The mental health status of children who have been evacuated or migrated from rural areas in Fukushima prefecture after the Fukushima daiichi nuclear power station accident: results from the Fukushima health management survey

Introduction: We evaluated the mental health status of children residing in Kawauchi village (Kawauchi), Fukushima Prefecture, after the 2011 accident at the Fukushima Daiichi Nuclear Power Station, based on the children’s experience of the nuclear disaster. Methods: We conducted this cross-sectional study within the framework of the Fukushima Health Management Survey (FHMS); FHMS data on age, sex, exercise habits, sleeping times, experience of the nuclear disaster, and the “Strengths and Difficulties Questionnaire (SDQ)” scores for 156 children from Kawauchi in 2012 were collected. Groups with and without experience of the nuclear disaster — “nuclear disaster (+)” and “nuclear disaster (−)” — were also compared. Results: Our effective response was 93 (59.6%); the mean SDQ score was 11.4±6.8 among elementary school-aged participants and 12.4±6.8 among junior high school-aged ones. We statistically compared the Total Difficulties Scores (TDS) and sub-item scores of the SDQ between “elementary school” and “junior high school” or “nuclear disaster” (+) and (−). There was no significant difference between these items. Conclusions: We found indications of poor mental health among elementary and junior high school-aged children in the disaster area immediately following the accident, but no differences based on their experience of the nuclear disaster. These results indicate the possibility of triggering stress, separate to that from experiences related to the nuclear disaster, in children who lived in affected rural areas and were evacuated just after the nuclear disaster.     

Changes in drinking behavior among evacuees after the Fukushima Daiichi Nuclear Power Plant accident: the Fukushima Health Management Survey

Introduction Traumatic experiences and disordered sleep are strongly associated with drinking problems. We examined the effects of experiencing the Great East Japan Earthquake and subsequent nuclear power plant accident, and of sleep problems, on behavioral changes observed in non-drinkers. Methods This study examined cross-sectional data from the Mental Health and Lifestyle Survey conducted among residents in restricted areas of Fukushima in 2012. Participants were 21,454 evacuees aged 20 years or older at the time of disaster. People who did not drink before the disaster but became drinkers afterwards were compared with the rest of the cohort. We analyzed the association between behavioral changes in non-drinkers and potentially predictive variables, using logistic regression. Results The behavioral change of non-drinkers becoming drinkers (n=2,148) was significantly related to being male (OR=1.93, 95% CI: 1.74-2.15), being younger (21-49 yrs, OR=1.85, 95% CI: 1.60-2.13), having less educational attainment (up to high school graduate, OR=1.21, 95% CI: 1.09-1.35), smoking (OR=1.22, 95% CI: 1.08-1.38), losing family or relatives (OR=1.21, 95% CI: 1.07-1.37), change in employment (OR=1.19, 95% CI: 1.07-1.32), having severe sleep problems as measured by a Japanese version of the Athens Insomnia Scale (3-8, OR=1.45, 95% CI: 1.30-1.62), and severity of traumatic symptoms as measured by the PTSD Checklist Stressor-Specific (PCL-S) score (<44, OR=1.33, 95% CI: 1.17–1.51). Conclusion Having sleep problems and having more severe traumatic symptoms are significantly related to non-drinkers becoming drinkers.     

An American hibakusha in Fukushima

A magnitude 9.0 earthquake and tsunami originating off the east coast of Japan triggered the explosive release of radioactive isotopes from one of four nuclear power plants in the affected area. This event has been compared with the 1986 nuclear accident at Chernobyl, the 1945 atomic bombing of Hiroshima and Nagasaki, and the intervening era of atmospheric nuclear weapons testing. The credibility of any comparison depends on the source, for which reason various specialists were invited to address an audience of media, healthcare, and disaster response professionals on July 18, 2011 in Fukushima City, Fukushima Prefecture. This article is based on a presentation given July 18, and interprets the Fukushima nuclear crisis from the perspective of an American doctor who grew up downwind of an atomic bomb test site, and who now works at Fukushima Medical University.     

IAEA consultancy meeting on low-dose radiation for patients and population

This paper reports on the IAEA’s Consultancy Meeting on “low-dose radiation for patients and population —Science, Technology and Society (STS) concepts for communication and perception among medical doctors and stakeholders—”, which was held on October 21 and 22, 2020. The meeting consisted of seven presentation sessions, with a total of 27 presentations and 39 participants from seven countries. The meeting focused on various areas including environmental, food, and personal dosimetry; radiation and other secondary health effects after nuclear disasters; communication between medical professionals and patients or residents; and medical education on nuclear accidents. This meeting was convened to discuss STS perspectives related to nuclear emergencies, to share the findings of the Fukushima Health Management Survey and the current situation in Fukushima with international experts. The meeting confirmed the importance of coordinated recovery of affected areas and global preparedness in the aftermath of nuclear accidents.     

Lessons from Chernobyl

The Chernobyl disaster on April 26th, 1986, led to the emission of radioactive substances such as iodine-131 and radioactive cesium. As the Soviet Union did not control food distribution and intake, residents were exposed to high levels of internal radiation, leading to the internal radiation exposure of the thyroid gland by iodine-131. As a result, the number of people who had thyroid cancer increased drastically among those who had been under 15 years old at the time of the accident. The age predilection is about to move to 25 or older. However, there has been no scientific evidence of impacts for solid tumor other than thyroid cancer, leukemia, benign diseases, or inheritance including unborn babies. On the other hand, the accident was thought to have caused social unrest and mental damage which had far more impact than that caused by radiation exposure. In this paper, we would like to summarize the impacts on the health of the people in Chernobyl compared to those caused by the accident at the Fukushima Daiichi Nuclear Power Plant.     

日本福岛核电站事故对人体健康影响及医学防护

日本福岛核电站事故对人类的危害可能仅次于前苏联的切尔诺贝利核电站事故,此次事故对抢险人员、附近居民和受放射性污染人员带来的健康影响,既有近期辐射损伤,也有远期生物效应,主要是以小剂量照射的远期辐射生物效应为主;飘落到我国的微量放射性尘埃远不足以对人体构成损伤.防护方面主要是利用房屋、衣物、口罩等进行屏蔽,及时清洗去除放...     

汶川地震后1月内脱离/未脱离震区的亲历者PTSD筛查阳性的发生及心理影响因素

目的：探讨汶川地震后1月内脱离/未脱离震区的亲历者创伤后应激障碍(posttraumatic stress disorder, PTSD)筛查阳性的发生及心理健康的影响因素。方法：对什邡地区235人(现场组, 称A组)、转入湘雅二医院住院的伤病员44人(伤病员组, 称B组)及家属36人(家属组, 称C组)采用事件影响量表修订版等进行心理评估。结果：(1)灾后1月内PTSD筛查总阳性率为35.56%,女性明显高于男性(χ2=16.27,P＜0.001);A组、B组和C组PTSD筛查阳性率分别为39.15%, 31.82%和16.67%,差异有统计学意义(χ2mh=5.243,P＜0.05);在PTSD筛查阳性者的3组人群中,A组在“麻木/回避”和“过度唤起”症状得分上明显高于B组和C组(均P＜0.01)。(2)A组和B组的“焦虑”、“抑郁”和“躯体化”因子得分均明显高于C组(均P＜0.05);(3)性别、居住地和是否脱离震区是PTSD症状的影响因素。结论：震后1月内对亲历者的心理影响较大,PTSD症状群、焦虑与抑郁症状是其主要心理问题,尤其是女性群体,应予更多关注。早期脱离震区环境、扩大和强化支持系统是其保护性因素。早期心理干预有助于提高亲历者的心理承受力,有效预防PTSD的发生。     

Smoking and mental health: results from a community survey

OBJECTIVE: To assess the relationship of smoking with depression and anxiety symptoms and with risk factors for depression. DESIGN AND SETTING: A community survey conducted in Canberra in 1997. PARTICIPANTS: 2725 persons aged 18-79 sampled from the electoral roll. MAIN OUTCOME MEASURES: Smoking was investigated in relation to psychiatric symptoms (anxiety, depression, alcohol misuse), sociodemographic characteristics (age, sex, education, occupational status), social stressors (divorce, unemployment, financial difficulties, negative life events, childhood adversity), personality (extraversion, neuroticism, psychoticism), and social support (family and friends). RESULTS: Smokers had more depression and anxiety symptoms, more stressors and lower socioeconomic status compared with non-smokers. The association between smoking and psychiatric symptoms persisted even when stressors, socioeconomic characteristics and other factors were statistically controlled. CONCLUSIONS: Smoking is associated with poorer mental health. In helping patients to give up smoking, doctors need to be aware that some may have underlying mental health problems that require attention.     

汶川地震丧亲与非丧亲者创伤后应激障碍焦虑和抑郁情绪的对比研究

目的 探讨在地震灾害发生半年后丧亲者与非丧亲者创伤后应激障碍、焦虑和抑郁的关系及对比情况.方法 采用一般情况凋查表、创伤后应激障碍(PTSD)检查表、贝克抑郁量表(BDI)、汉密尔顿焦虑量表(HAMA)在地震半年后对都汀堰灾区安置点的人群560人进行调查.结果 10.9%的被调查者在地震中丧失亲人.丧亲组符合PTSD症状诊断的比例(44.4%)显著高于非丧亲组(15.1%)(t=4.737,P<0.05).丧亲组中重度抑郁、焦虑和自杀观念的发生率分别为55.5%、44.4%和44.5%显著高于非丧亲组17.4%、16.7%和14.2%(χ~2=46.522,P<0.01).丧亲组符合PTSD症状诊断者中合并中重度抑郁的占79.2%,合并焦虑或明显焦虑的占75%;中重度抑郁中合并焦虑或明显焦虑的占83.4%.抑郁总分、焦虑总分、既往焦虑、噩梦、丧亲后感到寂寞为丧亲者创伤后应激障碍症状的预测因素.结论 地震灾区丧亲者的抑郁、焦虑、自杀观念及符合PTSD症状诊断的均较非丧亲者高.丧亲人群的抑郁、焦虑及PTSD症状三者共病率高.丧亲者PTSD症状的预测因素足多方面的.     

汶川地震后6个月安县受灾群众创伤后应激障碍(PTSD)的发生率及相关因素的分析

目的:汶川地震震后6个月安县受灾群众创伤后应激障碍(PTSD)发生率、症状分布及其相关因素。方法:应用PTSD调查表、症状自评量表(SCL-90)、焦虑自评量表、抑郁自评量表和标准化评定工具,对地震时在安县地区居住的群众,进行DSM-ⅣPTSD诊断检查及相关量表的测查。结果:完成调查的289人中,PTSD筛查阳性率为11.4%。抑郁症状阳性率为23.4%,8.7%报告有自杀观念。灾后6个月PTSD发生率为11.4%,PTSD组反复更现创伤性体验、持续性警觉性增高、持续的回避等症状较对照组明显。SCL-90总分和躯体化、强迫、人际关系、抑郁、焦虑、敌对、恐怖、偏执、精神及其他因子分、SDS总分和标准分、SAS总分和标准分均显著高于对照组。结论:地震后PTSD的发生率是11.4%(6个月)。PTSD患者无法摆脱精神创伤的痛苦记忆,PTSD严重影响了患者的心身健康。     

Psychiatric disorders among survivors of the Oklahoma City bombing.

CONTEXT: Disasters expose unselected populations to traumatic events and can be used to study the mental health effects. The Oklahoma City, Okla, bombing is particularly significant for the study of mental health sequelae of trauma because its extreme magnitude and scope have been predicted to render profound psychiatric effects on survivors. OBJECTIVE: To measure the psychiatric impact of the bombing of the Alfred P. Murrah Federal Building in Oklahoma City on survivors of the direct blast, specifically examining rates of posttraumatic stress disorder (PTSD), diagnostic comorbidity, functional impairment, and predictors of postdisaster psychopathology. DESIGN, SETTING, AND PARTICIPANTS: Of 255 eligible adult survivors selected from a confidential registry, 182 (71%) were assessed systematically by interviews approximately 6 months after the disaster, between August and December 1995. MAIN OUTCOME MEASURES: Diagnosis of 8 psychiatric disorders, demographic data, level of functioning, treatment, exposure to the event, involvement of family and friends, and physical injuries, as ascertained by the Diagnostic Interview Schedule/Disaster Supplement. RESULTS: Forty-five percent of the subjects had a postdisaster psychiatric disorder and 34.3% had PTSD. Predictors included disaster exposure, female sex (for any postdisaster diagnosis, 55% vs 34% for men; chi2 = 8.27; P=.004), and predisaster psychiatric disorder (for PTSD, 45% vs 26% for those without predisaster disorder; chi2 = 6.86; P=.009). Onset of PTSD was swift, with 76% reporting same-day onset. The relatively uncommon avoidance and numbing symptoms virtually dictated the diagnosis of PTSD (94% meeting avoidance and numbing criteria had full PTSD diagnosis) and were further associated with psychiatric comorbidity, functional impairment, and treatment received. Intrusive reexperience and hyperarousal symptoms were nearly universal, but by themselves were generally unassociated with other psychopathology or impairment in functioning. CONCLUSIONS: Our data suggest that a focus on avoidance and numbing symptoms could have provided an effective screening procedure for PTSD and could have identified most psychiatric cases early in the acute postdisaster period. Psychiatric comorbidity further identified those with functional disability and treatment need. The nearly universal yet distressing intrusive reexperience and hyperarousal symptoms in the majority of nonpsychiatrically ill persons may be addressed by nonmedical interventions of reassurance and support.     

妇科癌症患者心理健康和应对方式的相关研究

目的调查妇科癌症患者创伤后应激障碍发生率、心理健康水平与心理弹性的关系。方法采用创伤后应激障碍症状清单-平民版(PTSD checklist-civilian version,PCL-C)、心理弹性量表(connor-davidson resilience scale,CD-RISC)、症状自评量表(symptom checklist 90,SCL-90)、艾森克人格问卷(Eysenck personality questionnaire,EPQ)、应对方式问卷对181例三甲医院的妇科癌症患者进行问卷调查。结果①妇科癌症患者的PTSD总分为(30.75±11.28)分,PTSD总分≥38分者41例(22.65%),总分≥45分者20例(11.05%),总分≥50分者11例(6.08%)。②PTSD阳性组在心理弹性的总分上显著低于PTSD阴性组(P<0.05)。③妇科癌症患者SCL-90阳性组在心理弹性总分上显著低于SCL-90阴性组(P<0.01)。在人格(EPQ)的神经质得分显著高于阴性组(P<0.01),在应对方式的自责、退避、合理化因子得分上显著高于阴性组(P<0.05)。④PTSD总分与SCL-90总分、自责、退避应对方式3个因素成正相关,与心理弹性(CD)总分、解决问题、求助、合理化应对方式4个因素成负相关。SCL-90总分与PTSD总分、自责、幻想、退避应对方式4个因素成正相关,与CD总分、外向性、合理化应对方式3个因素成负相关。结论妇科癌症患者创伤后应激障碍发生率较高,低心理弹性、低心理健康水平、消极的应对方式是创伤后应激障碍的重要预测因素。     

灾害救援医务人员一年后心理健康状况及心理知识重要性的研究

目的研究玉树救援医务人员远期心理健康状况,探讨灾害相关心理知识培训等因素对救援医务人员心理的影响,为今后更好的维持救援人员近期的乃至远期的心理健康提供依据。方法采用症状自评量表(SCL-90)、创伤后应激障碍自评量表(PCL-C)及自行设计的调查表对116名医务人员进行心理健康状况调查。SCL-90和PCL-C根据症状的严重程度以1～5级评分,分数越低表明心理状态越好。结果调查的玉树救援医务人员与常模比较其心理健康状况良好。是否接受过灾害相关心理知识培训的两组救援人员SCL-90比较结果显示,敌对因子两组之间差异无统计学意义(P>0.05),其余各因子两组比较差异均有统计学意义(P<0.05),总均分两组比较差异有统计学意义(P<0.01)。救援本身对医务人员心理状态的影响有78人(68.42%)认为是积极的,8人(7.02%)认为是消极的,28人(24.56%)认为没有影响。PCL-C的3个症状群中,创伤再体验的平均分最高(1.184分),其次是麻木和回避得分(1.154分),第三是警觉性增高得分(1.104分)。结论参与救援的医务人员心理素质较高,灾害相关心理知识的培训教育有助于救援人员尽快恢复和保持自身的心理健康状态。     

矿难后2个月和10个月创伤后应激障碍的发生率及相关因素

目的:调查矿难后2个月及10个月创伤后应激障碍(posttraumatic stress disorder,PTSD)的发生率及相关因素.方法:采用创伤后应激障碍清单(PTSD Checklist-Civilian Version,PCL-C)调查104名矿难幸存者PTSD的发生率.选取48名幸存者(包括24名重性PTSD患者及24名非PTSD对照)进行详细症状、心理评估.结果:矿难后2个月,PTSD的发生率为50%.重性PTSD患者和非PTSD对照在PTSD症状分析、焦虑抑郁、个性及记忆功能方面有显著差别.逐步回归分析显示状态焦虑、矿难后恢复上班情况、Beck抑郁问卷(BDI)总分、神经质、矿难发生时所在位置、井下工龄进入回归方程.矿难后10个月,符合PTSD诊断标准的占30.6%;与矿难后2个月相比,PTSD患者在PTSD症状、焦虑症状及短时记忆方面有明显改善,抑郁症状无显著差别;逐步回归分析显示,状态焦虑改善、矿难后恢复上班情况、积极应对、情感平衡、井下工龄是PTSD症状减轻的因素.结论:矿难后PTSD的发病率高、症状严重,对幸存矿工的心理影响很大,需要及时干预与治疗.状态焦虑、矿难后恢复上班晚、抑郁、神经质、矿难发生时所在位置危险度高、井下工龄短是PTSD发生的危险因素.积极应时是PTSD恢复的积极因素之一.     

日本福岛核事故的信息跟踪与服务

分析了福岛核事故后信息跟踪的意义,简介了全球十大核事故,提出了核事故的信息收集与跟踪是辐射防护与核安全科研中的重要环节。     

地震灾后灾民精神卫生调查

目的 了解汶川地震后灾区居民的精神卫生状况,为灾后重建工作中的心理治疗提供方向和科学依据.方法 对北川县两个受灾乡镇193个居民的精神卫生状况进行抽样调查,用EpiData进行数据录入用SPSS12.0进行统计分析.结果 灾民精神卫生损害相当严重,整体状况不容乐观,受灾程度越大,精神损害程度越大,主要表现在压力加大、失眠以及生活不快乐等方面.结论 改善灾区灾民的精神状况是灾后重建工作的一个重要部分,在了解了灾区严重的精神损害情况后,应选择适当措施对灾区居民实施心理治疗,以恢复灾民的精神健康.     

Effectiveness of near-peer simulation for managing the acutely deteriorating patient among residents of an internal medicine junior residency programme

INTRODUCTIONNear-peer teaching is gaining popularity as a teaching modality, as it improves the learner’s understanding, is targeted at an appropriate level and promotes familiarisation. This study was initiated to evaluate the effectiveness of incorporating near-peer instruction into simulation-based training within a junior residency programme.METHODS42 first-year residents from an internal medicine junior residency programme were recruited. Participants underwent a simulation-based training programme conducted over five weeks. Each week involved either an emergency or acute clinical scenario. A structured questionnaire was administered prior to and after the course to compare participants’ perceived knowledge, experience and confidence in managing the clinical scenarios.RESULTSIn our study, 83% of participants agreed/strongly agreed that the scenarios were realistic. There were improvements in perceived knowledge, experience and confidence after the course. The greatest improvement was seen for experience (post-simulation: median 7.00 [interquartile range (IQR) 6.00‒8.00] vs. pre-simulation: median 5.00 [IQR 3.00–6.25]). 65% of participants were keen to help with future training.CONCLUSIONNear-peer simulation training was found to be a viable and valuable method of instruction for first-year residents for increasing experience, instilling confidence and improving perceived knowledge. Integration of such programmes within medical education curricula shows good promise of continuity, with many first-year residents inspired to organise subsequent sessions.     

Mental health problems among adults in tsunami-affected areas in southern Thailand

Context  On December 26, 2004, an undersea earthquake occurred off the northwestern coast of Sumatra, Indonesia. The tsunami that followed severely affected all 6 southwestern provinces of Thailand, where 5395 individuals died, 2991 were unaccounted for, and 8457 were injured. Objective  To assess the prevalence of symptoms of posttraumatic stress disorder (PTSD), anxiety, and depression among individuals residing in areas affected by the tsunami in southern Thailand as part of a public health emergency response and rapid assessment. Design, Setting, and Participants  A multistage, cluster, population-based mental health survey was conducted from February 15 to 22, 2005, of random samples of displaced (n = 371) and nondisplaced persons in Phang Nga province (n = 322) and nondisplaced persons in the provinces of Krabi and Phuket (n = 368). Data were collected using an interviewer-administered questionnaire on handheld computers. A surveillance follow-up survey of the displaced persons (n = 371) and nondisplaced persons (n = 322) in Phang Na was conducted in September 2005. Main Outcomes Measures  Medical Outcomes Study-36 Short-Form Health Survey SF-36 to assess self-perceived general health, bodily pain, and social and emotional functioning; the Harvard Trauma Questionnaire to assess tsunami-specific traumatic events; and the Hopkins Checklist-25 to detect symptoms of anxiety and depression. Results  Participation rates for displaced and nondisplaced persons in the rapid assessment survey were 69% and 58%, respectively. Symptoms of PTSD were reported by 12% of displaced and 7% of nondisplaced persons in Phang Nga and 3% of nondisplaced persons in Krabi and Phuket. Anxiety symptoms were reported by 37% of displaced and 30% of nondisplaced persons in Phang Nga and 22% of nondisplaced persons in Krabi and Phuket. Symptoms of depression were reported by 30% of displaced and 21% of nondisplaced persons in Phang Nga and 10% of nondisplaced persons in Krabi and Phuket. In multivariate analysis, loss of livelihood was independently and significantly associated with symptoms of all 3 mental health outcomes (PTSD, anxiety, and depression). In the 9-month follow-up surveillance survey of 270 (73%) displaced and 250 (80%) nondisplaced participants in Phang Nga, prevalence rates of symptoms of PTSD, anxiety, and depression among displaced persons decreased to 7%, 24.8%, and 16.7%, respectively, and among nondisplaced persons, prevalence rates decreased to 2.3%, 25.9%, and 14.3%, respectively. Conclusions  Among survivors of the tsunami in southern Thailand, elevated rates of symptoms of PTSD, anxiety, and depression were reported 8 weeks after the disaster, with higher rates for anxiety and depression than PTSD symptoms. Nine months after the disaster, the rates of those reporting these symptoms decreased but were still elevated. This information is important for directing, strengthening, and evaluating posttsunami mental health needs and interventions.      

矿难后创伤后应激障碍患者明尼苏达多项个性量表的研究

目的 探讨明尼苏达多项个性测查量表对辅助诊断矿难后创伤后应激障碍(PTSD)的临床价值,并了解PTSD患者应激后在不同时间段的个性特征.方法 采用明尼苏达多项个性测查表对48例矿难生还者进行测查.结果 明尼苏达多项个性测查表测试结果显示PTSD患者与非PTSD者之间存在显著性差异,PTSD患者伪装、疑病、妄想、精神衰弱、精神分裂症量表评分[分别为(67.27±17.81)分,(61.13±13.35)分,(65.27±12.61)分,(62.47±11.78)分,(62.40±15.08)分],明显高于非PTSD患者[分别为(50.67±7.19)分,(50.89±12.77)分,(51.56±7.38)分,(51.33±10.09)分,(50.89±7.03)分],差异具有显著性(P<0.05),这一差异对矿难1年后PTSD的发生仍具有预测价值.结论 明尼苏达多项个性测查表是精神科临床较好的测评工具;明尼苏达多项个性测查表测试结果所显示的个性特征为矿难后PTSD发生提供了重要辅助诊断价值.     

Investigations on radioactive substances released from the Fukushima Daiichi nuclear power plant

The Great East Japan Earthquake on March 11th, 2011, severely damaged the Fukushima Daiichi Nuclear Power Plant resulting in the diffusion of many radioactive substances throughout Fukushima prefecture. To examine these substances, we have carried out investigations for several months since immediately after the accident. We revealed that environmental high-level radiation spread northwesterly from the nuclear plant and several areas in Nakadori, the region located in the central part of the prefecture between Hamadori (east part of the prefecture) and Aizu-chihou (west part), was contaminated with mid-level radiation. We also analyzed radionuclides in soil and estimated future radiation levels.The importance of topsoil removal for decontamination has become an obvious countermeasure since many radioactive substances have settled on the surface. In addition, we investigated residential areas and their surroundings to find where high-level doses were likely to be detected for lowering the risk of exposure among residents.When little information was available, the investigations were implemented and the results contributed to both administrative policies and civil life.