Mental Health Recovery of Evacuees and Residents from the Fukushima Daiichi Nuclear Power Plant Accident after Seven Years-Contribution of Social Network and a Desirable Lifestyle

Prevalence, incidence, and recovery of metabolic syndrome after the fukushima nuclear power plant disaster: A 10-year longitudinal study

After the 2011 Fukushima nuclear power plant accident, the prevalence of metabolic syndrome sharply increased in municipalities near the nuclear power plant, where a massive evacuation of community residents occurred (the evacuation area). However, after the initial increase, the rate of increase in metabolic syndrome in the evacuation area was slower than that in the surrounding area (non-evacuation area). In this study, we compared the incidence of and recovery from metabolic syndrome as well as its prevalence between evacuation and non-evacuation areas during the 10 years after the accident to explore whether the slower increase in metabolic syndrome after the initial increase in the evacuation area stemmed from suppressed incidence or from fast recovery. We analyzed specific health check-up data of community residents aged 40-74 in Fukushima Prefecture from fiscal year (FY) 2012 to FY 2021 (N = 710,201). To explore the prevalence of metabolic syndrome, we examined the associations of time, residential area, and their interaction with metabolic syndrome using mixed-model repeated measures. We used data from those without metabolic syndrome in FY 2012 to investigate the incidence. We similarly examined the associations of time, residential area, and their interaction with metabolic syndrome using FY 2013 to FY 2021 data. To explore recovery, we used the data of those with metabolic syndrome in FY 2012 and repeated the same procedure. The rate of increase in the prevalence and incidence of metabolic syndrome was slower in the evacuation area than in the non-evacuation area. On the other hand, as for the recovery, the time trend of metabolic syndrome did not differ between the two areas. The slower increase in metabolic syndrome in the evacuation area was partly explained by the slower incidence in the evacuation area but not by recovery.

Relationship between physical activity and individual mental health after traumatic events: a systematic review

Background: Traumatic events can cause social tension, anxiety, panic and other psychological crises, and can even cause post-traumatic stress disorder (PTSD) and suicide. Physical activity has a good role in promoting mental health, and has a great application prospect in individual psychological intervention after traumatic events. However, no systematic review of the relationship between physical activity and individual mental health after traumatic events affecting many people has been published so far, which makes it impossible for people to understand the research status in this field from a holistic perspective.Objective: This review explores the relationship between physical activity and individual psychology, physiology, subjective quality of life and well-being after traumatic events, so as to provide some valuable clues or enlightenment for individual psychological intervention after traumatic events.Method: Relevant literature was searched in five databases, summarised, sorted and studied.Results: Thirty-three study papers were included in this review, the main study findings include: (1) Physical activity is positively correlated with individual mental resilience and subjective well-being after traumatic events, and negatively correlated with anxiety, depression, tension and PTSD. (2) Individuals with higher levels of physical activity have better mental health status after traumatic events than those who do not regularly engage in physical activity. (3) Physical activity can promote sleep quality, self-efficacy, subjective quality of life and various physiological functions of those experiencing traumatic events. (4) Physical activity (including exercise) is regarded as one of the preferred nursing measures to buffer against mental stress and maintain physical and mental health for those experiencing traumatic events.Conclusion: The level of physical activity is positively correlated with individual physical and mental health before and after traumatic events. Physical activity can be used as one of the effective measures to improve individual mental health after traumatic events.

Nuclear Radiation Knowledge and Anxiety Levels among Residents around a Nuclear Power Plant in Liaoning Province, China

Awareness of radiation-related knowledge (RRK) and nuclear energy-related knowledge (NERK) among residents around a nuclear power plant (NPP), as well as their concerns about a NPP, were investigated. A face-to-face survey was conducted among 1,775 residents within 30 km around the NPP in Liaoning Province, China. A single-item Likert scale, Spearman's/Pearson's correlation coefficients, Student's t-test, ANOVA, and multiple-linear regression analysis were employed. Awareness of RRK and NERK among residents around the NPP was 27.7% and 36.6%, respectively. The anxiety level of respondents was negatively corelated with the distance from their residence to the NPP and age. Also, 55.6% of respondents thought that the publicity about nuclear energy/NPPs was insufficient, and 82.7% of respondents wanted to know relevant information about NPPs. Awareness of RRK and NERK among residents around the NPP was relatively low, which was related to education, occupation, and income. The anxiety level among residents was related to distance and age. The public was eager to know about RRK and NERK. These findings indicate that the publicity and education of RRK and NERK among residents around the NPP should be strengthened.

Disaster Resilience Reduces Radiation-Related Anxiety Among Affected People 10 Years After the Fukushima Daiichi Nuclear Power Plant Accident

This study examined whether disaster resilience affects the recovery of mental health states and mitigates psychosocial anxiety 10 years later the Fukushima Daiichi nuclear power plant accident. The survey was conducted in Fukushima's evacuation-directed and non-evacuation-directed areas in January 2020. The 695 participants responded to a questionnaire including items on radiation-related anxiety regarding the Fukushima Daiichi accident, an action-oriented approach as a resilience factor, psychological distress, and demographic information. The structural equation modeling showed that the action-oriented approach also eased radiation-related anxiety by mediating with improving mental health states. Moreover, a multi-group model analysis was conducted for evacuation-directed and non-directed areas. In the evacuation-directed area, we found stronger associations among resilience, mental health states, and radiation-related anxiety, and a direct effect of resilience factors on radiation risk anxiety. These findings emphasize the importance of resilience in post-disaster contexts, at least for a decade, where mental health deteriorates and various psychosocial issues become more complex.

LIFE SATISFACTION AND FACTORS AFFECTING SATISFACTION IN KAWAUCHI VILLAGE RESIDENTS AT 10 Y AFTER THE FUKUSHIMA DAIICHI NUCLEAR POWER PLANT ACCIDENT

We assessed the life satisfaction and related factors, including the mental health state, of residents of Kawauchi village, Fukushima Prefecture. Among the 374 residents who responded, 237 (63.4%) were satisfied with their current life. Of all respondents, 275 (73.5%) had a sense of belonging to the Kawauchi village community and 158 (42.2%) thought that Kawauchi had recovered after the Fukushima Daiichi Nuclear Power Station (FDNPS) accident. Regression analysis revealed that post-traumatic stress disorder checklist-Specific score, sense of belonging to the Kawauchi village community, opinion that Kawauchi village had recovered, timing of return to Kawauchi <2 y and concern about consumption of mushrooms and wild plants from Kawauchi were independently associated with life satisfaction. Although 10 y have passed since the FDNPS accident, it is necessary to continue with risk communication, particularly for new residents of Kawauchi.

Evaluation of Residents' Timing of Return to or New Settlement in Kawauchi Village, at 10 Years after the Fukushima Daiichi Nuclear Power Plant Accident

Kawauchi village in Fukushima prefecture was affected by the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident, and residents had to evacuate from their hometown in 2011. This study clarified the timing and related factors with regard to residents returning to or newly settling in Kawauchi. A survey was conducted using a questionnaire, from February to March 2021, with assistance from the Kawauchi village office and post office. Of the 374 residents, 170 (45.5%) had returned to or newly settled in Kawauchi within the past 2 years (group 1), 84 (22.5%) in the past 2-5 years (group 2), and 99 (26.5%) after more than 5 years (group 3) following the evacuation order. An additional 21 residents (5.5%) who had lived in Kawauchi at the time of the FDNPP had not yet returned (group 4). Compared with the other groups, residents in group 1 were more satisfied with their current lives and were coping better with stress. Even though they had experienced a serious nuclear disaster, residents of Kawauchi village who returned to their hometown in the early phase had a high sense of satisfaction with their current life one decade after the FDNPP accident.

Psychologic distress and QOL in medical staff after a disaster: A longitudinal 4-year study

Aiming to improve post-disaster care of medical staff, we conducted an early and ongoing assessment of post-disaster psychologic distress and quality of life (QOL) in one center of a disaster-response hospital. Twelve days after the Great East Japan Earthquake, as the Fukushima Daiichi Nuclear Power Plant crisis was unfolding, we began a survey to examine the physical and mental state of medical staff to assess their motivation toward work. Surveys were administered in March 2011 (Survey 1), March 2012 (Survey 2), March 2013 (Survey 3), March 2014 (Survey 4), and March 2015 (Survey 5). Participants completed the Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), EuroQol (EQ-5D), and MOS Short-Form 36-item Health Survey (SF-36). Although BDI scores significantly improved over time following Survey 1, participants in their 30s had significantly higher Survey 2 scores than those in their 40s/50s, and significantly higher Survey 3 scores than those in their 20s. STAI scores significantly improved over time following Survey 1. However, participants in their 30s had significantly higher Survey 3 scores than those in their 20s. EQ-5D scores did not significantly vary among survey time points or age groups. SF-36 physical functioning, role physical, social functioning, role emotional, and mental health subscale scores significantly improved over time. In conclusion, post-disaster longitudinal changes, including recovery period, differed among age groups. Thus, age should be taken into account in longitudinal evaluations of psychologic distress and QOL in medical staff after a disaster and, as more recent events suggest, during a pandemic.

Those Who Have Continuing Radiation Anxiety Show High Psychological Distress in Cases of High Post-Traumatic Stress: The Fukushima Nuclear Disaster

Background: this cross-sectional study aimed to clarify the associations among media utilization, lifestyles, and the strong radiation anxiety that has persisted 9 years after the 2011 nuclear accident. Moreover, the relationships among psychological distress, post-traumatic stress, and strong radiation anxiety were examined. Methods: for the multivariate regression analysis, the independent variables were radiation anxiety at the time of the accident and the current status, categorized as “continuing/emerging strong radiation anxiety”. Media utilization (local, national, internet, and public broadcasts, and public relations information) and lifestyle variables (sleep quality, regular exercise, and drinking habits) were set as the dependent variables. Moreover, the psychological distress of residents with continuing/emerging strong radiation anxiety was examined by an analysis of covariance stratified by post-traumatic stress. Result: there was no significant association between lifestyle variables and media utilization, except for local media (OR: 0.435, 95% CI: 0.21–0.90). Conversely, significantly high psychological distress was confirmed among residents with continuing/emerging radiation anxiety. The K6 score, representing psychological distress, for those with higher post-traumatic stress was 12.63; for those with lower post-traumatic stress, it was 5.13 (p = 0.004). Conclusions: residents with continuing/emerging strong radiation anxiety showed high psychological distress, which has been strengthened by higher post-traumatic stress.

Trends in Suicide Mortality in 10 Years around the Great East Japan Earthquake: Analysis of Evacuation and Non-Evacuation Areas in Fukushima Prefecture

This study analyzed the suicide mortality rate in 12 municipalities in Fukushima Prefecture designated as evacuation areas following the 2011 nuclear disaster. Changes in suicide rates were examined using an exponential smoothing time series model. In the evacuation areas, the suicide rate of men increased immediately after the disaster and then decreased from 47.8 to 23.1 per 100,000 during about 1½ years after the disaster. However, with the lifting of the evacuation order, it again exceeded that of non-evacuation areas and continued to do so for the next 3 years. On the other hand, the suicide rate in women in the evacuation areas increased later than that in men. These results indicate the need for continuous support following the lifting of the evacuation order. In addition, it is necessary to enhance social networks, which continue to confer protection, because of the isolation of the elderly as highlighted in our previous study.

Current Psychological Distress, Post-traumatic Stress, and Radiation Health Anxiety Remain High for Those Who Have Rebuilt Permanent Homes Following the Fukushima Nuclear Disaster

Objective: The Fukushima Daiichi nuclear disaster in 2011 produced psychological reactions among evacuees. Despite the harsh situation, subsequently, there has been gradual progress in reconstruction, with more than half of the evacuees returning after the evacuation. Our hypothesis is that evacuee mental health will now be better due to new stable living conditions. This study aims to clarify the statuses of psychological distress, post-traumatic stress, and radiation health anxiety among evacuees who have rebuilt permanent homes after evacuation. Methods: A cross-sectional questionnaire survey of 1600 residents was conducted in 2020. As primary outcomes, the survey measured psychological distress (Kessler 6), post-traumatic stress (post-traumatic stress four-item checklist), and radiation health anxiety. The data are compared for residents who have rebuilt permanent home and those who did not evacuate. Results: In the co-variant analysis, the statuses of psychological distress (p < 0.001), post-traumatic stress (p < 0.001), and radiation health anxiety (p < 0.001) are found to still be high, with significant differences when compared to those who did not evacuate. These results are still at an equivalent level for the continuing evacuation. Conclusion: Our findings may indicate a necessity for continuing disaster-related mental health activities even though the living conditions have improved.

Re-Increased Male Suicide Rates in the Recovery Phase Following the Great East Japan Earthquake

Abstract. Background: Monitoring of suicide rates in the recovery phase following a devastating disaster has been limited. Aim: We report on a 7-year follow-up of the suicide rates in the area affected by the Great East Japan Earthquake, which occurred in March 2011. Method: This descriptive study covered the period from March 2009 to February 2018. Period analysis was used to divide the 108-month study period into nine segments, in which suicide rates were compared with national averages using Poisson distribution. Results: Male suicide rates in the affected area from March 2013 to February 2014 increased to a level higher than the national average. After subsequently dropping, the male rates from March 2016 to February 2018 re-increased and showed a greater difference compared with the national averages. The difference became significant in the period from March 2017 to February 2018 ( p = .047). Limitations: Specific reasons for increasing the rates in the recovery phase were not determined. Conclusion: The termination of the provision of free temporary housing might be influential in this context. Provision of temporary housing was terminated from 2016, which increased economic hardship among needy evacuees. Furthermore, disruption of the social connectedness in the temporary housing may have had an influence. Our findings suggest the necessity of suicide rate monitoring even in the recovery phase.

Resilience Factors Contributing to Mental Health Among People Affected by the Fukushima Disaster: Development of Fukushima Resilience Scale

Aim: The aims of the present study were to develop and validate a psychological resilience scale reflecting the specificity of the Fukushima disaster, and to examine the effects of this scale on mental health.

Methods: The Fukushima Resilience Scale was developed based on data obtained from semi-structured interviews with seven people who had lived in the affected area of Fukushima Prefecture at the time of the disaster. The reliability and validity of the scale were then examined in cross-sectional studies conducted on 500 evacuees through an epidemiological mail survey. To examine the effects of the scale and disaster-related factors on the general mental health status of the respondents, a logistic regression analysis was performed using the six-item Kessler psychological distress scale.

Results: The newly developed scale consisted of a four-factor structure: “coping with stigma-related issues,” “sharing experiences of the disaster,” “action-oriented approach,” and “sense of support.” Internal consistency coefficients ranged from 0.66 to 0.79. The multivariable logistic regression analysis showed that the only significant association was between “action-oriented approach” (odds ratio = 1.26) and respondents with a K6 score <5 points.

Conclusion: The reliability and concurrent validity of the new developed scale in residents of the evacuation area of Fukushima Prefecture were acceptable. A significant association was found between “action-oriented approach” and good mental health among the evacuees, which suggests that this may improve resilience among people affected by the Fukushima disaster.