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      Mental Health Distress and Related Factors Among Prefectural Public Servants Seven Months After the Great East Japan Earthquake

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          Abstract

          Background

          To develop an empirically informed support measure for workers, we examined mental health distress and its risk factors among prefectural public servants who were affected by the Great East Japan Earthquake and faced a demanding workload in the midterm of the disaster.

          Methods

          We conducted a self-administered health survey of all public servants in the Miyagi prefectural government two and seven months after the Great East Japan Earthquake (3743 workers, 70.6% of all employees). We calculated odds ratios (ORs) and 95% confidence intervals (CIs) for mental distress (defined as K6 score ≥10) in the domain of disaster-work-related stressors, work-related stressors, and disaster-related stressors.

          Results

          Among those with better levels of workplace communication, the only factor that increased the risk of mental distress was not taking a non-work day each week (adjusted OR 2.55, 95% CI 1.27–5.14). Among those with poorer levels of workplace communication, in addition to not taking a non-work day each week (adjusted OR 3.93, 95% CI 3.00–5.15), handling residents’ complaints (adjusted OR 1.55, 95% CI 1.00–2.42), having dead or missing family members (adjusted OR 2.87, 95% CI 1.53–5.38), and living in a shelter more than two months after the disaster (adjusted OR 2.80, 95% CI 1.32–5.95) increased the risk of mental distress.

          Conclusions

          All workers should be encouraged to take a non-work day each week. Among workers with poor workplace communication, special attention should be given to those who handle residents’ complaints, have lost a family member(s), and are living in a shelter for a prolonged period of time.

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          Most cited references9

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          Twelve-month prevalence, severity, and treatment of common mental disorders in communities in Japan: preliminary finding from the World Mental Health Japan Survey 2002-2003.

          To estimate the prevalence, severity, and treatment of Diagnostic and Statistical Manual of Mental Disorders (4th edn; DSM-IV) mental disorders in community populations in Japan, face-to-face household surveys were conducted in four community populations in Japan. A total of 1663 community adults responded (overall response rate, 56%). The DSM-IV disorders, severity, and treatment were assessed with the World Mental Health version of the World Health Organization (WHO) Composite International Diagnostic Interview (WMH-CIDI), a fully structured lay-administered psychiatric diagnostic interview. The prevalence of any WMH-CIDI/DSM-IV disorder in the prior year was 8.8%, of which 17% of cases were severe and 47% were moderate. Among specific disorders, major depression (2.9%), specific phobia (2.7%), and alcohol abuse/dependence (2.0%) were the most prevalent. Although disorder severity was correlated with probability of treatment, only 19% of the serious or moderate cases received medical treatment in the 12 months before the interview. Older and not currently married individuals had a greater risk of having more severe DSM-IV disorders if they had experienced any within the previous 12 months. Those who had completed high school or some college were more likely to seek medical treatment than those who had completed college. The study confirmed that the prevalence of DSM-IV mental disorders was equal to that observed in Asian countries but lower than that in Western countries. The percentage of those receiving medical treatment was low even for those who suffered severe or moderate disorders. Possible strategies are discussed.
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            Differences in PTSD prevalence and associated risk factors among World Trade Center disaster rescue and recovery workers.

            This study compared the prevalence and risk factors of current probable posttraumatic stress disorder (PTSD) across different occupations involved in rescue/recovery work at the World Trade Center site. Rescue and recovery workers enrolled in the World Trade Center Health Registry who reported working at the World Trade Center site (N=28,962) were included in the analysis. Interviews conducted 2-3 years after the disaster included assessments of demographic characteristics, within-disaster and work experiences related to the World Trade Center, and current probable PTSD. The overall prevalence of PTSD among rescue/recovery workers was 12.4%, ranging from 6.2% for police to 21.2% for unaffiliated volunteers. After adjustments, the greatest risk of developing PTSD was seen among construction/engineering workers, sanitation workers, and unaffiliated volunteers. Earlier start date and longer duration of time worked at the World Trade Center site were significant risk factors for current probable PTSD for all occupations except police, and the association between duration of time worked and current probable PTSD was strongest for those who started earlier. The prevalence of PTSD was significantly higher among those who performed tasks not common for their occupation. Workers and volunteers in occupations least likely to have had prior disaster training or experience were at greatest risk of PTSD. Disaster preparedness training and shift rotations to enable shorter duration of service at the site may reduce PTSD among workers and volunteers in future disasters.
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              Posttraumatic stress disorder following the September 11, 2001, terrorist attacks: a review of the literature among highly exposed populations.

              The September 11, 2001 (9/11), terrorist attacks were unprecedented in their magnitude and aftermath. In the wake of the attacks, researchers reported a wide range of mental and physical health outcomes, with posttraumatic stress disorder (PTSD) the one most commonly studied. In this review, we aim to assess the evidence about PTSD among highly exposed populations in the first 10 years after the 9/11 attacks. We performed a systematic review. Eligible studies included original reports based on the full Diagnostic and Statistical Manual of Mental Disorders (4th ed., rev.; American Psychiatric Association, 2000) criteria of PTSD among highly exposed populations such as those living or working within close proximity to the World Trade Center (WTC) and the Pentagon in New York City and Washington, DC, respectively, and first responders, including rescue, cleaning, and recovery workers. The large body of research conducted after the 9/11 attacks in the past decade suggests that the burden of PTSD among persons with high exposure to 9/11 was substantial. PTSD that was 9/11-related was associated with a wide range of correlates, including sociodemographic and background factors, event exposure characteristics, loss of life of significant others, and social support factors. Few studies used longitudinal study design or clinical assessments, and no studies reported findings beyond six years post-9/11, thus hindering documentation of the long-term course of confirmed PTSD. Future directions for research are discussed. © 2011 American Psychological Association
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                Author and article information

                Journal
                J Epidemiol
                J Epidemiol
                JE
                Journal of Epidemiology
                Japan Epidemiological Association
                0917-5040
                1349-9092
                5 July 2014
                24 May 2014
                2014
                : 24
                : 4
                : 287-294
                Affiliations
                [1 ]Department of Adult Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
                [2 ]Miyagi Mental Health and Welfare Center, Osaki, Miyagi, Japan
                [3 ]National Information Center of Disaster Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
                Author notes
                Address for correspondence. Yuriko Suzuki, MD, MPH, PhD, Department of Adult Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8553, Japan (e-mail: yrsuzuki@ 123456ncnp.go.jp ).
                Article
                JE20130138
                10.2188/jea.JE20130138
                4074633
                24857952
                8a0e6239-96ba-4984-81e0-40fa83cce368
                © 2014 Yuriko Suzuki et al.

                This is an open access article distributed under the terms of Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 19 September 2013
                : 16 February 2014
                Categories
                Original Article
                Others

                mental health,disaster,worker,cross-sectional study,risk factors

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