Sakuma Atsushi, Takahashi Yoko, Ueda Ikki, Sato Hirotoshi, Katsura Masahiro, Abe Mikika, Nagao Ayami, Suzuki Yuriko, Kakizaki Masako, Tsuji Ichiro, Matsuoka Hiroo, Matsumoto Kazunori
Department of Psychiatry, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
Miyagi Disaster Mental Health Care Center, 2-18-21 Honcho, Aoba-ku, Sendai, Miyagi, 980-0014, Japan.
BMC Psychiatry. 2015 Mar 24;15:58. doi: 10.1186/s12888-015-0440-y.
Many local workers have been involved in rescue and reconstruction duties since the Great East Japan Earthquake (GEJE) on March 11, 2011. These workers continuously confront diverse stressors as both survivors and relief and reconstruction workers. However, little is known about the psychological sequelae among these workers. Thus, we assessed the prevalence of and personal/workplace risk factors for probable post-traumatic stress disorder (PTSD), probable depression, and high general psychological distress in this population.
Participants (N = 1294; overall response rate, 82.9%) were workers (firefighters, n = 327; local municipality workers, n = 610; hospital medical workers, n = 357) in coastal areas of Miyagi prefecture. The study was cross-sectional and conducted 14 months after the GEJE using a self-administered questionnaire which included the PTSD Checklist-Specific Version, the Patient Health Questionnaire-9, and the K6 scale. Significant risk factors from bivariate analysis, such as displacement, dead or missing family member(s), near-death experience, disaster related work, lack of communication, and lack of rest were considered potential factors in probable PTSD, probable depression, and high general psychological distress, and were entered into the multivariable logistic regression model.
The prevalence of probable PTSD, probable depression, and high general psychological distress was higher among municipality (6.6%, 15.9%, and 14.9%, respectively) and medical (6.6%, 14.3%, and 14.5%, respectively) workers than among firefighters (1.6%, 3.8%, and 2.6%, respectively). Lack of rest was associated with increased risk of PTSD and depression in municipality and medical workers; lack of communication was linked to increased PTSD risk in medical workers and depression in municipality and medical workers; and involvement in disaster-related work was associated with increased PTSD and depression risk in municipality workers.
The present results indicate that at 14 months after the GEJE, mental health consequences differed between occupations. High preparedness, early mental health interventions, and the return of ordinary working conditions might have contributed to the relative mental health resilience of the firefighters. Unlike the direct effects of disasters, workplace risk factors can be modified after disasters; thus, we should develop countermeasures to improve the working conditions of local disaster relief and reconstruction workers.
自2011年3月11日东日本大地震（GEJE）以来，许多当地工作人员参与了救援和重建工作。这些工作人员作为幸存者以及救援和重建工作者，不断面临各种压力源。然而，对于这些工作人员的心理后遗症知之甚少。因此，我们评估了该人群中可能患创伤后应激障碍（PTSD）、可能患抑郁症以及存在高度一般心理困扰的患病率及个人/工作场所风险因素。
参与者（N = 1294；总应答率为82.9%）为宫城县沿海地区的工作人员（消防员327名、当地市政工作人员610名、医院医务人员357名）。该研究为横断面研究，在东日本大地震14个月后使用自填式问卷进行，问卷包括PTSD检查表特定版本、患者健康问卷-9和K6量表。二元分析中的显著风险因素，如流离失所、家庭成员死亡或失踪、濒死经历、与灾难相关的工作、缺乏沟通以及缺乏休息，被视为可能患PTSD、可能患抑郁症和存在高度一般心理困扰的潜在因素，并纳入多变量逻辑回归模型。
市政工作人员（分别为6.6%、15.9%和14.9%）和医务人员（分别为6.6%、14.3%和14.5%）中可能患PTSD、可能患抑郁症和存在高度一般心理困扰的患病率高于消防员（分别为1.6%、3.8%和2.6%）。缺乏休息与市政工作人员和医务人员患PTSD和抑郁症的风险增加相关；缺乏沟通与医务人员患PTSD风险增加以及市政工作人员和医务人员患抑郁症相关；参与与灾难相关的工作与市政工作人员患PTSD和抑郁症的风险增加相关。
目前的结果表明，在东日本大地震14个月后，不同职业的心理健康后果有所不同。高度的准备、早期的心理健康干预以及恢复正常工作条件可能有助于消防员保持相对的心理健康恢复力。与灾难的直接影响不同，工作场所风险因素在灾难后可以改变；因此，我们应该制定对策来改善当地救灾和重建工作人员的工作条件。
