title: Posttraumatic symptoms in elementary and junior high school children after the 2011 Japan earthquake and tsunami: symptom severity and recovery vary by age and sex.
abstract: OBJECTIVE
  To measure psychiatric symptoms exhibited by children in Ishinomaki City, Japan, an area severely damaged by the 2011 earthquake and tsunami, at 8 and 20 months post-tsunami to investigate differences in symptom severity and recovery rate by age, sex, and degree of trauma experienced.
  
  
  METHODS
  Prospective data were collected from children in elementary school (5th and 6th grades) and junior high school (8th and 9th grades). Students completed the Post-Traumatic Stress Symptoms for Children-15 (PTSSC-15) survey. Trauma severity was scored according to experiences of bereavement, home damage, and evacuation. In total, 3795 PTSSC-15 surveys were analyzed, yielding total scores, post-traumatic stress disorder (PTSD) factor subscores, and depression factor subscores, which were analyzed according to grade group, sex, and degree of trauma (trauma dose).
  
  
  RESULTS
  In the elementary school children, mean total PTSSC-15 score, PTSD factor score, and depression factor score were significantly improved at 20 months post-tsunami compared with 8 months (P < .0001 for all), whereas there were no significant improvements in the junior high school children. In females of the older group, the depression factor score at 20 months post-tsunami was significantly higher than at 8 months (P < .01).
  
  
  CONCLUSIONS
  Elementary school and junior high school children living near the epicenter of the 2011 Japan earthquake and tsunami exhibited marked differences in PTSD and depressive symptoms. The mental health status of elementary school children improved, whereas that of junior high school children did not.
authors.affiliation: Department of Child and Adolescent Psychiatry, National Center for Global Health and Medicine, Kohnodai Hospital, Ichikawa, Japan. Electronic address: yoshi.iwadare@gmail.com.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Iwadare
authors.affiliation: Department of Child and Adolescent Psychiatry, National Center for Global Health and Medicine, Kohnodai Hospital, Ichikawa, Japan.
authors.forename: Masahide
authors.initials: M
authors.lastname: Usami
authors.affiliation: Department of Adult Mental Health, National Institute of Mental Health, National Center of Psychiatry and Neurology, Kodaira, Japan.
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Suzuki
authors.affiliation: Department of Child and Adolescent Psychiatry, National Center for Global Health and Medicine, Kohnodai Hospital, Ichikawa, Japan.
authors.forename: Hirokage
authors.initials: H
authors.lastname: Ushijima
authors.affiliation: Department of Child and Adolescent Psychiatry, National Center for Global Health and Medicine, Kohnodai Hospital, Ichikawa, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Tanaka
authors.affiliation: Department of Child and Adolescent Psychiatry, National Center for Global Health and Medicine, Kohnodai Hospital, Ichikawa, Japan.
authors.forename: Kyota
authors.initials: K
authors.lastname: Watanabe
authors.affiliation: Department of Child and Adolescent Psychiatry, Aiiku Hospital, Minato, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Kodaira
authors.affiliation: Department of Child and Adolescent Psychiatry, Aiiku Hospital, Minato, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Saito
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D002648:Child; D055866:Earthquakes; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D011446:Prospective Studies; D012720:Severity of Illness Index; D017678:Sex Distribution; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology*; D057192:Tsunamis