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Novel treatment (new drug/intervention; established drug/procedure in new situation)
Case report
Efficacy of prolonged exposure therapy for a patient with late-onset PTSD affected by evacuation due to the Fukushima nuclear power plant accident
  1. Arinobu Hori1,
  2. Yoshitake Takebayashi2,
  3. Masaharu Tsubokura3 and
  4. Yoshiharu Kim4
  1. 1Department of Psychiatry, Hori Mental Clinic, Minami-Soma, Fukushima, Japan
  2. 2Department of Health Risk Communication, School of Medicine, Fukushima Medical University, Fukushima, Japan
  3. 3Department of Public Health, School of Medicine, Fukushima Medical University, Fukushima, Japan
  4. 4National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
  1. Correspondence to Dr Arinobu Hori; arinobu.h{at}gmail.com

Abstract

Trauma-focused cognitive–behavioural therapy (TF-CBT), such as prolonged exposure therapy, is a first-line treatment for post-traumatic stress disorder (PTSD). However, adapting TF-CBT as an intervention in situations with limited resources, such as in disaster settings, is problematic. This case report concerns a Japanese man in his 30s who was diagnosed with late-onset PTSD 5 years after the 2011 Great East Japan Earthquake. The onset and progression of his symptoms were heavily affected by changes in his life after evacuation due to the postearthquake nuclear power plant accident. We were able to successfully implement structured CBT and help the patient better cope with his symptoms in a disaster-stricken location. CBT for PTSD includes exposure to traumatic memories, which may lead to worsening of PTSD symptoms, but we were able to administer the therapy successfully with clinical support through the use of modern information and communication technology.

  • cognitive behavioural psychotherapy
  • anxiety disorders (including OCD and PTSD)
  • migration and health
  • healthcare improvement and patient safety
  • medical management

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bcr-2019-231960

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    Footnotes

    • Contributors AH was the main therapist of the case and wrote the initial manuscript. YT was the cotherapist of the case. MT critically revised the manuscript. YK supervised the case. All authors contributed to the refinement of the paper and approved the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.