Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Iwate, Japan.
Department of Hygiene and Preventive Medicine, School of Medicine, Iwate Medical University, Iwate, Japan.
BMC Public Health. 2023 Jun 20;23(1):1154. doi: 10.1186/s12889-023-16082-z.
Whether past disaster experiences affect the association between changes in social isolation and depressive symptoms is largely unknown. This study examined the association between changes in social isolation and depressive symptoms among survivors who experienced earthquake damage in the aftermath of the Great East Japan Earthquake (GEJE).
We analyzed longitudinal data from 10,314 participants who responded to self-report questionnaires on the Lubben Social Network Scale-6 (LSNS-6) and the Center for Epidemiological Studies-Depressive Scale (CES-D) in both the baseline survey (FY2013 to FY2015) and follow-up survey (FY2017 to FY2019) after the GEJE. According to changes in the presence of social isolation (< 12 of LSNS-6) at two time points, participants were categorized into four groups: "not socially isolated," "improved socially isolated," "newly socially isolated," and "continuously socially isolated." At the follow-up survey, a CES-D score of ≥ 16 indicates the presence of depressive symptoms. The adjusted odds ratios (AORs) and 95% confidence intervals (CIs) were estimated using the logistic regression analysis to examine the influence of the change in social isolation over four years on depressive symptoms.
Participants who were newly socially isolated had a significantly higher prevalence of depressive symptoms than those who were not socially isolated (AOR = 1.89, 95% CI = 1.61 - 2.23). In addition, AORs were highest for those who were continuously socially isolated and had experienced house damage (AOR = 2.17, 95% CI = 1.73 - 2.72) and those who were newly socially isolated and had not experienced the death of family members due to the GEJE (AOR = 1.88, 95%CI = 1.60 - 2.22).
Our longitudinal findings suggest that being newly or continuously socially isolated is associated with a risk of depressive symptoms, not only among those who had experienced house damage or the death of a family member, but also those who had not, in the disaster-affected area. Our study underlines the clinical importance of social isolation after a large-scale natural disaster and draws attention to the need for appropriate prevention measures.
以往的灾难经历是否会影响社会隔离变化与抑郁症状之间的关联，目前尚不清楚。本研究旨在探讨经历东日本大地震（GEJE）后地震破坏的幸存者中，社会隔离变化与抑郁症状之间的关系。
我们分析了来自 10314 名参与者的纵向数据，这些参与者在 GEJE 后分别于基线调查（2013 财年至 2015 财年）和随访调查（2017 财年至 2019 财年）中，通过卢本社会网络量表-6（LSNS-6）和流行病学研究中心抑郁量表（CES-D）回答了自我报告问卷。根据两次时间点社会隔离的有无（LSNS-6 评分<12），参与者分为四组：“无社会隔离”、“社会隔离改善”、“新出现社会隔离”和“持续社会隔离”。在随访调查中，CES-D 评分≥16 表示存在抑郁症状。使用逻辑回归分析估计调整后的优势比（AOR）和 95%置信区间（CI），以检查四年内社会隔离变化对抑郁症状的影响。
与无社会隔离者相比，新出现社会隔离者的抑郁症状患病率显著更高（AOR=1.89，95%CI=1.61-2.23）。此外，房屋受损（AOR=2.17，95%CI=1.73-2.72）和未经历因 GEJE 而导致家庭成员死亡（AOR=1.88，95%CI=1.60-2.22）的连续社会隔离者和新出现社会隔离者的 AOR 最高。
我们的纵向研究结果表明，新出现或持续的社会隔离与抑郁症状的风险有关，不仅与那些经历过房屋受损或家庭成员死亡的人有关，也与那些没有经历过这些情况的人有关，在受灾地区。我们的研究强调了大规模自然灾害后社会隔离的临床重要性，并提请注意需要采取适当的预防措施。
