Atsuro Tsutsumi

Mental Health Promotion

Mental health is a set of positive attributes intrinsic to the health of individuals and communities. Poor mental health is associated with relative social disadvantage in whole populations and vulnerable subgroups. Adverse conditions such as poverty, discrimination, and violence have a powerful influence on mental health in high- and low-income countries. Conversely, mental health is linked with human, social, and economic development. Mental health promotion is integral to the new public health and health promotion. Evidence is available on the effectiveness of public health and social interventions for enhancing the mental health of populations in locally devised and culturally appropriate ways.

Prevalence of Mental Disorders and Suicidal Thoughts Among Community-Dwelling Elderly Adults 3 Years After the Niigata-Chuetsu Earthquake

Background Japan is located in an area prone to natural disasters, and major earthquakes have occurred recently in rural areas where the proportion of elderly adults is high. Although elderly persons are vulnerable members of communities at a time of disaster, the prevalence of mental disorders among this population has yet to be reported in Japan. This study aimed to determine the prevalence of mental disorders and suicidal thoughts among community-dwelling elderly persons 3 years after an earthquake and to identify risk factors associated with their quality of life (QOL). Methods Face-to-face interviews were conducted with 496 community-dwelling persons aged 65 years or older in areas of Japan where 2 major earthquakes had occurred during a 3-year period. The main outcome was diagnosis of a mental disorder or suicidality. Results During the 3-year period after the earthquake, 1.6% of men and 5.5% of women had received a diagnosis of major depression. There were no cases of posttraumatic stress disorder. Women were more likely than men to report suicidality (7.8% vs 3.8%, P = 0.075). Conclusions The prevalence of mental disorders was lower than that reported in previous studies. Despite the low prevalence of mental disorders, the percentage of community-dwelling elderly persons with subclinical mental health symptoms was high. The results indicate that appropriate public health and medical interventions are warranted after a natural disaster.

Reliability and validity of the Bangla version of WHOQOL-BREF in an adult population in Dhaka, Bangladesh

Abstract  The aim of the present study was to evaluate the validity and reliability of the Bangla version of the World Health Organization Quality of Life questionnaire (WHOQOL‐BREF) in an adult population in Bangladesh. Approximately 200 adults in the Dhaka district were interviewed using a questionnaire containing the Bangla version of the WHOQOL‐BREF, as well as questions related to sociodemographic data. To assess the reliability of WHOQOL‐BREF, Cronbach’s α was calculated, and test–retest reliability was evaluated using intraclass correlation coefficient (ICC) of the first and second administrations. For comparison, approximately 200 leprosy patients were also interviewed with the questionnaire to examine the discriminant validity between groups. On the whole, sufficient validity was observed, and the Bangla version of the WHOQOL‐BREF was deemed to be valid and reliable in assessing the quality of life of an adult population in Bangladesh.

Persistent distress after psychological exposure to the Nagasaki atomic bomb explosion

BACKGROUND Although there is speculation that individuals living in the vicinity of nuclear disasters have persistent mental health deterioration due to psychological stress, few attempts have been made to examine this issue. AIMS To determine whether having been in the vicinity of the Nagasaki atomic bomb explosion in the absence of substantial exposure to radiation affected the mental health of local inhabitants more than half a century later. METHOD Participants were randomly recruited from individuals who lived in the vicinity of the atomic bomb explosion in uncontaminated suburbs of Nagasaki. This sample (n = 347) was stratified by gender, age, perception of the explosion and current district of residence. Controls (n = 288) were recruited from among individuals who had moved into the area from outside Nagasaki 5-15 years after the bombing, matched for gender, age and district of residence. The primary outcome measure was the proportion of those at high risk of mental disorder based on the 28-item version of the General Health Questionnaire, with a cut-off point of 5/6. Other parameters related to individual perception of the explosion, health status, life events and habits were also assessed. RESULTS Having been in the vicinity of the explosion was the most significant factor (OR = 5.26, 95% CI 2.56-11.11) contributing to poorer mental health; erroneous knowledge of radiological hazard showed a mild association. In the sample group, anxiety after learning of the potential radiological hazard was significantly correlated with poor mental health (P<0.05), whereas anxiety about the explosion, or the degree of perception of it, was not; 74.5% of the sample group believed erroneously that the flash of the explosion was synonymous with radiation. CONCLUSIONS Having been in the vicinity of the atomic bomb explosion without radiological exposure continued to be associated with poorer mental health more than half a century after the event. Fear on learning about the potential radiological hazard and lack of knowledge about radiological risk are responsible for this association.

Mental health and wellbeing in the Sustainable Development Goals

This paper is about how sustainable development cannot be achieved without the inclusion of mental health as a key global priority. Until recently the international community had not mobilised the necessary attention, efforts, and resources for people with mental illness and disability, despite the knowledge that the economic cost of mental disorders is more than 4% of GDP worldwide, depression is a leading cause of disability, and more than 800 000 deaths by suicide occur every year, many of which are preventable.

Effect of having a subsequent child on the mental health of women who lost a child in the 2008 Sichuan earthquake: a cross-sectional study

OBJECTIVE To assess whether having a subsequent child had an effect on the mental health of Chinese mothers who lost a child during an earthquake. METHODS A cross-sectional survey of bereaved mothers was conducted 30 to 34 months after the 2008 Sichuan earthquake using individual structured interviews to assess sociodemographic characteristics, post-disaster experiences and mental health. The interviews incorporated standardized psychometric measures of anxiety, depression, post-traumatic stress disorder (PTSD) and complicated grief (CG). Social support was also assessed. An adjusted model taking potential confounders into account was used to explore any association between psychological symptoms and the birth of a subsequent child. FINDINGS The prevalence of psychological symptoms was higher in mothers who did not have a child after losing the first one. In an adjusted model, symptoms of anxiety (odds ratio, OR: 3.37; 95% confidence interval, CI: 1.51-7.50), depression (OR: 9.47; 95% CI: 2.58-34.80), PTSD (OR: 5.11; 95% CI: 2.31-11.34) and CG (OR: 10.73; 95% CI: 1.88-61.39) were significantly higher among the 116 women without a subsequent child than among the 110 mothers who had another child after bereavement. More than two thirds of the mothers with new infants had clinically important psychological symptoms. CONCLUSION Women who have lost an only child in a natural disaster are especially vulnerable to long-term psychological problems, especially if they have reached an age when conception is difficult. Research should focus on developing and evaluating interventions designed to provide women with psychosocial support and reproductive services.

Comparative study of the prevalence of suicidal behavior and sexual abuse history in delinquent and non-delinquent adolescents

The present study examined the prevalence of suicidal behavior and sexual abuse history in delinquent and non‐delinquent adolescents aged 15–17 years. Results showed that delinquent adolescents, particularly girls, more frequently reported histories of suicidal behavior and sexual abuse than non‐delinquent adolescents.

Comprehensive SDG goal and targets for non-communicable diseases and mental health.

The negotiations on the SDG goals and targets, leading to the sustainable development Declaration in September 2015, are now in the final stages. Ensuring that people with mental disorders are not left behind in the global development program from 2015 to 2030 will require specific and explicit commitments and targets against which progress in mental health can be measured and reported. The arguments for inclusion of explicit mental health targets in the SDGs are compelling. The final negotiations on the SDG goals and targets will now determine whether people with mental illness and psychosocial disabilities will continue to be neglected or will benefit equitably from inclusion in the post-2015 development program.

Mental health mainstreamed in new UN disaster framework

The Nepal earthquake of April, 2015, is a tragic reminder of the physical devastation, loss of life, and effects on mental wellbeing that are more likely to occur when effective strategies for disaster risk reduction have not been implemented sufficiently. It also serves as a stark reminder of the fact that it is people with disabilities who are hit hardest when disaster strikes.

Nutritional and Mental Health Status of Afghan Refugee Children in Peshawar, Pakistan: A Descriptive Study

The study sought to ascertain and describe the physical and mental health states of Afghan refugee children after the terrorist attack on September 11, 2001 in the US and the aerial bombing of Afghanistan that followed. A cross-sectional survey was carried out in four refugee camps in Peshawar, Pakistan from February to March 2002, and comparisons among camps were made. A total of 70 males (mean age SD = 9.81 ±1.98 years old) and 30 females (7.94 ±2.07) answered a self-developed questionnaire on demographic data, traumatic events experience, living environment in the camps, and physical and mental health, through interviews. Anthropometric measures were measured and physical symptoms including anaemia and edema were assessed. Severe malnutrition was not shown and there were no significant differences in most nutritional and physical states among the camps. Nevertheless, in the newer camps more children experienced war related traumatic events. Mental symptoms were prevalent in all camps, though the characteristics of the symptoms differed among the camps. Asia Pac J Public Health 2005; 17(2): 93-98.