Impaired psychological recovery in the elderly after the Niigata-Chuetsu Earthquake in Japan: A population-based study

Department of Medical Informatics, Niigata University Medical and Dental Hospital, Asahimachi-Dori 1, Niigata 951-8520, Japan.
BMC Public Health (Impact Factor: 2.26). 02/2006; 6(6):230. DOI: 10.1186/1471-2458-6-230
Source: PubMed


An earthquake measuring 6.8 on the Richter scale struck the Niigata-Chuetsu region of Japan at 5.56 P.M. on the 23rd of October, 2004. The earthquake was followed by sustained occurrence of numerous aftershocks, which delayed reconstruction of community lifelines. Even one year after the earthquake, 9,160 people were living in temporary housing. Such a devastating earthquake and life after the earthquake in an unfamiliar environment should cause psychological distress, especially among the elderly.
Psychological distress was measured using the 12-item General Health Questionnaire (GHQ-12) in 2,083 subjects (69% response rate) who were living in transient housing five months after the earthquake. GHQ-12 was scored using the original method, Likert scoring and corrected method. The subjects were asked to assess their psychological status before the earthquake, their psychological status at the most stressful time after the earthquake and their psychological status at five months after the earthquake. Exploratory and confirmatory factor analysis was used to reveal the factor structure of GHQ12. Multiple regression analysis was performed to analyze the relationship between various background factors and GHQ-12 score and its subscale.
GHQ-12 scores were significantly elevated at the most stressful time and they were significantly high even at five months after the earthquake. Factor analysis revealed that a model consisting of two factors (social dysfunction and dysphoria) using corrected GHQ scoring showed a high level of goodness-of-fit. Multiple regression analysis revealed that age of subjects affected GHQ-12 scores. GHQ-12 score as well as its factor 'social dysfunction' scale were increased with increasing age of subjects at five months after the earthquake.
Impaired psychological recovery was observed even at five months after the Niigata-Chuetsu Earthquake in the elderly. The elderly were more affected by matters relating to coping with daily problems.

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    • "Many factors have been identified that seem to impact the mental health of populations affected by natural disasters, which contribute to the onset and severity of posttraumatic stress disorder (PTSD): female gender (Carr et al. 1995; Karanci and Rustemli 1995; Sharan et al. 1996; C. C. Chen et al. 2001; Basoglu et al. 2002; Livanou et al. 2002; Salcioglu et al. 2003; Kiliç and Ulusoy 2003; Chang et al. 2005; Montazeri et al. 2005; Sattler et al. 2006; Hansson et al. 1994; C. H. Chen et al. 2007; Kuwabara et al. 2008; Priebe et al. 2009; Steel et al. 2011; Ahmad et al. 2010; Dell'Osso et al. 2011b; Zhang and Ho 2011), older (Carr et al. 1997; Salcioglu et al. 2003; Toyabe et al. 2006; C. H. Chen et al. 2007; Priebe et al. 2009; Zhang and Ho 2011) or younger age at trauma (Kato et al. 1996), lower education (Karanci and Rustemli 1995; Armenian et al. 2000; Basoglu et al. 2002; Kiliç and Ulusoy 2003; Montazeri et al. 2005; C. H. Chen et al. 2007; Priebe et al. 2009; Wang et al. 2009; Ahmad et al. 2010), epigenetic vulnerability (Broekman et al. 2007; Mehta and Binder 2012), previous psychiatric illness (Nolen-Hoeksema and Morrow 1991; Basoglu et al. 2002; Salcioglu et al. 2003), fear of death at the time of the disaster (Basoglu et al. 2002; Livanou et al. 2002; Bergiannaki et al. 2003; Salcioglu et al. 2003; Kiliç and Ulusoy 2003; Basoglu et al. 2004; Kuwabara et al. 2008), degree of exposure to the disaster (Goenjian et al. 1994; Carr et al. 1995; Armenian et al. 2000; Sattler et al. 2006; Wang et al. 2009; Zhang and Ho 2011), closer proximity to the epicenter of an earthquake (Ahmad et al. 2010), loss of loved ones (Basoglu et al. 2002; Livanou et al. 2002; Montazeri et al. 2005; Goenjian et al. 1994; Dell'Osso et al. 2011a), property or resource loss (Freedy et al. 1994; Armenian et al. 2000; C. C. Chen et al. 2001; Bland et al. 2005; Sattler et al. 2006; C. H. Chen et al. 2007; Kuwabara et al. 2008; Sharan et al. 1996), having been trapped/injured under rubble and/or participation in rescue work (Basoglu et al. 2002; Salcioglu et al. 2003; Kuwabara et al. 2008; Ehring et al. 2011), greater number of traumatic experiences (Chang et al. 2005), relocation after a disaster (Najarian et al. 2001; Kiliç et al. 2006), less social support (Bland et al. 1997; Armenian et al. 2000; Sattler et al. 2006; Bland et al. 2005; Wang et al. 2009), and diminished individual coping (Olff et al. 2005). Within one month after exposure to an extreme traumatic stressor, a mental disorder, such as acute stress disorder (ASD) can manifest. "
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    ABSTRACT: The aim of our 6-month follow-up study was to assess predictors of post-traumatic stress disorder (PTSD) among individuals seeking treatment at the General Hospital Psychiatric Unit within the first month following the L’Aquila earthquake. Clinical, trauma-related and neurocognitive variables were considered. At the 6-month follow-up, 91 (74.5%) out of 122 subjects were re-assessed and administered the Impact of Events Scale-revised (IES-R) for the detection of PTSD according to DSM-IV criteria. Within 4 weeks following the earthquake, patients were assessed with a checklist of traumatic-event-related variables, along with the Stanford Acute Stress Disorder Questionnaire (SASDQ) for the detection of ASD, with a short battery on working (Wechler Memory Scale-R, Digit Forward and Backward) and verbal memory (subtest of Milan Overall Dementia Assessment, MODA). A statistically significant higher proportion of subjects affected by ‘partial’ ASD showed a PTSD diagnosis (80.6%, N = 29) compared to not diagnosed subjects (40%, N = 22) and a PTSD diagnosis was shown by all the 4 subjects (4.4%) affected by ‘full’ ASD at the entry in the study. At the 6-month follow-up 56% of the sample could be considered affected by PTSD on the IES-R scale. The results of the logistic regression analysis on our selected predictors indicated that the persistent fear of aftershocks seemed to increase by over 57 times the likelihood of positive estimate of PTSD, followed by impairment of working memory backward (OR 48.2), and having being diagnosed as ASD case in the first 4 week after the earthquake (OR 17.4). This study underlines the importance of identifying PTSD predictors, in order to planning early treatment interventions after natural disasters.
    SpringerPlus 11/2013; 2(1):636. DOI:10.1186/2193-1801-2-636
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    • "Older children and adolescents, like most adults, can remember and communicate the incidences long after the disaster. The recovery might delay and take several months in elderly victims.[1617] On the contrary, stress-related symptoms are transient in younger children.[18] "
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    ABSTRACT: Psychological stress following natural disaster is common. Despite several earthquakes in India, data on evaluation of acute stress among the child victims in the early postdisaster period is scarce. Immediately following a devastating earthquake (6.9 Richter) at Sikkim on September, 18 2011, many children attended North Bengal Medical College, the nearest government tertiary care institution, with unusual stress symptoms. Evaluation of acute stress symptoms in children in the immediate postearthquake period. This was a cross-sectional study done over 4 weeks and includes all the children from 1 to 12 years presenting with unusual physical or behavioral symptoms. Those with major injuries requiring admission were excluded. They were divided into two age groups. For older children (8-12 years) the 8-item Children Impact of Event Scale (CIES) was used for screening of stress. Unusual symptoms were recorded in younger children (1-8 years) as CIES is not validated < 8 years. A total of 84 children (2.66%) out of 3154 had stress symptoms. Maximum attendance was noted in first 3 days (65.47%) and declined gradually. In children ≥ 8 years, 48.78% had psychological stress, which was statistically significant on CIES scores without any gender predilection. Static posturing (41.86%), sleeplessness (32.55%), anorexia (9.30%), recurrent vomiting (13.95%), excessive crying (13.95%), or night-awakenings (4.65%) were found in younger children (n = 43) and three required admission. This study represent the first Indian data showing statistically significant psychological impact in older children (8-12 years) and various forms of physical stress symptoms in young children (1-8 years) following earthquake.
    08/2013; 4(Suppl 1):S19-23. DOI:10.4103/0976-3147.116434
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    • "For all this, particular groups are likely to remain vulnerable, with earthquakes liable to trigger multiple negative life events [6], and with delayed dysfunction often a consequence of natural disasters [45]. To deal with this, a number of studies have suggested post-event interventions that utilise both family and existing community resources to reduce distress [28], [45], [46]. At the same time, while strong levels of social support following natural disasters in Japan have been related to positive health outcomes [47], our findings also suggest that sharing risk respresentations amongst close others can encourage worry and fear. "
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    ABSTRACT: The Great East Japan (Tōhoku/Kanto) earthquake of March 2011 was followed by a major tsunami and nuclear incident. Several previous studies have suggested a number of psychological responses to such disasters. However, few previous studies have modelled individual differences in the risk perceptions of major events, or the implications of these perceptions for relevant behaviours. We conducted a survey specifically examining responses to the Great Japan earthquake and nuclear incident, with data collected 11-13 weeks following these events. 844 young respondents completed a questionnaire in three regions of Japan; Miyagi (close to the earthquake and leaking nuclear plants), Tokyo/Chiba (approximately 220 km from the nuclear plants), and Western Japan (Yamaguchi and Nagasaki, some 1000 km from the plants). Results indicated significant regional differences in risk perception, with greater concern over earthquake risks in Tokyo than in Miyagi or Western Japan. Structural equation analyses showed that shared normative concerns about earthquake and nuclear risks, conservation values, lack of trust in governmental advice about the nuclear hazard, and poor personal control over the nuclear incident were positively correlated with perceived earthquake and nuclear risks. These risk perceptions further predicted specific outcomes (e.g. modifying homes, avoiding going outside, contemplating leaving Japan). The strength and significance of these pathways varied by region. Mental health and practical implications of these findings are discussed in the light of the continuing uncertainties in Japan following the March 2011 events.
    PLoS ONE 05/2012; 7(5):e37690. DOI:10.1371/journal.pone.0037690 · 3.23 Impact Factor
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