4.6 Article

Against an insufficient intervention for patients with alcoholism or PTSD: An activity report on a psychiatric clinic after the 2011 complex disaster in Fukushima, Japan

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DOI: 10.1016/j.ijdrr.2023.103990

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The Great East Japan earthquake; Fukushima; PTSD (post-traumatic stress disorder); Alcoholism; Psychiatric clinic; Treatment discontinuation

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Despite a deterioration in the mental health of disaster survivors, there is still a scarcity of concrete evidence regarding increased psychiatric treatment seeking. This study found that patients with high traumatic stress during the disaster had a higher treatment discontinuation rate, but violence during treatment was correlated with a diagnosis of complex PTSD.
Despite numerous studies using questionnaires to assess mental health problems among disaster victims following a disaster, only a few have examined actual medical treatment situations. Surveys of residents in disaster-affected areas following the Great East Japan Earthquake and Fukushima nuclear power plant disaster also indicate deteriorated mental health among survivors; however, concrete evidence of increased individuals seeking treatment at psychiatric institutions is still scarce.Using medical records of a psychiatric clinic in an affected area during the chronic phase after a disaster, this study investigated the status of interventions for patients with alcoholism, post traumatic stress disorder (PTSD), and others, including whether violence occurred during treatment.We found that 730 patients visited the clinic for a year, but a few with alcoholism received treatment. Patients who experienced traumatic stress during the disaster had a higher treatment discontinuation rate, though it is not correlated with their involvement in violence. However, a diagnosis of complex PTSD was correlated with involvement in violence during the treatment.The psychiatric clinic providing care during the chronic phase of the post-disaster period did not provide sufficient treatment for alcoholism, where therapeutic interpersonal interaction is emphasized, or for PTSD, where trauma-focused psychotherapy is the standard of care. It is difficult to ensure the availability of highly specialized resources and the establishment of comprehensive ties with the local people in affected areas, however, such a situation poses a challenge.

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