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Background: Post-evacuation return after mandatory hospital evacuation due to complicated disasters is often overlooked and not well-discussed. Aims: In this study, we explored the factors which are related to the ease or difficulty of the post-evacuation return to Fukushima prefecture of psychiatric inpatients who had been evacuated to hospitals outside the prefecture because of the Great East Japan Earthquake (GEJE) and subsequent Fukushima Daiichi Nuclear Power Plant (FDNPP) accident. Method: This retrospective cohort study included evacuated psychiatric hospital inpatients who were registered in the Matching Project for Community Transition (MPCT) and had been traced until July 31, 2019. A total of 531 patients were included for the analyses. Univariable and multivariable analysis were conducted to detect the patients' traits including their psychiatric/physical backgrounds which were associated with their outcome – the time from GEJE to the date of return to Fukushima. Results: Over half of the patients returned to Fukushima. In the multivariable analysis, the patients' gender (male), age (older), and psychiatric diagnoses of schizophrenia, schizotypal and delusional disorders (ICD-10, F20–29) showed lower hazard ratio (HR) and statistically significant association with the difficulties of post-evacuation return. Meanwhile, disorders of psychological development (F80–89), diseases of the nervous (G00–99, except G40–41) and genitourinary (N00–99) systems showed higher HR and statistically significant association with the ease of return. Conclusions: The specific characteristics of the psychiatric inpatients including their psychiatric and physical status are associated with their post-evacuation return to their hometown. These results indicated that the evacuated hospitals' practitioners and staffs from the MPCT understood the necessity of the earlier return of inpatients to their hometown. Moreover, clinicians should pay more attention to some symptoms unique to psychiatric patients which contributed to their difficulties in returning safely or expressing their hope to return. [ABSTRACT FROM AUTHOR]

Background: The Great East Japan Earthquake triggered accidents at the Fukushima Daiichi Nuclear Power Plant, becoming the first complex disaster that included both a natural and a nuclear power disaster. This study examines how complex disasters affect patients with dementia. Methods: Participants included the 331 people diagnosed with dementia out of the 2482 new patients (between January 2008 and December 2015) at a psychiatric hospital located in the indoor sheltering zones nearby mandatory evacuation zones. Medical records were retrospectively examined to identify the number of new patients with dementia, the severity, their chief complaints, and the behavioural and psychological symptoms of dementia (BPSD) types. BPSD were classified into the hyperactive BPSD group and the hypoactive BPSD group. The hyperactive BPSD group was further subdivided into the hyperactivity‐impulsivity‐irritability‐disinhibition‐aggression‐agitation group, which exhibited agitation, disinhibition, and irritability, and the psychosis group, which exhibited delusions and hallucinations. The hypoactive BPSD group included depression, inactivity, apathy, and anxiety. Results were divided into the period before the complex disaster (2008–2010) and after (2012–2015) and were compared. In addition, the post‐complex‐disaster period was subdivided into the early phase (2012–2013) and the late phase (2014–2015). Results: The proportion of new patients with dementia increased significantly after the disaster. Although there was no change in patients' age and the disease's severity, the proportion of patients whose chief complaint was BPSD increased significantly after the disaster. Furthermore, there was a significant increase in the hyperactivity‐impulsivity‐irritability‐disinhibition‐aggression‐agitation group in the early post‐complex‐disaster phase and a significant increase in the psychosis group in the late post‐complex‐disaster phase. Conclusion: This complex disaster caused increased consultations from patients with dementia and increased BPSD. Additionally, it increased participants' symptoms of agitation and irritability in the early post‐complex‐disaster phase and the proportion of hallucinations and delusions in the late post‐complex‐disaster phase. [ABSTRACT FROM AUTHOR]

The debate regarding the need for hospital evacuation and the evacuation distance remains rather chaotic. Furthermore, the relationship between hospital evacuation and the prognoses of psychiatric inpatients has not yet been investigated. We aimed to reveal the association between the long-term prognosis of psychiatric inpatients evacuated immediately following the Fukushima Daiichi Nuclear Power Plant accident and their backgrounds. In this retrospective cohort study, 777 psychiatric inpatients who were immediately evacuated from their hospitals following the accident were included for analysis. Survival time was the primary outcome. We conducted univariable and multivariable analyses to examine the associations between mortality and linear distance of evacuation and different backgrounds, including psychiatric/physical traits. Univariable analysis showed that the estimated survival time among patients was significantly associated with their evacuation distance. A multivariable analysis showed that a longer evacuation distance had a significantly lower hazard ratio (HR) and resulted in lower mortality. In contrast, older patients with physical complications of respiratory disease (International Statistical Classification of Diseases and Related Health Problems 10th revision, J00–99) and genitourinary disease (N00–99) showed a significantly higher HR and had a higher mortality than patients without these complications. To prevent death among elderly psychiatric inpatients with physical comorbidities during disasters, the evacuation destination should be determined taking into consideration the evacuees' tolerance for long-distance transportation and the availability of post-evacuation care in the destination hospitals. [ABSTRACT FROM AUTHOR]

Several articles have reported long-term outcomes and factors related to mortality among evacuated hospitalized patients or nursing home residents after the Fukushima Daiichi Nuclear Power Plant accident associated with the Great East Japan Earthquake,1-4 but little is known about these outcomes among psychiatric inpatients. The SMR of all psychiatric inpatients in 2011 was seriously high (3.33; 95% confidence interval [CI], 2.53-4.29), particularly for inpatients evacuated within Fukushima Prefecture (5.43; 95%CI, 3.82-7.49) compared with that for inpatients evacuated outside the prefecture (2.02; 95%CI, 1.26-3.05). [Extracted from the article]

Psychiatric inpatients in the Fukushima prefecture were immediately evacuated from hospitals following the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident in 2011. Whereas the psychiatric status and physical condition of these patients have been considered as factors related to triage during hospital evacuation, few studies show how this background affects the evacuation destination. Thus, the study objective was to reveal associations between hospital evacuation destinations among psychiatric inpatients and their characteristics. This retrospective study enrolled psychiatric inpatients who had been evacuated by the Fukushima prefectural government following the FDNPP accident (N = 783). Patients were classified into two groups based on their evacuation destination (within/outside the Fukushima prefecture). Univariable and multivariable analyses were conducted to investigate the associations between evacuation destination and patients' traits, including psychiatric/physical backgrounds. Three-quarters of inpatients were evacuated to hospitals outside the prefecture. Multivariable analysis showed that patients diagnosed with mental retardation (ICD-10 F70–79) and psychiatric patients with respiratory diseases (J00–99), genitourinary diseases (N00–99) as comorbidities tended to have been evacuated to hospitals within the prefecture. By contrast, patients with nervous system diseases (G00–99) as comorbidity tended to have been evacuated to hospitals outside the prefecture. In psychiatric patients, specific psychiatric diagnoses and several types of physical comorbidities were associated with the evacuation destination. Prospective follow-up studies are necessary to reveal how the presumed triage strategy has improved the outcomes in evacuated psychiatric patients. [ABSTRACT FROM AUTHOR]