Skip to main content

Advertisement

SpringerLink
Log in

Impact of the 2018 Japan Floods on benzodiazepine use: a longitudinal analysis based on the National Database of Health Insurance Claims

  • Original Paper
  • Published:
Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Purpose

Natural disaster has an impact on mental health. The 2018 Japan Floods, which took place in July 2018 were one of the largest water disasters in Japan’s recorded history. We aimed to evaluate the change in the number of benzodiazepine prescriptions by physicians before and after the disaster.

Methods

A retrospective cohort study based on the National Database of Health Insurance Claims was conducted in the flood-stricken areas between July 2017 and June 2019. The subjects were divided between victims and non-victims according to certification by local governments. Members of both groups were then categorized into three groups based on their pre-flood use of benzodiazepines: non-user, occasional user, and continuous user. Difference-in-differences (DID) analysis with a logistic regression model was conducted to estimate the effect of the disaster among victims by comparing the occurrence of benzodiazepine prescriptions before and after the disaster.

Results

Of 5,000,129 people enrolled, 31,235 were victims. Among all participants, the mean prescription rate for benzodiazepines in victims before the disaster (11.3%) increased to 11.8% after the disaster, while that in non-victims (8.3%) decreased to 7.9%. The DID analysis revealed that benzodiazepine prescription among victims significantly increased immediately after the disaster (adjusted ratio of odds ratios (ROR) 1.07: 95% confidence interval 1.05–1.11), and the effect of the disaster persisted even 1 year after the disaster (adjusted ROR 1.2: 95% confidence interval 1.16–1.24).

Conclusion

The flood increased the number of benzodiazepines prescriptions among victims, and the effect persisted for at least 1 year.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Data availability

This data of this research was obtained from the National Database of Health Insurance Claims and was permitted to be used by the Ministry of Health, Labor and Welfare.

References

  1. Dr BR, Wooding S, Burns P, Stevens MG, Raphael K, Thomson C, Kennett V (2012) NSW Health Disaster Mental Health Manual 2012

  2. Kario K, McEwen BS, Pickering TG (2003) Disasters and the heart: A review of the effects of earthquake-induced stress on cardiovascular disease. Hypertens Res 26(5):355–367. https://doi.org/10.1291/hypres.26.355

    Article  PubMed  Google Scholar 

  3. Yoshida S, Kashima S, Matsumoto M (2021) The effect of the 2018 Japan Floods on cognitive decline among long-term care insurance users in Japan: a retrospective cohort study. Environ Health Prev Med 26(1):1–11. https://doi.org/10.1186/S12199-021-01038-9/FIGURES/3

    Article  Google Scholar 

  4. Fassaert T, Dorn T, Spreeuwenberg PM, van Dongen MC, van Gool CJ, Yzermans CJ (2007) Prescription of benzodiazepines in general practice in the context of a man-made disaster: a longitudinal study. Eur J Public Health 17(6):612–617. https://doi.org/10.1093/eurpub/ckm020

    Article  PubMed  Google Scholar 

  5. Usher K, Brown LH, Buettner P, Glass B, Boon H, West C, Grasso J, Chamberlain-Salaun J, Woods C (2012) Rate of prescription of antidepressant and anxiolytic drugs after cyclone Yasi in North Queensland. Prehosp Disaster Med 27(6):519–523. https://doi.org/10.1017/S1049023X12001392

    Article  PubMed  Google Scholar 

  6. Lecher M (2010) The estimation of causal effects by difference-in-difference methods. Found Trends Econom 4(3):165–224

    Article  Google Scholar 

  7. International Narcotics Control B (2015) Special report: availability of internationally controlled drugs: ensuring adequate access for medical and scientific purpose. 37–67

  8. Ishigooka J, Sugiyama T, Suzuki M, Kobayashi K, Takeuchi H, Murasaki M (1998) Survival analytic approach to long-term prescription of benzodiazepine hypnotics. Psychiatry Clin Neurosci 52(5):541–545. https://doi.org/10.1046/j.1440-1819.1998.00422.x

    Article  CAS  PubMed  Google Scholar 

  9. Patient Surveys (2017) https://www.e-stat.go.jp/stat-search/files?page=1&layout=datalist&toukei=00450022&tstat=000001031167&cycle=7&tclass1=000001124800&tclass2=000001124802&stat_infid=000031790690&tclass3val=0. Accessed 24 November 2021.

  10. Centers for Disease Control and Prevention (2020) Caring for Children in a Disaster. https://www.cdc.gov/childrenindisasters/differences.html. Accessed 10 November 2021

  11. Veronese A, Garatti M, Cipriani A, Barbui C (2007) Benzodiazepine use in the real world of psychiatric practice: Low-dose, long-term drug taking and low rates of treatment discontinuation. Eur J Clin Pharmacol 63:867–873. https://doi.org/10.1007/s00228-007-0341-1

    Article  CAS  PubMed  Google Scholar 

  12. Inada T, Inagaki A (2015) Psychotropic dose equivalence in Japan. Psychiatry Clin Neurosci 69(8):440–447. https://doi.org/10.1111/pcn.12275

    Article  PubMed  Google Scholar 

  13. Dimick JB, Ryan AM (2014) Methods for evaluating changes in health care policy: the difference-in-differences approach. JAMA 312:2401–2402. https://doi.org/10.1001/jama.2014.16153

    Article  CAS  PubMed  Google Scholar 

  14. Moran JL, Santamaria JD, Duke GJ (2021) Modelling hospital outcome: problems with endogeneity. BMC Med Res Methodol 21(1):124. https://doi.org/10.1186/s12874-021-01251-8

    Article  PubMed  PubMed Central  Google Scholar 

  15. Zhang J, Yu KF (1998) What’s the relative risk? A method of correcting the odds ratio in cohort studies of common outcomes. J Am Med Assoc 280:1690–1691. https://doi.org/10.1001/jama.280.19.1690

    Article  CAS  Google Scholar 

  16. Tang B, Liu X, Liu Y, Xen C, Zhang L (2014) A meta-analysis of risk factors for depression in adults and children after natural disasters. BMC Public Health 14:623–623. https://doi.org/10.1186/1471-2458-14-623

    Article  PubMed  PubMed Central  Google Scholar 

  17. Vlahov D, Galea S, Resnick H, Ahern J, Boscarino JA, Bucuvalas M, Gold J, Kilpatrick D (2002) Increased use of cigarettes, alcohol, and marijuana among Manhattan, New York, residents after the September 11th terrorist attacks. Am J Epidemiol 155(11):988–996. https://doi.org/10.1093/aje/155.11.988

    Article  PubMed  Google Scholar 

  18. Beaglehole B, Bell C, Frampton C, Hamilton G, McKean A (2015) The impact of the Canterbury earthquakes on prescribing for mental health. Aust N Z J Psychiatry 49(8):742–750. https://doi.org/10.1177/0004867415589794

    Article  PubMed  Google Scholar 

  19. Sederer LI (2012) Are human made disasters different? Epidemiol Psych Sci 21(5):23–25. https://doi.org/10.1017/S2045796011000710

    Article  CAS  Google Scholar 

  20. Mulcahy AW, Whaley CM, Gizaw M, Schwam D, Edenfield N, Becerra-Ornelas AU (2021) International prescription drug price comparisons. RAND Corpor. https://doi.org/10.7249/RR2956

    Article  Google Scholar 

  21. Koichiro S (2000) Co-payment, coinsurance rate and the elderly care in Japan. Med Soc 10(2):115–138

    Google Scholar 

  22. Simonsen M, Skipper L, Skipper N, Illemann A (2021) Spot price biases in non-linear health insurance contracts. J Public Econ 203:104508. https://doi.org/10.1016/j.jpubeco.2021.104508

    Article  Google Scholar 

  23. Cunningham CM, Hanley GE, Morgan S (2010) Patterns in the use of benzodiazepines in British Columbia: Examining the impact of increasing research and guideline cautions against long-term use. Health Policy 97(2–3):122–129. https://doi.org/10.1016/j.healthpol.2010.03.008

    Article  PubMed  Google Scholar 

  24. Alessi-Severini S, Bolton JM, Enns MW, Dahl M, Collins DM, Chateau D, Sareen J (2014) Use of benzodiazepines and related drugs in Manitoba: a population-based study. CMAJ Open 2(4):E208–E216. https://doi.org/10.9778/cmajo.20130076

    Article  PubMed  PubMed Central  Google Scholar 

  25. Lazaratou H, Paparrigopoulos T, Anomitri C, Alexandropoulou N, Galanos G, Papageorgiou C (2018) Sleep problems six-months after continuous earthquake activity in a Greek island. Psychiatrike 29 (1):25–33. https://doi.org/10.22365/jpsych.2018.291.25

  26. Kato H, Asukai N, Miyake Y, Minakawa K, Nishiyama A (1996) Post-traumatic symptoms among younger and elderly evacuees in the early stages following the 1995 Hanshin-Awaji earthquake in Japan. Acta Psychiatr Scand 93(6):477–481. https://doi.org/10.1111/j.1600-0447.1996.tb10680.x

    Article  CAS  PubMed  Google Scholar 

  27. Billioti S, Bégaud B, Bazin F, Verdoux H, Dartigues JF, Pérès K, Kurth T, Pariente A (2012) Benzodiazepine use and risk of dementia: prospective population based study. BMJ 345:e6231. https://doi.org/10.1136/bmj.e6231

    Article  CAS  Google Scholar 

  28. Soyka M (2017) Treatment of benzodiazepine dependence. N Engl J Med 376(12):1147–1157. https://doi.org/10.1056/NEJMra1611832

    Article  CAS  PubMed  Google Scholar 

  29. Donnelly K, Bracchi R, Hewitt J, Routledge PA, Carter B (2017) Benzodiazepines, Z-drugs and the risk of hip fracture: A systematic review and meta-analysis. PLoS One 12(4):e0174730. https://doi.org/10.1371/journal.pone.0174730

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Smink BE, Egberts ACG, Lusthof KJ, Uges DRA, De Gier JJ (2010) The relationship between benzodiazepine use and traffic accidents: A systematic literature review. CNS Drugs 24(8):639–653. https://doi.org/10.2165/11533170-000000000-00000

    Article  CAS  PubMed  Google Scholar 

  31. Weich S, Pearce HL, Croft P, Singh S, Crome I, Bashford J, Frisher M (2014) Effect of anxiolytic and hypnotic drug prescriptions on mortality hazards: Retrospective cohort study. BMJ 348:g1996. https://doi.org/10.1136/bmj.g1996

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. National Institute for Health and Care Excellence (NICE) (2019) Generalised anxiety disorder and panic disorder in adults: management. NICE

  33. World Health Organization (WHO) (2013) Assessment and Management of Conditions Specifically Related To Stress: mhGAP Intervention Guide Module (version 1.0). WHO

  34. Yehuda R (2002) Post-traumatic stress disorder. N Engl J Med 346(2):108–114. https://doi.org/10.1056/NEJMra012941

    Article  CAS  PubMed  Google Scholar 

  35. Votaw VR, Geyer R, Rieselbach MM, McHugh RK (2019) The epidemiology of benzodiazepine misuse: A systematic review. Drug Alcohol Depend 200:95–114. https://doi.org/10.1016/j.drugalcdep.2019.02.033

    Article  PubMed  PubMed Central  Google Scholar 

  36. Statistics Division, Hiroshima Prefectural Government. https://www.pref.hiroshima.lg.jp/soshiki/21/jinkougepposaisin.html. Assessed 7 May 2021

  37. Japan medical analysis platform, Japan Medical Association. https://jmap.jp/ Accessed 28 February 2022

  38. Mansournia MA, Nazemipour M, Naimi AI et al (2021) Reflection on modern methods: Demystifying robust standard errors for epidemiologists. Int J Epidemiol 50:346–351. https://doi.org/10.1093/ije/dyaa260

    Article  PubMed  Google Scholar 

  39. Colin Cameron A, Gelbach JB, Miller DL (2008) Bootstrap-based improvements for inference with clustered errors. Rev Econ Stat 90:414–427. https://doi.org/10.1162/rest.90.3.414

    Article  Google Scholar 

Download references

Acknowledgements

Not applicable.

Funding

This work was not supported by any funding.

Author information

Authors and Affiliations

  1. Department of Emergency Medicine, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Naka-ku, Hiroshima, 730-8518, Japan

    Yuji Okazaki

  2. Department of Community-Based Medical Systems, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan

    Yuji Okazaki, Shuhei Yoshida & Masatoshi Matsumoto

  3. Environmental Health Sciences Laboratory, Graduate School of Advanced Science and Engineering, Hiroshima University, 1-5-1 Kagamiyama, Higashi-Hiroshima, Hiroshima, 739-8529, Japan

    Saori Kashima

  4. Department of Medicine for Integrated Approach to Social Inclusion, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan

    Shinya Ishii

  5. Division of Health Policy and Management, Center for Community Medicine, Jichi Medical University, 3311-1 Yakushiji, Tochigi, 329-0498, Japan

    Soichi Koike

Authors
  1. Yuji Okazaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shuhei Yoshida
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Saori Kashima
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shinya Ishii
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Soichi Koike
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Masatoshi Matsumoto
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the development of this manuscript. YO was responsible for study design, analysis, interpretation of data and writing of the draft. SY contributed to data collection, analysis and interpretation of data and SaK assisted with the analysis and interpretation of data. MM supervised the whole study by contributing to the study design, data collection, interpretation of data and writing of the draft. SoK and SI contributed to the interpretation of data and writing of the draft. All authors have read and approved the final version of this manuscripts.

Corresponding author

Correspondence to Yuji Okazaki.

Ethics declarations

Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

The requirement for informed consent was waived because the anonymous data of National Database of Health Insurance Claims was used in this study.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 4286 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Okazaki, Y., Yoshida, S., Kashima, S. et al. Impact of the 2018 Japan Floods on benzodiazepine use: a longitudinal analysis based on the National Database of Health Insurance Claims. Soc Psychiatry Psychiatr Epidemiol 57, 2411–2421 (2022). https://doi.org/10.1007/s00127-022-02289-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00127-022-02289-9

Keywords

Search

Navigation