Background: The Great East Japan Earthquake was one of the most devastating natural disasters ever to hit Japan.

Purpose: This paper reviews the results of research into psychological outcomes following the catastrophic earthquake in children and adolescents to determine methods of effective support.

Method: Literature and articles retrieved using multiple medical search engines with earthquakes, children, and psychology as keywords were reviewed and classified into three categories by theme. Theme 1 : PTSD in children following earthquake disasters. Theme 2: Mental problems harbored by children after disastrous quakes. Theme 3: Risk profiles affecting such mental problems.

Results: Most studies on the mental issues affecting children in the aftermath of earthquake disasters focused on PTSD. Post-quake PTSD was found to be correlated with age, somatic disorders, social aid, sex, and experience of tsunami. Adolescence is a high-risk group prone to present PTSD, suggesting greater need for continuous intervention for this age group. Moreover, it was found that children experiencing the tsunami–a principal feature of the Great East Japan Earthquake—suffered mental consequences beyond those affecting victims of conventional earthquakes, pointing to the critical need and significance of subsequent mental health care for adolescents exposed to the Great East Japan Earthquke.

Objective: This study was designed to investigate the effects of the Great East Japan Earthquake upon child mental health, through analysis of the clinical picture of outpatients examined at the child psychiatric clinic of Miyagi Comprehensive Children's Center for symptoms related to the disaster.

Methods: Outpatients presenting with symptoms related to the disaster within two years of the event were assessed. The items surveyed were: gender, age, diagnosis, onset time, disparity in Children's Global Assessment Scale (C-GAS) scores, risk factors affecting their lives before the disaster, and at the time of examination.

Results: While the number of new outpatients presenting with disaster-related symptoms decreased with time, some children were seen to exhibit persistent symptoms, and presentation with late-onset symptoms continued to be seen more than 1 year from the disaster.

Discussion: The data indicated the Great East Japan Earthquake was exerting medium and long-term effects upon child mental health, suggesting the importance of continuing appropriate child mental health measures in the affected regions.

The American Psychiatric Association published the fifth edition of the diagnostic and statistical manual of mental disorders (DSM-5) in 2013, which is expected to have great impact on psychiatric clinical practice and research in Japan.

The DSM-5 is similar to the DSM-Ⅳ with respect to the constitutive approach and adoption of operational criteria for diagnosis, although the shift in emphasis towards the dimensional and developmental aspects of mental disorders is new. Even though the diagnostic method of the DSM series has been effective in improving the reliability of diagnosis between psychiatrists, the lateral arrangement of symptoms with no regard to hierarchical relationships has given rise to a multitude of comorbidities, while the operational nature has generated a rampancy of reductionistic diagnoses, resulting in a massive increase in the number of patients diagnosed with mental disorders—a feature that remains unchanged in the DSM-5.

DSM-5 has altered the diagnostic criteria of some disorders, while introducing a number of new concepts, particularly in the area of child and adolescent disorders.

An example of the former is autism spectrum disorder, while social (pragmatic) communication disorder and disruptive dysregulation disorder exemplify the latter. These newly introduced disorder concepts need to undergo extensive discussion and evaluation among researchers before acceptance, and recognition of such immature concepts as official constructs at this point is highly problematic.

As such, while the DSM does have its advantages, our clinical practice must be a heuristic process, calling for rapid advances in psychopathology that would allow us to fully appreciate the individual specificity expressed by each patient, instead of reducing the process of diagnosis to a simple mechanical application of criteria defined by a diagnostic and statistical manual.