title: Psychological distress among tsunami refugees from the Great East Japan earthquake.
abstract: BACKGROUND
  The 2011 Great Japan tsunami and nuclear leaks displaced 300 000 people, but there are no large studies of psychological distress suffered by these refugees.
  
  
  OBJECTIVE
  To provide a first assessment of major factors associated with distress and dysfunctional behaviour following the disasters.
  
  
  METHODS
  All refugee families living in Miyagi were sent a questionnaire 10-12 months after the disasters. 21 981 participants (73%) returned questionnaires. Questions assessed psychological distress (Kessler Psychological Distress Scale, K6), dysfunctional behaviours, demographics, event exposure, change in physical activity, household visitors and emotional support.
  
  
  RESULTS
  Nine percent scored 13+ on the K6 indicating risk of severe mental illness. Psychological distress was greater among Fukushima refugees. Demographic variables, family loss, illness history and change in physical activity were associated with psychological distress and dysfunctional behaviours. Associations between psychological distress and dysfunction and visitors/supporters depended on relation to supporter.
  
  
  CONCLUSIONS
  Practitioners need to recognise existing disease burden, community histories and family roles when intervening following disasters.
  
  
  BACKGROUND
  None.
  © The Royal College of Psychiatrists 2015. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.
authors.affiliation: , PhD, Department of Psychology, University of Warwick, Coventry, UK.
authors.forename: Robin
authors.initials: R
authors.lastname: Goodwin
authors.affiliation: , MA, Faculty of Humanities, Yamaguchi University, Yamaguchi, Japan.
authors.forename: Masahito
authors.initials: M
authors.lastname: Takahashi
authors.affiliation: , PhD, School of Journalism, Fudan University, Shanghai, China.
authors.forename: Shaojing
authors.initials: S
authors.lastname: Sun
authors.affiliation: , PhD, School of Social Work, Ariel University, Ariel, Israel.
authors.forename: Menachem
authors.initials: M
authors.lastname: Ben-Ezra