title: Psychological distress of residents in Kawauchi village, Fukushima Prefecture after the accident at Fukushima Daiichi Nuclear Power Station: the Fukushima Health Management Survey.
abstract: BACKGROUND
  To shed light on the mental health of evacuees after the accident at Fukushima Daiichi Nuclear Power Station (FDNPS), we evaluate the results of the Fukushima Health Management Survey (FHMS) of the residents at Kawauchi village in Fukushima, which is located less than 30 km from the FDNPS.
  
  
  METHODS
  We conducted the cross-sectional study within the framework of the FHMS. Exposure values were "anorexia," "subjective feelings about health," "feelings about sleep satisfaction," and "bereavement caused by the disaster," confounding variables were "age" and "sex," and outcome variables were "K6 points." We collected data from the FHMS, and employed the Kessler Psychological Distress Scale (K6) and the posttraumatic stress disorder (PTSD) Checklist Stressor-Specific Version (PCL-S) to carry out the research. A total of 13 or greater was the cut-off for identifying serious mental illness using the K6 scale. The study subjects included residents (n = 542) of over 30 years of age from Kawauchi village, and data were used from the period of January 1, 2012 to October 31, 2012.
  
  
  RESULTS
  A total of 474 residents (87.5%) scored less than 13 points in the K6 and 68 (12.6%) scored 13 points or more. The proportion of elderly residents (over 65 years old) among people with K6 score above the cut-off was higher than that among people with K6 score below the cut-off (44.1 vs 31.0%, p < 0.05). In addition, the proportion of residents with anorexia and mental illness among people with K6 score above the cut-off was higher than among people with K6 score below the cut-off (p < 0.001 and p < 0.05, respectively). The amount of residents who scored 44 points or more in the PCL-S among people with K6 score above the cut-off was also considerably higher than among people with K6 score below the cut-off (79.4 vs 12.9%, p < 0.001). Interestingly, the proportion of residents who scored more than among people with K6 score above the cut-off and the among people with PCL-S score above the cut-off in Kawauchi was higher than in previous studies in other locations.
  
  
  CONCLUSIONS
  These results suggest that there are severe mental health problems, such as depression and PTSD, among adults as a consequence of the accident at the FDNPS. Our study showed that residents who lived in the evacuation zone before the disaster are at high risk psychological distress. To facilitate local residents' recovery from Fukushima, there is a need to continue providing them with physical and mental support, as well as communication regarding the health risks of radiation.
authors.affiliation: Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Education Center for Disaster Medicine, Fukushima Medical University, Fukushima, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Yoshida
authors.affiliation: Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan.
authors.forename: Tetsuko
authors.initials: T
authors.lastname: Shinkawa
authors.affiliation: Department of Molecular Medicine, Atomic Bomb Disease Institute, Nagasaki University , Nagasaki , Japan.
authors.forename: Hideko
authors.initials: H
authors.lastname: Urata
authors.affiliation: Department of Global Health, Medicine and Welfare, Atomic Bomb Disease Institute, Nagasaki University , Nagasaki , Japan.
authors.forename: Kanami
authors.initials: K
authors.lastname: Nakashima
authors.affiliation: Department of Global Health, Medicine and Welfare, Atomic Bomb Disease Institute, Nagasaki University , Nagasaki , Japan.
authors.forename: Makiko
authors.initials: M
authors.lastname: Orita
authors.affiliation: Education Center for Disaster Medicine, Fukushima Medical University , Fukushima , Japan.
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Yasui
authors.affiliation: Education Center for Disaster Medicine, Fukushima Medical University , Fukushima , Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kumagai
authors.affiliation: Department of Radiation Health Management, Fukushima Medical University, School of Medicine , Fukushima , Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Ohtsuru
authors.affiliation: Department of Neuropsychiatry, Fukushima Medical University, School of Medicine , Fukushima , Japan.
authors.forename: Hirooki
authors.initials: H
authors.lastname: Yabe
authors.affiliation: Department of Disaster Psychiatry, Fukushima Medical University, School of Medicine , Fukushima , Japan.
authors.forename: Masaharu
authors.initials: M
authors.lastname: Maeda
authors.affiliation: Division of Promotion of Collaborative Research on Radiation and Environment Health Effects, Atomic Bomb Disease Institute, Nagasaki University , Nagasaki , Japan.
authors.forename: Naomi
authors.initials: N
authors.lastname: Hayashida
authors.affiliation: Department of Radioisotope Medicine, Atomic Bomb Disease Institute, Nagasaki University , Nagasaki , Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kudo
authors.affiliation: Department of Radiation Medical Sciences, Atomic Bomb Disease Institute, Nagasaki University , Nagasaki , Japan.
authors.forename: Shunichi
authors.initials: S
authors.lastname: Yamashita
authors.affiliation: Department of Global Health, Medicine and Welfare, Atomic Bomb Disease Institute, Nagasaki University , Nagasaki , Japan.
authors.forename: Noboru
authors.initials: N
authors.lastname: Takamura
keywords: Fukushima Daiichi Nuclear Power Station; Fukushima Health Management Survey; Kessler Psychological Distress Scale; Mental health; Nuclear disaster; Posttraumatic stress disorder