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  • 1.
    Inoue, Y.
    et al.
    The University of North Carolina at Chapel Hill, Chapel Hill, USA / The University of Tokyo, Tokyo, Japan.
    Stickley, Andrew
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). The University of Tokyo, Tokyo, Japan.
    Yazawa, A.
    The University of Tokyo, Tokyo, Japan.
    Aida, J.
    Tohoku University, Sendai, Japan / Miyagi Prefectural Government Office, Sendai, Japan.
    Kawachi, I.
    Harvard University, Boston, USAChiba University, Chiba, Japan.
    Kondo, K.
    Chiba University, Chiba, Japan / Nihon Fukushi University, Aichi, Japan / National Center for Geriatrics and Gerontology, Aichi, Japan.
    Fujiwara, T.
    The University of North Carolina at Chapel Hill, Chapel Hill, USA / Tokyo Medical and Dental University, Tokyo, Japan.
    Adverse childhood experiences, exposure to a natural disaster and posttraumatic stress disorder among survivors of the 2011 Great East Japan earthquake and tsunami2019In: Epidemiology and Psychiatric Sciences, ISSN 2045-7960, E-ISSN 2045-7979, Vol. 28, no 1, p. 45-53Article in journal (Refereed)
    Abstract [en]

    Aims.: To investigate whether adverse childhood experiences (ACEs) modify the impact of exposure to a natural disaster (the 2011 Great East Japan earthquake and tsunami) on the occurrence of posttraumatic stress disorder (PTSD) among older people. Methods.: Data were collected as part of the Japan Gerontological Evaluation Study (JAGES), which is an on-going epidemiological survey investigating social determinants of health among older people across Japan. Information on PTSD symptoms based on the Screening Questionnaire for Disaster Mental Health, traumatic exposure to the earthquake (i.e., house damage and loss of relatives/friends during the earthquake/tsunami) and ACEs was obtained from 580 participants aged 65 or older living in Iwanuma City, Miyagi Prefecture, which suffered severe damage as a result of the earthquake and the subsequent tsunami in March 2011. Associations were examined using Poisson regression analysis with a robust variance estimator after adjusting for covariates. Results.: The prevalence of PTSD was 9.7% in this population; compared to those with no traumatic experience, the prevalence of PTSD was approximately two times higher among those who experienced the loss of close friends/relatives (PR = 1.84, 95% CI = 1.11–3.03, p = 0.018), or whose house was damaged (PR = 2.15, 95% CI = 1.07–4.34, p = 0.032). ACE was not significantly associated with PTSD. Stratified analyses by the presence of ACE showed that damage due to the earthquake/tsunami was associated with PTSD only among those without ACEs; more specifically, among non-ACE respondents the PR of PTSD associated with house damage was 6.67 (95% CI = 1.66–26.80), while for the loss of a relative or a close friend it was 3.56 (95% CI = 1.18–10.75). In contrast, no statistically significant associations were observed among those with ACEs. Conclusion.: Following the Great East Japan earthquake/tsunami in 2011 a higher risk of developing PTSD symptoms was observed in 2013 especially among older individuals without ACEs. This suggests that ACEs might affect how individuals respond to subsequent traumatic events later in life.

  • 2.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). National Center for Neurology & Psychiatry, Tokyo, Japan.
    Ng, C F S
    Nagasaki University, Nagasaki, Japan.
    Watanabe, C
    University of Tokyo, Tokyo, Japan.
    Inoue, Y
    University of North Carolina at Chapel Hill, Chapel Hill, USA.
    Koyanagi, Ai
    Universitat de Barcelona, Barcelona, Spain / CIBERSAM, Madrid, Spain.
    Konishi, S
    University of Tokyo, Tokyo, Japan / University of Washington, Seattle, USA.
    General thoughts of death and mortality: findings from the Komo-Ise cohort, Japan.2019In: Epidemiology and Psychiatric Sciences, ISSN 2045-7960, E-ISSN 2045-7979, Vol. 28, no 6, p. 662-669Article in journal (Refereed)
    Abstract [en]

    AimsDeath ideation (thinking about/wishing for one's own death, thinking that one would be better off dead) is linked to an increased mortality risk. However, comparatively little is known about more general thoughts of death (GTOD) where no wish to die or life value is expressed. This study examined whether GTOD predicted mortality in a community-based cohort of older adults.

    METHODS: Data came from the Komo-Ise cohort study in Gunma prefecture, Japan. The analytic sample comprised 8208 individuals (average age 61.3 (range 47-77)) who were asked in wave 2 of the study in 2000 if they had 'Thought about death more than usual, either your own, someone else's or death in general?' in the past 2 weeks. Death data were obtained from the municipal resident registration file. Cox proportional hazards regression analysis was used to examine associations.

    RESULTS: During the follow-up period (2000-2008), there were 672 deaths. In a model adjusted for baseline covariates, GTOD were significantly associated with all-cause mortality (hazards ratio 1.66, 95% confidence interval 1.20-2.29). Stratified analyses showed an association between GTOD and mortality in men, older subjects (⩾70 years), married individuals and those with higher social support.

    CONCLUSIONS: GTOD are associated with an increased mortality risk among older citizens in Japan. Research is now needed to determine the factors underlying this association and assess the clinical relevance of screening for GTOD in older individuals.

  • 3.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). National Institute of Mental Health, Kodaira, Tokyo, Japan.
    Oh, H.
    University of Southern California, Los Angeles, CA, USA.
    Sumiyoshi, T.
    National Institute of Mental Health, Kodaira, Tokyo, Japan.
    Mckee, M.
    London School of Hygiene and Tropical Medicine, London, UK.
    Koyanagi, A.
    CIBERSAM, Barcelona, Spain / ICREA, Barcelona, Spain.
    Injury and depression among 212 039 individuals in 40 low- and middle-income countries2020In: Epidemiology and Psychiatric Sciences, ISSN 2045-7960, E-ISSN 2045-7979, Vol. 29, article id e32Article in journal (Refereed)
    Abstract [en]

    AimsAlthough injuries have been linked to worse mental health, little is known about this association among the general population in low- A nd middle-income countries (LAMICs). This study examined the association between injuries and depression in 40 LAMICs that participated in the World Health Survey.MethodsCross-sectional information was obtained from 212 039 community-based adults on the past 12-month experience of road traffic and other (non-traffic) injuries and depression, which was assessed using questions based on the World Mental Health Survey version of the Composite International Diagnostic Interview. Multivariable logistic regression analysis and meta-analysis were used to examine associations.ResultsThe overall prevalence (95% CI) of past 12-month traffic injury, other injury, and depression was 2.8% (2.6-3.0%), 4.8% (4.6-5.0%) and 7.4% (7.1-7.8%), respectively. The prevalence of traffic injuries [range 0.1% (Ethiopia) to 5.1% (Bangladesh)], and other (non-traffic) injuries [range 0.9% (Myanmar) to 12.1% (Kenya)] varied widely across countries. After adjusting for demographic variables, alcohol consumption and smoking, the pooled OR (95%CI) for depression among individuals experiencing traffic injury based on a meta-analysis was 1.72 (1.48-1.99), and 2.04 (1.85-2.24) for those with other injuries. There was little between-country heterogeneity in the association between either form of injury and depression, although for traffic injuries, significant heterogeneity was observed between groups by country-income level (p = 0.043) where the pooled association was strongest in upper middle-income countries (OR = 2.37) and weakest in low-income countries (OR = 1.46).ConclusionsAlerting health care providers in LAMICs to the increased risk of worse mental health among injury survivors and establishing effective trauma treatment systems to reduce the detrimental effects of injury should now be prioritised.

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