A wide range of physical and psychological problems have been observed among victims even several years after the earthquake. These problems were mainly related to stressful experiences and conditions of the victims. However, other environmental factors and direct physical damage also played an important role. For example, hypertension among victims could be caused by several causes such as salty instant food, stressful living conditions, and nightmares. It will take a long time to obtain data on such possible effects of the earthquake as those on the psychosocial development of children, and those on the immune function (and on the incidence of allergy, cancer, etc.).
The isolated lifestyle increased alcohol use and cigarette-smoking, thus increasing the risk of hypertension and coronary heart disease. The lack of intake of fresh vegetables and the increased intake of ''fast food'' increased the risk of coronary heart disease among victims. Cold temperature and insufficient air-conditioning caused colds, bronchitis, and emphysema.
A small number of victims have been chronically disabled by the earthquake. They are suffering from head injuries and spinal cord injuries, and some have developed paraplegia. Pseudodementia has been suspected among a sizable number of elderly victims. Heavy drinking caused alcoholic hepatitis in some victims. A high-risk group for chronic stress disorders is elderly males who lost their family members. However, large-scale epidemiologic studies have yet to be completed for the victims of the earthquake.
Among the major problems affecting the victims are psychological difficulties resulting from isolated life in temporary housing. This isolation and the loss of community sometimes have led to tragedies such as suicides and so-called solitary death (unattended death in temporary housing). More than 250 cases of solitary death have been reported among victims of the earthquake. This has become a major social concern among the population in Kobe and a reason to blame the local government. Lack of local health personnel was cited as one of the contributing factors for this tragedy. According to our study on schoolchildren, psychological effects have been marked among girls of a younger age who lost families and friends. Neurotic symptoms decreased after 6 months but depressive symptoms and physical complaints continued even after 12 months [7,8]. A few articles from the Kobe area report a relatively low prevalence of post-traumatic stress disorder (PTSD) among victims compared with data in other countries [9-11].
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