title: Persistent distress after psychological exposure to the Nagasaki atomic bomb explosion.
abstract: BACKGROUND
  Although there is speculation that individuals living in the vicinity of nuclear disasters have persistent mental health deterioration due to psychological stress, few attempts have been made to examine this issue.
  
  
  OBJECTIVE
  To determine whether having been in the vicinity of the Nagasaki atomic bomb explosion in the absence of substantial exposure to radiation affected the mental health of local inhabitants more than half a century later.
  
  
  METHODS
  Participants were randomly recruited from individuals who lived in the vicinity of the atomic bomb explosion in uncontaminated suburbs of Nagasaki. This sample (n = 347) was stratified by gender, age, perception of the explosion and current district of residence. Controls (n = 288) were recruited from among individuals who had moved into the area from outside Nagasaki 5-15 years after the bombing, matched for gender, age and district of residence. The primary outcome measure was the proportion of those at high risk of mental disorder based on the 28-item version of the General Health Questionnaire, with a cut-off point of 5/6. Other parameters related to individual perception of the explosion, health status, life events and habits were also assessed.
  
  
  RESULTS
  Having been in the vicinity of the explosion was the most significant factor (OR = 5.26, 95% CI 2.56-11.11) contributing to poorer mental health; erroneous knowledge of radiological hazard showed a mild association. In the sample group, anxiety after learning of the potential radiological hazard was significantly correlated with poor mental health (P<0.05), whereas anxiety about the explosion, or the degree of perception of it, was not; 74.5% of the sample group believed erroneously that the flash of the explosion was synonymous with radiation.
  
  
  CONCLUSIONS
  Having been in the vicinity of the atomic bomb explosion without radiological exposure continued to be associated with poorer mental health more than half a century after the event. Fear on learning about the potential radiological hazard and lack of knowledge about radiological risk are responsible for this association.
authors: Department of Adult Mental Health, National Institute of Mental Health, National Centre of Neurology and Psychiatry, 1-4-4 Ogawa Higashi Cho, Kodaira, Tokyo 187-8553, Japan. kim@ncnp.go.jp
authors: Yoshiharu
authors: Y
authors: Kim
authors: Atsuro
authors: A
authors: Tsutsumi
authors: Takashi
authors: T
authors: Izutsu
authors: Noriyuki
authors: N
authors: Kawamura
authors: Takao
authors: T
authors: Miyazaki
authors: Takehiko
authors: T
authors: Kikkawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000453:epidemiology; D001290:Attitude; D002908:Chronic Disease; D005260:Female; D006304:Health Status; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D009689:Nuclear Warfare / Q000523:psychology*; D054043:Nuclear Weapons; D011848:Radioactive Pollutants; D012044:Regression Analysis; D013315:Stress, Psychological / Q000453:epidemiology* / Q000209:etiology; D013383:Suburban Population / Q000706:statistics & numerical data; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data; D047789:World War II
chemical_list: D011848:Radioactive Pollutants