Synergistic Effect of History of Cardiovascular Disease and Mental Distress on Post-Traumatic Stress Disorder after the Great East Japan Earthquake: The Fukushima Health Management Survey

Kazuhide Tezuka, Yasuhiko Kubota, Tetsuya Ohira, Hironori Nakano, Masaharu Maeda, Hirooki Yabe, Seiji Yasumura, Mayumi Harigane, Yuji Shimizu, Takeo Okada, Masahiko Kiyama, Kenji Kamiya and on behalf of the Fukushima Health Management Survey Group
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Kazuhide Tezuka: Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka 536-0025, Japan
Yasuhiko Kubota: Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka 536-0025, Japan
Tetsuya Ohira: Department of Epidemiology, School of Medicine, Fukushima Medical University, Fukushima 960-1295, Japan
Hironori Nakano: Department of Epidemiology, School of Medicine, Fukushima Medical University, Fukushima 960-1295, Japan
Masaharu Maeda: Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan
Hirooki Yabe: Department of Neuropsychiatry, School of Medicine, Fukushima Medical University, Fukushima 960-1295, Japan
Seiji Yasumura: Department of Public Health, School of Medicine, Fukushima Medical University, Fukushima 960-1295, Japan
Mayumi Harigane: Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan
Yuji Shimizu: Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka 536-0025, Japan
Takeo Okada: Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka 536-0025, Japan
Masahiko Kiyama: Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka 536-0025, Japan
Kenji Kamiya: Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan
on behalf of the Fukushima Health Management Survey Group: Membership of the Fukushima Health Management Survey Group is provided in the Acknowledgments.

IJERPH, 2021, vol. 18, issue 19, 1-7

Abstract: Cardiovascular disease (CVD) and mental distress have been suggested to be associated with post-traumatic stress disorder (PTSD), but the effect of their combination on PTSD is unknown. We reviewed the synergistic effects of the history of CVD and mental distress on the possibility of PTSD among residents in Fukushima after the Great East Japan Earthquake. This cross-sectional study was conducted among 38,392 participants aged 40–74 years in the evacuation area who applied for the Fukushima Health Management Study in Fiscal Year 2011. Relative excess risk due to interaction (RERI), attributable proportion (AP), odds ratio (OR), and 95% confidence interval (CI) were calculated to investigate the combined effect of history of CVD and mental distress on PTSD. We identified 8104 probable cases of PTSD (21.1%). History of CVD, mental distress, and their combination were positively associated with probable PTSD: the multivariable ORs (95% CIs) were 1.44 (1.04, 2.01), 20.08 (18.14, 22.22), and 26.60 (23.07, 30.67), respectively. There was a significant increase in RERI: the corresponding RERI (95% CI) and AP were 6.08 (3.16, 9.00) and 22.9%. Gender-specific analyses showed similar associations. Thus, we found a supra-additive association of history of CVD and mental distress with probable PTSD after the disaster.

Keywords: the Great East Japan Earthquake; cardiovascular disease; mental distress; post-traumatic stress disorder; the relative excess risk due to interaction; attributable proportion (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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