Increased antidepressant prescriptions following the 2018 Japan floods: a longitudinal analysis using the national health insurance database

Background: Natural disasters are known to affect the mental health of the victims; however, the understanding of their impact on real-world clinical practice remains insufficient.Objective: This study aimed to evaluate the effects of the 2018 Japan floods, one of the largest disasters in Japan’s re...

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Main Authors: Miyuki Hattori, Shuhei Yoshida, Shinichiro Ohshimo, Nobuaki Shime, Masatoshi Matsumoto
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:European Journal of Psychotraumatology
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Online Access:https://www.tandfonline.com/doi/10.1080/20008066.2025.2537547
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author Miyuki Hattori
Shuhei Yoshida
Shinichiro Ohshimo
Nobuaki Shime
Masatoshi Matsumoto
author_facet Miyuki Hattori
Shuhei Yoshida
Shinichiro Ohshimo
Nobuaki Shime
Masatoshi Matsumoto
author_sort Miyuki Hattori
collection DOAJ
description Background: Natural disasters are known to affect the mental health of the victims; however, the understanding of their impact on real-world clinical practice remains insufficient.Objective: This study aimed to evaluate the effects of the 2018 Japan floods, one of the largest disasters in Japan’s recorded history, on antidepressant prescriptions over time.Method: Prescription data from the medical insurance claims database covering three prefectures that accounted for 90% of flood damage were analyzed for the years before and after the floods. Participants were categorized as disaster victims or nonvictims based on local government designations. A difference-in-differences analysis compared the trends in antidepressant prescriptions between victims and non-victims during the period surrounding the floods.Results: Of 5,000,129 participants, 31,235 were disaster victims. Victims were more likely to be prescribed antidepressants after the disaster than nonvictims (p < .001). This trend peaked 2–3 months after the disaster (adjusted Ratio of Odds Ratios [ROR], 1.13; 95% confidence interval [CI] 1.07–1.20) and persisted up to 1 year later (adjusted ROR, 1.20; 95% CI 1.12–1.28). Among antidepressants, noradrenergic and specific serotonergic antidepressants (NaSSAs) and serotonin antagonist and reuptake inhibitors (adjusted ROR 1.47, 1.49; 95% CI 1.21–1.80, 1.22–1.83) were particularly prescribed more frequently among victims. When limited to those who had not used antidepressants before the disaster, NaSSAs (adjusted ROR 2.56; 95% CI 2.14–3.07, p < .001) were conspicuously more prescribed.Conclusions: The floods were associated with an increase in antidepressant prescriptions, suggesting the development of disaster-related mental health conditions such as depression and post-traumatic stress disorder. The need for care became pronounced 2–3 months after the event and persisted for 1 year. These findings highlight the need for psychiatric drug treatment among disaster victims and emphasize the importance of identifying appropriate timing for such interventions.
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spelling doaj-art-8aa8df5fcf9347a5ade387b7d5ffb69c2025-08-20T14:02:52ZengTaylor & Francis GroupEuropean Journal of Psychotraumatology2000-80662025-12-0116110.1080/20008066.2025.2537547Increased antidepressant prescriptions following the 2018 Japan floods: a longitudinal analysis using the national health insurance databaseMiyuki Hattori0Shuhei Yoshida1Shinichiro Ohshimo2Nobuaki Shime3Masatoshi Matsumoto4Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JapanDepartment of General Internal Medicine, Hiroshima University Hospital, Hiroshima-shi, JapanDepartment of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JapanDepartment of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JapanDepartment of Community-Based Medical Systems, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JapanBackground: Natural disasters are known to affect the mental health of the victims; however, the understanding of their impact on real-world clinical practice remains insufficient.Objective: This study aimed to evaluate the effects of the 2018 Japan floods, one of the largest disasters in Japan’s recorded history, on antidepressant prescriptions over time.Method: Prescription data from the medical insurance claims database covering three prefectures that accounted for 90% of flood damage were analyzed for the years before and after the floods. Participants were categorized as disaster victims or nonvictims based on local government designations. A difference-in-differences analysis compared the trends in antidepressant prescriptions between victims and non-victims during the period surrounding the floods.Results: Of 5,000,129 participants, 31,235 were disaster victims. Victims were more likely to be prescribed antidepressants after the disaster than nonvictims (p < .001). This trend peaked 2–3 months after the disaster (adjusted Ratio of Odds Ratios [ROR], 1.13; 95% confidence interval [CI] 1.07–1.20) and persisted up to 1 year later (adjusted ROR, 1.20; 95% CI 1.12–1.28). Among antidepressants, noradrenergic and specific serotonergic antidepressants (NaSSAs) and serotonin antagonist and reuptake inhibitors (adjusted ROR 1.47, 1.49; 95% CI 1.21–1.80, 1.22–1.83) were particularly prescribed more frequently among victims. When limited to those who had not used antidepressants before the disaster, NaSSAs (adjusted ROR 2.56; 95% CI 2.14–3.07, p < .001) were conspicuously more prescribed.Conclusions: The floods were associated with an increase in antidepressant prescriptions, suggesting the development of disaster-related mental health conditions such as depression and post-traumatic stress disorder. The need for care became pronounced 2–3 months after the event and persisted for 1 year. These findings highlight the need for psychiatric drug treatment among disaster victims and emphasize the importance of identifying appropriate timing for such interventions.https://www.tandfonline.com/doi/10.1080/20008066.2025.2537547Antidepressantpost-traumatic stress disorderfloodmental healthdisasterAntidepresivos
spellingShingle Miyuki Hattori
Shuhei Yoshida
Shinichiro Ohshimo
Nobuaki Shime
Masatoshi Matsumoto
Increased antidepressant prescriptions following the 2018 Japan floods: a longitudinal analysis using the national health insurance database
European Journal of Psychotraumatology
Antidepressant
post-traumatic stress disorder
flood
mental health
disaster
Antidepresivos
title Increased antidepressant prescriptions following the 2018 Japan floods: a longitudinal analysis using the national health insurance database
title_full Increased antidepressant prescriptions following the 2018 Japan floods: a longitudinal analysis using the national health insurance database
title_fullStr Increased antidepressant prescriptions following the 2018 Japan floods: a longitudinal analysis using the national health insurance database
title_full_unstemmed Increased antidepressant prescriptions following the 2018 Japan floods: a longitudinal analysis using the national health insurance database
title_short Increased antidepressant prescriptions following the 2018 Japan floods: a longitudinal analysis using the national health insurance database
title_sort increased antidepressant prescriptions following the 2018 japan floods a longitudinal analysis using the national health insurance database
topic Antidepressant
post-traumatic stress disorder
flood
mental health
disaster
Antidepresivos
url https://www.tandfonline.com/doi/10.1080/20008066.2025.2537547
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AT shinichiroohshimo increasedantidepressantprescriptionsfollowingthe2018japanfloodsalongitudinalanalysisusingthenationalhealthinsurancedatabase
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