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Mental Health Problems in a Community After the Great East Japan Earthquake in 2011

A Systematic Review

Ando, Shuntaro MD, MScPH, PhD; Kuwabara, Hitoshi MD, PhD; Araki, Tsuyoshi MD, PhD; Kanehara, Akiko MScPH; Tanaka, Shintaro MA; Morishima, Ryo MA; Kondo, Shinsuke MD; Kasai, Kiyoto MD, PhD

doi: 10.1097/HRP.0000000000000124

Introduction On March 11, 2011, the Great East Japan Earthquake caused a tsunami and led to the collapse of the Fukushima-Daiichi Nuclear Power Plant, thus severely damaging the surrounding area.

Methods A systematic review was conducted in March 2015 with the following objectives: (1) to clarify the type, severity, and prevalence of mental health problems in the areas affected by the disaster, (2) to investigate trends in mental health problems over time, (3) to reveal demographic and socio-environmental characteristics associated with the post-disaster risk for developing mental health problems, and (4) to examine the impact of this natural disaster on the mental health of people in Fukushima.

Results Forty-two papers were included in this review. The reported prevalence of posttraumatic stress reaction exceeded 10% in all studies. While some longitudinal studies observed an improvement in posttraumatic stress reaction over time, none reported a decrease in depression. Most risk factors for mental health problems were related to resettlement of daily lives, preexisting illnesses, and social networks. Overall, the reported prevalence of posttraumatic stress reaction seemed to be higher in Fukushima than in other affected areas.

Conclusion Given that some mental health problems had not improved even two years after the disaster occurred, long-term mental health support is required for people in the affected area. Our finding that mental health problems seemed to be more severe in residents of Fukushima than among those in other areas suggests that residents in this prefecture require special care.

From the Department of Psychiatry and Behavioral Science, Tokyo Metropolitan Institute of Medical Science (Dr. Ando and Messrs. Tanaka and Morishima); Department of Neuropsychiatry, Graduate School of Medicine, the University of Tokyo (Drs. Ando, Kondo, and Kasai); Disability Services Office, the University of Tokyo (Dr. Kuwabara); Department of Youth Mental Health, Graduate School of Medicine, the University of Tokyo (Dr. Araki, Ms. Kanehara, and Messrs. Tanaka and Morishima).

Original manuscript received 12 October 2015; revised manuscript received 25 December 2015, accepted for publication subject to revision 1 February 2016; revised manuscripts received 4 February and 17 March 2016.

Supported, in part, by the Japan Ministry of Education, Culture, Sports, Science and Technology Grant-in-Aid for Scientific Research on Innovative Areas (grant no. 26118716 to Dr. Ando); Japan Society for the Promotion of Science KAKENHI (grant nos. 16H01689, JP16H06395, JP16H06399, and JP16K21720 to Dr. Kakai); and Japan Agency for Medical Research and Development Grants for Comprehensive Research for Persons with Disabilities (grant nos. 16dk0307066 and 16dk0307059 to Dr. Kakai).

Correspondence: Shuntaro Ando, MD, MScPH, PhD, 2-1-6 Kamikitazawa, Setagaya-ku, Tokyo, Japan. Email:

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© 2017 President and Fellows of Harvard College
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