Factors Associated With Worsened or Improved Mental Health in the Great East Japan Earthquake Survivors.

OBJECTIVE: The aim of this study was to identify factors contributing to the worsening or improved mental health of long-term evacuees over three years following the Great East Japan Earthquake. METHOD: The Japanese version of the K6 questionnaire was used as a measure of mental health. The first- and third-year survey results were compared and differences in mental health status calculated. Respondents were then divided into two groups according to worsening or improved mental health status. Differences in stress factors, stress relief methods, and demographics were compared between the two groups. RESULTS: Factors associated with exacerbation of poor mental health were the stress factors "Uncertainty about future" (p=0.048) and "Loss of purpose in life" (p=0.023). Multivariable analysis identified two factors associated with improved mental health, the stress relief methods "Accepting myself" (odds ratio (OR): 2.15, 95% confidence interval (CI): 1.02-4.51) and "Interactions with others" (OR: 3.34, 95% CI: 1.43-7.79). CONCLUSION: While motivation and hope of livelihood reconstruction have gradually risen in the three years since the disaster, anxieties about an uncertain future, loss of purpose in life, and disruption of social networks continue adversely to affect the mental health of survivors.

Efficacy of a Peer-Led, Recovery-Oriented Shared Decision-Making System: A Pilot Randomized Controlled Trial.

OBJECTIVE: The effects of a comprehensive shared decision-making system based on the CommonGround approach and incorporating peer support and a computerized decision aid were investigated. METHODS: A pilot randomized controlled trial with six-month follow-up was conducted in Japan. Fifty-six outpatients with mental illness were randomly allocated to a shared decision-making system (intervention) group or treatment as usual (control) group. The implementation process and several outcomes were compared between groups. RESULTS: The core components and processes of shared decision making were observed in the intervention group more frequently than in the control group. The intervention group also reported a significantly more positive participants' view of the relationship with their doctor than the control group. The intervention did not have a significant effect on most clinical and recovery-related outcomes. CONCLUSIONS: The shared decision-making system appeared to partly improve patients' perceptions of communication and relationships with doctors but did not have a significant effect on other patient-level outcomes.