the JBI standardized critical appraisal and extraction instruments. Findings from the review will be categorized according to their similarity in meaning and their categories subjected to a meta-synthesis to produce a single comprehensive set of synthesized findings. The final synthesized findings will be graded according to the ConQual approach.

Did the Number of Older People Requiring Long-Term Care and Expenditure Increase after the 2011 Great East Japan Earthquake? Analysis of Changes over Six Years

On 11 March 2011, the great earthquake hit Japan, resulting in 15,895 deaths, 6156 serious injuries, and 2539 missing persons. This event affected the health and lives of older residents, and reports showed an increase in the number of people eligible for long-term care afterward. In this study, among the places affected by the 2011 Great East Japan Earthquake and tsunami, we focused on 15 municipalities, including designated municipalities based on the Special Act on Nuclear Evacuation in Fukushima Prefecture, and aimed to clarify the medium-term effects (six years post-disaster) on the long-term care certification rate and expenditure for provision of services. We used the Ministry of Health, Labour, and Welfare Monthly Status Report on Long-Term Care Insurance and the Ministry of Internal Affairs and Communications Population Register for 2011, 2014, and 2017. In 2011, we found no intergroup differences among the 15 Fukushima municipalities and other municipalities in either the long-term care certification rate or the per-person expenditure for use of services. In 2014, after the earthquake, the long-term care certification rate was 5.4% higher in the 15 Fukushima municipalities than in other municipalities for those aged 75 years or older. The rate of 2014-2017 has not increased significantly, partly because of stability after the disaster and change in the population structure. Nevertheless, the long-term care certification rate in the 15 Fukushima municipalities is higher than that of the other two groups even after six years since the earthquake. Similarly, the per-person expenditure for use of services for one month was 11,800 yen higher in the 15 Fukushima municipalities than in other municipalities in 2014, and this trend continued into 2017. Strong, ongoing governmental support is needed, especially for those aged 75 or older, following a disaster.

Neighborhood Ties Reduced Depressive Symptoms in Older Disaster Survivors: Iwanuma Study, a Natural Experiment

Objective: As most studies relating to mental health and disasters have employed cross-sectional or follow-up assessments about psychological health with post-disaster information, the association between changes in social ties and mental health remains unclear. We examined the relationship between the changes in survivor neighborhood ties and depressive symptoms before and after a natural disaster. Methods: Participants were 3567 individuals aged ≥65 years living in Iwanuma city who had responded to questionnaires by the Japan Gerontological Evaluation Study both predating the 2011 Great East Japan Earthquake and Tsunami, and 2.5 years afterward. Changes in the depressive symptoms were assessed using the geriatric depression scale (GDS) at the baseline and follow-up survey. Changes in the neighborhood ties were assessed by asking the participants about their interactions with people in their neighborhood. Possible confounders were adjusted in a linear regression model. Results: Among the 3111 participants in this analysis, 1073 (34.5%) had increased GDS score after the disaster. There were 336 (10.8%) individuals who had neighborhood ties before the disaster, but had no ties afterward; their mean GDS score increased from 2.93 points in 2010 to 3.19 points in 2013. Among those who had not had ties before and after the disaster the mean GDS score remained almost stable, from 2.19 points in 2010 to 2.12 points in 2013. The participants with post-disaster ties were significantly less likely to have an increased GDS score compared with those who had not had ties before and after the disaster (β = −0.39; 95% confidence interval: −0.72, −0.06). Conclusions: Increased neighborhood ties after the disaster reduced the risk of depressive symptoms even when survivors suffered disaster damages. The study reinforces the importance of social capital in disaster recovery and suggests to local governments and local communities that fostering horizontal, neighborhood ties may improve disaster preparedness and mental health resilience.

Temporal Transitions in Patterns of Posttraumatic Stress Disorder and Depression Among Adolescents Following the Wenchuan Earthquake

Posttramatic stress disorder (PTSD) and depression are persistent disorders with heterogeneous comorbidity. Cross-sectional design limitations have prevented previous studies from examining symptom pattern transitions, which limits the understanding on the change of mental health over time since trauma. This study examined transition patterns of PTSD and depression comorbidity and assessed the role of personality. PTSD, depression, and personality scales were used to assess 619 adolescents 1 year after the Wenchuan earthquake and then to longitudinally assess 332 adolescents 2 years post-earthquake. Data were analyzed using latent transition analysis and logistic regression. Four PTSD and depression comorbidity patterns were identified at both times: moderate comorbidity, high comorbidity, no symptoms, and depression. Patterns of PTSD and depression changed in 23.4% of adolescents: 4.4% and 7.1% transitioned from no symptoms to depression and from depression to moderate comorbidity, respectively; 7.5% transitioned from moderate comorbidity to depression. Extraversion and conscientiousness were more likely and openness was less likely to be associated with moderate comorbidity symptoms transitioned to depression symptoms. These findings indicated that patterns of PTSD and depression in adolescents are heterogeneous and show temporal change.

Medium- and long-term health effects of earthquakes in high-income countries: a systematic review and meta-analysis

Background

Accurate monitoring of population health is essential to ensure proper recovery after earthquakes. We aimed to summarize the findings and features of post-earthquake epidemiological studies conducted in high-income countries and to prompt the development of future surveillance plans.

Methods

Medline, Scopus and six sources of grey literature were systematically searched. Inclusion criteria were: observational study conducted in high-income countries with at least one comparison group of unexposed participants, and measurement of health outcomes at least 1 month after the earthquake.

Results

A total of 52 articles were included, assessing the effects of 13 earthquakes that occurred in eight countries. Most studies: had a time-series (33%) or cross-sectional (29%) design; included temporal comparison groups (63%); used routine data (58%); and focused on patient subgroups rather than the whole population (65%). Individuals exposed to earthquakes had: 2% higher all-cause mortality rates [95% confidence interval (CI), 1% to 3%]; 36% (95% CI, 19% to 57%) and 37% (95% CI, 29% to 46%) greater mortality rates from myocardial infarction and stroke, respectively; and 0.16 higher mean percent points of glycated haemoglobin (95% CI, 0.07% to 0.25% points). There was no evidence of earthquake effects for blood pressure, body mass index or lipid biomarkers.

Conclusions

A more regular and coordinated use of large and routinely collected datasets would benefit post-earthquake epidemiological surveillance. Whenever possible, a cohort design with geographical and temporal comparison groups should be used, and both communicable and non-communicable diseases should be assessed. Post-earthquake epidemiological surveillance should also capture the impact of seismic events on the access to and use of health care services.

Environmental Exposures and Depression: Biological Mechanisms and Epidemiological Evidence

Mental health and well-being are consistently influenced—directly or indirectly—by multiple environmental exposures. In this review, we have attempted to address some of the most common exposures of the biophysical environment, with a goal of demonstrating how those factors interact with central structures and functions of the brain and thus influence the neurobiology of depression. We emphasize biochemical mechanisms, observational evidence, and areas for future research. Finally, we include aspects of contextual environments—city living, nature, natural disasters, and climate change—and call for improved integration of environmental issues in public health science, policies, and activities. This integration is necessary for reducing the global pandemic of depression.

A bibliometric analysis of health-related literature on natural disasters from 1900 to 2017

BACKGROUND

Worldwide, natural disasters have caused a large number of deaths and considerable morbidity. Nevertheless, limited information is available on how the health-related literature on natural disasters has evolved. The current study aims to assess the growth and pattern of health-related literature on natural disasters.

METHOD

A bibliometric method was implemented using Scopus database for the period from 1900 to 2017. Keywords used in the search strategy were obtained from the classifications of natural disasters presented by the Centre for Research on the Epidemiology of Disasters. The health component was determined by selecting the health-related subject areas in Scopus.

RESULTS

In total, 9073 documents were retrieved. The annual number of publications showed a noticeable sharp increase after 2004. The retrieved documents received 97,605 citations, an average of 10.8 per document. The h-index of the retrieved documents was 113. Author keywords with the highest occurrence were 'earthquakes' followed by 'disaster medicine', 'disaster planning', 'tsunami', 'mental health', 'disaster preparedness', 'PTSD', 'emergency preparedness', and 'public health'. Authors from the United States of America contributed to 3127 (34.5%) publications and ranked first, followed by those from Japan (700; 7.7%) and China (636; 7.0%). When research output was standardised by Gross Domestic Product per capita, India ranked first, followed by China and the United States. The United Kingdom had the highest percentage of documents with international authors, followed by those from Switzerland and Canada. The Prehospital and Disaster Medicine journal published the most articles (636; 7.0%). The Sichuan University and its affiliated hospital contributed to 384 (7.0%) documents and ranked first in the field.

CONCLUSION

The current baseline information on health-related literature on natural disasters showed that this field is growing rapidly but with inadequate international research collaboration. Research collaboration in this field needs to be strengthened to improve the global response to natural disasters in any place in the world. There is a need to expand the research focus in this field to include communicable and non-communicable diseases. Finally, the health effects of other natural disasters, such as floods, droughts and disease outbreaks, need to be addressed.

Stress and the Mental Health of Populations of Color: Advancing Our Understanding of Race-related Stressors

This article provides an overview of research on race-related stressors that can affect the mental health of socially disadvantaged racial and ethnic populations. It begins by reviewing the research on self-reported discrimination and mental health. Although discrimination is the most studied aspect of racism, racism can also affect mental health through structural/institutional mechanisms and racism that is deeply embedded in the larger culture. Key priorities for research include more systematic attention to stress proliferation processes due to institutional racism, the assessment of stressful experiences linked to natural or manmade environmental crises, documenting and understanding the health effects of hostility against immigrants and people of color, cataloguing and quantifying protective resources, and enhancing our understanding of the complex association between physical and mental health.

High prevalence of toothache among Great East Japan Earthquake survivors living in temporary housing

OBJECTIVES

The Great East Japan Earthquake and subsequent tsunami cause large-scale destruction in the north-eastern coastal areas in Japan, and forced many survivors to relocate to prefabricated temporary housing, a typical emergency accommodation. Based on the hypothesis that higher toothache prevalence among the disaster survivors is associated with postdisaster distress, we determined the impact of temporary residential environment as potential stressor on the subjective toothache prevalence.

METHODS

A repeated cross-sectional health survey based on self-reported questionnaire was conducted in 2776 disaster survivors, of whom 1446 participants underwent dental examination by dentists. Housing type was categorized into three groups including the same housing as before the earthquake, temporary housing and rented/new housing. The association of housing type with subjective toothache prevalence was examined using multivariate logistic regression analysis in all subjects and subgroup analysis in dental examination applicants. Stratified analysis by survey wave was applied with inclusion of covariates such as the socio-demographic factors, and presence of insomnia and psychological distress. In subgroup analysis, presence of dental caries and gum problems in dental examination were included as factors of direct exposure to subjective toothache.

RESULTS

In the first survey wave, the participants living in the temporary housing had significantly higher odds ratio (OR) for toothache prevalence compared to the participants living in the same housing (OR: 3.76, 95% confidence interval [CI]: 1.85-7.65, P < 0.001); whereas in all other survey waves, there was no significant difference. Subgroup analysis of dental examination applicants confirmed the presence of significant association of subjective toothache prevalence in the temporary housing group alone (OR: 3.27, 95% CI: 1.38-7.76, P = 0.004), but not in the rented/new housing group (OR: 1.50, 95% CI: 0.57-3.91, P = 0.411), even after adjusting for covariates related to oral findings.

CONCLUSION

Temporary housing may be a factor to increase the risk of subjective toothache among disaster survivors only at postdisaster acute phase.

Pre-disaster PTSD as a moderator of the relationship between natural disaster and suicidal ideation over time

BACKGROUND

Natural disasters are associated with a variety of negative health consequences, including enhanced suicide risk. Factors that moderate the relationship between disaster exposure and enhanced suicide risk are unknown. The aim of the current study was to determine whether pre-disaster PTSD moderates the association between change over time in thoughts of death, suicidal ideation (SI), suicide plans, and suicide attempts (SA) from pre- to post-disaster.

METHODS

Participants (n = 2832) were recruited from Chile as part of the larger PREDICT study and completed a measure of lifetime PTSD and panic disorder at baseline and a lifetime death/suicide measure at baseline in 2003 and again 6, 12, and 24 months later (i.e. "pre-disaster"). One year following a major earthquake and tsunami in 2010 (i.e., "post-disaster"), participants completed another death/suicide measure.

RESULTS

Both those with and without pre-disaster PTSD experienced significant increases in SI from pre- to post-disaster. However, pre-disaster PTSD was associated with significantly accelerated increases in thoughts of death and SI from pre-to post-disaster. At nearly all time-points, pre-disaster PTSD was associated with higher thoughts of death and SI, suicide planning, and SA. In contrast, panic disorder did not moderate the association between time and changes in SI.

LIMITATIONS

There was a long time-gap between pre-disaster and post-disaster, with limited data about what occurred during this time.

CONCLUSION

Pre-disaster PTSD is an important predictor of increased SI following a natural disaster, and groups with pre-disaster PTSD should be prioritized for receipt of mental health resources following a natural disaster.

Trajectories of Emotional Symptoms and Peer Relationship Problems in Children after Nuclear Disaster: Evidence from the Fukushima Health Management Survey

The Fukushima Daiichi Nuclear Power Plant accident, which occurred in March 2011, is having long-term effects on children. We planned this study to describe the trajectories of emotional symptoms and peer relationship problems in children and to examine potential risks and protective factors over the 35 months following the accident. The sample was 11,791 children in the first to sixth elementary grades. We identified four patterns for emotional symptoms and three patterns for peer relationship problems, using group-based trajectory modelling. For emotional symptoms, female gender, experience of tsunami and nuclear plant accident, out-of-prefecture evacuees, and insufficient physical activity were associated with the very severe trajectory. In contrast, for peer relationship problems, male gender, experience of nuclear plant accident, and insufficient physical activity were associated with the very severe trajectory. Different factors might be related to the very severe trajectories of emotional symptoms and peer relationship problems.

Trends in psychological distress and alcoholism after The Great East Japan Earthquake of 2011

AIMS

Many studies have shown that natural disasters affect mental health; however, longitudinal data on post-disaster mental health problems are scarce. The aims of our study were to investigate the trend in psychological distress and alcoholism after The Great East Japan Earthquake and tsunami in north eastern Japan, in March 2011.

METHODS

A longitudinal study was conducted using annual health check data for the general population, in the city of Higashi-Matsushima, which was affected by the high impact of tsunami. In 2012 and 2013, the Kessler Psychological Distress Scale and the CAGE questionnaire (for screening for alcoholism) were used to assess psychological distress and prevalence of alcoholism.

RESULTS

Of 11,855 total eligible residents, 2192 received the annual check in 2012 and 2013. The prevalence of mental illness and the mean score of alcoholism tendency increased during the follow-up period. The majority of respondents (43.8%) with baseline serious mental illness (SMI) continued to have SMI at follow-up; only 16.7% reported recovering. Older age, female sex, and severity of home damage predicted higher psychological distress, while male sex was a risk factor for alcoholism at follow-up.

CONCLUSIONS

Psychological distress deteriorated 2 years after the huge natural disaster, compared with 1 year after the disaster. Long-term mental health care is needed for those affected by natural disasters, particularly those who have suffered loss.