[The mental health of school children after the Great Hanshin-Awaji Earthquake: II. Longitudinal analysis].
We conducted surveys to investigate the nature of the recovery processes and psychological reactions of children and adolescents affected by the Great Hanshin Awaji Earthquake. The investigations were carried out 4 times at 4 months, 6 months, one year and two years after the disaster.


METHODS
About 9000 school children in the 3rd grade, the 5th grade, the 8th grade living in the disaster area.


METHODS
The questionnaire consisted of 9-12 items regarding situation and behavior when the earthquake occurred, and 22 items regarding mental health condition, and was filled out in the classroom under supervision by the teacher in charge. The responses were rated from 1 to 4 depending on the frequency of the symptoms, and statistically analyzed.


RESULTS
By factor analysis, three factors were elicited. Factor 1 was interpreted as being related to fear and anxiety, factor 2 as related to depression and physical symptoms, and factor 3 as related to pro-social tendencies. These 3 factors were distinct and stable throughout all 4 surveys and each of them showed unique recovery processes. The mean score of factor 1 was highest at 4 months after the earthquake, and decreased as time passed. This factor shows that fear and anxiety seem to be directly related to the experience of the earthquake. According to the severity of the disaster, more severe damage brought about a higher mean score of factor 1. Furthermore, younger children and girls were more strongly affected. Each of the differences in the severity of disaster, in age, and in gender decreased as time passed. The mean score of factor 2 peaked at 6 months, and it slightly recovered after one year. However, the score at the 1st year was still higher than that of the 4th month. At two years the score returned to almost the same level as that of the 4th month. We think that factor 2, involving depressive mood and psychophysical symptoms, may be a secondary phenomenon to fear and anxiety. Other possibilities are that they may be caused by environmental changes after the disaster, inconveniences of daily life, loss of jobs of parents, or masked by hypomanic mood which covered over the disaster area soon after the earthquake (so-called heroic phase). Older children have a greater tolerance for depressive mood and psychophysical symptoms, but those symptoms occurring in older children have a tendency to continue for a longer time. Girls are more heavily affected and need more time to recover from trauma than boys. The mean score of factor 3 showed a gradual decrease as time passed. There was no difference in the way of decrease according to the severity of disaster, age and gender. It may be natural that, since the interest in the earthquake decreased as time passed, consideration for the victims decreased.


CONCLUSIONS
The problems of mental health of children and adolescents after the disaster may consist of at least 2 different components; "fear and anxiety," which appeared just after the disaster and decreased earlier; "depressive and psychophysical symptoms" appeared later and stayed longer.
Shioyama
A
A
Hyogo Prefectural Kofu Hospital.
Uemoto
M
M
Shinfuku
N
N
Ide
H
H
Seki
W
W
Mori
S
S
Inoue
S
S
Natsuno
R
R
Asakawa
K
K
Osabe
H
H
D000293:Adolescent; D000367:Age Factors; D002648:Child; D004190:Disasters; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health; D000297:Psychology, Adolescent; D002666:Psychology, Child; D012737:Sex Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D013997:Time Factors