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The aim of the present study was to examine the psychological impact on adolescent survivors of a maritime disaster that resulted in the deaths of nine people, including four high school students, and the effects of psychiatric intervention for the survivors.
Methods: Long-term multidimensional intervention consisting of psychoeducation, hospital treatment, family support and day care, was provided for nine adolescent survivors. To evaluate these effects, the survivors were also assessed using self-rating scales (Impact of Event Scale, General Health Questionnaire and Self-rating Depression Scale) and psychiatric structured interviews (Clinician-Administered Post-Traumatic Stress Disorder [PTSD] Scale) at 2, 8, 14, 26, and 38 months after the accident.
Results: Prevalence of PTSD among adolescent survivors was much higher than in adult survivors at the 2-month examination (78% vs 12%, respectively). Although the observed prevalence remained high until the 14-month examination, remarkable improvement occurred thereafter and none was diagnosed with PTSD at the 38-month examination.
Conclusion: Adolescents may have a specific vulnerability to PTSD and community-based intervention is effective for adolescents with serious symptoms of PTSD.
SINCE THE INDUSTRIAL revolution of the late 18th century, transportation disasters, such as air, sea, and rail accidents, have affected many people. Several studies have found that transportation disasters can also provoke post-traumatic stress disorder (PTSD) or major depression among survivors.1 For example, investigations into maritime disasters have outlined that approximately two-thirds of survivors from two major car ferry accidents had symptoms of serious traumatic responses at 3–30 months after the accident.2,3 Furthermore, Yule et al., using standardized interviews, examined 217 young survivors of the Jupiter cruise ship accident and demonstrated that 51.7% had developed PTSD within 8 years after the accident.4 Compared with natural disasters, however, few longitudinal studies exist on the psychological influence of transportation disasters, due to the difficulty involved in performing a long-term study of the victims of transportation disasters, owing mainly to their dispersion after accidents.
The Ehime Maru disaster, which involved a Japanese training vessel, occurred in the Pacific Ocean in 2001 and resulted in nine deaths, four of which were of high school students. A total of nine high school students survived the accident and witnessed the deaths of their classmates. In order to examine the long-term influence of this disaster on the survivors, particularly the students, mental health care was provided for 26 survivors soon after the accident, and a longitudinal study was conducted. Some of the results of that study have previously appeared in a monograph,5 but more detailed data and analysis of the adolescent (students) and adult (crewmembers) survivors have not yet been presented. The aims of the present study were (i) to examine the psychological impact of the accident on the adolescent survivors (students), in comparison with the adults (crew members); and (ii) to examine the effect of psychiatric intervention, based on a community care system, on the adolescent survivors.