Hatsumi Yoshii

Report on Maternal Anxiety 16 Months After the Great East Japan Earthquake Disaster: Anxiety Over Radioactivity

The Great East Japan Earthquake occurred on March 11, 2011. The tsunami caused extensive damage to the Fukushima Daiichi Nuclear Power Plant, resulting in a level 7 nuclear accident. Among those affected by this combined disaster were many pregnant and parturient women. Sixteen months after the earthquake, we conducted a questionnaire survey on anxiety among 259 women who gave birth around the time of the earthquake in Miyagi Prefecture, one of the affected areas. Participants reported 12 categories of anxiety, including anxiety over radioactivity. This study aimed to determine anxiety over radioactivity among this specific population and to record measures for future study. Anxiety over radiation was classified into seven subcategories: food safety, outdoor safety, effects on the fetuses of pregnant women, effects on children, radiation exposure, economic problems, and distrust of information disclosed. This study confirmed that concrete types of anxiety over radiation were keenly felt by mothers who had experienced the disaster who were currently raising children. The findings suggest the need to provide accurate information to these mothers, who are otherwise inundated with miscellaneous confusing information.

Stigma toward schizophrenia among parents of junior and senior high school students in Japan

BackgroundStigma toward schizophrenia is a substantial barrier to accessing care and adhering to treatment. Provisions to combat stigma are important, but in Japan and other developed countries there are few such provisions in place that target parents of adolescents. The attitudes of parents are important to address as first schizophrenic episodes typically occur in adolescence. In overall efforts to develop an education program and provisions against stigma, here we examined the relationship between stigma toward schizophrenia and demographic characteristics of parents of junior and senior high school students in Japan. The specific hypothesis tested was that contact and communication with a person with schizophrenia would be important to reducing stigma. A questionnaire inquiring about respondent characteristics and which included a survey on stigma toward schizophrenia was completed by 2690 parents.ResultsThe demographic characteristics significantly associated with the Devaluation- Discrimination Measure were family income, occupation, presence of a neighbor with schizophrenia, and participation in welfare activities for people with mental illness (p < 0.05). The mean ± SD score was 32.74 ± 5.66 out of a maximum of 48 points on the Link Devaluation-Discrimination Measure.ConclusionsStigma toward schizophrenia among parents of junior and senior high school students was in fact significantly stronger among members of the general public who had had contact with individuals with schizophrenia. In addition, stigma was associated with family income.

Effect of an Education Program on Improving Help-Seeking among Parents of Junior and Senior High School Students in Japan

Early intervention in schizophrenia is important for patient prognosis and quality of life. At the time of the first episode, quality of life is influenced by identification of symptoms and by medical help-seeking behavior. In this prospective cohort study, we investigated help-seeking among 2690 parents of junior and senior high school students before and after the parents viewed a newly developed web-based education program aimed at improving knowledge of schizophrenia. Our web-based education program aimed to improve understanding of schizophrenia, including promotion of help-seeking. Many parents (33.1%-50.0%) consulted a physician in a department of psychosomatic medicine when their child experienced symptoms. Characteristics that predicted a decision not to seek psychiatric medical help were having child with all symptoms, younger parent age, and lower family income (p<0.05). After the education program, the rate of parents who sought medical help within 1 week was significantly higher for all symptom categories except sleeplessness (p=0.001). These findings suggest that the present web-based education program was useful in promoting medical help-seeking behavior among parents of junior and senior high school students in Japan.

Reliability and validity of the workplace social distance scale.

Self-stigma, defined by a negative attitude toward oneself combined with the consciousness of being a target of prejudice, is a critical problem for psychiatric patients. Self-stigma studies among psychiatric patients have indicated that high stigma is predictive of detrimental effects such as the delay of treatment and decreases in social participation in patients, and levels of self-stigma should be statistically evaluated. In this study, we developed the Workplace Social Distance Scale (WSDS), rephrasing the eight items of the Japanese version of the Social Distance Scale (SDSJ) to apply to the work setting in Japan. We examined the reliability and validity of the WSDS among 83 psychiatric patients. Factor analysis extracted three factors from the scale items: “work relations,” “shallow relationships,” and “employment.” These factors are similar to the assessment factors of the SDSJ. Cronbach’s alpha coefficient for the WSDS was 0.753. The split-half reliability for the WSDS was 0.801, indicating significant correlations. In addition, the WSDS was significantly correlated with the SDSJ. These findings suggest that the WSDS represents an approximation of self-stigma in the workplace among psychiatric patients. Our study assessed the reliability and validity of the WSDS for measuring self-stigma in Japan. Future studies should investigate the reliability and validity of the scale in other countries.

Self-stigma of Schizophrenia Patients with Work Experiences and Reasons Not to Disclose Their Illness

Questionnaires were distributed to 49 stable schizophrenia patients with work experience who were either hospitalized in an open ward of a psychiatric hospital or were outpatients of the hospital to gain understanding of schizophrenia patients’ experiences at work, reasons for not disclosing their illness, and self-stigma. The questionnaire used in the present study consisted of 3 sections. Section 1 collected demographic information. Section 2 assessed the social distance of schizophrenia. Section 3 examined the reasons for not disclosing mental illness. The Kruskal–Wallis test and Mann–Whitney U test were used to examine associations between Social Distance Scale Japanese version (SDSJ) score and demographic characteristics. I categorized the qualitative data on reasons for non-disclosure and analyzed these categories. Work experience as a full-time employee was associated with total SDSJ score (p < 0.05). The four reasons not to disclose illness to the employer at the time of employment were: avoiding non-employment, avoiding worse treatment, feeling no need to disclose, and feeling unable confess. The three reasons for not disclosing illness to the employer once employed the job were: anxiety about stigma, anxiety about dismissal, and feeling no need to disclose. Measures for reducing self-stigma should focus on people with schizophrenia who currently work full-time. At the same time, it is necessary to establish measures based on evidence. Such measures should also include support for illness disclosure.

Workplace Social Distance toward Psychiatric Patients among Employers

Employment-related problems of psychiatric patients are attracting attention in the field of mental health and welfare. Employers’ social distance from psychiatric patients negatively influences patients’ chances to work. Therefore, social distance should be carefully measured and evaluated among employers. In this study, we developed the Workplace Social Distance Scale (WSDS), rephrasing the eight items of the Japanese version of the SDS to apply to the work setting in Japan. We examined the reliability and validity of the WSDS among 938 employers. Factor analysis extracted two factors from the scale items: ‘negative factor’ and ‘positive factor.’ Cronbach’s alpha coefficient for the WSDS was 0.821. In the scores for the test and the retest, a significant correlation was seen for the scale overall and respective subscales, although the correlation for positive items was somewhat low, at 0.415. In addition, the WSDS was significantly correlated with the Japanese version of the SDS. These findings suggest that the WSDS represents an approximation of social distance in the workplace among employers. Our study assessed the reliability and validity of the newly developed WSDS for measuring social distance among employers in Japan. Future studies should investigate the reliability and validity of the scale in other countries. Original Research Article Yoshii; BJESBS, 8(1): 63-69, 2015; Article no.BJESBS.2015.100 64

Factors Associated with an Absence of Effect of an Education Program for Improving Knowledge of Schizophrenia

Schizophrenia can develop in junior and senior high school students. Correct identification of schizophrenia symptoms is an important factor in subsequent healthcare. The present study conducted a multifaceted evaluation of factors associated with an absence of effect of an education program for improving knowledge of schizophrenia among parents of Japanese junior and senior high school students. Regarding discrimination of prodromal symptoms, the factors associated with an absence of effect of the education program were graduate school education, family income >110 000 USD, proximity to a person with schizophrenia, employment as a professional, and participation in welfare activities for people with mental illness. Regarding discrimination of schizophrenia, the factors associated with an absence of effect were a family income of 53 000 to 110 000 USD (P<0.05), and employment in production/labor service (P<0.05).