title: Mental health and psychological impacts from the 2011 Great East Japan Earthquake Disaster: a systematic literature review.
abstract: BACKGROUND
  On March 11, 2011, Japan experienced an unprecedented combination of earthquake/tsunami/nuclear accidents (the Great East Japan Earthquake; GEJE). We sought to identify mental health and psychosocial consequences of this compound disaster.
  
  
  METHODS
  A systematic literature review was conducted of quantitative research articles addressing mental health of survivors and the psychological impact of the GEJE. For articles between March 2011 and December 2014, PubMed, PsychINFO, and EMBASE databases were searched with guidance on literature review method.
  
  
  RESULTS
  Forty-nine studies met the inclusion criteria. A substantial proportion of the affected individuals experienced considerable psychological distress. Mental health outcomes included, but were not limited to, posttraumatic stress disorder, depression, and anxiety symptoms. Physical health changes, such as sleeping and eating disturbances, also occurred. In Fukushima, radioactive release induced massive fear and uncertainty in a large number of people, causing massive distress among the affected residents, especially among mothers of young children and nuclear plant workers. Stigma was additional challenge to the Fukushima residents. The review identified several groups with vulnerabilities, such as disaster workers, children, internally displaced people, patients with psychiatric disorders, and the bereaved.
  
  
  CONCLUSIONS
  Following the GEJE, a considerable proportion of the population was mentally affected to a significant degree. The affected individuals showed a wide array of mental and physical consequences. In Fukushima, the impact of nuclear disaster was immense and complex, leading to fear of radiation, safety issues, and stigma issues.
authors.affiliation: Division of Nursing, School of Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513 Japan.|William F. Connell School of Nursing, Boston College, Maloney Hall 140 Commonwealth Avenue, Chestnut Hill, MA 02467 USA.
authors.forename: Nahoko
authors.initials: N
authors.lastname: Harada
authors.affiliation: Department of Psychiatry, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513 Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Shigemura
authors.affiliation: Department of Psychiatry, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513 Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Tanichi
authors.affiliation: Division of Nursing, School of Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513 Japan.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Kawaida
authors.affiliation: Division of Nursing, School of Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513 Japan.
authors.forename: Satomi
authors.initials: S
authors.lastname: Takahashi
authors.affiliation: Division of Nursing, School of Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513 Japan.
authors.forename: Fumiko
authors.initials: F
authors.lastname: Yasukata
keywords: Disaster; Earthquake; Fukushima Daiichi nuclear accident; Great East Japan Earthquake; Mental health; Posttraumatic stress disorder; Psychological service; Radiation fear; Tsunami