TY - JOUR
T1 - Persistent mental health impacts of disaster. Five-year follow-up after the 2011 great east Japan earthquake and tsunami
T2 - Iwanuma Study
AU - Kino, Shiho
AU - Aida, Jun
AU - Kondo, Katsunori
AU - Kawachi, Ichiro
N1 - Funding Information:
We previously reported that housing damage was associated with an increased risk of short-term onset (2.5 years post-disaster) of PTSS (Hikichi et al., 2016). Interestingly, at the 5.5 year mark, we did not find any lingering impact of housing damage on PTSS. Previous studies of disaster survivors, e.g., the Indian Ocean tsunami, also suggest that posttraumatic stress reactivity was significantly linked to traumatic experiences (such as loss of kin and property damage) in the 1–2 year follow-up period (Frankenberg et al., 2008). Raker et al. also concluded that housing damage was a significant predictor of PTSS in the earlier follow-up of Hurricane Katrina victims while it was not a predictor in the long-term (Raker et al., 2019). Our findings also support the evidence that disaster-related traumatic experiences (such as loss of loved ones, housing damage) predict PTSS for up to 2.5 years, but that the effect fades by 5.5 years. On the other hand, the risk factors that predict persistent PTSS and delayed onset seem to be lingering economic circumstances, such as job loss and subjective financial hardship. This finding seems to converge with a recent study about the influence of COVID-19 pandemic on PTSS, which pointed a large impact of the expectation of economic hardship on mental health (Guo et al., 2020).We found a very strong association between pre-disaster depressive symptoms and persistent/delayed onset PTSS, which is very consistent with previous literature (Norris et al., 2002). Several reviews have also found that lack of social support is a predictor of long-term PTSD (Brewin et al., 2000; Galea et al., 2008b; Steinert et al., 2015). In the Iwanuma Study, people receiving more emotional support prior to the disaster appeared to be at lower risk of PTSS persistence & delayed onset, although the estimates were imprecise due to sample size (Table 2).We appreciate the support and cooperation of the Iwanuma Mayor's office, and the staff of the Department of Health and Welfare of Iwanuma city government. This work was supported by a grant from the National Institutes of Health (R01 AG042463); Grants-in-Aid for Scientific Research from the Japan Society for the Promotion of Science (KAKENHI 15H01972, KAKENHI 23243070, KAKENHI 22390400, KAKENHI 22592327 and KAKENHI 24390469); a Health Labour Sciences Research Grant from the Japanese Ministry of Health, Labour and Welfare (H22-Choju-Shitei-008, H24-Choju-Wakate-009 and H28-Chouju-Ippan-002); and a grant from the Strategic Research Foundation Grant-Aided Project for Private Universities from the Japanese Ministry of Education, Culture, Sports, Science and Technology (S0991035); Japan Agency for Medical Research and development (AMED) (JP17dk0110017, JP18dk0110027, JP18ls0110002, JP18le0110009). The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Funding Information:
We appreciate the support and cooperation of the Iwanuma Mayor's office, and the staff of the Department of Health and Welfare of Iwanuma city government . This work was supported by a grant from the National Institutes of Health ( R01 AG042463 ); Grants-in-Aid for Scientific Research from the Japan Society for the Promotion of Science (KAKENHI 15H01972 , KAKENHI 23243070 , KAKENHI 22390400 , KAKENHI 22592327 and KAKENHI 24390469 ); a Health Labour Sciences Research Grant from the Japanese Ministry of Health, Labour and Welfare (H22-Choju-Shitei-008, H24-Choju-Wakate-009 and H28-Chouju-Ippan-002); and a grant from the Strategic Research Foundation Grant-Aided Project for Private Universities from the Japanese Ministry of Education, Culture, Sports, Science and Technology ( S0991035 ); Japan Agency for Medical Research and development (AMED) ( JP17dk0110017 , JP18dk0110027 , JP18ls0110002 , JP18le0110009 ). The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Publisher Copyright:
© 2020 Elsevier Ltd
PY - 2021/4
Y1 - 2021/4
N2 - Few studies have tracked the long-term mental health outcomes following major disaster. We sought to document the trajectories of depressive symptoms and post-traumatic stress symptoms (PTSS) in the aftermath of the 2011 Great East Japan earthquake and tsunami. A cohort of community-dwelling older adults were followed for 5.5 years after the disaster at 3 waves (2010, 2013 and 2016). Depressive symptoms were measured by the Geriatric Depression Scale Short Form, while PTSS was assessed by the Screening Questionnaire for Disaster Mental Health. We examined the trajectories of mental illness symptoms based on the probabilities of persistence, recovery, and delayed onset. Among people without pre-disaster depressive symptoms, 13.6% had developed depressive symptoms 2.5 years after the disaster. Of these, half of those had recovered and half had persisted at the 5.5 year follow-up. 11.1% of survivors reported post-traumatic stress symptoms in 2013; of these, 58% recovered by 2016, while 4.8% experienced delayed onset. Job loss was associated with persistent PTSS (OR 2.03; 95%CI 1.01–4.12) while a drop in subjective economic status predicted delayed onset of PTSS (OR 2.13; 1.34–3.39). However, disaster-related experiences were unrelated to the trajectory of depressive symptoms at 5.5 years. The probabilities of remission (58%) and delayed onset (5%) of PTSS are consistent with prior disaster research. The experience of job loss and drop in subjective economic status appeared to exert a lingering influence on the persistence or delayed onset of PTSS. Depressive symptoms after the disaster had remitted in roughly half of the survivors after 5.5 years.
AB - Few studies have tracked the long-term mental health outcomes following major disaster. We sought to document the trajectories of depressive symptoms and post-traumatic stress symptoms (PTSS) in the aftermath of the 2011 Great East Japan earthquake and tsunami. A cohort of community-dwelling older adults were followed for 5.5 years after the disaster at 3 waves (2010, 2013 and 2016). Depressive symptoms were measured by the Geriatric Depression Scale Short Form, while PTSS was assessed by the Screening Questionnaire for Disaster Mental Health. We examined the trajectories of mental illness symptoms based on the probabilities of persistence, recovery, and delayed onset. Among people without pre-disaster depressive symptoms, 13.6% had developed depressive symptoms 2.5 years after the disaster. Of these, half of those had recovered and half had persisted at the 5.5 year follow-up. 11.1% of survivors reported post-traumatic stress symptoms in 2013; of these, 58% recovered by 2016, while 4.8% experienced delayed onset. Job loss was associated with persistent PTSS (OR 2.03; 95%CI 1.01–4.12) while a drop in subjective economic status predicted delayed onset of PTSS (OR 2.13; 1.34–3.39). However, disaster-related experiences were unrelated to the trajectory of depressive symptoms at 5.5 years. The probabilities of remission (58%) and delayed onset (5%) of PTSS are consistent with prior disaster research. The experience of job loss and drop in subjective economic status appeared to exert a lingering influence on the persistence or delayed onset of PTSS. Depressive symptoms after the disaster had remitted in roughly half of the survivors after 5.5 years.
KW - Depression
KW - Disaster victims
KW - Japan
KW - Natural disasters
KW - Post-traumatic stress disorders
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U2 - 10.1016/j.jpsychires.2020.08.016
DO - 10.1016/j.jpsychires.2020.08.016
M3 - Article
C2 - 32948310
AN - SCOPUS:85090977530
VL - 136
SP - 452
EP - 459
JO - Journal of Psychiatric Research
JF - Journal of Psychiatric Research
SN - 0022-3956
ER -