title: Post-traumatic stress disorder and depression prevalence and associated risk factors among local disaster relief and reconstruction workers fourteen months after the Great East Japan Earthquake: a cross-sectional study.
abstract: BACKGROUND
  Many local workers have been involved in rescue and reconstruction duties since the Great East Japan Earthquake (GEJE) on March 11, 2011. These workers continuously confront diverse stressors as both survivors and relief and reconstruction workers. However, little is known about the psychological sequelae among these workers. Thus, we assessed the prevalence of and personal/workplace risk factors for probable post-traumatic stress disorder (PTSD), probable depression, and high general psychological distress in this population.
  
  
  METHODS
  Participants (N = 1294; overall response rate, 82.9%) were workers (firefighters, n = 327; local municipality workers, n = 610; hospital medical workers, n = 357) in coastal areas of Miyagi prefecture. The study was cross-sectional and conducted 14 months after the GEJE using a self-administered questionnaire which included the PTSD Checklist-Specific Version, the Patient Health Questionnaire-9, and the K6 scale. Significant risk factors from bivariate analysis, such as displacement, dead or missing family member(s), near-death experience, disaster related work, lack of communication, and lack of rest were considered potential factors in probable PTSD, probable depression, and high general psychological distress, and were entered into the multivariable logistic regression model.
  
  
  RESULTS
  The prevalence of probable PTSD, probable depression, and high general psychological distress was higher among municipality (6.6%, 15.9%, and 14.9%, respectively) and medical (6.6%, 14.3%, and 14.5%, respectively) workers than among firefighters (1.6%, 3.8%, and 2.6%, respectively). Lack of rest was associated with increased risk of PTSD and depression in municipality and medical workers; lack of communication was linked to increased PTSD risk in medical workers and depression in municipality and medical workers; and involvement in disaster-related work was associated with increased PTSD and depression risk in municipality workers.
  
  
  CONCLUSIONS
  The present results indicate that at 14 months after the GEJE, mental health consequences differed between occupations. High preparedness, early mental health interventions, and the return of ordinary working conditions might have contributed to the relative mental health resilience of the firefighters. Unlike the direct effects of disasters, workplace risk factors can be modified after disasters; thus, we should develop countermeasures to improve the working conditions of local disaster relief and reconstruction workers.
authors: Department of Psychiatry, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan. asakuma-thk@umin.ac.jp.|Miyagi Disaster Mental Health Care Center, 2-18-21 Honcho, Aoba-ku, Sendai, Miyagi, 980-0014, Japan. asakuma-thk@umin.ac.jp.
authors: Atsushi
authors: A
authors: Sakuma
authors: Miyagi Disaster Mental Health Care Center, 2-18-21 Honcho, Aoba-ku, Sendai, Miyagi, 980-0014, Japan. takahashi-yoko@umin.ac.jp.|Department of Preventive Psychiatry, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan. takahashi-yoko@umin.ac.jp.
authors: Yoko
authors: Y
authors: Takahashi
authors: Miyagi Disaster Mental Health Care Center, 2-18-21 Honcho, Aoba-ku, Sendai, Miyagi, 980-0014, Japan. u.ik.n.n.a.2226@gmail.com.|Department of Psychiatry, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan. u.ik.n.n.a.2226@gmail.com.
authors: Ikki
authors: I
authors: Ueda
authors: Department of Psychiatry, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan. hirotoshi-sato@umin.net.|Miyagi Disaster Mental Health Care Center, 2-18-21 Honcho, Aoba-ku, Sendai, Miyagi, 980-0014, Japan. hirotoshi-sato@umin.net.
authors: Hirotoshi
authors: H
authors: Sato
authors: Department of Psychiatry, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan. katsura-thk@umin.ac.jp.|Miyagi Disaster Mental Health Care Center, 2-18-21 Honcho, Aoba-ku, Sendai, Miyagi, 980-0014, Japan. katsura-thk@umin.ac.jp.
authors: Masahiro
authors: M
authors: Katsura
authors: Miyagi Disaster Mental Health Care Center, 2-18-21 Honcho, Aoba-ku, Sendai, Miyagi, 980-0014, Japan. abemikika@med.tohoku.ac.jp.|Department of Preventive Psychiatry, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan. abemikika@med.tohoku.ac.jp.
authors: Mikika
authors: M
authors: Abe
authors: Miyagi Disaster Mental Health Care Center, 2-18-21 Honcho, Aoba-ku, Sendai, Miyagi, 980-0014, Japan. ayami.n@med.tohoku.ac.jp.|Department of Preventive Psychiatry, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan. ayami.n@med.tohoku.ac.jp.
authors: Ayami
authors: A
authors: Nagao
authors: Department of Adult Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan. yrsuzuki@ncnp.go.jp.
authors: Yuriko
authors: Y
authors: Suzuki
authors: Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan. m-kaki@umin.ac.jp.
authors: Masako
authors: M
authors: Kakizaki
authors: Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan. tsuji1@med.tohoku.ac.jp.
authors: Ichiro
authors: I
authors: Tsuji
authors: Miyagi Disaster Mental Health Care Center, 2-18-21 Honcho, Aoba-ku, Sendai, Miyagi, 980-0014, Japan. mtok-thk@umin.ac.jp.|Department of Psychiatry, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan. mtok-thk@umin.ac.jp.
authors: Hiroo
authors: H
authors: Matsuoka
authors: Miyagi Disaster Mental Health Care Center, 2-18-21 Honcho, Aoba-ku, Sendai, Miyagi, 980-0014, Japan. kaz-mat@umin.net.|Department of Preventive Psychiatry, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan. kaz-mat@umin.net.
authors: Kazunori
authors: K
authors: Matsumoto
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology*; D004190:Disasters / Q000706:statistics & numerical data; D055866:Earthquakes; D060731:Emergency Responders / Q000523:psychology*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology*; D013315:Stress, Psychological / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D055815:Young Adult