FUKUSHIMA Lives on the Line

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185chap.IVPatient Relief Activity Records [Essays and Research Publications]FUKUSHIMA: Lives on the Line(12.2%) had no history of psychiatric diagnosis.The conditions on admission were as follows: 28 (37.8%) were hallucinating or delusional, eight (10.8%) confused, eight (10.8%) manic, eight (10.8%) depressed, seven (9.5%) had a nervous breakdown, one (1.4%) catatonic, three (4.1%) delirious, five (6.8%) had dementia, and six (8.1%) were others.Admission diagnoses by ICD-10 classification were as follows: 10 (13.5%) were in F0 (organic including symptomatic, mental disorders), two (2.7%) in F1 (mental and behavioral disorders due to psychoactive substance use), 36 (48.6%) in F2 (schizophrenia and schizotypal and delusional disorders), 15 (20.3%) in F3 (mood [affective] disorders), eight (10.8%) in F4 (neurotic, stress-related, and somatoform disorders), and three (4.1%) in others.The types of admission were as follows: 41 (55.4%) were voluntary admissions, 30 (40.5%) for medical protection, and three (4.1%) involuntary admissions. Figure 5 shows the period from the earthquake to the admission.4. Discussion Since this study does not include all patients admitted in Fukushima Prefecture, we are unable to compare the results with those of patients admitted under normal circumstances. In addition, since this is a preliminary survey not strictly controlled for statistical processing and a simple review of the trend of newly admitted patients after the earthquake and nuclear accident, a detailed discussion will be challenging. However, there is no previous report of newly admitted patients to a psychiatric ward after a major disaster including a nuclear incident. Thus, this study serves the important role of providing fundamental data for future studies. The characteristics of newly admitted patients with psychiatric disorders after the catastrophes are discussed as follows: First, 33.1% were in F2 (schizophrenia spectrum), the most diagnosed condition on admission; 23.8% in F3 (mood disorder spectrum); and 7.4% in F4 (neurotic, stress-related, and somatoform disorders, including Post Traumatic Stress Disorder [PTSD]), which was relatively rare. Second, 11.6% of all admitted patients were in a manic state on admission, which is relatively high. Third, among all newly admitted patients, 12.1% were associated with the fear of radiation exposure after the nuclear power plant accident. We focus on reviewing statistics from outpatient psychiatric wards in Fukushima Prefecture after the earthquake and excluded data on PTSD since it is beyond the scope of our study. 1) There was an increase in the admission of patients in a manic state after the earthquake.There were 71 patients (11.6% of all admissions) who were in a manic state on admission. Considering that mood disorder symptoms seasonally fluctuate, comparative data of the same season under normal circumstance is required; however, there was no such data available. Therefore, we decided to compare new admission data at Fukushima Medical University Hospital, Department of Psychosomatic Medicine between March 12 and May 11 from 2007 to 2010. There were 112 new admissions over a period of four years, of which four (3.6%) were admitted in a manic state. Our data shows that the admissions of patients in a manic state were approximately three times higher at 11.6%, illustrating a higher trend after the earthquake. In addition, this study shows the statistics of admission applications submitted for medical protection by type of disorder in Fukushima in 2009. The necessary approval has been provided by the Welfare division, Fukushima Prefecture. The admission rate for medical protection for F3 disorders, such as manic and depressive states, was a total of 14.5%. Admissions of patients in both depressive and manic states were 14.5% under normal circumstances, while those only in a manic state were 11.6% of all admissions after the earthquake. Although we cannot compare manic and depressive states because data available shows admission for medical protection only, and considering that depression is far more common than manic cases, the rate of manic cases is higher than that under ordinary circumstances. There have been several reports about the increase in manic state after major disasters. Yamaguchi et al. reported that there were numerous admission cases of patients with bipolar disorder who had a relapse of the manic phase after the Great Hanshin-Awaji Earthquake12. Figure 5. Period from the Earthquake to the Date of Admission of Patients whose Admissions are Associated with Radiation ExposureNumber of patients admittedUnit : DayUnit : PersonStudy of Newly Admitted Psychiatric Patients after the Fukushima Nuclear Power Plant Accident

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