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Published in: BMC Psychiatry 1/2015

Open Access 01-12-2015 | Research article

Post-traumatic stress disorder and depression prevalence and associated risk factors among local disaster relief and reconstruction workers fourteen months after the Great East Japan Earthquake: a cross-sectional study

Authors: Atsushi Sakuma, Yoko Takahashi, Ikki Ueda, Hirotoshi Sato, Masahiro Katsura, Mikika Abe, Ayami Nagao, Yuriko Suzuki, Masako Kakizaki, Ichiro Tsuji, Hiroo Matsuoka, Kazunori Matsumoto

Published in: BMC Psychiatry | Issue 1/2015

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Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.
Literature
1.
go back to reference Norris F, Friedman M, Watson P, Byrne C, Diaz E, Kaniasty K. 60,000 disaster victims speak: part I. An empirical review of the empirical literature, 1981–2001. Psychiatry. 2002;65(3):207–39.CrossRefPubMed Norris F, Friedman M, Watson P, Byrne C, Diaz E, Kaniasty K. 60,000 disaster victims speak: part I. An empirical review of the empirical literature, 1981–2001. Psychiatry. 2002;65(3):207–39.CrossRefPubMed
2.
go back to reference Pietrzak RH, Tracy M, Galea S, Kilpatrick DG, Ruggiero KJ, Hamblen JL, et al. Resilience in the face of disaster: prevalence and longitudinal course of mental disorders following Hurricane Ike. PLoS One. 2012;7:e38964.CrossRefPubMedPubMedCentral Pietrzak RH, Tracy M, Galea S, Kilpatrick DG, Ruggiero KJ, Hamblen JL, et al. Resilience in the face of disaster: prevalence and longitudinal course of mental disorders following Hurricane Ike. PLoS One. 2012;7:e38964.CrossRefPubMedPubMedCentral
3.
go back to reference Bills CB, Levy NA, Sharma V, Charney DS, Herbert R, Moline J, et al. Mental health of workers and volunteers responding to events of 9/11: review of the literature. Mt Sinai J Med. 2008;75(2):115–27.CrossRefPubMed Bills CB, Levy NA, Sharma V, Charney DS, Herbert R, Moline J, et al. Mental health of workers and volunteers responding to events of 9/11: review of the literature. Mt Sinai J Med. 2008;75(2):115–27.CrossRefPubMed
4.
go back to reference Benedek DM, Fullerton C, Ursano RJ. First responders: Mental health consequences of natural and human-made disasters for public health and public safety workers. Annu Rev Public Health. 2007;28:55–68.CrossRefPubMed Benedek DM, Fullerton C, Ursano RJ. First responders: Mental health consequences of natural and human-made disasters for public health and public safety workers. Annu Rev Public Health. 2007;28:55–68.CrossRefPubMed
5.
go back to reference Neria Y, Nandi A, Galea S. Post-traumatic stress disorder following disasters: a systematic review. Psychol Med. 2008;38(4):467–80.CrossRefPubMed Neria Y, Nandi A, Galea S. Post-traumatic stress disorder following disasters: a systematic review. Psychol Med. 2008;38(4):467–80.CrossRefPubMed
6.
go back to reference Galea S, Nandi A, Vlahov D. The epidemiology of post-traumatic stress disorder after disasters. Epidemiol Rev. 2005;27:78–91.CrossRefPubMed Galea S, Nandi A, Vlahov D. The epidemiology of post-traumatic stress disorder after disasters. Epidemiol Rev. 2005;27:78–91.CrossRefPubMed
7.
go back to reference Perrin MA, DiGrande L, Wheeler K, Thorpe L, Farfel M, Brackbill R. Differences in PTSD prevalence and associated risk factors among World Trade Center disaster rescue and recovery workers. Am J Psychiatry. 2007;164:1385–94.CrossRefPubMed Perrin MA, DiGrande L, Wheeler K, Thorpe L, Farfel M, Brackbill R. Differences in PTSD prevalence and associated risk factors among World Trade Center disaster rescue and recovery workers. Am J Psychiatry. 2007;164:1385–94.CrossRefPubMed
8.
go back to reference Wisnivesky JP, Teitelbaum SL, Todd AC, Boffetta P, Crane M, Crowley L, et al. Persistence of multiple illnesses in World Trade Center rescue and recovery workers: a cohort study. Lancet. 2011;378(9794):888–97.CrossRefPubMed Wisnivesky JP, Teitelbaum SL, Todd AC, Boffetta P, Crane M, Crowley L, et al. Persistence of multiple illnesses in World Trade Center rescue and recovery workers: a cohort study. Lancet. 2011;378(9794):888–97.CrossRefPubMed
9.
go back to reference Wang XL, Chan CLW, Shi ZB, Wang B. Mental health risks in the local workforce engaged in disaster relief and reconstruction. Qual Health Res. 2013;23(2):207–17.CrossRefPubMed Wang XL, Chan CLW, Shi ZB, Wang B. Mental health risks in the local workforce engaged in disaster relief and reconstruction. Qual Health Res. 2013;23(2):207–17.CrossRefPubMed
11.
go back to reference Suzuki Y, Fukasawa M, Obara A, Kim Y. Mental health distress and related factors among prefectural public servants seven months after the Great East Japan earthquake. J Epidemiol. 2014;24(4):287–94.CrossRefPubMedPubMedCentral Suzuki Y, Fukasawa M, Obara A, Kim Y. Mental health distress and related factors among prefectural public servants seven months after the Great East Japan earthquake. J Epidemiol. 2014;24(4):287–94.CrossRefPubMedPubMedCentral
13.
go back to reference Weathers FWFJ. Psychometric review of PTSD checklist (PCL-C, PCL-S, PCL-M, PCL-PR). Brooklandville, MD: Sidran Institute Press; 1996. p. 250–1. Weathers FWFJ. Psychometric review of PTSD checklist (PCL-C, PCL-S, PCL-M, PCL-PR). Brooklandville, MD: Sidran Institute Press; 1996. p. 250–1.
14.
go back to reference Kroenke K, Spitzer RL. The PHQ-9: A new depression diagnostic and severity measure. Psychiatr Annals. 2002;32(9):509–15.CrossRef Kroenke K, Spitzer RL. The PHQ-9: A new depression diagnostic and severity measure. Psychiatr Annals. 2002;32(9):509–15.CrossRef
15.
go back to reference Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek DK, Normand SLT, et al. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med. 2002;32(6):959–76.CrossRefPubMed Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek DK, Normand SLT, et al. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med. 2002;32(6):959–76.CrossRefPubMed
16.
go back to reference American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, DC: American Psychiatric Association; 1994. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, DC: American Psychiatric Association; 1994.
17.
go back to reference Smith MY, Redd W, DuHamel K, Vickberg SJ, Ricketts P. Validation of the PTSD Checklist-Civilian Version in survivors of bone marrow transplantation. J Trauma Stress. 1999;12(3):485–99.CrossRefPubMed Smith MY, Redd W, DuHamel K, Vickberg SJ, Ricketts P. Validation of the PTSD Checklist-Civilian Version in survivors of bone marrow transplantation. J Trauma Stress. 1999;12(3):485–99.CrossRefPubMed
18.
go back to reference Blanchard EB, Jones-Alexander J, Buckley TC, Forneris CA. Psychometric properties of the PTSD Checklist (PCL). Behav Res Ther. 1996;34(8):669–73.CrossRefPubMed Blanchard EB, Jones-Alexander J, Buckley TC, Forneris CA. Psychometric properties of the PTSD Checklist (PCL). Behav Res Ther. 1996;34(8):669–73.CrossRefPubMed
19.
go back to reference Muramatsu K, Miyaoka H, Kamijima K, Muramatsu Y, Yoshida M, Otsubo T, et al. The patient health questionnaire, Japanese version: validity according to the mini-international neuropsychiatric interview-plus. Psychol Rep. 2007;101:952–60.PubMed Muramatsu K, Miyaoka H, Kamijima K, Muramatsu Y, Yoshida M, Otsubo T, et al. The patient health questionnaire, Japanese version: validity according to the mini-international neuropsychiatric interview-plus. Psychol Rep. 2007;101:952–60.PubMed
20.
go back to reference Martin A, Rief W, Klaiberg A, Braehler E. Validity of the brief patient health questionnaire mood scale (PHQ-9) in the general population. Gen Hosp Psychiatry. 2006;28(1):71–7.CrossRefPubMed Martin A, Rief W, Klaiberg A, Braehler E. Validity of the brief patient health questionnaire mood scale (PHQ-9) in the general population. Gen Hosp Psychiatry. 2006;28(1):71–7.CrossRefPubMed
21.
go back to reference Wittkampf KA, Naeije L, Schene AH, Huyser J, van Weert HC. Diagnostic accuracy of the mood module of the Patient Health Questionnaire: a systematic review. Gen Hosp Psychiatry. 2007;29(5):388–95.CrossRefPubMed Wittkampf KA, Naeije L, Schene AH, Huyser J, van Weert HC. Diagnostic accuracy of the mood module of the Patient Health Questionnaire: a systematic review. Gen Hosp Psychiatry. 2007;29(5):388–95.CrossRefPubMed
23.
go back to reference Furukawa TA, Kawakami N, Saitoh M, Ono Y, Nakane Y, Nakamura Y, et al. The performance of the Japanese version of the K6 and K10 in the World Mental Health Survey Japan. Int J Methods Psychiatr Res. 2008;17(3):152–8.CrossRefPubMed Furukawa TA, Kawakami N, Saitoh M, Ono Y, Nakane Y, Nakamura Y, et al. The performance of the Japanese version of the K6 and K10 in the World Mental Health Survey Japan. Int J Methods Psychiatr Res. 2008;17(3):152–8.CrossRefPubMed
24.
go back to reference Sakurai K, Nishi A, Kondo K, Yanagida K, Kawakami N. Screening performance of K6/K10 and other screening instruments for mood and anxiety disorders in Japan. Psychiatry Clin Neurosci. 2011;65:434–41.CrossRefPubMed Sakurai K, Nishi A, Kondo K, Yanagida K, Kawakami N. Screening performance of K6/K10 and other screening instruments for mood and anxiety disorders in Japan. Psychiatry Clin Neurosci. 2011;65:434–41.CrossRefPubMed
25.
go back to reference Kessler RC, Barker PR, Colpe LJ, Epstein JF, Gfroerer JC, Hiripi E, et al. Screening for serious mental illness in the general population. Arch Gen Psychiatry. 2003;60:184–9.CrossRefPubMed Kessler RC, Barker PR, Colpe LJ, Epstein JF, Gfroerer JC, Hiripi E, et al. Screening for serious mental illness in the general population. Arch Gen Psychiatry. 2003;60:184–9.CrossRefPubMed
27.
go back to reference Tsuji I. higashinihondaishinsai-kara-kangaeru-kongono-hisaitishien (future support of the disaster affected area, perspective seen from the Great East Japan Earthquake health study). Jpn Med J. 2011;4569:18–21. Tsuji I. higashinihondaishinsai-kara-kangaeru-kongono-hisaitishien (future support of the disaster affected area, perspective seen from the Great East Japan Earthquake health study). Jpn Med J. 2011;4569:18–21.
29.
go back to reference Shigemura J, Tanigawa T, Saito I, Nomura S. Psychological distress in workers at the Fukushima nuclear power plants. JAMA. 2012;308:667–9.CrossRefPubMed Shigemura J, Tanigawa T, Saito I, Nomura S. Psychological distress in workers at the Fukushima nuclear power plants. JAMA. 2012;308:667–9.CrossRefPubMed
30.
go back to reference Fukasawa M, Suzuki Y, Obara A, Kim Y. Relationships Between Mental Health Distress and Work-Related Factors Among Prefectural Public Servants Two Months After the Great East Japan Earthquake. Int J Behav Med. 2015;22(1):1–10.CrossRefPubMed Fukasawa M, Suzuki Y, Obara A, Kim Y. Relationships Between Mental Health Distress and Work-Related Factors Among Prefectural Public Servants Two Months After the Great East Japan Earthquake. Int J Behav Med. 2015;22(1):1–10.CrossRefPubMed
31.
go back to reference Guo YJ, Chen CH, Lu ML, Tan HK, Lee HW, Wang TN. Posttraumatic stress disorder among professional and non-professional rescuers involved in an earthquake in Taiwan. Psychiatry Res. 2004;127:35–41.CrossRefPubMed Guo YJ, Chen CH, Lu ML, Tan HK, Lee HW, Wang TN. Posttraumatic stress disorder among professional and non-professional rescuers involved in an earthquake in Taiwan. Psychiatry Res. 2004;127:35–41.CrossRefPubMed
32.
go back to reference Kawakami N, Takeshima T, Ono Y, Uda H, Hata Y, Nakane Y, et al. Twelve-month prevalence, severity, and treatment of common mental disorders in communities in Japan: preliminary finding from the World Mental Health Japan Survey 2002–2003. Psychiatry Clin Neurosci. 2005;59(4):441–52.CrossRefPubMed Kawakami N, Takeshima T, Ono Y, Uda H, Hata Y, Nakane Y, et al. Twelve-month prevalence, severity, and treatment of common mental disorders in communities in Japan: preliminary finding from the World Mental Health Japan Survey 2002–2003. Psychiatry Clin Neurosci. 2005;59(4):441–52.CrossRefPubMed
33.
go back to reference Shibahara S. The 2011 Tohoku earthquake and devastating tsunami. Tohoku J Exp Med. 2011;223(4):305–7.CrossRefPubMed Shibahara S. The 2011 Tohoku earthquake and devastating tsunami. Tohoku J Exp Med. 2011;223(4):305–7.CrossRefPubMed
35.
go back to reference Norris FH, Murrell SA. Prior experience as a moderator of disaster impact on anxiety symptoms in older adults. Am J Community Psychol. 1988;16(5):665–83.CrossRefPubMed Norris FH, Murrell SA. Prior experience as a moderator of disaster impact on anxiety symptoms in older adults. Am J Community Psychol. 1988;16(5):665–83.CrossRefPubMed
36.
go back to reference Fushimi M. Posttraumatic Stress in Professional Firefighters in Japan: Rescue Efforts after the Great East Japan Earthquake (Higashi Nihon Dai-Shinsai). In: Prehosp Disaster Med. edn. 2012. p. 1–3. Fushimi M. Posttraumatic Stress in Professional Firefighters in Japan: Rescue Efforts after the Great East Japan Earthquake (Higashi Nihon Dai-Shinsai). In: Prehosp Disaster Med. edn. 2012. p. 1–3.
37.
go back to reference Kato H, Asukai N. Psychological effects of rescue workers; a large scale survey of fire fighters following the 1995 Kobe Earthquake. Jpn J Trauma Stress. 2004;2(1):51–9. Kato H, Asukai N. Psychological effects of rescue workers; a large scale survey of fire fighters following the 1995 Kobe Earthquake. Jpn J Trauma Stress. 2004;2(1):51–9.
38.
go back to reference Osawa T. Critical incident stress measures led by the fire and disaster management agency - from the Great Hanshin-Awaji earthquake to the Great East Japan earthquake, and future prospects. Jpn J Trauma Stress. 2013;11(2):17–24. Osawa T. Critical incident stress measures led by the fire and disaster management agency - from the Great Hanshin-Awaji earthquake to the Great East Japan earthquake, and future prospects. Jpn J Trauma Stress. 2013;11(2):17–24.
39.
go back to reference Brewin CR, Andrews B, Valentine JD. Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. J Consult Clin Psychol. 2000;68(5):748–66.CrossRefPubMed Brewin CR, Andrews B, Valentine JD. Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. J Consult Clin Psychol. 2000;68(5):748–66.CrossRefPubMed
40.
go back to reference Norris FH, Friedman MJ, Watson PJ. 60,000 Disaster victims speak: Part II. Summary and implications of the disaster mental health research. Psychiatry. 2002;65(3):240–60.CrossRefPubMed Norris FH, Friedman MJ, Watson PJ. 60,000 Disaster victims speak: Part II. Summary and implications of the disaster mental health research. Psychiatry. 2002;65(3):240–60.CrossRefPubMed
41.
go back to reference Thormar SB, Gersons BPR, Juen B, Marschang A, Djakababa MN, Olff M. The mental health impact of volunteering in a disaster setting: A review. J Nerv Ment Dis. 2010;198(8):529–38.CrossRefPubMed Thormar SB, Gersons BPR, Juen B, Marschang A, Djakababa MN, Olff M. The mental health impact of volunteering in a disaster setting: A review. J Nerv Ment Dis. 2010;198(8):529–38.CrossRefPubMed
44.
go back to reference Ehring T, Razik S, Emmelkamp PMG. Prevalence and predictors of posttraumatic stress disorder, anxiety, depression, and burnout in Pakistani earthquake recovery workers. Psychiatry Res. 2011;185(1–2):161–6.CrossRefPubMed Ehring T, Razik S, Emmelkamp PMG. Prevalence and predictors of posttraumatic stress disorder, anxiety, depression, and burnout in Pakistani earthquake recovery workers. Psychiatry Res. 2011;185(1–2):161–6.CrossRefPubMed
45.
go back to reference Kohn R, Levav I, Garcia ID, Machuca ME, Tamashiro R. Prevalence, risk factors and aging vulnerability for psychopathology following a natural disaster in a developing country. Int J Geriatr Psychiatry. 2005;20(9):835–41.CrossRefPubMed Kohn R, Levav I, Garcia ID, Machuca ME, Tamashiro R. Prevalence, risk factors and aging vulnerability for psychopathology following a natural disaster in a developing country. Int J Geriatr Psychiatry. 2005;20(9):835–41.CrossRefPubMed
46.
go back to reference Van Griensven F, Chakkraband M, Thienkrua W, Pengjuntr W, Lopes Cardozo B, Tantipiwatanaskul P, et al. Mental health problems among adults in tsunami-affected areas in southern Thailand. JAMA. 2006;296(5):537–48.CrossRefPubMed Van Griensven F, Chakkraband M, Thienkrua W, Pengjuntr W, Lopes Cardozo B, Tantipiwatanaskul P, et al. Mental health problems among adults in tsunami-affected areas in southern Thailand. JAMA. 2006;296(5):537–48.CrossRefPubMed
47.
go back to reference Goto T, Wilson JP, Kahana B, Slane S. The Miyake Island volcano disaster in Japan: Loss, uncertainty, and relocation as predictors of PTSD and depression. J Appl Soc Psychol. 2006;36(8):2001–26.CrossRef Goto T, Wilson JP, Kahana B, Slane S. The Miyake Island volcano disaster in Japan: Loss, uncertainty, and relocation as predictors of PTSD and depression. J Appl Soc Psychol. 2006;36(8):2001–26.CrossRef
48.
go back to reference Başoǧlu M, Kiliç C, Şalcioǧlu E, Livanou M. Prevalence of posttraumatic stress disorder and comorbid depression in earthquake survivors in Turkey: an epidemiological study. J Trauma Stress. 2004;17(2):133–41.CrossRefPubMed Başoǧlu M, Kiliç C, Şalcioǧlu E, Livanou M. Prevalence of posttraumatic stress disorder and comorbid depression in earthquake survivors in Turkey: an epidemiological study. J Trauma Stress. 2004;17(2):133–41.CrossRefPubMed
49.
go back to reference Fullerton CS, Ursano RJ, Wang L. Acute stress disorder, posttraumatic stress disorder, and depression in disaster of rescue workers. Am J Psychiatry. 2004;161(8):1370–6.CrossRefPubMed Fullerton CS, Ursano RJ, Wang L. Acute stress disorder, posttraumatic stress disorder, and depression in disaster of rescue workers. Am J Psychiatry. 2004;161(8):1370–6.CrossRefPubMed
50.
go back to reference Nagashima S, Suwazono Y, Okubo Y, Uetani M, Kobayashi E, Kido T, et al. Working hours and mental and physical fatigue in Japanese workers. Occup Med. 2007;57(6):449–52.CrossRef Nagashima S, Suwazono Y, Okubo Y, Uetani M, Kobayashi E, Kido T, et al. Working hours and mental and physical fatigue in Japanese workers. Occup Med. 2007;57(6):449–52.CrossRef
51.
go back to reference Kawakami N, Haratani T, Araki S. Effects of perceived job stress on depressive symptoms in blue-collar workers of an electrical factory in Japan. Scand J Work Environ Health. 1992;18(3):195–200.CrossRefPubMed Kawakami N, Haratani T, Araki S. Effects of perceived job stress on depressive symptoms in blue-collar workers of an electrical factory in Japan. Scand J Work Environ Health. 1992;18(3):195–200.CrossRefPubMed
52.
go back to reference Keiko S, Hisanaga S, Yutaka M. Relationships among mood/anxiety disorder, occupational stress and the life situation: Results of survey of a local government staff. Bulletin of Akita University Graduate School of Medicine Doctoral Course in Health Sciences. 2010;18(2):120–9. Keiko S, Hisanaga S, Yutaka M. Relationships among mood/anxiety disorder, occupational stress and the life situation: Results of survey of a local government staff. Bulletin of Akita University Graduate School of Medicine Doctoral Course in Health Sciences. 2010;18(2):120–9.
53.
go back to reference North CS, Tivis L, McMillen JC, Pfefferbaum B, Spitznagel EL, Cox J, et al. Psychiatric disorders in rescue workers after the Oklahoma City bombing. Am J Psychiatry. 2002;159(5):857–9.CrossRefPubMed North CS, Tivis L, McMillen JC, Pfefferbaum B, Spitznagel EL, Cox J, et al. Psychiatric disorders in rescue workers after the Oklahoma City bombing. Am J Psychiatry. 2002;159(5):857–9.CrossRefPubMed
54.
go back to reference North CS, Pfefferbaum B. Research on the mental health effects of terrorism. JAMA. 2002;288(5):633–6.CrossRefPubMed North CS, Pfefferbaum B. Research on the mental health effects of terrorism. JAMA. 2002;288(5):633–6.CrossRefPubMed
55.
go back to reference Pietrzak RH, Southwick SM, Tracy M, Galea S, Norris FH. Posttraumatic stress disorder, depression, and perceived needs for psychological care in older persons affected by Hurricane Ike. J Affect Disord. 2012;138(1–2):96–103.CrossRefPubMedPubMedCentral Pietrzak RH, Southwick SM, Tracy M, Galea S, Norris FH. Posttraumatic stress disorder, depression, and perceived needs for psychological care in older persons affected by Hurricane Ike. J Affect Disord. 2012;138(1–2):96–103.CrossRefPubMedPubMedCentral
56.
go back to reference Woodall A, Morgan C, Sloan C, Howard L. Barriers to participation in mental health research: are there specific gender, ethnicity and age related barriers? BMC Psychiatry. 2010;10:103.CrossRefPubMedPubMedCentral Woodall A, Morgan C, Sloan C, Howard L. Barriers to participation in mental health research: are there specific gender, ethnicity and age related barriers? BMC Psychiatry. 2010;10:103.CrossRefPubMedPubMedCentral
Metadata
Title
Post-traumatic stress disorder and depression prevalence and associated risk factors among local disaster relief and reconstruction workers fourteen months after the Great East Japan Earthquake: a cross-sectional study
Authors
Atsushi Sakuma
Yoko Takahashi
Ikki Ueda
Hirotoshi Sato
Masahiro Katsura
Mikika Abe
Ayami Nagao
Yuriko Suzuki
Masako Kakizaki
Ichiro Tsuji
Hiroo Matsuoka
Kazunori Matsumoto
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2015
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-015-0440-y

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