title: Predictors of severe psychological distress trajectory after nuclear disaster: evidence from the Fukushima Health Management Survey.
abstract: The Fukushima Daiichi Nuclear Power Plant accident, which occurred after the Great East Japan Earthquake and Tsunami in March 2011, may have a considerable long-term impact on the lives of area residents. The aims of this study were to determine the trajectories of psychological distress using 3-year consecutive data, and to find predictive factors of severe distress that may also prove useful for public health intervention.
  
  
  
  Data were obtained on 12 371 residents who were registered in the municipalities categorised as complete evacuation areas for 3 years after the disaster and who completed an assessment in each of the 3 years.
  
  
  
  Using group-based trajectory modelling, we identified four trajectory patterns distinguished by the levels of psychological distress, which gradually improved over time in all trajectories. Subjective sleep insufficiency, problem drinking, poor social support and perception of radiation risk 3 years after the accident were associated with the severity of psychological distress, according to the multivariate analysis.
  
  
  
  The identified factors may be useful for community-based mental healthcare over the long term following a nuclear disaster.
authors: Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan.
authors: Misari
authors: M
authors: Oe
authors: Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.|Department of Disaster Psychiatry, School of Medicine, Fukushima Medical University, Fukushima, Japan.
authors: Masaharu
authors: M
authors: Maeda
authors: Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.|Department of Epidemiology, School of Medicine, Fukushima Medical University, Fukushima, Japan.
authors: Masato
authors: M
authors: Nagai
authors: Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.|Department of Public Health, School of Medicine, Fukushima Medical University, Fukushima, Japan.
authors: Seiji
authors: S
authors: Yasumura
authors: Department of Neuropsychiatry, School of Medicine, Fukushima Medical University, Fukushima, Japan.
authors: Hirooki
authors: H
authors: Yabe
authors: National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan.
authors: Yuriko
authors: Y
authors: Suzuki
authors: Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.
authors: Mayumi
authors: M
authors: Harigane
authors: Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.|Department of Epidemiology, School of Medicine, Fukushima Medical University, Fukushima, Japan.
authors: Tetsuya
authors: T
authors: Ohira
authors: Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.
authors: Masafumi
authors: M
authors: Abe
mesh_terms: D004307:Dose-Response Relationship, Radiation; D005260:Female; D062406:Fukushima Nuclear Accident; D006306:Health Surveys; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008603:Mental Health; D000069079:Radiation Exposure; D013313:Stress Disorders, Post-Traumatic / Q000139:chemically induced / Q000453:epidemiology*; D013315:Stress, Psychological / Q000139:chemically induced / Q000453:epidemiology*
keywords: SOCIAL MEDICINE