Premature Death of a Schizophrenic Patient due to Evacuationafter a Nuclear Disaster in Fukushima

Although psychiatric patients are likely to be adversely impacted by disasters, information regarding the processes involved inadverse impacts is limited. In March 2011, Japan experienced an earthquake, tsunami, and the Fukushima Daiichi Nuclear PowerPlant accident. In its aftermath, Takano Hospital, 22 km south of the power plant, underwent forced patient evacuation. A 54-year-old Japanese male with schizophrenia, who had been hospitalized in the psychiatric ward for over 20 years, was transferred andexperienced a series of hospital relocations. Although his physical status was intact when he left Takano Hospital, his conditiongradually worsened, presumably due to incomplete exchange of patient information between institutions and changes in thetreatment environment. Having developed ileus a few days prior, he was bedridden when he returned to Takano Hospital in May2011. Over the course of treatment, he developed aspiration pneumonia and died in August 2011. A review of medical recordsrevealed that all his purgative medicines had been stopped after his evacuation, possibly contributing to the development of ileus.This case highlights the necessity of establishing systems enabling patient information sharing between institutions in disastersettings and the importance of recognizing that long-term evacuation may have fatal impacts for psychiatric patients