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      Suicide Rates in Evacuation Areas After the Fukushima Daiichi Nuclear Disaster : A 5-Year Follow-Up Study in Fukushima Prefecture

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          Abstract

          Abstract. Background: Associations between nuclear disasters and suicide have been examined to a limited extent. Aim: To clarify the suicide rates in evacuation areas after the nuclear disaster in Fukushima, which occurred in March 2011. Method: This descriptive study used monthly data from vital statistics between March 2009 and December 2015. Suicide rates in areas to which evacuation orders had been issued, requiring across-the-board, compulsory evacuation of residents from the entire or part of municipalities, were obtained and compared with the national average. Results: Male suicide rates in evacuation areas increased significantly immediately after the disaster, and then began to increase again 4 years after the disaster. Female suicide rates declined slightly during the first year and then increased significantly over the subsequent 3-year period. Moreover, male rates in areas where evacuation orders were issued for the total area declined over the course of approximately 2 years, but then began to increase thereafter. Analysis by age revealed postdisaster male rates in evacuation areas decreased for those aged 50–69 years and increased for those aged ≤ 29 years and ≥ 70 years. Limitations: The number of suicides among females and the female population in the evacuation area was small. Conclusion: Our findings suggest the need to keep in mind that, when providing post-disaster mental health services, suicide rates can eventually increase even if they initially decrease.

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          Social emotion recognition, social functioning, and attempted suicide in late-life depression.

          : Lack of feeling connected and poor social problem solving have been described in suicide attempters. However, cognitive substrates of this apparent social impairment in suicide attempters remain unknown. One possible deficit, the inability to recognize others' complex emotional states has been observed not only in disorders characterized by prominent social deficits (autism-spectrum disorders and frontotemporal dementia) but also in depression and normal aging. This study assessed the relationship between social emotion recognition, problem solving, social functioning, and attempted suicide in late-life depression. : There were 90 participants: 24 older depressed suicide attempters, 38 nonsuicidal depressed elders, and 28 comparison subjects with no psychiatric history. We compared performance on the Reading the Mind in the Eyes test and measures of social networks, social support, social problem solving, and chronic interpersonal difficulties in these three groups. : Suicide attempters committed significantly more errors in social emotion recognition and showed poorer global cognitive performance than elders with no psychiatric history. Attempters had restricted social networks: they were less likely to talk to their children, had fewer close friends, and did not engage in volunteer activities, compared to nonsuicidal depressed elders and those with no psychiatric history. They also reported a pattern of struggle against others and hostility in relationships, felt a lack of social support, perceived social problems as impossible to resolve, and displayed a careless/impulsive approach to problems. : Suicide attempts in depressed elders were associated with poor social problem solving, constricted social networks, and disruptive interpersonal relationships. Impaired social emotion recognition in the suicide attempter group was related.
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            Psychological and perceived health effects of the Chernobyl disaster: a 20-year review.

            The mental health impact of Chernobyl is regarded by many experts as the largest public health problem unleashed by the accident to date. This paper reviews findings reported during the 20-y period after the accident regarding stress-related symptoms, effects on the developing brain, and cognitive and psychological impairments among highly exposed cleanup workers. With respect to stress-related symptoms, the rates of depressive, anxiety (especially post-traumatic stress symptoms), and medically unexplained physical symptoms are two to four times higher in Chernobyl-exposed populations compared to controls, although rates of diagnosable psychiatric disorders do not appear to be elevated. The symptom elevations were found as late as 11 y after the accident. Severity of symptomatology is significantly related to risk perceptions and being diagnosed with a Chernobyl-related health problem. In general, the morbidity patterns are consistent with the psychological impairments documented after other toxic events, such as the atomic bombings of Hiroshima and Nagasaki, the Three Mile Island accident, and Bhopal. With respect to the developing brain of exposed children who were in utero or very young when the accident occurred, the World Health Organization as well as American and Israeli researchers have found no significant associations of radiation exposure with cognitive impairments. Cognitive impairments in highly exposed cleanup workers have been reported by Ukrainian researchers, but these findings have not been independently confirmed. A seminal study found a significant excess death rate from suicide in cleanup workers, suggesting a sizable emotional toll. Given the magnitude and persistence of the adverse mental health effects on the general population, long-term educational and psychosocial interventions should be initiated that target primary care physicians, local researchers, and high risk populations, including participants in ongoing cohort studies.
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              The mental health of clean-up workers 18 years after the Chernobyl accident.

              The psychological aftermath of the Chernobyl accident is regarded as the largest public health problem unleashed by the accident to date. Yet the mental health of the clean-up workers, who faced the greatest radiation exposure and threat to life, has not been systematically evaluated. This study describes the long-term psychological effects of Chernobyl in a sample of clean-up workers in Ukraine. The cohorts were 295 male clean-up workers sent to Chernobyl between 1986 and 1990 interviewed 18 years after the accident (71% participation rate) and 397 geographically matched controls interviewed as part of the Ukraine World Mental Health (WMS) Survey 16 years after the accident. The World Health Organization (WHO) Composite International Diagnostic Interview (CIDI) was administered. We examined group differences in common psychiatric disorders, suicide ideation and severe headaches, differential effects of disorder on days lost from work, and in the clean-up workers, the relationship of exposure severity to disorder and current trauma and somatic symptoms. Analyses were adjusted for age in 1986 and mental health prior to the accident. Relatively more clean-up workers than controls experienced depression (18.0% v. 13.1%) and suicide ideation (9.2% v. 4.1%) after the accident. In the year preceding interview, the rates of depression (14.9% v. 7.1%), post-traumatic stress disorder (PTSD) (4.1% v. 1.0%) and headaches (69.2% v. 12.4%) were elevated. Affected workers lost more work days than affected controls. Exposure level was associated with current somatic and PTSD symptom severity. Long-term mental health consequences of Chernobyl were observed in clean-up workers.
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                Author and article information

                Journal
                Crisis
                Crisis
                cri
                Crisis
                Hogrefe Publishing
                0227-5910
                2151-2396
                April 5, 2018
                2018
                : 39
                : 5
                : 353-363
                Affiliations
                [ 1 ]Department of Public Health, Fukushima Medical University School of Medicine, Fukushima City, Japan
                [ 2 ]National Institute of Mental Health, National Center of Neurology and Psychiatry, Department of Adult Mental Health, Tokyo, Japan
                [ 3 ]Department of Disaster Psychiatry, Fukushima Medical University School of Medicine, Fukushima City, Japan
                Author notes
                Masatsugu Orui, Department of Public Health, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima City 960-1295, Japan, oruima@ 123456fmu.ac.jp
                Article
                10.1027/0227-5910/a000509
                6263751
                29618266
                8d7ad92b-16b2-4af0-ac4f-89f4511650c2
                Distributed under the Hogrefe OpenMind License (https://doi.org/10.1027/a000001)

                Distributed under the Hogrefe OpenMind License (https://doi.org/10.1027/a000001)

                History
                : May 2, 2017
                : September 25, 2017
                : September 27, 2017
                Categories
                Research Trends

                Clinical Psychology & Psychiatry
                disaster,epidemiology,mental health care,suicide,nuclear
                Clinical Psychology & Psychiatry
                disaster, epidemiology, mental health care, suicide, nuclear

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