Psychological distress in 248 evacuees from a volcanic eruption was evaluated using a 30-item General Health Questionnaire (GHQ-30) at four time points after evacuation: 6 months, 12 months, 24 months and 44 months. The proportion of evacuees with psychological distress (defined as a GHQ score >/= 8) significantly decreased from 66.1% (6 months) to 45.6% (44 months). The GHQ mean score significantly improved from 12.6 to 8.9. Investigation of each factor on the GHQ showed progressive improvement over time in 'anxiety, tension and insomnia' and 'anergia and social dysfunction'. However, 'depression' began to improve only after 44 months and 'interpersonal dysfunction' started to worsen after 12 months. The dysfunction in interpersonal relationships continued at 44 months. Examination of the relation between GHQ mean scores and age group showed that recovery from psychological distress was more difficult in middle-aged and older evacuees than in younger evacuees.