title: The psychological impact of a dual-disaster caused by earthquakes and radioactive contamination in Ichinoseki after the Great East Japan Earthquake.
abstract: BACKGROUND
  The psychological impact of dual-disasters (earthquakes and a nuclear accident), on affected communities is unknown. This study investigated the impact of a dual-disaster (earthquakes and radioactive contamination) on the prevalence of psychological distress in a landlocked city within the Tohoku area, Japan.
  
  
  METHODS
  A cross-sectional mail-in survey with a random sample of inhabitants from Ichinoseki city was conducted eleven months after the disasters, and data from 902 respondents were analyzed by logistic regression models, with multiple imputation methodology. The K6 was used to determine psychological distress.
  
  
  RESULTS
  The estimated prevalence of psychological distress was 48.0 percent. House damage due to earthquakes and anxiety about radioactive contamination were significantly associated with psychological distress (p < 0.05), while an interactive effect between house damage and anxiety about radioactive contamination was not significant. Being female, middle-to-low educational status and unemployed were additional risk factors for psychological distress.
  
  
  CONCLUSIONS
  This dual-disaster was associated with a moderate prevalence of psychological distress in the area. The impact of the earthquake and radioactive contamination appeared additive.
authors.affiliation: Research Center for Child Mental Development, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan. niitsu@chiba-u.jp.
authors.forename: Tomihisa
authors.initials: T
authors.lastname: Niitsu
authors.forename: Kota
authors.initials: K
authors.lastname: Takaoka
authors.forename: Saho
authors.initials: S
authors.lastname: Uemura
authors.forename: Akiko
authors.initials: A
authors.lastname: Kono
authors.forename: Akihiko
authors.initials: A
authors.lastname: Saito
authors.forename: Norito
authors.initials: N
authors.lastname: Kawakami
authors.forename: Michiko
authors.initials: M
authors.lastname: Nakazato
authors.forename: Eiji
authors.initials: E
authors.lastname: Shimizu
mesh_terms: D000328:Adult; D000368:Aged; D000398:Air Pollution, Radioactive; D004190:Disasters; D055866:Earthquakes; D005843:Geography; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D013315:Stress, Psychological / Q000453:epidemiology* / Q000523:psychology*; D055815:Young Adult