Functional impairment in outpatients with mental disorders after the 2011 Great East Japan Earthquake
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Background： It is generally accepted that functional impairments are found in the course of patients withmental disorders who have exhibited vulnerability to a disaster. However, there has been no study examiningpost-disaster functional changes among them. The aim of the present study is to evaluate functionalchanges related to the 2011 Great East Japan Earthquake among patients with mental disorders living in theperipheral area of the earthquake zone, i.e., Tochigi Prefecture just adjacent to Fukushima Prefecture.Methods：A total of 612 outpatients with schizophrenic disorders （n = 163）, mood disorders （n = 299）,and neurotic disorders （n = 150） were evaluated in terms of their post-disaster functional changes usingthe function subscale of the Global Assessment of Functioning（ GAF-F） assessed before and after the 2011Great East Japan Earthquake.Results：Seventeen percent of the subjects showed a decline of their GAF-F scores after the disaster,compared to those before the disaster. The frequencies of the declined GAF-F score were 22％ for thepatients with neurotic disorders, 19％ for those with mood disorders, and 7％ for those with schizophrenicdisorders with a significant difference among the 3 diagnostic groups. In 102 subjects who showed adecline of their GAF-F scores after the disaster, the net changes of the decline of the GAF-F scores afterthe disaster in patients with mood disorders and those with neurotic disorders were significantly greaterthan those in patients with schizophrenic disorders, respectively. The multivariate logistic regressionanalysis revealed that patients with mood disorders（ F3）（ OR = 4.28, 95％ CI = 2.03-9.02） and those withneurotic disorders（ F4）（ OR = 4.56, 95％ CI = 2.09-9.95） were more than 4 times as likely to decline theirGAF-F scores after the disaster than those with schizophrenic disorders（ F2）.Conclusion：We found that in the peripheral area of the earthquake zone 17％ of the outpatients withmood disorders, neurotic disorders and schizophrenic disorders developed a significant functional declineafter the 2011 Great East Japan Earthquake. Patients with mood disorders and neurotic disorders weremore vulnerable to the disaster, compared to those with schizophrenic disorders. Close monitoring ofthe psychiatric conditions of individuals with mental disorders, in particular mood disorders and neuroticdisorders, may be of critical importance after a major disaster.
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自治医科大学 | 論文
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