Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Hikarigaoka-1, Fukushima, 960-1295, Japan.
Department of Disaster Psychiatry, International Research Institute of Disaster Science, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, 980-8573, Japan.
Community Ment Health J. 2024 May;60(4):764-771. doi: 10.1007/s10597-024-01232-3. Epub 2024 Feb 3.
This study sought to explore factors related to community transition after the mandatory evacuation of psychiatric inpatients to other hospitals owing to the Fukushima Daiichi Nuclear Power Plant accident. A retrospective cohort design was adopted and 391 psychiatric patients were examined. Univariate and multivariate analyses were conducted to confirm the association between the achievement or non-achievement of discharge to community living and their backgrounds (age, gender, evacuation destination, psychiatric diagnoses, and physical complications). Multivariate analysis indicated that patients with psychiatric diagnoses of schizophrenia, schizotypal, and delusional disorders (International Statistical Classification of Diseases and Related Health Problems 10th revision, F20-29), and those with physical diagnoses of the circulatory (I00-95) and digestive (K00-93) systems showed a significant association with the non-attainment of community transition. From these results, we hypothesized that difficulties in the management of medication during and immediately after the extremely chaotic settings of evacuation could have negative effects on the community transitions. Furthermore, another possible concern was that individuals' persistent psychotic status before the accident had been carried over to the destination hospitals. Therefore, pre-disaster daily cooperation across hospitals and challenges for vulnerable psychiatric patients' future community lives are also essential.
本研究旨在探讨由于福岛第一核电站事故,精神科住院患者被迫转移至其他医院后,与社区过渡相关的因素。采用回顾性队列设计,对 391 名精神科患者进行了检查。通过单因素和多因素分析,确认了实现或未实现社区生活出院与背景(年龄、性别、疏散目的地、精神科诊断和身体并发症)之间的关联。多因素分析表明,患有精神分裂症、分裂型和妄想障碍(国际疾病分类第 10 次修订版 F20-29)的患者,以及患有循环系统(I00-95)和消化系统(K00-93)疾病的患者,与未能实现社区过渡显著相关。根据这些结果,我们假设在疏散期间极其混乱的情况下,药物管理方面的困难可能对社区过渡产生负面影响。此外,另一个可能的问题是,事故发生前个体持续的精神病状态已经转移到了目的地医院。因此,灾难前医院之间的日常合作以及弱势精神科患者未来社区生活的挑战也至关重要。