津波災害による負傷者の神経内分泌学的ストレス分析

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  • Neuroendocrinological evaluation of psychological stress in tsunami victims.

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There have been few studies on mental stress caused by natural disasters from a neuroendocrinological viewpoint. In this study we examined five patients with physical injures as a result of the Hokkaido Nansei-oki earthquake and tsunami and evaluated stress over a two-week period after the disaster. Blood cortisol and catecholamines (epinephrine, norepinephrine, and dopamine) were measured as indices of acute stress reaction, and urine 17-OHCS, 17-KS-S and 17-KS-S/17-OHCS ratio, often used to evaluate psychosocial stress, were also measured as indices of “wear and tear”, “repair and recovery”and “distortion of adaptation”, respectively (the former two expressed as creatinine ratio, all three expressed as percentages of the mean values in a healthy 25-year-old group). Serum cortisol was increased in two of the five patients only on the 4th day after the disaster, while plasma catecholamines remained within normal limits. 17-OHCS increased (over 100%), 17-KS-S clearly decreased (below 50%), and the 17-KS-S/17-OHCS ratio markedly decreased (far below 50%) during the observation period in all of the patients, who experienced continuous mental and physical distress throughout the period. This reveals that disasters create intensive mental stress in which long-term care is indispensable to mental and psychological recovery, as well as physical recovery.

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