Predictors of depressive symptoms following the Great East Japan earthquake: A prospective study.
Predictors of depressive symptoms following the Great East Japan earthquake: A prospective study.
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DOI：
10.1016/j.socscimed.2016.05.026
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发表时间：
2016-07
期刊：
影响因子：
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通讯作者：
Kawachi I
中科院分区：
文献类型：
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作者：
Tsuboya T;Aida J;Hikichi H;Subramanian SV;Kondo K;Osaka K;Kawachi I
我们试图前瞻性地调查灾难暴露（2011年东日本地震）与社区居住的老年幸存者抑郁症状变化之间的关系。我们使用了来自日本老年学评估研究（JAGES）的两组数据，这是一项正在日本进行的基于人群的前瞻性队列研究。我们研究的一个独特之处在于，灾难发生前，人们可以获得心理健康状况的信息。我们的样本包括65岁及以上居住在社区的幸存者，他们分别在2010年（即灾难发生前一年）和2013年（n= 3,464）接受了调查。我们根据三种类型的经历对灾害风险进行了分类：失去家人/朋友、财产损失和无法获得医疗服务。我们的主要结局是抑郁症状的改变，由15项老年抑郁量表（GDS）测量。在参与者中，917人（26.5%）报告在灾难中失去了一位家庭成员，另有537人（15.5%）报告失去了一位朋友。超过一半的参与者报告说他们的房屋受到了一定程度的破坏。在调整人口统计和基线心理健康后，房屋被完全摧毁的人在三年后抑郁症状得分显著升高（+1.22点，95%CI: 0.80, 1.64, p< 0.0001）。精神科护理中断也与GDS评分变化相关（+2.51分，95%CI: 1.28, 3.74, p< 0.0001）。相比之下，3年后失去家人/朋友不再与GDS相关；+0.18分（95%CI: -0.018, 0.37, p=0.08）， - 0.045分（95%CI: -0.28, 0.19, p=0.71）。灾难发生三年后，2011年地震和海啸的幸存者似乎已经从失去亲人的悲痛中恢复过来。相比之下，精神病学治疗的财产损失和中断与对精神健康的持续不利影响有关。
We sought to investigate prospectively the association between exposure to disaster (the 2011 East Japan Earthquake) and change in depressive symptoms among community-dwelling older adult survivors. We used two waves of data from the Japan Gerontological Evaluation Study (JAGES), an ongoing population-based, prospective cohort study in Japan. A unique feature of our study was the availability of information about mental health status pre-dating the disaster. Our sample comprised community-dwelling survivors aged 65 and older, who responded to surveys in 2010 (i.e. one year before the disaster) and in 2013 (n= 3,464). We categorized disaster exposure according to three types of experiences: loss of family/friends, property damage, and disruption in access to medical service. Our main outcome was change in depressive symptoms, measured by the 15-item geriatric depression scale (GDS). Among the participants, 917(26.5%) reported losing a family member to the disaster, while a further 537(15.5%) reported losing a friend. More than half of the participants reported some damage to their homes. After adjusting for demographics and baseline mental health, people whose homes were completely destroyed had significantly elevated depressive symptom scores three years later (+1.22 points, 95%CI: 0.80, 1.64, p<.0001). Disruption of psychiatric care was also associated with change in GDS scores (+2.51 points, 95%CI: 1.28, 3.74, p<.0001). By contrast, loss of family/friends was no longer associated with GDS after 3 years; +0.18 points (95%CI: -0.018, 0.37, p=0.08) for loss of family, and −0.045 points (95%CI: -0.28, 0.19, p=0.71) for loss of friends. Three years after the disaster, survivors of the 2011 earthquake and tsunami appeared to have recovered from loss of loved ones. By contrast, property loss and disruption of psychiatry care were associated with persistent adverse impact on mental health.