Search

After disasters, direct deaths and secondary health effects, such as diabetes and psychological distress, can occur. It is critical to compare the magnitudes of these risks to promote effective public health measures. In this study, we used the loss of happy life expectancy (LHpLE) to compare the risks associated with diabetes, psychological distress, and radiation-induced cancer after the 2011 Fukushima disaster. Two questionnaire surveys were conducted on people affected by the disaster to investigate the potential associations between diabetes and psychological distress, as well as breast cancer and reduced emotional happiness, with 680 and 582 participants, respectively. Additionally, we calculated the LHpLE owing to these risks. Although no significant reduction was found in emotional happiness due to diabetes or breast cancer, a significant reduction occurred due to psychological distress (0.265 and 0.476 for males and females, respectively). In the population aged 40–74 years, the LHpLE due to radiation-induced cancer, diabetes, and psychological distress were 0.0013, 0.14, and 0.21 years, respectively. This suggests that the association of LHpLE with diabetes and psychological distress was over two orders of magnitude greater than that associated with radiation-induced cancer. Within 7 years following the disaster, LHpLE due to diabetes increased, highlighting that diabetes is an ongoing issue. Therefore, this novel indicator of the LHpLE can provide a foundation for promoting effective public health measures following disasters.

In this study, we aimed to use the loss of happy life expectancy (LHpLE), an indicator that enables risk assessment considering wellbeing, to compare the risks of environmental carcinogenic chemicals in Japan. First, we surveyed Japanese people to determine their emotional happiness by age and sex and evaluated whether cancer incidence reduced emotional happiness. Questionnaires were administered to a general population panel and a panel of patients with cancer in 2022, recruiting a predetermined number of responses of 5000 and 850, respectively. Second, using the survey data, LHpLE was calculated for radon, arsenic, and fine particulate matter (aerodynamic diameter 2.5) and compared to psychological distress, considering increased mortality and decreased emotional happiness due to these risks. We discovered no significant decrease in emotional happiness due to cancer incidence and no significant associations between emotional happiness and cancer type, history, or stage. LHpLE was calculated to be 6.4 × 10−3years for radon, 2.6 × 10−3years for arsenic, 1.1 × 10−2years (2012 exposure) and 8.6 × 10−4years (2020 exposure) for PM2.5, and 9.7 × 10−1years for psychological distress. The fraction of losses caused by these carcinogenic chemicals to HpLE exceeded 10−5, suggesting that risk reduction for these chemicals is important in environmental policies. The LHpLE indicator allows for comparing different types of risks, such as environmental chemicals and psychological distress. This is the first study to compare chemical risks using the LHpLE indicator.

Background The efficacy of the unified protocol of the transdiagnostic treatment for emotional disorders (UP) has been poorly studied in patients with depressive disorders. This study aimed to examine the efficacy of UP for improving depressive symptoms in patients with depressive and/or anxiety-related disorders. Methods This assessor-blinded, randomized, 20-week, parallel-group, superiority study compared the efficacy of the UP with treatment-as-usual (UP-TAU) v. wait-list with treatment-as-usual (WL-TAU). Patients diagnosed with depressive and/or anxiety disorders and with depressive symptoms participated. The primary outcome was depressive symptoms assessed by GRID-Hamilton depression rating scale (GRID-HAMD) at 21 weeks. The secondary outcomes included assessor-rated anxiety symptoms, severity and improvement of clinical global impression, responder and remission status, and loss of principal diagnosis. Results In total, 104 patients participated and were subjected to intention-to-treat analysis [mean age = 37.4, s.d. = 11.5, 63 female (61%), 54 (51.9%) with a principal diagnosis of depressive disorders]. The mean GRID-HAMD scores in the UP-TAU and WL-TAU groups were 16.15 (s.d. = 4.90) and 17.06 (s.d. = 6.46) at baseline and 12.14 (s.d. = 5.47) and 17.34 (s.d. = 5.78) at 21 weeks, with a significant adjusted mean change difference of −3.99 (95% CI −6.10 to −1.87). Patients in the UP-TAU group showed significant superiority in anxiety and clinical global impressions. The improvement in the UP-TAU group was maintained in all outcomes at 43 weeks. No serious adverse events were observed in the UP-TAU group. Conclusions The UP is an effective approach for patients with depressive and/or anxiety disorders.

Objective: Those affected by the Fukushima disaster have reported a decline in well-being. Although listening to music is expected to promote well-being, no study has revealed this association after a disaster. This study’s objective is to clarify the association between well-being and music listening habits in the aftermath of the Fukushima disaster. Methods: A self-report online survey was conducted with 420 residents who were asked to rate 5 types of well-being: life satisfaction, positive emotion, negative emotion, psychological distress, and mental health changes after the Fukushima disaster. To meet inclusion criteria, the participants had to be research company monitors between the ages of 20 and 59 and living in Fukushima Prefecture at the time of the survey. Their music listening habits (eg, recent favorite music) and demographic information (eg, evacuation experience due to the disaster: 20.7%) were also collected. We examined the associations between well-being and music listening habits by univariate analysis followed by a logistic analysis with an adjustment for covariates. Results: Positive emotions were significantly associated with any type of music listening habits that participants practiced. We also observed gender and age differences between the associations. Conclusion: This study provides foundational insights into the role of music in improving post-disaster well-being.

BACKGROUND With increases in both the number of mental health disorders people are experiencing and the difficulty in accessing mental health care, the demand for accessible mental health care services has increased. The use of mobile devices has allowed people to receive care in their daily lives without restrictions from time or location. However, the majority of publicly available mobile health apps are not evidence-based, and the top-rated apps are not always safe or user-friendly and may not offer clinically beneficial results. OBJECTIVE This study aims to create a cultural adaptation of the American Psychiatric Association’s comprehensive app-evaluation framework in Japan using a modified Delphi expert consensus. METHODS A modified Delphi study has three rounds. In the first round, our working group sends a questionnaire to the panelists, who then complete it. In the second and third rounds, the working group sends a questionnaire and a summary of the panelists’ answers based on each of the previous rounds. The panelists answer the questionnaires based on this summary. The summarization procedure is automated to help reduce the biases that can be generated when panelists’ answers are summarized and when the panelists receive them. The working group sends only the result of the summarization with the next round’s questionnaire. All interactions between the working group and the panelists will be conducted on Qualtrics, a questionnaire platform. To culturally validate the comprehensive mental health app evaluation framework, participants from the following three categories will be recruited in Japan: (a) researchers, (b) practitioners, and (c) app developers. RESULTS This study received funding from a crowdfunding campaign in Japan (https://readyfor.jp/projects/mhealth-app-db). The Delphi study would begin in January 2023. We have already completed the translation of the 105 original application evaluation item questions by December 2022. CONCLUSIONS The results of the modified Delphi method presented in this paper may provide direction for the development and use of mental health apps in the future.

Measuring long-term antibody titer kinetics and subsequent COVID-19 vaccinations are crucial for identifying vulnerable populations. Our aim was to determine the association between long-term antibody kinetics up to seven months post second vaccination, including peak titers and factors. A three-time survey was performed in 2021 on healthcare workers in Japan to investigate the changes in humoral immunity using chemiluminescence immunoassay. We included participants who completed the second-dose vaccination, the antibody survey for all three terms, and those who were not infected with COVID-19. A latent growth curve model was used to identify the factors affecting the peak titer and decreasing the antibody slope. Overall, 205 eligible participants were included in the final analysis. Of these, the mean titers of immunoglobulin G (IgG) against the spike (S) protein and the neutralizing activity at seven months after the second vaccination decreased to 154.3 AU/ml (8.8% of the peak titer) and 62.1 AU/ml (9.5% of the peak titer), respectively. The growth model of IgG showed that age significantly affected peak titers (p < 0.001); however, a significant difference was not found for the decreasing slope. In conclusion, aging adults had significantly lower peak antibody titers, however age did not relate to decreasing slope.

To determine the relationship between family uncertainty and family quality of life (QOL) during the recovery period of patients with cerebrovascular disease in Japan, and the factors that influence family uncertainty.Data were collected from copies of patient medical files and interviews with family members of 85 patients admitted to two rehabilitation wards in Japan. Family uncertainty was measured using the Japanese version of the Managing Uncertainty in Illness Scale-Family Member form (MUIS-FM) and family QOL using the World Health Organization Five Well-Being Index (WHO-5). Multiple linear regression analysis was applied to investigate associated factors.WHO-5 score was significantly negatively associated with MUIS-FM score (β = - 0.236, p = 0.03); other factors associated with MUIS-FM score were the Care Shared Decision-Making Questionnaire for care providers score (β = - 0.384, p 0.001), Short Intolerance of Uncertainty Scale score (β = 0.296, p = 0.001), and history of surgical treatment (β = 0.199, p = 0.032).Family QOL could be improved by reducing family uncertainty. It is also suggested that promoting shared decision-making between healthcare providers and patients' families may help reduce family uncertainty. It is necessary to take into account not only family intolerance of uncertainty but also uncertainty that varies by type of acute care provided.

It is crucial to evaluate ethical issues regarding evacuation orders, especially after a nuclear disaster. After the Fukushima accident in 2011, the Japanese government ordered the affected people to evacuate. The evacuation orders have now been lifted in many areas. A risk trade-off analysis between benefits and risk associated with returning home would help in evaluating the justification for the lifting of the evacuation order in the aftermath of a nuclear disaster. Here, we performed a risk trade-off analysis among people returning home after the lifting of an evacuation order between an increase in emotional happiness (positive effect) and loss of life expectancy due to additional radiation exposure (negative effect), using a happy life expectancy (HpLE) indicator. Emotional happiness was estimated using questionnaires distributed among the affected people who lived in municipalities where evacuation orders were lifted. Loss of life expectancy was estimated under a scenario that returnees received 20 mSv in the year of return and subsequent radiation exposure. Increase in emotional happiness due to returning home was ~1–2 orders of magnitude higher among women aged 20, 40 and 65 years than the loss of life expectancy due to additional radiation exposure. This finding has implications for the justification for the lifting of evacuation orders.

The Fukushima Daiichi Nuclear Power Station (NPS) accident, which occurred in March 2011, is having long-term effects on children. About 3 years after the accident, we identified three patterns of peer relationship problems and four patterns of emotional symptoms using group-based trajectory modeling. As a result, we reported that different factors might be related to very severe trajectories of peer relationship problems and emotional symptoms. In this study, we used five waves of data from fiscal year (FY) 2011 to FY2015 from the Mental Health and Lifestyle Survey, a detailed survey of the Fukushima Health Management Survey started in FY2011. We analyzed 7013 residents within the government-designated evacuation zone (aged 6–12 years old as of 11 March 2011) with responses to all items of psychological distress in at least one wave from FY2011 and FY2015. We planned this study to describe the trajectories of peer relationship problems and emotional symptoms in children and to examine potential risks and protective factors over the 5 years following the NPS accident. We identified four patterns of peer relationship problems and five patterns of emotional symptoms using latent class growth analysis. For peer relationship problems, male sex, experiencing the NPS explosion and lack of exercise habits were associated with the severe trajectory group. For emotional symptoms, experiencing the NPS explosion, experiencing the tsunami disaster and lack of exercise habits were associated with the severe trajectory group. Exercise habits are very important for the mental health of evacuees after a nuclear disaster.

After the 2011 Fukushima nuclear accident, intercultural friction and aversion arose between evacuees and host community residents in relocation areas. We examined whether a belief in group interdependence—the extent to which an individual believes that group function is realized through interdependence with related other groups—is consistent with positive interactions between evacuees and hosts. A door‐to‐door survey of 77 evacuees and 75 hosts revealed that residents with an integrated social identity interacted favorably with both ingroup and outgroup members, and that a belief in group interdependence was consistent with the integration of social identity between the evacuee and host communities. Those findings suggest that a belief in group interdependence can reduce intercultural conflict by allowing both immigrants and host residents to acquire an integrated social identity without the dilemma of internalizing different cultures into an individual's mind.

Objectives Despite evidence of negative aspects of the work–caregiving interface (e.g., work–family conflict) among family caregivers of people with dementia (PWD), little is known about the positive aspects (e.g., enrichment). We examined antecedents and outcomes of family-to-work enrichment (FWE) and work-to-family enrichment (WFE) among working family caregivers of PWD. In terms of antecedents, we investigated whether factors that alleviated work–family conflict increased enrichment. Method We conducted a 3-wave 6-month-interval longitudinal online survey of Japanese working family caregivers of PWD (N = 747). We examined the mediational effects of WFE and FWE on associations between participants’ work resources (job control, supervisor support, co-worker support, and organizational support) and caregiving support and their well-being (psychological distress and quality of life). We also examined the moderating effect of caregiving self-efficacy on the relationships between caregiving support/caregiving demands and FWE. Results Our longitudinal analysis confirmed supervisor support had a positive effect on WFE. FWE had no significant longitudinal mediating effect on the association between caregiving support and well-being, and self-efficacy had no longitudinal moderating effect on FWE. Discussion Supervisor support is important for WFE, but greater enrichment does not necessarily improve family caregiver well-being. Caregiving experience (i.e., caregiving demands and caregiving support) has little effect on the work–caregiving interface. Policy makers should focus on supporting companies to create family-friendly work environments. More research is needed on factors that increase FWE and moderate the relationship between enrichment and working family caregivers’ well-being.

Affective styles are assumed to play an important role in maintaining negative affect, including anxiety and depression. However, little is known about the longitudinal relationship between affective styles and symptoms. Therefore, we conducted a longitudinal study to examine the influence of affective styles, assessed using the Affective Style Questionnaire, on anxiety and depression among clinical populations in Japan. Using an online survey, 1521 participants (406 with major depressive disorder; 479 with one or more anxiety disorders; and 636 with both) answered the Affective Style Questionnaire and measures of emotion regulation, anxiety and depression symptoms. Data were collected twice over 2 months. Confirmatory factor analyses replicated the same four-factor structure found in a previous sample of Japanese university students. Hierarchical regression analyses revealed that the affective styles had a slightly greater effect on anxiety symptoms but not on depression compared to other common emotion regulation strategies, such as suppression and reappraisal measured by the Emotion Regulation Questionnaire (ERQ). Limitations of this study were that it used online surveys, in which, participants' diagnostic statuses were based on unverifiable self-reports. In conclusion, the association of affective styles with anxiety and depression among the clinical populations was prospectively confirmed. Further study is needed to examine the association considering the combination or profiles of affective styles among different emotional disorders.

Although the coronavirus disease 2019 (COVID-19) pandemic and relevant preventive measures can affect the economic status and mental health of the public, their effect remains unraveled owing to a limited number of surveys conducted before and during the COVID-19 pandemic. We investigated the association of COVID-19 and relevant measures with multivariate outcomes among people affected by the Fukushima disaster in 2011 using the difference-in-differences (DID) method. We then analyzed the associations between sociodemographic factors and outcomes. We assessed psychological distress, problem drinking, insomnia state, unemployment, household economic decline, and interpersonal problems using three questionnaire surveys administered in 2018, 2019, and 2020. Participants were grouped according to three time periods by dates of voluntary stay-at-home requests (February 26) and the declaration of emergency (April 16) in Japan. The years 2020 and 2019 were regarded as the treatment group and control group, respectively, after confirming that no DIDs were found between 2018 and 2019. We performed regression analyses to identify the risk factors for outcomes. The DIDs were significant for household economic decline after the declaration of emergency, whereas problem drinking significantly improved. No significant DIDs were observed for other mental health outcomes including psychological distress and insomnia state. Absence of counselors was positively and significantly associated with all outcomes in 2020. Overall, people affected by the Fukushima disaster experienced more economic damage after the declaration of emergency during the COVID-19 pandemic but their mental health status did not reduce. Identifying people who have no counselors and providing them with support are emergent requirements to prevent a subsequent mental health decline., Highlights • The economic status and mental health were evaluated after coronavirus disease 2019. • We assess the effect in Fukushima residents by the difference-in-differences method. • The economic status worsened after governmental restrictions of social activities. • The mental health status was maintained after implementing public measures. • Lack of counselors was a risk factor for a worsening economy and poor mental health.

After the Fukushima accident, airborne monitoring was implemented to measure airborne radiation. We examined the relationships between airborne and individual radiation monitoring and clarified the use of airborne monitoring to evaluate the effects of decontamination on residents’ received doses. We used the air dose rate data from four airborne monitors conducted between 2013 and 2016, and the dose data from four individual monitors (in which a total of 18 392 adults and 3650 children participated), conducted in Minamisoma City during the same period. We examined the Pearson correlation coefficients between the airborne and individual monitoring data and estimated exposure ratios (ERs; ratios of individual dose to air dose rates) among adults and children. We also estimated the effects of decontamination on residents’ doses based on airborne monitoring data, adjusting this for timing and dosing through propensity score matching, which were then compared to individual monitoring data. There were significant correlations between airborne and individual monitoring doses among adults and children, and more than 80% of residents showed a good estimation–observation agreement within a factor of two. The median of ERs was 0.304 and 0.250 among adults and children, respectively. There was a significant difference between the two. Effects of decontamination on residents’ doses estimated from airborne monitoring were significantly lower than those estimated from individual monitoring. These findings suggest that airborne monitoring can be used to estimate representative radiation doses within residential areas. It may be a useful tool for enhancing communication among stakeholders and supporting individual and policy decisions; however, it is less sensitive for evaluating individual effects of decontamination than individual monitoring. Combined use of airborne and individual monitoring also showed a lower median of ERs in children than in adults and in a Japanese government’s model, possibly due to prioritised decontamination for children and differences between their behavioral patterns.

Background The Posttraumatic Stress Disorder (PTSD) Checklist (PCL) is a widely used self-report measure of PTSD. The reliability/precision and validity of the updated PCL version for the fifth edition of the Diagnostic and Statistical Manual for Mental Disorders (PCL-5) have only been evaluated in limited populations. This study aimed to examine the factor structure, reliability/precision, and validity of the PCL-5 as assessed by convergent and discriminant relationships with related constructs among Japanese individuals who experienced various traumatic events. Methods We conducted an online survey of Japanese adults using the PCL-5 and other assessments for PTSD, depression, anxiety, other psychiatric comorbidities, and functionality. A total of 3090 individuals who met a probable diagnosis of PTSD and another 1837 who had experienced traumatic events but did not meet the probable PTSD diagnosis answered the questionnaires. Results Confirmatory factor analysis demonstrated the best fit with a 7-factor model. This factor structure was temporally stable across 2 time points for 4 months. The total and subscale scores showed good internal consistency and modest test-retest reliability. The convergent and discriminant relationships of the PCL-5 total score with related constructs were demonstrated. Limitations This study did not use the gold standard interview to assess the diagnostic status of PTSD. Also, the sampled population was younger and had lower incomes in comparison to the census data. Conclusions Our results support the utility of the PCL-5 for assessing PTSD symptoms in Asian populations.

After the Fukushima nuclear accident in 2011, there was confusion among the public caused by uncoordinated information about radiation provided by diverse channels. We explored the association between information sources regarding reconstruction progress after the disaster and mental fatigue in Fukushima. We used data from the annual public opinion survey by the Fukushima Prefectural Government on its policies from 2013 to 2015, which contained survey responses from 1,300 community residents randomly selected from the 28 municipalities in the Fukushima Prefecture. The survey contained a question assessing mental fatigue: "How often do you usually feel mentally tired or depressed?" In total, 2,130 participants (758 participants in 2013, 699 participants in 2014, and 673 participants in 2015) were analyzed. The respondents were classified as two categories, "high mental fatigue" and "low mental fatigue," based on their responses to this question. Overall, the proportion of participants with high mental fatigue was 13.2%. There was no association between the year of survey or occupation and high mental fatigue. Cluster analysis was performed to classify information sources. Then, we conducted a cross-sectional analysis of the associations between clusters of information sources and high mental fatigue. We found that unreliable information sources, such as "Internet" and "a combination of TV, radio, and word of mouth," were significantly associated with high mental fatigue, compared with reliable information sources, such as "municipal public relations in addition to major media (newspaper, TV, and radio)." These findings provide important insights into how information sources affect mental fatigue following a disaster.

We aimed to clarify the factor structure of a bonding measure among Japanese fathers with infants and the factors associated with the subscales. Among fathers of children attending the 4-month health checkup, the Japanese version of the Mother-to-Infant Bonding Scale had a two-factor structure comprising "anger" and "lack of affection." Anger was associated with fathers' work demands and poor mental condition, and lack of affection with fathers' older age, poor mental condition, and interpersonal problems at home. Paternal parenting support needs to account for not only the fathers themselves, but also interpersonal communication at home and in the work environment.Nos propusimos clarificar la estructura de factores de una medida de acercamiento afectivo entre los papás japoneses con infantes y los factores asociados con las subescalas. Entre los papás de niños que asistían al chequeo de salud de 4 meses, la versión japonesa de la Escala de Acercamiento Afectivo Madre a Infante tuvo una estructura de dos factores que comprende “ira” y “falta de afecto.” La “Ira” se asoció con las responsabilidades del trabajo de los papás y la débil condición mental, y la “falta de afecto” con la más vieja edad de los papás, la débil condición mental y los problemas interpersonales en casa. La crianza paterna apoya las necesidades de dar cuenta no sólo de los padres mismos, sino también de la comunicación interpersonal en casa y el ambiente de trabajo.Notre but était de clarifier la structure de facteur d'une mesure de lien entre les pères japonais de nourrissons et les facteurs liés aux sous-échelles. Parmi les pères d'enfants présents pour leur visite médicale de 4 mois la version japonaise de l'Echelle de Lien Mère-Nourrisson était une structure de deux facteurs comprenant “la colère” et “le manque d'affection”. “La colère” était liée aux exigences du travail des pères et à une condition mentale moins élevée, et “le manque d'attention” était lié à l’âge plus élevés des pères, à une condition mentale moins élevée et à des problèmes relationnels à la maison. Le soutien de parentage paternel a besoin d’être pris en compte non seulement pour ce qui concerne les pères eux-mêmes mais aussi la communication relationnelle à la maison et l'environnement au travail.Vater-Kind-Bindung bei japanischen Vätern von Säuglingen: Eine gemeindebasierte Studie zum Zeitpunkt einer 4-Monats-Kinderuntersuchung Unser Ziel war es, die Faktorenstruktur und die mit den Subskalen verbundenen Faktoren eines Maßes für Bindung bei japanischen Vätern von Kleinkindern zu untersuchen. Die japanische Version der Mutter-Kind-Bindungsskala hatte bei den Vätern, deren Kinder 4 Monate nach der Geburt ärztlich untersucht wurden, eine Zwei-Faktoren-Struktur, die “Ärger” und “Mangel an Zuneigung” umfasste. “Ärger” war mit Arbeitsanforderungen und schlechter psychischer Verfassung bei den Vätern assoziiert, während “fehlende Zuneigung” mit zunehmendem Alter und schlechter psychischer Verfassung bei den Vätern sowie zwischenmenschlichen Problemen zu Hause assoziiert war. Erziehungsunterstützung für Väter sollte nicht nur die Väter selbst, sondern auch die zwischenmenschliche Kommunikation zu Hause und das Arbeitsumfeld berücksichtigen.日本人の乳幼児の父親における父−子ボンディング:3−4カ月健診での地方自治体ベースの研究 本研究の目的は、日本人の乳児の父親におけるボンディング尺度の因子構造と下位尺度に関連する因子を明らかにすることである。4ヶ月健診を受けた乳児の父親に対して行ったMother-to-Infant Bonding Scale (MIBS) 母子絆尺度の日本語版は、「怒り」と「愛情の欠如」の2因子構造であった。「怒り」は父親の仕事の負担と不健全な精神状態に関連し、「愛情の欠如」は父親の高齢化、不健全な精神状態、家庭での対人関係の問題に関連していた。父親への育児支援においては、父親自身だけでなく、家庭や職場環境での対人コミュニケーションも考慮する必要がある。.我们旨在阐明一次日本父亲与婴儿之间连结关系测量的因素结构, 以及与各分量表相关的因素。在四个月的儿童参加健康检查时, 其父亲在日本版的“母婴连结量表”中, 有一个由“愤怒”和“缺乏亲情”组成的双因素结构。“愤怒”与父亲的工作烦恼和不良心理状况有关, 而“缺乏亲情”与父亲年龄大、不良心理状况和家庭人际关系问题有关。父亲的育儿支持不仅要考虑父亲本身, 还要考虑家庭和工作环境中的人际沟通。.الترابط بين الأب والطفل بين الآباء اليابانيين للرضع: دراسة محلية في وقت إجراء فحص صحة الطفل في عمر أربعة شهور استهدفت الدراسة توضيح الهيكل العامل لمقياس الترابط بين الآباء اليابانيين مع الرضع والعوامل المرتبطة بالمقاييس الفرعية. ومن بين آباء الأطفال الذين يحضرون الكشف الطبي في عمر أربعة شهور، كان للنسخة اليابانية من مقياس الترابط بين الأم والرضيع هيكل مكون من عاملين يتألف من “الغضب” و “انعدام المودة”. ارتبط “الغضب” بمطالب عمل الآباء وسوء الحالة النفسية، وارتبط “نقص المودة” بتقدم الآباء في السن، وسوء الحالة النفسية والمشاكل الشخصية في المنزل. ولذلك لا يحتاج دعم التربية الأبوية إلى أن يكون مسؤولا عن الآباء أنفسهم فحسب، بل أيضا عن التواصل بين الأشخاص في المنزل وبيئة العمل.

Disasters can hinder access to health information among cancer patients. However, little is known regarding overall health information exposure (HIE), its barriers and its impacts on attitudes toward healthcare among cancer patients in the long-term aftermath of disasters. The aims of this study were threefold: assess the extent of HIE; identify associations between family composition and a non-engagement with HIE; and examine the effects of HIE on attitudes toward healthcare among local cancer patients—5 years after the 2011 triple disaster (earthquake, tsunami, and nuclear disaster) in Fukushima, Japan. We conducted self-administered surveys with all cancer and non-cancer surgery department outpatients at Minamisoma Municipal General Hospital (MMGH), Minamisoma City, from October 2016 to January 2017. In total, 404 patients (263 cancer patients and 141 non-cancer patients) voluntarily participated in the study. The results revealed that a regular level of HIE occurred among 90.5% of the cancer patients. In cancer patients, family composition was not significantly associated with HIE, and HIE was not associated with attitude toward healthcare. In conclusion, most cancer patients visiting the MMGH surgical department were regularly engaged in HIE.

Various studies have investigated radiation risk perceptions after the accident at the Fukushima Daiichi Nuclear Power Station. However, student surveys are limited. This study aimed to investigate the perception of radiation risk among students aged 18–20 years who were in the 5th and 6th grades of elementary school at the time of the accident. We surveyed students in the Fukushima Prefecture and outside the prefecture. Out of all the data, 59% of the respondents were living in the Fukushima Prefecture at the time of the accident and 41% outside the prefecture. Trajectory analysis showed that changes in anxiety levels over time since 2011 could be divided into five classes: (a) the anxiety was the highest, and this tendency persisted. (b) High at the beginning, but decreased more quickly than class 1. (c) High at the beginning, but it diminished quickly. (d) Not high, but did not diminish easily in later years. (e) Low from the beginning, and persisted. Multinomial logistic analysis showed that among students living outside the prefecture at the time of the accident, a significantly higher proportion was in groups 4 and 5 than in group 2. A significant proportion of boys were present in groups 3, 4 and 5. A significant proportion of students whose current educational institutions were inside the prefecture were present in group 3. The level of anxiety was associated with the academic course, but not with subjective knowledge of radiation. In contrast, in the qualitative analysis of the free text, 31% considered ‘knowledge about radiation’ as the reason for the reduction in anxiety level. At the time of the investigation, most young people were not anxious about radiation. However, approximately 20% still had strong anxiety. We established that continuous risk communication is necessary. Furthermore, that stabilization and support related to life in general is important.

Aiichiro Nakajima,1 Ayako Kanie,1 Masaya Ito,1 Naotsugu Hirabayashi,2 Fumi Imamura,3 Yoshitake Takebayashi,1,4 Masaru Horikoshi1 1National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, Tokyo, Japan; 2Department of Psychiatry, National Center of Neurology and Psychiatry, Tokyo, Japan; 3Department of Clinical Psychology, National Center of Neurology and Psychiatry, Tokyo, Japan; 4Department of Health Risk Communication, School of Medicine, Fukushima Medical University, Fukushima, JapanCorrespondence: Aiichiro NakajimaNational Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, 4-1-1, Ogawahigashi, Kodaira, Tokyo 187-8551, JapanTel +81-42-341-2711Fax +81-42-346-1944Email aiichiro.nakajima@ncnp.go.jpPurpose: Benzodiazepines (BZDs) are prescribed to treat psychiatric diseases. However, many guidelines recommend limiting the use of BZDs because of side effects and lack of evidence regarding long-term efficacy. Moreover, reducing BZDs’ use is difficult because of dependency and the severity of withdrawal symptoms. The efficacy of cognitive behavioral therapy (CBT) for mood and anxiety disorders has been demonstrated. However, there is scant evidence that CBT has effectively reduced BZDs use, especially in Japan, where the BZDs prescription rate is high. Therefore, we sought to examine the impact of CBT on reducing BZDs use in a Japanese psychiatric setting.Patients and Methods: Participants were outpatients with mood and anxiety disorders who were prescribed BZD anxiolytics. We retrospectively reviewed changes in BZD anxiolytics prescription dosages during CBT (66 patients; mean number of CBT sessions, 14.6) from our hospital record between April 2015 and September 2017. We checked prescriptions at four time points: at first interview for judging adaptation of CBT (baseline), at the first CBT session, at the last CBT session, and 3 months after the last CBT session.Results: A total of 13 of 66 patients discontinued BZD anxiolytics during CBT, and 21 of 66 reduced their prescribed dosage by 50%. The association between discontinuation and dose-reduction and assessment period was modeled simultaneously using Bayesian hierarchical hurdle model. Results from the modeling showed a significant discontinuation at post-CBT and at 3 months post-CBT session compared to baseline (estimated median odds ratio [OR] post-CBT = 9.79 [95% CI: 4.65– 20.45]; OR at 3 months post-CBT = 11.53 [95% CI: 6.06– 22.33]). Moreover, a significant dose reduction was observed post-intervention (estimated median relative risk = 0.845 [95% CI: 0.729– 0.982]), with a median reduction of 1.7 mg (diazepam conversion) in BZD use.Conclusion: Our results suggest that CBT possibly aids in reducing and discontinuing BZD anxiolytics use for Japanese patients.Keywords: psychiatric diseases, depression, acquired dependency, discontinuation

The global threat posed by the COVID-19 pandemic has highlighted the need to accurately identify the immediate and long-term postdisaster impacts on disaster-relief workers. We examined the case of a local government employee suffering from post-traumatic stress disorder (PTSD) and bipolar II disorder following the Great East Japan Earthquake. The complex and harsh experience provoked a hypomanic response such as elated feelings with increased energy, decreased need for sleep and an increase in goal-directed activity, which allowed him to continue working, even though he was adversely affected by the disaster. However, 3.5 years later, when he suffered further psychological damage, his PTSD symptoms became evident. In addition to treating mood disorders, trauma-focused psychotherapy was required for his recovery. Thereafter, we considered the characteristics of mental health problems that emerge in disaster-relief workers, a long time after the disaster, and the conditions and treatments necessary for recovery.

Here we present the Japanese version of the COVID Stress Scale (Taylor et al., 2020).

During the COVID-19 outbreak, the mental health of health care workers has become a major public health concern. Particularly in Japan, women health care workers are experiencing a mental health crisis because of gender imbalance. In addition to honoring health care workers as heroes, we must promote efforts to compensate health care workers, strengthen infection prevention, and promote mental health. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Background Chronic pain is a major health problem, and cognitive behavioral therapy (CBT) is its recommended treatment; however, efforts to develop CBT programs for chronic pain and assess their feasibility are remarkably delayed in Asia. Therefore, we conducted this pilot study to develop a basic individualized CBT for chronic pain (CBT-CP) and assessed its feasibility for use in Japan. Methods Our study was an open-labeled before–after trial without a control group conducted cooperatively in five Japanese tertiary care hospitals. Of 24 outpatients, 15, age 20–80, who experienced chronic pain for at least three months were eligible. They underwent an eight-session CBT-CP consisting of relaxation via a breathing method and progressive muscle relaxation, behavioral modification via activity pacing, and cognitive modification via cognitive reconstruction. The EuroQol five-dimensional questionnaire five level (EQ5D-5 L) assessment as the primary outcome and quality of life (QOL), pain severity, disability, catastrophizing, self-efficacy, and depressive symptoms as secondary outcomes were measured using self-administered questionnaires at baseline, post-treatment, and 3-month follow-up. Intention-to-treat analyses were conducted. Results Effect size for EQ5D-5 L score was medium from baseline to post-treatment (Hedge’s g = − 0.72, 90% confidence interval = − 1.38 to − 0.05) and up to the 3-month follow-up (g = − 0.60, CI = − 1.22 to 0.02). Effect sizes for mental and role/social QOL, disability, catastrophizing, self-efficacy, and depressive symptoms were medium to large, although those for pain severity and physical QOL were small. The dropout rate was acceptably low at 14%. No severe adverse events occurred. Conclusion The findings suggest that CBT-CP warrants a randomized controlled trial in Japan. Trial registration University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR), UMIN000020880. Registered on 04 February 2016.

Abstract. Background: Suicide is a major concern after the 2011 earthquake and nuclear accident in Fukushima. Aims: This study delineates characteristics of the disaster-related suicides in Fukushima. Method: Data provided by the Fukushima Prefectural Police and data published by the Fukushima or Japanese Government were analyzed. Numbers of disaster-related suicides and evacuees were compared among the three prefectures affected. Age, sex, occupation, and means for disaster-related suicides in Fukushima were compared with overall suicides in Fukushima or Japan. History of medical treatment, changes in job and family structure after the disaster, and signs of contemplation were examined within the disaster-related suicides of Fukushima. Results: While other prefectures have experienced a drop in disaster-related suicides, Fukushima has not. Age-standardized disaster-related suicide rates were remarkably higher in men than in women. Moreover, disaster-related suicide rates in Fukushima were higher in women in their 50s and 80s as compared with overall suicide rates in Fukushima or Japan. Limitations: No detailed comparisons were made between disaster-related and non-disaster-related suicides. Conclusion: Disaster-related suicide rates were higher in men than in women. Also, it was found that the disaster-related suicide rates of elderly women were higher compared with overall suicide rates in Japan and Fukushima. In addition, many who died by suicide showed signs of contemplation before the attempt and had started psychiatric treatment. Improvement of suicide risk assessment skills for mental health professionals and gatekeeper training among residents will be essential to prevent disaster-related suicides.