Abstract
Kobe Red Cross Hospital was the headquarter for the Japan Red Cross disaster relief response to the Great Hanshin-Awaji Earthquake of January 1995. In January 1996, the Department of Psychosomatic Internal Medicine was established. Its objective was to offer psychosomatic care for patients who had been traumatized by the earthquake. Many disaster victims complained of physical symptoms such as autonomic imbalance, depression masked by somatic disorders, and various types of psychosomatic disorders. The Niigata-Chuetsu Earthquake occurred in October 2004. Our entire psychosomatic internal medicine staff was sent to the disaster area under the Japan Red Cross's disaster rescue plan. They learned the fact that many had needed immediate care for acute psychosomatic disorders such as common cold, hypertension, insomnia, anxiety and constipation, due to their stressful living environment. To examine the current state ten years after the earthquake, we repeated the survey that we had done 5 years earlier with our outpatients. We sent out 151 questionnaires and had a 95% response rate. To the question:"Do you think your current illness is related to the earthquake experience?" 9% of the subjects responded "Largely or directly related," and 30%"Somewhat or indirectly related," with a total affirmative response of 39%. The persentage of these 2 types of answers to the same question 5 years ago was 13, 24 and 37 respectively. The percentage rose to 62% among 62 subjects who had the most difficult experiences, such as total destruction of their residence caused by earthquake or fire, death of family members or acquaintances, being trapped or buried under rubble, or living in emergency shelters for more than one week. Of the group who had experienced grate changes in their daily lives such as moving to a new residence, job loss, job transfer or a change in the family structure, 68% thought that these were related to their illnesses. It has been ten full years since the earthquake, but we still find many complaints of various psychosomatic symptoms resulting from earthquake experiences. The victims experience the following continuous generalized or integrated pains: Physical pain from injuries and illnesses; Psychological pain such as fear, anxiety, anger or depression; Social pain from destruction of or damage to their houses, job loss, worsening of financial situation, or loss of their community; as well as Spiritual pain such as confusion about the meaning of life or wondering whether or not there is a God. In order to care for the patients with such bio-psycho-socio-spiritual pains, we must provide a comprehensive team care by networking not only with medical and psychological specialists but also with various other professions. To prevent psychosomatic disorders under such circumstances, it is necessary to have psychosomatic intervention based on the long-term plan. In other words, a great disaster means the time for us to initiate immediate bio-psycho-social medical care.
