Through the experience of providing care for Tokyo subway sarin gas victims in the aftermath of the March, 1995 attack, the authors observed various unexplained physical symptoms as well as psychological symptoms. Most of the physical symptoms in these victims seemed to have been related not to the sarin poisoning, but to psychological aftereffects.
There are two aims to this study. The first aim is the development of the St. Luke’s questionnaire of posttraumatic stress symptoms: (SLQ-PTSS), to document the aftereffects of this traumatic sarin event with both psychological and physical indicators.
The second is the study of the longitudinal course of posttraumatic stress symptoms (PTSS) in victims (n = 1722) 5-8 years after the attack. Based on their Impact of Events (-R) (IES-R) score five years following the attack, victims were divided into three groups: a high impact group (IES-R total score >25), a medium group (12-24), and a normal group (≤ 11). Each group showed a different course on the SLQ-PTSS during the chronic phase.
American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders (4th edition). Washington, D.C.
2.
Andreski, P., Chilcoat, H., & Breslau, N. (1998). Posttraumatic stress disorder and somatization symptoms: A prospective study. Psychiatry Research, 79, 131-138.
3.
Asukai, N., Nishizono, A., & Miyake, Y. (1998) A Study of Epidemiology and Diagnostic Assessment of PTSD: Official Report for Psycho-Neuro-Epidemiology Financially Supported Japanese Government of Health and Welfare.
4.
Beaton, R., Murphy, S., Johnson, C., & Nemuth, M. (2004). Secondary traumatic stress response in firefighters in the aftermath of 9/11/2001. Traumatology, 10, 7-16.
5.
Corneil, W., Beaton, R., Murphy, S., Johnson, C, & Pike, K. (1999). Exposure to traumatic incidents and prevalence of posttraumatic symptomatology in urban firefighters in two countries. Journal of Occupational Health Psychology, 4, 131-141.
6.
Davidson, J. T., Hughes, D., Blazer, D., & George, L. K. (1991). Posttraumatic stress disorder in the community: An epidemiological study. Psychological Medicine, 21, 713-721.
7.
Dougall, A. L., Ursano, R. J., Posluszny, D. M., & Fullerton, C. S. (2001). Predictors of posttraumatic stress among victims of motor vehicle accidents. Psychosomatic Medicine, 63, 402-411.
8.
Engel, C. C., Liu, X., McCarthy, B. D., Miller, R. F., & Ursano, R. (2000). Relationship of physical symptoms to posttraumatic stress disorder among veterans seeking care for Gulf War-related health concerns. Psychosomatic Medicine, 62, 739-745.
9.
Ford, D. J., Campbell, K. A. (2001). Posttraumatic stress symptomology is associated with unexplained illness attributed to Persian War military service. Psychosomatic Medicine, 63, 842-849.
10.
Harvey, A. G., & Bryant, R. A. (1999). Predictors of acute stress following motor vehicle accidents. Journal of Traumatic Stress, 12(3), 519-525.
11.
Horowitz, M. J. (2001). Stress Response Syndromes (4th Edition). Jason Aronson Inc., London.
12.
Horowitz, M., Wilner, N., & Alvarez, W. (1979). The Impact of Event Scale: A measure of subjective stress. Psychosomatic Medicine, 41, 209-218.
13.
Kasl, S. V., Chisholm, R. F., & Eskenazi, B. (1981). Impact of accident at Three Mile Island on the behavior and well-being of nuclear workers. American Journal of Public Health, 71(5), 472-495.
14.
Kawana, N., Ishimatsu, S., & Kanda, K. (2001). Psycho-physiological effects of the terrorist sarin attack on the Tokyo subway system. Military Medicine, 166(Suppl)2, 23-26.
15.
Kessler, R. C., Sonnega, A., Bromet, E., Hughes, M., & Nelson, C. B. (1995). Posttraumatic stress disorder in the national comorbidity survey. Archives of General Psychiatry, 52, 1048-1060.
16.
Lopez-Ibor, Jr., J. J., Soria, J., Canas, F., & Rodriguez-Gamazo, M. (1985). Psychopathological aspects of the toxic oil syndrome catastrophe. British Journal of Psychiatry, 147, 352-365.
17.
Matsui, Y., Kawana, N., Ishimatsu, S., Tamaki, S., & Kanda, K. (2003). Psychological aftereffects among Tokyo subway sarin attack: The development of instrument and the longitudinal study. Official Report of Health Science Study Supported by the Fund of Japanese Ministry of Health and Welfare. (In press.) (Japanese.)
18.
McFarlane, A. C. (1988). The longitudinal course of posttraumatic morbidity: The range of outcome and their predictors. Journal of Nervous and Mental Disease, 167, 30-39.
19.
McFarlane, A. C., & Papay, P. (1992). Multiple diagnoses in posttraumatic stress disorder in victims of a natural disaster, Journal of Nervous and Mental Disease, 180(8), 498-504.
20.
McLeod, W. R. (1975). Merphos poisoning or mass panic? Australian and New Zealand Journal of Psychiatry, 9, 225-229.
21.
Nakagawa, Y., & Daibou, I. (1985). Guidebook for instrument use-Japanese. Tokyo: Nihon Bunka Kagakusha Co. GHQ Japanese version.
22.
Nakajima, T. (1997). After effects of sarin poisoning. Igaku no Ayumi, 182(11), 828-829. (Japanese)
23.
Nakajima, T., Ohta, S., Fukushima, Y., & Yanagisawa. (1999). Sequelae of sarin toxicity at one and three years after exposure in Matsumoto. Japan, 9(5), 337-343.
24.
Nakano, K. (1997). Masked PTSD and subway sarin attack. Ieshiro, T (Ed.) Poisoning of Organophosphate (sarin poisoning): Fundamentals and Clinical Issues of Subway Sarin Attack (p. 58-62). Shindan to chiryou sha. (Japanese)
25.
Nakano, K. (1998). Psychopathological discussion of posttraumatic stress disorder. Saishin Seishin-Igaku, 3(3), 207-215 (Japanese).
26.
Nakano, K. (2000). Posttraumatic stress disorder (PTSD): Case of subway sarin attack. Rinshou Seishin-Igaku Kouza, S6, 158-166. (Japanese)
27.
Nasu, T. (2000). Report of governmental health survey of poison gas exposure casualties in Matsumoto City. Public Health and Hygiene of Matsumoto, 22(suppl), 52-56. (Japanese)
28.
National Research Institute of Police Service. (2001). Official Report of Victims of Subway Sarin Attack. National Police Agency, Tokyo.
29.
Nohara, M. (2000). Ophthalmologic health survey after sarin exposure. Public Health and Hygiene of Matsumoto, 22(suppl), 42-51. (Japanese)
30.
Okamura, T. (1999). Stat Call: Subway Sarin Attack Described by ER Doctor. Kawade shobo Publishing Company, Tokyo. (Japanese)
31.
Sekijima, Y. (2000). The long-term effect of sarin poisoning: Report of health survey in Matsumoto (3rd-7th). Public Health and Hygiene of Matsumoto, 22(suppl), 36-41.
32.
Shalev, A., Bleich, A., & Ursano, R. J. (1990). Posttraumatic stress disorder: Somatic comorbidity and effort tolerance. Psychosomatics, 31(2), 197-203.
33.
Sidell, F. R. (1997). Nerve agent. Textbook of Military Medicine. Washington, DC. 139-143.
34.
Solomon, Z. (1988). Somatic complaints, stress reaction, and posttraumatic stress disorder: Three year follow up study. Behavioral Medicine, 14, 179-185.
35.
Solomon, Z., & Mikulinger, M. (1987). Combat stress reactions: Posttraumatic stress disorder and somatic complaints among Israeli soldiers. Journal of Psychosomatic Research, 31(1), 131-137.
36.
Verbeke, G., & Molenberghs, G. (1997). Linear Mixed Model in Practice: A SAS Oriented Approach. New York: Springer-Verlag.
37.
Weisberg, R. B., & Bruce S. R. (2002). Non-psychiatric illness among primary care patients with trauma histories and posttraumatic stress disorder. Psychiatric Services, 53(7), 848-854.
38.
Wolfe, J., Proctor, S. P., Erikson, D. J., Heeren, T., Friedman, M. J., Huang, M. T., Sutker, P. B., & Vasterling, J. J. (1999). Relationship of psychiatric status to Gulf War veteran’s health problems. Psychosomatic Medicine, 61, 532-540.
