The prevalence of mental distress before the Great East Japan Earthquake and the associated impact of an aged society: An ecological study

Abstract

Various studies have determined that the Great East Japan Earthquake (GEJE) caused mental distress among residents in affected areas. However, previous studies had not considered the prevalence of mental distress before the GEJE, and ignored the impact of an aged society on mental distress. Therefore, we aimed to describe the prevalence of mental distress before the GEJE in Miyagi Prefecture, Japan and elucidate the effect of an aged society on mental distress. We conducted an ecological study, using municipality in Miyagi Prefecture as the study unit. We used the cross-sectional mail survey data conducted in February 2011. We performed a correlation analysis in each of the 39 municipalities in Miyagi Prefecture. The prevalence of serious mental distress was 9.1%. The proportion of the population aged 65 years or older was related to the prevalence of serious mental distress in municipalities with a low proportion of all workers engaged in primary industry and with a high estimated number of inpatients with mental illness. We found that residents in Miyagi Prefecture suffered from poor mental health before the GEJE. Aged society was related to serious mental distress in the areas with advanced industrial structure and more patients with mental illness. We should approach mental health problems in the context of social structure, particularly in an aged society, based on facts about mental distress before the GEJE.

Psychological distress after the Great East Japan Earthquake: two multilevel 6-year prospective analyses

“…Across both samples we found relatively low levels of psychological distress, particularly considering the high levels of household destruction suffered by our samples and the already high levels of distress recorded in Miyagi Prefecture prior to the earthquake. 17 Studies in Fukushima over a period of 3 years after the Great East Japan Earthquake 18 and in Niigata in the 5 years consecutive to the 2004 earthquake in that prefecture 19 showed decreases in distress over time, and in our prospective multilevel models time was also the major contributor to variance in post-disaster distress. As elsewhere, effects for gender and previous psychiatric disorders persisted across waves: in previous studies women carried the heavier emotional burden post-disaster, 19 potentially as a result of their lesser access to positive social support.…”

“…Ecological analyses conducted shortly before the earthquake suggest particular vulnerability among in-patients with mental illness. 17 Given that many of these institutions were severely disrupted during the Great East Japan Earthquake, special care must be taken to support those with enduring clinical vulnerabilities in newly dispersed communities. Where records survive, clinicians may seek out those with pre-existing diagnoses and offer targeted support if required.…”

“…There is evidence that prevalence of severe mental illness was already high in Miyagi Prefecture in the months before the Great East Japan Earthquake (estimated at 9.1% in February 2011), and was therefore not necessarily significantly augmented by these subsequent events. 17 The lack of significant increase in mental illness may partly result from a culturally fatalistic belief in shouganai ('it cannot be helped'), often attributed to an affected population's familiarity with natural disasters in Japan. It is also consistent with the wider finding, across the research literature on mass trauma, that only a minority of those affected are severely distressed.…”

“…Our outcome variable (psychological distress) was measured using the Japanese version of the six-item Kessler Psychological Distress Scale (K6), 15 a self-report scale intended to detect non-specific psychological distress and widely employed in Japan. 16,17 Items were scored on five-point scales ranging from 0 (no distress) to 4 (maximum stress), with possible total scores ranging from 0 to 24. Scores of 8–12 indicate probable mild to moderate mental illness and scores of 13–24 indicate severe mental illness.…”

The impact of uncertainty in society on the use of traditional, complementary and alternative medicine: a comparative study on visits to alternative/traditional/folk health care practitioners

“…In such uncertain social contexts, people experience various anxieties in their lives [36]. With regard to the relationship between health and uncertainty in society, previous researches have reported that uncertain social contexts, such as social inequality, economic recession, and ageing population are harmful to health [37–39]. Furthermore, previous studies have shown that various anxieties in life, such as job insecurity, adversely affect the health of individuals experiencing them [40, 41].…”