Disaster Psychiatry: Lessons Learned from the Great Hanshin Awaji Earthquake

災難精神醫學：從阪神淡路大地震所學到的經驗

10.29478/TJP.201104.0002

新福尚隆(Naotaka Shinfuku)

disaster psychiatry ； earthquate victims ； post-disaster psychiatric symptoms

台灣精神醫學

25卷1期（2011 / 04 / 01）

3 - 12

英文

Background: In the early morning of January 17, 1995, the Kobe city (1.5 million inhabitants) and surrounding urban areas were devastated by the Great Hanshin Awaji Earthquake. This Earthquate killed more than 5,500 people immediately and made more than 350,000 people homeless. But the Japanese have learned many lessons through experiencing this tragic event. Methods: I personally experienced the Earthquake on spot at that time. I have also been witnessing the recovery process in the Kobe area over 15 years. As a psychiatrist, I have also been observing the changes of psychiatric problems of the Earthquate victims over the time. Results: Inhabitants in the Kobe area started to experience various physical and psychological problems after the disaster. These problems have been changing over the time. The first victims' symptoms were panic attacks, which were gradually replaced with depressive symptoms, alcohol abuse and alcohol-related problems as well as so-called ”solitary death.” But posttraumatic stress disorder was not common among those victims. In one year, those psychopathologic problems had quickly become social problems in Japan. The recovery process was accompanied with the efforts of the Kobe people to transfer their experiences to the victims of similar disasters in Asia and in the world. Conclusion: The Hanshin Awaji Earthquake was tragic. But, the lessons learned in Kobe is being shared by psychiatrists and mental health experts in Asia and in other developing countries. This transfer of experiences has constituted a continuous process in Japanese recovery from the Great Hanshin Awaji Earthquake. One could say, ”sharing is the main source of our recovery from the disaster.”

1. Aoyama, N、Kinoshita, Y、Kasuga, M(1998)。Peptic ulcer after the Hanshin-Awaji Earthquake-increased incidence of bleeding gastric ulcers。Comprehensive Medical Studies on the Earthquake Victims，Kobe, Japan:
2. Araki, K.,Nakane, Y.,Ohta, Y.,Kawasaki, N.(1998).The nature of psychiatric problems among disaster victims.Psychiatry Clin Neurosci,52(Suppl),317-9.
3. Baba, S.,Taniguchi, H.,Nambu, S.(1996).Essay, the great Hanshin earthquake.Lancet,347,307-9.
4. Chen, CC,Yeh, TL,Yang, YK(2001).Psychiatric morbidity and post-traumatic symptoms among survivors in the early stage following the 1999 earthquake in Taiwan.Psychiatry Res,15,13-22.
5. Coenjian, AK,Najarian, LM,Pynoos, RS(1994).Posttraumatic stress disorder in elderly and younger adults after the 1988 earthquake in Armenia.Am J Psychiatry,151,895-901.
6. Inui, A.,Kitaoka, H.,Majima, M.(1998).Effect of the earthquake on stress and glycemic control in patients with diabetes mellitus.Arch Intern Med,158,274-8.
7. Kato, H.,Asukai, N.,Miyake, Y.,Minakawa, K.,Nishiyama, A.(1996).Post-traumatic symptoms among younger and elderly evacuees in the early stages following the 1995 Hanshin-Awaji earthquake in Japan.Acta Psychiatr Scand,93,471-7.
8. Kokai, M.、Shinfuku, N.(2000)。PTSD in Asian society。Encyclopedia of Clinical Psychiatry，S6，309-18。
9. Kokai, M.、Shinfuku, N.(1998)。Post-traumatic stress disorder and somatoform disorder。Psychosom Med，2，193-7。
10. Kokai, M.、Takeuchi, S.、Ohara, K.(1998)。PTSD among victims of the Great Hanshin Awaji earthquake。Sheishin-lgaku，478，1061-8。
11. Ono, Y(ed.),Janca, A(ed.),Asai, M(ed.)(1999).Somatoform Diorders: Worldwide Perspective.Tokyo:Springer.
12. Saito, K.,Kim, JL,Maekawa, K.(1997).The Great Hanshin Awaji earthquake-aggravated blood pressure control in treated hypertensive patients.Am J Hypertens,10,217-21.
13. Sharan, P.,Chaudgary, G.,Kavathkar, SA.,Saxena, S.(1996).Preliminary report of psychiatric disorder in survivors of a severe earthquake.Am J Psychiatry,153,556-8.
14. Shinfuku, N(1998)。Psychological consequences of the Great Hanshin Awaji Earthquake。Comprehensive Medical Studies on the Earthquake Victims，Kobe, Japan:
15. Shinfuku, N.(2002).Disaster mental health: lessons learned from the Hanshin Awaji Earthquake.World Psychiatry,1,158-9.
16. Shinfuku, N.(1996).Psychological consequences of the Great Hanshin Earthquake.Stress Science,10,25-30.
17. Shinfuku, N.(1999).To be a victim and a survivor of the Great Hanshin-Awaji Earthquake.J Psycholomat Res,46,541-8.
18. Shinfuku, N、Honda, M、Uemoto, M(1998)。Epidemiological study of the Great Hanshin-Awaji Earthquake's psychological consequences on affected school children。Comprehensive Medical Studies on the Earthquake Victims，Kobe, Japan:
19. Ueno, Y,Nishimura, A,Tatsuno, Y(1998).Analysis of the result of inquests in the Great Hanshin Earthquake.Comprehensive Medical Studies on the Earthquake Victims,Kobe, Japan:
20. Wang, X,Gao, L,Shinfuku, N,Zhang, H.,Zhao, C,Shen, Y(2000).Longitudinal study of earthquake-related PTSD in a randomly selected community sample in north China.Am J Psychiatry,157,1260-6.

1. Lee, Min-Soo(2014).Psychiatric Interventions in National Disasters: The Rôle of Psychiatrists for Survivor Victims in the Sewol Ferry Accident.諮商與輔導,28(4),211-216.
2. Naotaka Shinfuku(2023)。What i have Learned from French Psychiatry。臺灣精神醫學，37(2)，61-69。