title: Psychological distress and the perception of radiation risks: the Fukushima health management survey.
abstract: OBJECTIVE
  To assess relationships between the perception of radiation risks and psychological distress among evacuees from the Fukushima nuclear power plant disaster.
  
  
  METHODS
  We analysed cross-sectional data from a survey of evacuees conducted in 2012. Psychological distress was classified as present or absent based on the K6 scale. Respondents recorded their views about the health risks of exposure to ionizing radiation, including immediate, delayed and genetic (inherited) health effects, on a four-point Likert scale. We examined associations between psychological distress and risk perception in logistic regression models. Age, gender, educational attainment, history of mental illness and the consequences of the disaster for employment and living conditions were potential confounders.
  
  
  RESULTS
  Out of the 180,604 people who received the questionnaire, we included 59,807 responses in our sample. There were 8717 respondents reporting psychological distress. Respondents who believed that radiation exposure was very likely to cause health effects were significantly more likely to be psychologically distressed than other respondents: odds ratio (OR) 1.64 (99.9% confidence interval, CI: 1.42-1.89) for immediate effects; OR: 1.48 (99.9% CI: 1.32-1.67) for delayed effects and OR: 2.17 (99.9% CI: 1.94-2.42) for genetic (inherited) effects. Similar results were obtained after controlling for individual characteristics and disaster-related stressors.
  
  
  CONCLUSIONS
  Among evacuees of the Fukushima nuclear disaster, concern about radiation risks was associated with psychological distress.
authors.affiliation: National Institute of Mental Health, National Center of Neurology and Psychiatry, Department of Adult Mental Health, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8553, Japan .
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Suzuki
authors.affiliation: Fukushima Medical University, Fukushima, Japan .
authors.forename: Hirooki
authors.initials: H
authors.lastname: Yabe
authors.affiliation: Fukushima Medical University, Fukushima, Japan .
authors.forename: Seiji
authors.initials: S
authors.lastname: Yasumura
authors.affiliation: Fukushima Medical University, Fukushima, Japan .
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Ohira
authors.affiliation: Fukushima Medical University, Fukushima, Japan .
authors.forename: Shin-Ichi
authors.initials: S
authors.lastname: Niwa
authors.affiliation: Fukushima Medical University, Fukushima, Japan .
authors.forename: Akira
authors.initials: A
authors.lastname: Ohtsuru
authors.affiliation: Fukushima Prefecture Developmental Disability Support Center, Fukushima, Japan .
authors.forename: Hirobumi
authors.initials: H
authors.lastname: Mashiko
authors.affiliation: Fukushima Medical University, Fukushima, Japan .
authors.forename: Masaharu
authors.initials: M
authors.lastname: Maeda
authors.affiliation: Fukushima Medical University, Fukushima, Japan .
authors.forename: Masafumi
authors.initials: M
authors.lastname: Abe
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D062406:Fukushima Nuclear Accident; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D000069079:Radiation Exposure; D012306:Risk; D013315:Stress, Psychological; D055815:Young Adult