title: Three-year trend survey of psychological distress, post-traumatic stress, and problem drinking among residents in the evacuation zone after the Fukushima Daiichi Nuclear Power Plant accident [The Fukushima Health Management Survey].
abstract: OBJECTIVE
  Prolonged periods of instability in terms of living environment can lead to a serious increase in mental health issues among disaster-affected individuals. The aim of this study was to assess long-term trends in mental health among adult residents in a nuclear-disaster-affected area.
  
  
  METHODS
  Mail-based, self-administered questionnaire surveys were conducted three times (T1-T3), targeting all residents registered with the municipalities in the evacuation zone in Fukushima prefecture at the time of the disaster. Age-adjusted prevalences of the following were analyzed by sex: risk of psychological distress by the Kessler 6-item Scale, post-traumatic stress by the Post-traumatic Stress Disorder Checklist, and problem drinking by CAGE.
  
  
  RESULTS
  The numbers of respondents and response rates were: 73 568, 40.7% (T1); 55 076, 29.9% (T2); and 46 386, 25.0% (T3). Compared with normal Japanese levels in non-disaster settings (4.7%), the prevalence of general psychological distress by Kessler 6-item Scale ≥ 13 was still high 3 years after the event in both men (11.4%) and women (15.8%). Although the age-adjusted prevalence of psychological distress and post-traumatic stress (Post-traumatic Stress Disorder Checklist ≥ 44) had decreased over time (from 19.0% [T1] to 17.8% [T3] for men, and from 25.3% [T1] to 23.3% [T3] for women), the age-adjusted prevalence of problem drinking (CAGE ≥ 2) remained steady in both men (20.7% [T2] and 20.4% [T3]; P = 0.18) and women (10.5% [T2] and 10.5% [T3]; P = 0.91).
  
  
  CONCLUSIONS
  Our results suggest that long-term interventions focused on post-traumatic stress as well as other mental health problems are strongly needed for disaster-affected individuals.
authors.affiliation: Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan.
authors.forename: Misari
authors.initials: M
authors.lastname: Oe
authors.affiliation: Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan.|Department of Disaster Psychiatry, School of Medicine, Fukushima Medical University, Fukushima, Japan.
authors.forename: Senta
authors.initials: S
authors.lastname: Fujii
authors.affiliation: Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan.|Department of Disaster Psychiatry, School of Medicine, Fukushima Medical University, Fukushima, Japan.
authors.forename: Masaharu
authors.initials: M
authors.lastname: Maeda
authors.affiliation: Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan.|Department of Epidemiology, School of Medicine, Fukushima Medical University, Fukushima, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Nagai
authors.affiliation: Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Harigane
authors.affiliation: Department of Neuropsychiatry, School of Medicine, Fukushima Medical University, Fukushima, Japan.
authors.forename: Itaru
authors.initials: I
authors.lastname: Miura
authors.affiliation: Department of Neuropsychiatry, School of Medicine, Fukushima Medical University, Fukushima, Japan.
authors.forename: Hirooki
authors.initials: H
authors.lastname: Yabe
authors.affiliation: Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan.|Department of Epidemiology, School of Medicine, Fukushima Medical University, Fukushima, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Ohira
authors.affiliation: Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan.
authors.forename: Hideto
authors.initials: H
authors.lastname: Takahashi
authors.affiliation: Department of Adult Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan.
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Suzuki
authors.affiliation: Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan.|Department of Public Health, School of Medicine, Fukushima Medical University, Fukushima, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Yasumura
authors.affiliation: Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Abe
mesh_terms: D000328:Adult; D000368:Aged; D019973:Alcohol-Related Disorders / Q000453:epidemiology*; D001007:Anxiety / Q000453:epidemiology*; D003863:Depression / Q000453:epidemiology*; D004190:Disasters; D055866:Earthquakes; D005260:Female; D062406:Fukushima Nuclear Accident; D006306:Health Surveys; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D013315:Stress, Psychological / Q000453:epidemiology*; D057192:Tsunamis; D055815:Young Adult
keywords: alcohol use; cross-sectional studies; epidemiologic studies; post-traumatic stress; stress disorders