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Sasaki T, Hashimoto K, Niitsu T, Hosoda Y, Oda Y, Shiko Y, Ozawa Y, Kawasaki Y, Kanahara N, Shiina A, Hashimoto T, Suzuki T, Sugawara T, Hanaoka H, Iyo M. Ifenprodil tartrate treatment of adolescents with post-traumatic stress disorder: A double-blind, placebo-controlled trial. Psychiatry Res 2022; 311:114486. [PMID: 35263680 DOI: 10.1016/j.psychres.2022.114486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 02/13/2022] [Accepted: 02/23/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Several lines of evidence suggest that glutamatergic neurotransmission via the N-methyl-D-aspartate (NMDA) receptor plays a role in certain behavioral manifestations common to Post-Traumatic Stress Disorder (PTSD). Ifenprodil tartrate is a neuroprotective agent that binds to the GluN2B subunit of the NMDA receptor. The aim of this study is to confirm whether ifenprodil tartrate is effective in the adolescent PTSD patients. METHODS This is a randomized, double-blind, placebo-controlled trial. Ten adolescent (13 to 18 years old) PTSD patients were randomized into two arms: placebo (n = 4), 40 mg/day ifenprodil tartrate (n = 6) for 4 weeks. All of the patients were assessed by IES-R-J (Primary outcome measure), TSCC-J, CDRS-R, DSRS-C-J and CGI-I. RESULTS A comparison of baseline IES-R-J total scores and 4-week end-point scores showed a mild trend of improvement (p = 0.0895) and the difference score was -9.314. A comparison of baseline scores and 2-week intermediate-point scores showed that IES-R-J hyperarousal subscores and TSCC-J subscores (dissociation subscores, sexual concerns subscores) improved significantly. A comparison of baseline TSCC-J sexual concerns subscores and 4-week end-point scores improved significantly. CONCLUSIONS Our study may prove to be an short-term effective alternative safe treatment for adolescent patients with PTSD.
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Affiliation(s)
- Tsuyoshi Sasaki
- Department of Child Psychiatry, Chiba University Hospital, Inohana 1-8-1, Chiba 260-8670, Japan; Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan.
| | - Kenji Hashimoto
- Chiba University Center for Forensic Mental Health, Chiba, Japan
| | - Tomihisa Niitsu
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yutaka Hosoda
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yasunori Oda
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yuki Shiko
- Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Yoshihito Ozawa
- Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Yohei Kawasaki
- Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | | | - Akihiro Shiina
- Chiba University Center for Forensic Mental Health, Chiba, Japan
| | - Tasuku Hashimoto
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Takaaki Suzuki
- Division of Pharmacy, Chiba University Hospital, Chiba, Japan
| | - Takeshi Sugawara
- Translational Research and Development Center, Chiba University Hospital, Chiba, Japan
| | - Hideki Hanaoka
- Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Masaomi Iyo
- Department of Child Psychiatry, Chiba University Hospital, Inohana 1-8-1, Chiba 260-8670, Japan; Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan; Chiba University Center for Forensic Mental Health, Chiba, Japan
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Yamamoto T, Sakurai K, Watanabe M, Sakuma I, Kanahara N, Shiina A, Hasegawa T, Watanabe H, Iyo M, Ishibashi R. Cyclothymic Temperament is Associated with Poor Medication Adherence and Disordered Eating in Type 2 Diabetes Patients: A Case-Control Study. Diabetes Ther 2021; 12:2611-2624. [PMID: 34331669 PMCID: PMC8384994 DOI: 10.1007/s13300-021-01121-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 07/16/2021] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Poor medication adherence and disordered eating are major self-care problems in patients with type 2 diabetes that worsen glycemic control and increase the risk of developing severe diabetes complications. Affective temperament, which remains mostly unchanged throughout life, is speculated to predict poor treatment response and high comorbidity. The aim of this study was to explore the link between affective temperament and poor glycemic control due to insufficient self-care. METHODS This single-center case-control study involved 77 outpatients divided into the 'poor glycemic control' group (n = 52) and the 'better glycemic control' group (n = 25) based on their mean glycated hemoglobin (HbA1c) levels over the past 12 months. All participants underwent one-on-one interviews during which they completed the following psychometric questionnaires: (1) the Mini-International Neuropsychiatric Interview 5.0.0; (2) the Temperament Evaluation of Memphis, Pisa, and San Diego Auto-questionnaire; (3) a researcher-designed single question for assessing subclinical stress-induced overeating; and (4) the Morisky Medication Adherence Scale. The difference between two continuous independent variables was determined using Student's t test. Discrete variables were compared using the Chi-square (χ2) or Fisher's exact test. Multiple testing corrections were performed using the false discovery rate. RESULTS Those outpatients in the poor glycemic control group exhibited significantly more stress-induced overeating (χ2 = 1.14, q statistic = 0.040) and poor medication adherence (t = 3.70, q = 0.034) than those in the better glycemic control group. However, there were no significant differences between the two groups in terms of affective temperaments, clinical eating disorders, or diabetes-specific distress. Patients with stress-induced overeating (t = - 2.99, p = 0.004) and poor medication adherence (t = - 4.34, p = 0.000) exhibited significantly higher scores for cyclothymic temperament than their counterparts. CONCLUSION Cyclothymic temperament is significantly associated with disordered eating and/or poor medication adherence in patients with type 2 diabetes and is possibly linked to poor glycemic control.
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Affiliation(s)
- Tetsuya Yamamoto
- Division of Diabetes, Endocrinology and Metabolism, Department of Medicine, Kimitsu Chuo Hospital, Sakurai 1010, Kisarazu, Chiba, 292-0822, Japan
- Center for Forensic Mental Health, Chiba University, Chiba, Japan
| | - Kenichi Sakurai
- Department of Nutrition and Metabolic Medicine, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Masahiro Watanabe
- Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Ikki Sakuma
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Nobuhisa Kanahara
- Center for Forensic Mental Health, Chiba University, Chiba, Japan
- Department of Psychiatry, Graduate School of Medicine and School of Medicine, Chiba University, Chiba, Japan
| | - Akihiro Shiina
- Center for Forensic Mental Health, Chiba University, Chiba, Japan
- Department of Psychiatry, Graduate School of Medicine and School of Medicine, Chiba University, Chiba, Japan
| | - Tadashi Hasegawa
- Department of Psychiatry, Graduate School of Medicine and School of Medicine, Chiba University, Chiba, Japan
| | | | - Masaomi Iyo
- Department of Psychiatry, Graduate School of Medicine and School of Medicine, Chiba University, Chiba, Japan
| | - Ryoichi Ishibashi
- Division of Diabetes, Endocrinology and Metabolism, Department of Medicine, Kimitsu Chuo Hospital, Sakurai 1010, Kisarazu, Chiba, 292-0822, Japan.
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan.
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Shiina A, Sato A, Iyo M, Igarashi Y. Identifying factors associated with criminal responsibility by analyzing court trial verdicts. Int J Law Psychiatry 2021; 77:101702. [PMID: 33962349 DOI: 10.1016/j.ijlp.2021.101702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 06/12/2023]
Abstract
The criminal responsibility of offenders with mental disorders is a key issue in forensic psychiatry. Japan's implementation of the Medical Treatment and Supervision Act and Lay Judge Act in the early 2000s raised public awareness of this issue. To determine how criminal court judges in Japan assess the criminal responsibility of offenders, we examined 453 district court verdicts that mention psychiatric evidence. We extracted elements from each verdict that may be associated with courts' decision-making regarding criminal responsibility and analyzed the relationship between each element and the adjudication of criminal responsibility. We investigated the changes in each element's prevalence over time. A logistic regression analysis revealed that the following were independently associated with the court decisions that offenders' criminal responsibility was intact: understandable motivation for committing the offense, homogeneity of the offense from the defendant's usual behavioral pattern, a coherent process used to commit the offense, alertness while offending, and absence of psychotic symptoms. We observed that recent verdicts are more focused on the offender's perception of illegality and the coherence of the offending process while disregarding the defendant's consciousness and memory while offending. Thus, the courts focus on some specific elements for evaluating the criminal responsibility of each offender.
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Affiliation(s)
- Akihiro Shiina
- Chiba University Center for Forensic Mental Health, Inohana 1-8-1, Chuo-ku, Chiba-shi, Chiba, Japan.
| | - Aiko Sato
- International University of Health and Welfare, Kouzunomori 4-3, Narita-shi, Chiba, Japan
| | - Masaomi Iyo
- Chiba University Center for Forensic Mental Health, Inohana 1-8-1, Chuo-ku, Chiba-shi, Chiba, Japan; Chiba University Graduate School of Medicine, Inohana 1-8-1, Chuo-ku, Chiba-shi, Chiba, Japan.
| | - Yoshito Igarashi
- Chiba University Center for Forensic Mental Health, Inohana 1-8-1, Chuo-ku, Chiba-shi, Chiba, Japan.
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Oishi K, Niitsu T, Kanahara N, Sato Y, Iwayama Y, Toyota T, Hashimoto T, Sasaki T, Takase M, Shiina A, Yoshikawa T, Iyo M. Genetic risks of schizophrenia identified in a matched case-control study. Eur Arch Psychiatry Clin Neurosci 2021; 271:775-781. [PMID: 32623490 DOI: 10.1007/s00406-020-01158-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 06/24/2020] [Indexed: 11/25/2022]
Abstract
It has been suggested that dopaminergic neurotransmission plays important roles for the psychotic symptoms and probably etiology of schizophrenia. In our recent preliminary study, we demonstrated that the specific allele combinations of dopamine-related functional single nucleotide polymorphisms (SNPs), rs10770141, rs4680, and rs1800497 could indicate risks for schizophrenia. The present validation study involved a total of 2542 individuals who were age- and sex-matched in a propensity score matching analysis, and the results supported the statistical significances of the proposed genetic risks described in our previous reports. The estimated odds ratios were 1.24 (95% CI 1.06-1.45, p < 0.001) for rs4680, 1.73 (95% CI 1.47-2.02, p < 0.0001) for rs1800497, and 1.79 (95% CI 1.35-2.36, p < 0.0001) for rs10770141. A significant relationship was also revealed among these three polymorphisms and schizophrenia, with corresponding coefficients (p < 0.0001). In this study, we also present a new scoring model for the identification of individuals with the disease risks. Using the cut-off value of 2, our model exhibited sensitivity for almost two-thirds of all of the schizophrenia patients: odds ratio 1.87, 95% CI 1.59-2.19, p < 0.0001. In conclusion, we identified significant associations of dopamine-related genetic combinations with schizophrenia. These findings suggest that some types of dopaminergic neurotransmission play important roles for development of schizophrenia, and this type of approach may also be applicable for other multifactorial diseases, providing a potent new risk predictor.
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Affiliation(s)
- Kengo Oishi
- Department of Psychiatry, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuou-ku, Chiba, Chiba, 260-8670, Japan.
| | - Tomihisa Niitsu
- Department of Psychiatry, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuou-ku, Chiba, Chiba, 260-8670, Japan
| | - Nobuhisa Kanahara
- Division of Medical Treatment and Rehabilitation, Chiba University Center for Forensic Mental Health, 1-8-1 Inohana, Chuou-ku, Chiba, Chiba, 260-8670, Japan
| | - Yasunori Sato
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, 35 Shinanomachi Shinjuku-ku, Tokyo, 160-0016, Japan
| | - Yoshimi Iwayama
- Laboratory for Molecular Psychiatry, RIKEN Center for Brain Science, Wako, Saitama, 351-0198, Japan
- Support Unit for Bio-Material Analysis, Research Resources Division, RIKEN Center for Brain Science, Wako, Saitama, 351-0198, Japan
| | - Tomoko Toyota
- Laboratory for Molecular Psychiatry, RIKEN Center for Brain Science, Wako, Saitama, 351-0198, Japan
| | - Tasuku Hashimoto
- Department of Psychiatry, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuou-ku, Chiba, Chiba, 260-8670, Japan
| | - Tsuyoshi Sasaki
- Department of Psychiatry, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuou-ku, Chiba, Chiba, 260-8670, Japan
- Department of Child Psychiatry, Chiba University Hospital, 1-8-1 Inohana, Chuou-ku, Chiba, Chiba, 260-8670, Japan
| | - Masayuki Takase
- Department of Psychiatry, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuou-ku, Chiba, Chiba, 260-8670, Japan
| | - Akihiro Shiina
- Division of Medical Treatment and Rehabilitation, Chiba University Center for Forensic Mental Health, 1-8-1 Inohana, Chuou-ku, Chiba, Chiba, 260-8670, Japan
| | - Takeo Yoshikawa
- Laboratory for Molecular Psychiatry, RIKEN Center for Brain Science, Wako, Saitama, 351-0198, Japan
| | - Masaomi Iyo
- Department of Psychiatry, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuou-ku, Chiba, Chiba, 260-8670, Japan
- Division of Medical Treatment and Rehabilitation, Chiba University Center for Forensic Mental Health, 1-8-1 Inohana, Chuou-ku, Chiba, Chiba, 260-8670, Japan
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Shiina A, Hasegawa T, Iyo M. Possible effect of blonanserin on gambling disorder: A clinical study protocol and a case report. World J Clin Cases 2021; 9:2469-2477. [PMID: 33889612 PMCID: PMC8040182 DOI: 10.12998/wjcc.v9.i11.2469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/08/2021] [Accepted: 02/01/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Gambling disorder is characterized by excessive and recurrent gambling and can have serious negative social consequences. Although several psychotherapeutic and pharmacological approaches have been used to treat gambling disorder, new treatment strategies are needed. Growing evidence suggests that dopamine D3 receptor plays a specific role in the brain reward system.
AIM To investigate if blonanserin, a dopamine D3 receptor antagonist, would be effective in reducing gambling impulses in patients with gambling disorder.
METHODS We developed a study protocol to measure the efficacy and safety of blonanserin as a potential drug for gambling disorder, in which up to 12 mg/d of blonanserin was prescribed for 8 wk.
RESULTS A 37-year-old female patient with gambling disorder, intellectual disability, and other physical diseases participated in the pilot study. The case showed improvement of gambling symptoms without any psychotherapy. However, blonanserin was discontinued owing to excessive saliva production.
CONCLUSION This case suggests that blonanserin is potentially an effective treatment for patients with gambling disorder who resist standard therapies, but it also carries a risk of adverse effects. Further studies are needed to confirm the findings.
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Affiliation(s)
- Akihiro Shiina
- Division of Medical Treatment and Rehabilitation, Chiba University Center for Forensic Mental Health, Chiba 260-8670, Japan
| | - Tadashi Hasegawa
- Department of Psychiatry, Chiba University Hospital, Chiba 260-8670, Japan
| | - Masaomi Iyo
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba 260-8670, Japan
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Seki R, Hashimoto T, Tanaka M, Ishii H, Ogawa M, Sato A, Kimura A, Shiina A, Nakazato M, Iyo M. Identification of psychological features and development of an assessment tool for event-related psychological distress after experiencing non-traumatic stressful events. PLoS One 2021; 16:e0249126. [PMID: 33788874 PMCID: PMC8011732 DOI: 10.1371/journal.pone.0249126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 03/11/2021] [Indexed: 11/30/2022] Open
Abstract
Stressful events in daily life that are non-traumatic (e.g., family-, school-, work-, interpersonal-, and health-related problems) frequently cause various mood disturbances. For some people, being exposed to non-traumatic but stressful events could trigger the onset and relapse of mood disorders. Furthermore, non-traumatic stressful events also cause event-related psychological distress (ERPD), similar to that of post-traumatic stress disorder (PTSD; i.e., intense intrusive imagery or memory recall, avoidance, and hyperarousal) in the general population and individuals with mood disorders. However, previous ERPD studies only showed that people with ERPD display PTSD-like symptoms after non-traumatic experiences; they failed to get to the crux of the matter by only utilizing trauma- or PTSD-related assessment tools. We thus aimed to identify the psychological phenomena and features of ERPD after individuals experienced non-traumatic stressful events, and to develop and validate an appropriate ERPD assessment tool. First, we conducted a qualitative study to obtain the psychological features through interviews with 22 individuals (mean age = 41.50 years old, SD = 12.24) with major depressive disorder or bipolar disorder. Second, in the quantitative component, we implemented a web-based survey with 747 participants of the general population (mean age = 41.96 years old, SD = 12.64) by using ERPD-related questionnaires created based on the qualitative study; then, we examined the reliability and validity of the ERPD assessment tool. Results yielded that the psychological features of ERPD comprised four factors: feelings of revenge, rumination, self-denial, and mental paralysis. These were utilized in the developed 24-item measure of ERPD—a novel self-report assessment tool. For various professionals involved in mental healthcare, this tool can be used to clarify and assess psychological phenomena in people with ERPD.
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Affiliation(s)
- Ryota Seki
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Tasuku Hashimoto
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
- Department of Psychiatry, School of Medicine, International University of Health and Welfare, Chiba, Japan
- * E-mail:
| | - Mami Tanaka
- Division of Clinical Study on Juvenile Delinquency, Center for Forensic Mental Health, Chiba University, Chiba, Japan
| | - Hiroki Ishii
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Michi Ogawa
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Aiko Sato
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
- Department of Psychiatry, School of Medicine, International University of Health and Welfare, Chiba, Japan
| | - Atsushi Kimura
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Akihiro Shiina
- Division of Medical Treatment and Rehabilitation, Center for Forensic Mental Health, Chiba University, Chiba, Japan
| | - Michiko Nakazato
- Department of Psychiatry, School of Medicine, International University of Health and Welfare, Chiba, Japan
| | - Masaomi Iyo
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
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Shiina A, Niitsu T, Kobori O, Idemoto K, Hashimoto T, Sasaki T, Igarashi Y, Shimizu E, Nakazato M, Hashimoto K, Iyo M. Perception of and anxiety about COVID-19 infection and risk behaviors for spreading infection: an international comparison. Ann Gen Psychiatry 2021; 20:13. [PMID: 33602250 PMCID: PMC7890773 DOI: 10.1186/s12991-021-00334-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 02/01/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND To control the spread of the new SARS-CoV-2 infection's disease (COVID-19), appropriate precautionary behaviors by the public should be promoted. There are international differences in public cognitive and behavioral pattern, attitudes toward information sources, and anxiety about COVID-19. Information about these differences could increase understanding of the patterns of epidemic-related anxiety and behavior, and would help optimize future policies for preventing the next wave of the epidemic. METHODS To examine between-country differences in perception, attitude, and precautionary behaviors toward COVID-19, we conducted a cross-sectional study using an online questionnaire survey. Participants were adults who had been registered in Cross Marketing Group Inc. and living in the UK, Spain, or Japan. A total of 8,000 people stratified by age were recruited on a first-come, first-serve basis. Knowledge of and anxiety about COVID-19, the frequency of access and perceived credibility of several information sources, and the frequency of each precautionary behavior were examined on March 27-28, 2020, in Japan and April 17-21, 2020, in the UK and Spain. RESULTS Knowledge, anxiety, and the frequency of precautionary behaviors were higher in the UK and Spain than in Japan. Participants with infected acquaintances were more concerned about COVID-19. However, participants in the UK rarely wore a medical mask. Participants in the UK and Spain were more eager to obtain information about COVID-19 than those in Japan. Participants in Spain tended not to trust official information and to believe specialists' comments instead. CONCLUSION The rapidity of the spread of COVID-19, cultural background, and recent political situations seemed to contribute to the international differences here.
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Affiliation(s)
- Akihiro Shiina
- Center for Forensic Mental Health, Chiba University, 260-8670 Inohana 1-8-1, Chuo-ku, Chiba, Japan.
| | - Tomihisa Niitsu
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Osamu Kobori
- Department of Psychology, International University of Health and Welfare, Akasaka, Japan
| | - Keita Idemoto
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Tasuku Hashimoto
- Department of Psychiatry, School of Medicine, International University of Health and Welfare, Narita, Japan
| | - Tsuyoshi Sasaki
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yoshito Igarashi
- Center for Forensic Mental Health, Chiba University, 260-8670 Inohana 1-8-1, Chuo-ku, Chiba, Japan
| | - Eiji Shimizu
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Michiko Nakazato
- Department of Psychiatry, School of Medicine, International University of Health and Welfare, Narita, Japan
| | - Kenji Hashimoto
- Center for Forensic Mental Health, Chiba University, 260-8670 Inohana 1-8-1, Chuo-ku, Chiba, Japan
| | - Masaomi Iyo
- Center for Forensic Mental Health, Chiba University, 260-8670 Inohana 1-8-1, Chuo-ku, Chiba, Japan.,Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
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Shiina A, Niitsu T, Iyo M. Need for self-medication using over-the-counter psychoactive agents: A national survey in Japan. PLoS One 2021; 16:e0245866. [PMID: 33493194 PMCID: PMC7833153 DOI: 10.1371/journal.pone.0245866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 01/10/2021] [Indexed: 11/24/2022] Open
Abstract
Self-medication using over-the-counter (OTC) drugs is an option for the autonomous treatment of several health problems. However, the use of OTC drugs to treat psychiatric conditions remains controversial. To clarify opinions regarding the use of OTC drugs to treat psychiatric problems, we conducted an anonymous online survey of 3000 people in Japan. Participants were stratified into three groups according to their history of mental health problems. Few participants had engaged in self-medication using OTC drugs for psychiatric symptoms, with the exception of insomnia. Participants who had used OTC drugs reported feeling less satisfied with their experience compared with those who had consulted a specialist. Participants who had used sleeping pills were likely to hold relatively positive opinions regarding the use of OTC psychiatric drugs. In conclusion, the need for self-medication of psychiatric symptoms appears to be limited. Education and further research may be necessary to promote self-medication for proper treatment of psychiatric conditions in Japan.
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Affiliation(s)
- Akihiro Shiina
- Division of Medical Care and Treatment, Center for Forensic Mental Health, Chiba University, Chiba, Japan
- * E-mail:
| | - Tomihisa Niitsu
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Masaomi Iyo
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
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Yakufujiang M, Higuchi Y, Aoyagi K, Yamamoto T, Sakurai T, Abe M, Okahara Y, Izumi M, Nagano O, Yamanaka Y, Hirano S, Shiina A, Murata A, Iwadate Y. Predicting Neurocognitive Change after Bilateral Deep Brain Stimulation of Subthalamic Nucleus for Parkinson's Disease. World Neurosurg 2021; 147:e428-e436. [PMID: 33359524 DOI: 10.1016/j.wneu.2020.12.081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/14/2020] [Accepted: 12/15/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Deep brain stimulation (DBS) of the bilateral subthalamic nucleus (STN) is a standard surgical treatment option in patients with advanced Parkinson's disease. Adverse effects on cognitive function have been reported, impacting the quality of life of patients and caregivers. We aimed to investigate a quantitative predictive preexisting cognitive factor for predicting postoperative cognitive changes. METHODS Thirty-five patients underwent STN-DBS. A battery of neuropsychological tests were used to examine executive function, processing speed, and visuospatial function both preoperatively and 1 year postoperatively. A multiple logistic regression analysis was performed to investigate the relationships between preoperative factors and cognitive outcomes. The predictive value of the preoperative factors for global cognitive decline during long-term follow-up were evaluated. RESULTS The patients exhibited significant changes in processing speed and visuospatial function after surgery. Using reliable change index values, lower preoperative scores on the Similarities and Object Assembly subtests of the Wechsler Adult Intelligence Scale III were associated with decreases in visuospatial function at 1 year after DBS. The odds ratios were 10.2 for Similarities and 9.53 for Object Assembly. The proportion of Mini Mental State Examination-maintained patients with low scores on the Similarities subtest was significantly lower than that of patients with high scores at 3 and 5 years. No factors were found to be related to decreases in processing speed. CONCLUSIONS Preoperative evaluation of the Similarities and Object Assembly subtests may be useful to identify patients who are at a greater risk of experiencing decreases in visuospatial functioning after STN-DBS. Furthermore, a low score on the Similarities subtest may predict future global cognitive deterioration.
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Affiliation(s)
- Maidinamu Yakufujiang
- Department of Neurological Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yoshinori Higuchi
- Department of Neurological Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
| | - Kyoko Aoyagi
- Department of Neurosurgery, Chiba Cerebral and Cardiovascular Center, Chiba, Japan
| | - Tatsuya Yamamoto
- Department of Neurology, Chiba University Graduate School of Medicine, Chiba, Japan; Department of Rehabilitation Sciences, Chiba Prefectural University of Health Sciences, Chiba, Japan
| | - Toru Sakurai
- Department of Neurology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Midori Abe
- Department of Rehabilitation Medicine, Chiba University Hospital, Chiba, Japan
| | - Yoji Okahara
- Department of Neurosurgery, Chiba Cerebral and Cardiovascular Center, Chiba, Japan
| | - Masaki Izumi
- Department of Neurological Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Osamu Nagano
- Department of Neurosurgery, Chiba Cerebral and Cardiovascular Center, Chiba, Japan
| | - Yoshitaka Yamanaka
- Department of Neurology, Chiba University Graduate School of Medicine, Chiba, Japan; Urayasu Rehabilitation Education Center, Chiba University HospitalTUMS Urayasu Hospital, Chiba, Japan
| | - Shigeki Hirano
- Department of Neurology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Akihiro Shiina
- Division of Medical Treatment and Rehabilitation, Chiba University Center for Forensic Mental Health, Chiba, Japan
| | - Atsushi Murata
- Department of Rehabilitation Medicine, Chiba University Hospital, Chiba, Japan
| | - Yasuo Iwadate
- Department of Neurological Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
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10
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Niitsu T, Hata T, Nishimoto M, Hosoda Y, Kimura A, Oda Y, Suzuki M, Takase N, Seki R, Fujita K, Endo M, Yoshida T, Inoue M, Hattori N, Murakami T, Imamura Y, Ogawa K, Fukami G, Sato T, Kawasaki Y, Hashimoto T, Ishikawa M, Shiina A, Kanahara N, Iyo M. A randomized-controlled trial of blonanserin and olanzapine as adjunct to antipsychotics in the treatment of patients with schizophrenia and dopamine supersensitivity psychosis: The ROADS study. Asian J Psychiatr 2020; 53:102369. [PMID: 32920492 DOI: 10.1016/j.ajp.2020.102369] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 08/13/2020] [Accepted: 08/23/2020] [Indexed: 12/14/2022]
Abstract
Dopamine supersensitivity psychosis (DSP) is a key factor contributing to the development of antipsychotic treatment-resistant schizophrenia. We examined the efficacy and safety of blonanserin (BNS) and olanzapine (OLZ) as adjuncts to prior antipsychotic treatment in patients with schizophrenia and DSP in a 24-week, multicenter (17 sites), randomized, rater-blinded study with two parallel groups (BNS and OLZ add-on treatments) in patients with schizophrenia and DSP: the ROADS Study. The primary outcome was the change in the Positive and Negative Syndrome Scale (PANSS) total score from baseline to week 24. Secondary outcomes were changes in the PANSS subscale scores, Clinical Global Impressions, and Extrapyramidal Symptom Rating Scale (ESRS), and changes in antipsychotic doses. The 61 assessed patients were allocated into a BNS group (n = 26) and an OLZ group (n = 29). The PANSS total scores were reduced in both groups (mean ± SD: -14.8 ± 24.0, p = 0.0042; -10.5 ± 12.9, p = 0.0003; respectively) with no significant between-group difference (mean, -4.3, 95 %CI 15.1-6.4, p = 0.42). The BNS group showed significant reductions from week 4; the OLZ group showed significant reductions from week 8. The ESRS scores were reduced in the BNS group and the others were reduced in both groups. The antipsychotic monotherapy rates at the endpoint were 26.3 % (n = 6) for BNS and 23.8 % (n = 5) for OLZ. The concomitant antipsychotic doses were reduced in both groups with good tolerability. Our results suggest that augmentations with BNS and OLZ are antipsychotic treatment options for DSP patients, and BNS may be favorable for DSP based on the relatively quick responses to BNS observed herein.
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Affiliation(s)
- Tomihisa Niitsu
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan.
| | - Tatsuki Hata
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan; Fujita Hospital, Sosa, Chiba, Japan
| | | | - Yutaka Hosoda
- Fujita Hospital, Sosa, Chiba, Japan; Child Psychiatry, Chiba University Hospital, Chiba, Japan
| | - Atsushi Kimura
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yasunori Oda
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | | | | | - Ryota Seki
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan; Chiba Hospital, Funabashi, Chiba, Japan
| | - Kiyoshi Fujita
- Okehazama Hospital Fujita Kokoro Care Center, Toyoake, Aichi, Japan
| | | | | | | | | | | | - Yukitsugu Imamura
- Department of Neuropsychiatry, Asahi General Hospital, Asahi, Chiba, Japan
| | - Kohei Ogawa
- Yowa Hospital, Tokyo, Japan; Department of Neuropsychiatry, Nippon Medical School, Tokyo, Japan
| | - Goro Fukami
- Chiba Psychiatric Medical Center, Chiba, Japan
| | - Takatoshi Sato
- Project Leader Office, Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Yohei Kawasaki
- Biostatistics Section, Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Tasuku Hashimoto
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan; Sodegaura-Satsukidai Hospital, Sodegaura, Chiba, Japan
| | - Masatomo Ishikawa
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Akihiro Shiina
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan; Division of Medical Treatment and Rehabilitation, Center for Forensic Mental Health, Chiba University, Chiba, Japan
| | - Nobuhisa Kanahara
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan; Division of Medical Treatment and Rehabilitation, Center for Forensic Mental Health, Chiba University, Chiba, Japan
| | - Masaomi Iyo
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan; Child Psychiatry, Chiba University Hospital, Chiba, Japan; Division of Medical Treatment and Rehabilitation, Center for Forensic Mental Health, Chiba University, Chiba, Japan
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11
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Oshima F, William M, Takahashi N, Tsuchiyagaito A, Kuwabara H, Shiina A, Seto M, Hongo M, Iwama Y, Hirano Y, Sutoh C, Taguchi K, Yoshida T, Kawasaki Y, Ozawa Y, Masuya J, Sato N, Nakamura S, Kuno M, Takahashi J, Ohtani T, Matsuzawa D, Inada N, Kuroda M, Ando M, Hori A, Nakagawa A, Shimizu E. Cognitive-behavioral family therapy as psychoeducation for adolescents with high-functioning autism spectrum disorders: Aware and Care for my Autistic Traits (ACAT) program study protocol for a pragmatic multisite randomized controlled trial. Trials 2020; 21:814. [PMID: 32993775 PMCID: PMC7526096 DOI: 10.1186/s13063-020-04750-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 09/17/2020] [Indexed: 11/23/2022] Open
Abstract
Background One aim of an autism spectrum disorder (ASD) diagnosis is to obtain special support for the disorder, though this does not guarantee practical support. We developed a psychoeducational program using cognitive-behavioral therapy (CBT) and Aware and Care for my Autistic Traits (ACAT) for Japanese adolescents with high-functioning ASD and their parents. Methods This multisite study is a randomized controlled trial. In total, 24 participants will be assigned to the ACAT group and 24 to the treatment-as-usual (TAU) group. The ACAT group will receive a weekly 100-min session for 6 weeks, regular medical care, and one follow-up session. In this ongoing clinical trial, we will compare the scores of the measures recorded in the pre- and post-intervention stages between the ACAT and TAU groups. A total of 41 patients out of a target of 48 have participated in the trial to date. The primary outcome measure is the Autism Knowledge Questionnaire. Secondary outcome measures include Barriers to Access to Care Evaluation 3rd Edition, the Strengths and Difficulties Questionnaire, the Vineland Adaptive Behavior Scales second edition, the Parenting Resilience Elements Questionnaire, the General Health Questionnaire 12, and the Depression Self-Rating Scale for Children assessments, as well as an electroencephalographic recording. Discussion It is expected that participants in the ACAT group will significantly increase their self-understanding and awareness of ASD symptoms compared to those in the TAU group. Additionally, the ACAT group is expected to exhibit improved social adaptation and mental health if children and parents are able to better understand the ASD characteristics through sessions. This intervention will contribute to the establishment of an effective evidence-based treatment strategy for adolescents with ASD. Trial registration UMIN Register 000029851. Registered on January 06, 2018
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Affiliation(s)
- Fumiyo Oshima
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana Chuouku, Chiba, 260-8670, Japan.
| | - Mandy William
- Research Department of Clinical, Educational & Health Psychology, University College London, London, UK
| | - Noriko Takahashi
- Fukushima University Child Mental Health-Care Center, Fukushima, Japan
| | - Aki Tsuchiyagaito
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana Chuouku, Chiba, 260-8670, Japan.,Laureate Instituto for Brain Research, Tulsa, OK, USA
| | - Hitoshi Kuwabara
- Department of Psychiatry, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Akihiro Shiina
- Chiba University Center for Forensic Mental Health, Chiba, Japan
| | - Mikuko Seto
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana Chuouku, Chiba, 260-8670, Japan
| | - Minako Hongo
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana Chuouku, Chiba, 260-8670, Japan
| | - Yui Iwama
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana Chuouku, Chiba, 260-8670, Japan
| | - Yoshiyuki Hirano
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana Chuouku, Chiba, 260-8670, Japan
| | - Chihiro Sutoh
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana Chuouku, Chiba, 260-8670, Japan
| | - Kayoko Taguchi
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana Chuouku, Chiba, 260-8670, Japan
| | - Tokiko Yoshida
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana Chuouku, Chiba, 260-8670, Japan
| | - Yohei Kawasaki
- Biostatistics Section, Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Yoshihito Ozawa
- Biostatistics Section, Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Jiro Masuya
- Fukushima University Child Mental Health-Care Center, Fukushima, Japan.,Department of Psychiatry, Tokyo Medical University Ibaraki Medical Center, Ibaraki, Japan
| | - Noriyuki Sato
- Fukushima University Child Mental Health-Care Center, Fukushima, Japan
| | - Shizuka Nakamura
- Fukushima University Child Mental Health-Care Center, Fukushima, Japan
| | - Masaru Kuno
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana Chuouku, Chiba, 260-8670, Japan
| | - Jumpei Takahashi
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana Chuouku, Chiba, 260-8670, Japan
| | - Toshiyuki Ohtani
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana Chuouku, Chiba, 260-8670, Japan
| | - Daisuke Matsuzawa
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana Chuouku, Chiba, 260-8670, Japan
| | - Naoko Inada
- Department of Psychology, Faculty of Liberal Arts, Teikyo University, Tokyo, Japan
| | - Miho Kuroda
- Department of Human Care, Nagoya University of Arts and Sciences, Nagoya, Japan
| | - Mika Ando
- Department of Psychiatry, Hibarigaoka Hospital, Fukushima, Japan
| | | | - Akiko Nakagawa
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana Chuouku, Chiba, 260-8670, Japan
| | - Eiji Shimizu
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana Chuouku, Chiba, 260-8670, Japan
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12
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Shiina A, Niitsu T, Kobori O, Idemoto K, Hashimoto T, Sasaki T, Igarashi Y, Shimizu E, Nakazato M, Hashimoto K, Iyo M. Relationship between perception and anxiety about COVID-19 infection and risk behaviors for spreading infection: A national survey in Japan. Brain Behav Immun Health 2020; 6:100101. [PMID: 32835297 PMCID: PMC7331545 DOI: 10.1016/j.bbih.2020.100101] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/19/2020] [Accepted: 06/25/2020] [Indexed: 12/20/2022] Open
Abstract
Background The novel corona virus infection (COVID-19) quickly became a pandemic state. Identifying characteristics of “possible super spreaders”, suggested as a dominant cause of rapid spreading transmission, will help us to design proper prevention strategies. Methods We conducted a nation-wide online survey to investigate the relationship of perception and anxiety levels about COVID-19 to the possible risk behaviors for spread of the virus in Japan. We recruited a total of 4,000 citizens, who responded to the questionnaire including several questions regarding the level of fear and anxiety about COVID-19, infection preventive behaviors and access to media with trust level about the virus as well as some demographic and socioeconomic data during March 27th and 28th, 2020. Findings Thirteen-point-three percent of the participants rated “1” on a nine-point Likert with respect to the knowledge about COVID-19. Ten-point-one percent and 11.7% presented no anxiety of being infected and transmission to others. Ten-point-eight percent showed no worry about symptomatic aggravation. Eight-point-one percent had no serious concern about expanding infection. The distribution of these items was highly correlated with each other. Participants with the low level of knowledge about COVID-19 were likely to less frequently access any information sources and neither trust them. They were less anxious about their health status, and less likely to put precautionary behaviors such as washing hands and avoiding crowded spaces, suggested by statistical analyses. Interpretation The present study suggests that it is greatly important to enlighten those have no concerns about this crisis of COVID-19 and modify their risk behavior via various ways, in order to prevent and control this viral pandemic. Funding This study was funded by the management grand provided to Chiba University Graduate School of Medicine and the Japan Society for the Promotion of Science KAKENHI grants. Lack of knowledge about COVID-19 is core trait of potential super spreaders, who occupy more than 10% of citizens. Super spreaders may be in a vicious circle of cognitive indifference, lack of information, and recurrent risky behaviors. Providing proper knowledge to indifferent individuals with any means is essential to resolve the pandemic of COVID-19.
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Affiliation(s)
- Akihiro Shiina
- Center for Forensic Mental Health, Chiba University, Japan
| | - Tomihisa Niitsu
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Japan
| | - Osamu Kobori
- Department of Psychology, International University of Health and Welfare, Japan
| | - Keita Idemoto
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Japan
| | - Tasuku Hashimoto
- Department of Psychiatry, School of Medicine, International University of Health and Welfare, Japan
| | - Tsuyoshi Sasaki
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Japan
| | | | - Eiji Shimizu
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Japan
| | - Michiko Nakazato
- Department of Psychiatry, School of Medicine, International University of Health and Welfare, Japan
| | | | - Masaomi Iyo
- Center for Forensic Mental Health, Chiba University, Japan.,Department of Psychiatry, Graduate School of Medicine, Chiba University, Japan
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13
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Shiina A, Sato A, Iyo M, Fujii C. Outcomes of administrative involuntary hospitalization: A national retrospective cohort study in Japan. World J Psychiatry 2019; 9:99-106. [PMID: 31799153 PMCID: PMC6885745 DOI: 10.5498/wjp.v9.i7.99] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 08/16/2019] [Accepted: 10/15/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Treatment for offenders with mental disorders is a key concern in public mental health. Provision of adequate psychiatric treatment is important for the offender and their community. An approach used in Japan to address this issue is administrative involuntary hospitalization. Under this scheme, a person at risk for harming themselves or others because of a mental disorder can be involuntarily hospitalized in a designated psychiatric hospital. However, this scheme does not include tracking of these patients after discharge. Although some data for administrative involuntary hospitalizations are available, it remains unclear what happens to these patients after discharge.
AIM To evaluate follow-up of patients under administrative involuntary hospitalization after discharge and obtain data for later comparisons with outcomes.
METHODS We used a retrospective design and conducted a national survey of administrative involuntary hospitalizations. Questionnaires were distributed to 939 facilities across Japan. The questionnaire collected data for selected involuntary hospitalization cases in the hospital on June 30, 2010 (census date), and the prognoses of each patient on a specified date in 2011 and 2012. We also asked about the treatment provided to each patient. We stratified patients by prognosis (good or poor), and used logistic regression analysis to examine the relationship between treatment and prognosis.
RESULTS We received completed questionnaires from 292 facilities (response rate 31.1%); 105 facilities had no relevant patients. Our analysis included data for 394 patients with valid data. Official statistics indicated 1503 patients were under administrative involuntary hospitalization as at June 30, 2012, meaning the capture rate was 27.2%. Approximately a fourth (104/394) at 1 year, and a third (137/294) at 2 years after the census had unknown prognosis. Treatment content included multi-disciplinary team meetings (78.2% of patients), counseling by public workers (59.9%), and discussion with external specialists (32.5%). Overall, 116 patients were categorized as having a good prognosis at 1 year, and 168 had a poor prognosis. At the 2-year point, 102 patients had a good prognosis and 150 had a poor prognosis. “Discussion with external specialists” was positively associated with a good prognosis at both 1 year (P = 0.016) and 2 years (P = 0.036).
CONCLUSION We found that facilities in Japan currently have limited ability to track the prognoses of patients who were hospitalized involuntarily. Discussion with external specialists is associated with a good prognosis.
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Affiliation(s)
- Akihiro Shiina
- Division of Medical Treatment and Rehabilitation, Chiba University Center for Forensic Mental Health, Chiba 2608670, Japan
| | - Aiko Sato
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba 2608670, Japan
| | - Masaomi Iyo
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba 2608670, Japan
| | - Chiyo Fujii
- Department of Community Mental Health and Law, National Institute of Mental Health, Kodaira-shi 1878552, Japan
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14
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Yakufujiang M, Higuchi Y, Aoyagi K, Yamamoto T, Abe M, Okahara Y, Izumi M, Nagano O, Yamanaka Y, Hirano S, Shiina A, Murata A, Iwadate Y. Predictive potential of preoperative electroencephalogram for neuropsychological change following subthalamic nucleus deep brain stimulation in Parkinson's disease. Acta Neurochir (Wien) 2019; 161:2049-2058. [PMID: 31278598 DOI: 10.1007/s00701-019-03991-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 06/25/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Deep brain stimulation of the bilateral subthalamic nucleus (STN-DBS) improves motor fluctuation and severe dyskinesia in advanced Parkinson's disease (PD). Effects on non-motor symptoms, such as neurocognitive side effects, can also influence the quality of life of both patients with PD and caregivers. Predictive quantitative factors associated with postoperative neurocognitive deterioration therefore warrant further attention. Here, we evaluated preoperative electroencephalogram (EEG) as a predictive marker for changes in neurocognitive functions after surgery. METHODS Scalp EEG was recorded preoperatively from 17 patients with PD who underwent bilateral STN-DBS. Global relative power in the theta, alpha, and beta bands was calculated. Cognitive function was assessed with neuropsychological batteries preoperatively and 1 year after STN-DBS. RESULTS Performance on the Symbol Search subtest of the WAIS III declined 1 year after DBS. The theta band was chosen for analysis with a 40% cutoff point for increased (≥ 40%) and decreased (< 40%) power. No significant differences between the two groups in baseline performance on most neuropsychological batteries were found, except for the Digit Symbol Coding subtest of the WAIS III. Changes in visual spatial functions were significantly different between groups. The increased theta band power group demonstrated a significant deterioration in performance on the WAIS III Matrix Reasoning subtest and the copy and immediate recall tasks of the Rey-Osterrieth complex figure test. CONCLUSIONS These findings suggest that preoperative increases in theta power are related to postoperative deterioration of visuospatial function, which indicates the predictive potential of preoperative quantitative EEG for neurocognitive changes after STN-DBS.
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15
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Shiina A, Niitsu T, Sato A, Omiya S, Nagata T, Tomoto A, Watanabe H, Igarashi Y, Iyo M. Effect of educational intervention on attitudes toward the concept of criminal responsibility. World J Psychiatry 2017; 7:197-206. [PMID: 29354482 PMCID: PMC5746663 DOI: 10.5498/wjp.v7.i4.197] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 08/03/2017] [Accepted: 09/13/2017] [Indexed: 02/05/2023] Open
Abstract
AIM To evaluate the effect of educational intervention on individuals’ knowledge of and attitudes toward forensic mental health.
METHODS We conducted a questionnaire regarding attitudes toward various ideas about forensic mental health. The respondents attended a 1-h seminar regarding forensic mental health after answering the questionnaire. On completion of the seminar, the respondents answered another questionnaire containing many of the same questions as contained in the pre-seminar questionnaire.
RESULTS A total of 86 individuals attended the seminar, and 78 responded to the questionnaire. Only 13 (18.8%) participants were supportive of the concept of criminal responsibility initially, and there was a statistically significant increase in those who became more supportive after the seminar, with 22 (33%) being supportive after the seminar (Wilcoxon signed-rank test, P < 0.001). Logistic regression analysis revealed that participants who were skeptical about forensic mental systems and those with fewer opportunities to see media reports regarding psychiatry were likely to become supportive of criminal responsibility after the intervention.
CONCLUSION These results suggest that public attitudes toward criminal responsibility and mental health can be influenced via educational interventions.
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Affiliation(s)
- Akihiro Shiina
- Division of Medical Treatment and Rehabilitation, Chiba University Center for Forensic Mental Health, Chiba 2608670, Japan
| | - Tomihisa Niitsu
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba 2608670, Japan
| | - Aiko Sato
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba 2608670, Japan
| | - Soichiro Omiya
- Social Psychiatry and Mental Health, Faculty of Medicine, University of Tsukuba, Ibaraki 3058577, Japan
| | - Takako Nagata
- Ministry of Health, Labour and Welfare, Tokyo 1008916, Japan
| | - Aika Tomoto
- Division of Law and Psychiatry, Chiba University Center for Forensic Mental Health, Chiba 2608670, Japan
| | - Hiroyuki Watanabe
- Division of Medical Treatment and Rehabilitation, Chiba University Center for Forensic Mental Health, Chiba 2608670, Japan
| | - Yoshito Igarashi
- Division of Law and Psychiatry, Chiba University Center for Forensic Mental Health, Chiba 2608670, Japan
| | - Masaomi Iyo
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba 2608670, Japan
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16
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Shiina A, Tomoto A, Omiya S, Sato A, Iyo M, Igarashi Y. Differences between British and Japanese perspectives on forensic mental health systems: A preliminary study. World J Psychiatry 2017; 7:8-11. [PMID: 28401045 PMCID: PMC5371174 DOI: 10.5498/wjp.v7.i1.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Revised: 09/23/2016] [Accepted: 11/22/2016] [Indexed: 02/05/2023] Open
Abstract
AIM To clarify the differences in views on forensic mental health (FMH) systems between the United Kingdom and Japan.
METHODS We conducted a series of semi-structured interviews with six leading forensic psychiatrists. Based on a discussion by the research team, we created an interview form. After we finished conducting all the interviews, we qualitatively analyzed their content.
RESULTS In the United Kingdom the core domain of FMH was risk assessment and management; however, in Japan, the core domain of FMH was psychiatric testimony. In the United Kingdom, forensic psychiatrists were responsible for ensuring public safety, and psychopathy was identified as a disease but deemed as not suitable for medical treatment. On the other hand, in Japan, psychopathy was not considered a mental illness.
CONCLUSION In conclusion, there are considerable differences between the United Kingdom and Japan with regard to the concepts of FMH. Some ideas taken from both cultures for better FMH practice were suggested.
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Matsumoto J, Hirano Y, Hashimoto K, Ishima T, Kanahara N, Niitsu T, Shiina A, Hashimoto T, Sato Y, Yokote K, Murano S, Kimura H, Hosoda Y, Shimizu E, Iyo M, Nakazato M. Altered serum level of matrix metalloproteinase-9 and its association with decision-making in eating disorders. Psychiatry Clin Neurosci 2017; 71:124-134. [PMID: 27891714 DOI: 10.1111/pcn.12490] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 11/13/2016] [Accepted: 11/16/2016] [Indexed: 12/11/2022]
Abstract
AIM The aims of this study were to determine whether the serum levels of precursor brain-derived neurotrophic factor (proBDNF), mature BDNF (mBDNF), and matrix metalloproteinase-9 (MMP-9) are altered in patients with eating disorders (ED), including anorexia nervosa (AN) and bulimia nervosa (BN), and to explore whether those levels are associated with decision-making abilities. METHODS Nineteen women with AN, 28 women with BN, and 22 age-matched healthy control women (HC) were enrolled in the current study. All participants had their decision-making abilities assessed using the Iowa Gambling Task (IGT). Their eating-related pathophysiology and depressive/anxiety symptoms were also evaluated. RESULTS The MMP-9 level in AN was significantly lower than that in either BN or HC, but the serum levels of proBDNF and mBDNF did not differ among the three groups. Investigation of the serum levels of proBDNF and MMP-9 in patients with ED and controls revealed a significant correlation between them. In the BN, there were positive correlations between mBDNF level and IGT performance and also between MMP-9 level and IGT performance, but these correlations did not occur in AN. The MMP-9 level was positively associated with the Symptom Scale, one of the subscales of the Bulimic Investigatory Test, Edinburgh, only in AN. CONCLUSION These results suggest that the serum level of MMP-9 plays a role in the pathophysiology of AN, and both the serum levels of mBDNF and MMP-9 may be associated with decision-making abilities in patients with BN.
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Affiliation(s)
- Junko Matsumoto
- Department of Regional Disaster Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yoshiyuki Hirano
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | | | | | | | - Tomihisa Niitsu
- Departments of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
| | | | - Tasuku Hashimoto
- Departments of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yasunori Sato
- Global Clinical Research, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Koutaro Yokote
- Clinical Cell Biology and Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Shunichi Murano
- Department of Regional Disaster Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hiroshi Kimura
- Departments of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yutaka Hosoda
- Departments of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Eiji Shimizu
- Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Masaomi Iyo
- Center for Forensic Mental Health, Chiba, Japan.,Departments of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Michiko Nakazato
- Research Center for Child Mental Development, Chiba University, Chiba, Japan.,Departments of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
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Sasaki T, Hashimoto K, Oda Y, Ishima T, Yakita M, Kurata T, Kunou M, Takahashi J, Kamata Y, Kimura A, Niitsu T, Komatsu H, Hasegawa T, Shiina A, Hashimoto T, Kanahara N, Shimizu E, Iyo M. Increased Serum Levels of Oxytocin in 'Treatment Resistant Depression in Adolescents (TRDIA)' Group. PLoS One 2016; 11:e0160767. [PMID: 27536785 PMCID: PMC4990411 DOI: 10.1371/journal.pone.0160767] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Accepted: 07/25/2016] [Indexed: 11/18/2022] Open
Abstract
Objective ‘Treatment-resistant depression’ is depression that does not respond to an adequate regimen of evidence-based treatment. Treatment-resistant depression frequently becomes chronic. Children with treatment-resistant depression might also develop bipolar disorder (BD). The objective of this study was to determine whether serum levels of oxytocin (OXT) in treatment-resistant depression in adolescents (TRDIA) differ from non-treatment-resistant depression in adolescents (non-TRDIA) or controls. We also investigated the relationships between serum OXT levels and the clinical symptoms, severity, and familial histories of adolescent depressive patients. Methods We measured serum OXT levels: TRDIA (n = 10), non-TRDIA (n = 27), and age- and sex- matched, neurotypical controls (n = 25). Patients were evaluated using the Children’s Depression Rating Scale-Revised (CDRS-R) and the Depression Self-Rating Scale for Children-Japanese Version (DSRS-C-J). The patients were also assessed retrospectively using the following variables: familial history of major depressive disorder and BD (1st degree or 2nd degree), history of disruptive mood dysregulation disorder, recurrent depressive disorder (RDD), history of antidepressant activation. Results Serum levels of OXT among the TRDIA and non-TRDIA patients and controls differed significantly. Interestingly, the rates of a family history of BD (1st or 2nd degree), RDD and a history of antidepressant activation in our TRDIA group were significantly higher than those of the non-TRDIA group. Conclusions Serum levels of OXT may play a role in the pathophysiology of TRDIA.
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Affiliation(s)
- Tsuyoshi Sasaki
- Department of Child Psychiatry, Chiba University Hospital, Chiba, Japan
- Departments of Psychiatry Chiba University Graduate School of Medicine, Chiba, Japan
- * E-mail:
| | - Kenji Hashimoto
- Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, Chiba, Japan
| | - Yasunori Oda
- Departments of Psychiatry Chiba University Graduate School of Medicine, Chiba, Japan
| | - Tamaki Ishima
- Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, Chiba, Japan
| | - Madoka Yakita
- Department of Child Psychiatry, Chiba University Hospital, Chiba, Japan
| | - Tsutomu Kurata
- Department of Child Psychiatry, Chiba University Hospital, Chiba, Japan
| | - Masaru Kunou
- Department of Child Psychiatry, Chiba University Hospital, Chiba, Japan
- Departments of Cognitive Behavioral Physiology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Jumpei Takahashi
- Department of Child Psychiatry, Chiba University Hospital, Chiba, Japan
| | - Yu Kamata
- Departments of Psychiatry Chiba University Graduate School of Medicine, Chiba, Japan
| | - Atsushi Kimura
- Departments of Psychiatry Chiba University Graduate School of Medicine, Chiba, Japan
| | - Tomihisa Niitsu
- Departments of Psychiatry Chiba University Graduate School of Medicine, Chiba, Japan
| | - Hideki Komatsu
- Departments of Psychiatry Chiba University Graduate School of Medicine, Chiba, Japan
| | - Tadashi Hasegawa
- Departments of Psychiatry Chiba University Graduate School of Medicine, Chiba, Japan
| | - Akihiro Shiina
- Departments of Psychiatry Chiba University Graduate School of Medicine, Chiba, Japan
| | - Tasuku Hashimoto
- Departments of Psychiatry Chiba University Graduate School of Medicine, Chiba, Japan
| | - Nobuhisa Kanahara
- Division of Medical Treatment and Rehabilitation, Chiba University Center for Forensic Mental Health, Chiba, Japan
| | - Eiji Shimizu
- Departments of Cognitive Behavioral Physiology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Masaomi Iyo
- Department of Child Psychiatry, Chiba University Hospital, Chiba, Japan
- Departments of Psychiatry Chiba University Graduate School of Medicine, Chiba, Japan
- Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, Chiba, Japan
- Division of Medical Treatment and Rehabilitation, Chiba University Center for Forensic Mental Health, Chiba, Japan
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Mellsop G, Choi WK, Every-Palmer S, Green B, Heffernan E, Kachaeva M, Shiina A, Wang X. Drug driven psychoses and legal responsibility or insanity in six Western Pacific nations. Int J Law Psychiatry 2016; 47:68-73. [PMID: 27021135 DOI: 10.1016/j.ijlp.2016.02.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Prompted by four questions, forensic mental health clinicians from Russia, China, Japan, Hong Kong, Australia and New Zealand provided information on both the legislative basis and current practice concerning the relationship between legal insanity, intoxication and drug induced psychosis in their six Pacific Rim Countries which account for nearly 20% of the world's population. Details of the survey for each contributing nation are provided. While there are significant variations in practice that have been shaped by regional legal, clinical and cultural influences there is considerable similarity in the legislation underpinning how these issues are considered. Consequently there remain similar challenges for each nation. In none of the legislative bases was the issue of drug induced psychosis specifically addressed. The authors conclude that evolving pharmaco-neuropsychiatric knowledge, societal values and patterns of substance misuse require nations to consider developments in scientific and clinical knowledge to support their interpretations of the relationship between altered mental states as a result of substance use and the legal construct of insanity.
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Affiliation(s)
| | | | | | - Bob Green
- Queensland Forensic Mental Health Services, Australia
| | - Ed Heffernan
- Queensland Forensic Mental Health Services, Australia
| | - Margarita Kachaeva
- Serbsky National Research Centre for Social & Forensic Psychiatry, Moscow, Russian Federation
| | | | - Xiaoping Wang
- Mental health Institute of the second Xiangya Hospital, Central South University, China
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20
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Nagata T, Nakagawa A, Matsumoto S, Shiina A, Iyo M, Hirabayashi N, Igarashi Y. Characteristics of female mentally disordered offenders culpable under the new legislation in Japan: A gender comparison study. Crim Behav Ment Health 2016; 26:50-58. [PMID: 25756745 DOI: 10.1002/cbm.1949] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Revised: 06/17/2014] [Accepted: 12/02/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND Although a substantial increase in the number of female offenders has drawn interest towards understanding their unique characteristics, few studies have investigated the characteristics of female mentally disordered offenders in Japan and none since the legislation enacted in 2005 in Japan, which provided for special services for them. AIMS The aim of this study is to identify those characteristics of people detained under this legislation, which distinguish the women from the men and may indicate special needs among the women. METHODS A retrospective records-based study of all patients admitted to one secure unit in the 8 years since its opening in July 2005 until a census date of 31 October 2013. RESULTS Thirty-six (15%) of the patients were women. Marriage, mood disorders, past suicide attempts and homicide were more common among the women than the men. Six of the female offender-patients had committed filicides, of which four were infanticides. CONCLUSION There appears to be a particularly vulnerable sub-group of women with severe mood disorders, a history of serious suicide attempts and young children at risk of harming those children. Our sample was small and from a single unit so, given the potential importance of improving understanding of who is at risk in such circumstances, extending our study nationally seems indicated.
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Affiliation(s)
- Takako Nagata
- Department of Psychiatry, National Center of Neurology & Psychiatry, Tokyo, Japan
- Division of Law & Psychiatry, Center for Forensic Mental Health, Chiba University, Chiba, Japan
| | - Atsuo Nakagawa
- Translational Medical Center, National Center of Neurology and Psychiatry, Tokyo, Japan
- Center for Clinical Research, Keio University School of Medicine, Tokyo, Japan
| | - Satoko Matsumoto
- Department of Psychiatry, National Center of Neurology & Psychiatry, Tokyo, Japan
| | - Akihiro Shiina
- Division of Law & Psychiatry, Center for Forensic Mental Health, Chiba University, Chiba, Japan
- Department of Psychiatry, Chiba University Hospital, Chiba, Japan
| | - Masaomi Iyo
- Division of Law & Psychiatry, Center for Forensic Mental Health, Chiba University, Chiba, Japan
- Department of Psychiatry, Chiba University Hospital, Chiba, Japan
| | - Naotsugu Hirabayashi
- Department of Psychiatry, National Center of Neurology & Psychiatry, Tokyo, Japan
| | - Yoshito Igarashi
- Division of Law & Psychiatry, Center for Forensic Mental Health, Chiba University, Chiba, Japan
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21
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Hashimoto T, Shiina A, Hasegawa T, Kimura H, Oda Y, Niitsu T, Ishikawa M, Tachibana M, Muneoka K, Matsuki S, Nakazato M, Iyo M. Effect of mirtazapine versus selective serotonin reuptake inhibitors on benzodiazepine use in patients with major depressive disorder: a pragmatic, multicenter, open-label, randomized, active-controlled, 24-week trial. Ann Gen Psychiatry 2016; 15:27. [PMID: 27777607 PMCID: PMC5070072 DOI: 10.1186/s12991-016-0115-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 09/19/2016] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND This study aimed to evaluate whether selecting mirtazapine as the first choice for current depressive episode instead of selective serotonin reuptake inhibitors (SSRIs) reduces benzodiazepine use in patients with major depressive disorder (MDD). We concurrently examined the relationship between clinical responses and serum mature brain-derived neurotrophic factor (BDNF) and its precursor, proBDNF. METHODS We conducted an open-label randomized trial in routine psychiatric practice settings. Seventy-seven MDD outpatients were randomly assigned to the mirtazapine or predetermined SSRIs groups, and investigators arbitrarily selected sertraline or paroxetine. The primary outcome was the proportion of benzodiazepine users at weeks 6, 12, and 24 between the groups. We defined patients showing a ≥50 % reduction in Hamilton depression rating scale (HDRS) scores from baseline as responders. Blood samples were collected at baseline, weeks 6, 12, and 24. RESULTS Sixty-five patients prescribed benzodiazepines from prescription day 1 were analyzed for the primary outcome. The percentage of benzodiazepine users was significantly lower in the mirtazapine than in the SSRIs group at weeks 6, 12, and 24 (21.4 vs. 81.8 %; 11.1 vs. 85.7 %, both P < 0.001; and 12.5 vs. 81.8 %, P = 0.0011, respectively). No between-group difference was observed in HDRS score changes. Serum proBDNF levels were significantly decreased (χ2 = 8.5, df = 3, P = 0.036) and serum mature BDNF levels were temporarily significantly decreased (F = 3.5, df = 2.4, P = 0.027) in the responders of both groups at week 24. CONCLUSION This study demonstrated mirtazapine as the first-choice antidepressant for current depressive episodes may reduce benzodiazepine use in patients with MDD. Trial registration UMIN000004144. Registered 2nd September 2010. The date of enrolment of the first participant to the trial was 24th August 2010. This study was retrospectively registered 9 days after the first participant was enrolled.
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Affiliation(s)
- Tasuku Hashimoto
- Department of Psychiatry, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670 Japan ; Sodegaura Satsukidai Hospital, 5-21 Nagauraekimae, Sodegaura-shi, 299-0246 Japan
| | - Akihiro Shiina
- Department of Psychiatry, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba, 260-0856 Japan ; Kokoronokenko Tsudanuma Clinic, 2-13-13 Maebaranishi, Funabashi-shi, Chiba, 274-0825 Japan
| | - Tadashi Hasegawa
- Department of Psychiatry, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba, 260-0856 Japan ; Kokoronokenko Tsudanuma Clinic, 2-13-13 Maebaranishi, Funabashi-shi, Chiba, 274-0825 Japan
| | - Hiroshi Kimura
- Department of Psychiatry, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670 Japan ; Kokoronokaze Funabashi Clinic, 1-26-2 Motomachi, Funabashi-shi, Chiba, 273-0005 Japan
| | - Yasunori Oda
- Department of Psychiatry, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670 Japan
| | - Tomihisa Niitsu
- Department of Psychiatry, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670 Japan ; Fujita Hospital, 3292-Ho Yokaichiba, Sosa-shi, Chiba, 289-2146 Japan
| | - Masatomo Ishikawa
- Department of Psychiatry, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670 Japan
| | - Masumi Tachibana
- Fujita Hospital, 3292-Ho Yokaichiba, Sosa-shi, Chiba, 289-2146 Japan
| | | | - Satoshi Matsuki
- Research Center for Child Mental Development, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670 Japan ; Kisarazu Hospital, 2-3-1 Iwane, Kisarazu-shi, Chiba, 292-0061 Japan
| | - Michiko Nakazato
- Research Center for Child Mental Development, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670 Japan ; Kokoronokaze Funabashi Clinic, 1-26-2 Motomachi, Funabashi-shi, Chiba, 273-0005 Japan
| | - Masaomi Iyo
- Department of Psychiatry, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670 Japan
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22
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Sasaki T, Hashimoto K, Oda Y, Ishima T, Kurata T, Takahashi J, Kamata Y, Kimura H, Niitsu T, Komatsu H, Ishikawa M, Hasegawa T, Shiina A, Hashimoto T, Kanahara N, Shiraishi T, Iyo M. Decreased levels of serum oxytocin in pediatric patients with Attention Deficit/Hyperactivity Disorder. Psychiatry Res 2015; 228:746-51. [PMID: 26168929 DOI: 10.1016/j.psychres.2015.05.029] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 04/06/2015] [Accepted: 05/23/2015] [Indexed: 10/23/2022]
Abstract
Attention Deficit/Hyperactivity Disorder (ADHD) and autism spectrum disorder (ASD) are highly comorbid, and both disorders share executive function deficits. Accumulating evidence suggests that ASD patients have significantly lower peripheral oxytocin (OXT) levels compared with their normal counterparts, and that the repetitive behavior seen in ASD is related to abnormalities in the OXT system. In this study, we investigated whether serum levels of OXT are altered in pediatric patients with ADHD. We measured serum OXT levels: drug naive ADHD (n=23), medicated ADHD (n=13), and age- and sex- matched, neurotypical controls (n=22). Patients were evaluated using the ADHD-RS. Serum levels of OXT in total subjects with ADHD were significantly decreased compared with those of neurotypical controls, and serum levels of OXT in drug naive ADHD patients were significantly lower than those in medicated ADHD patients. Interestingly, there was a significant negative correlation between serum OXT levels and ADHD-RS total scores, as well as ADHD-RS inattentive scores in all ADHD patients. In conclusion, this study suggests that decreased levels of OXT may play a role in the pathophysiology of patients with ADHD and its inherent inattentiveness.
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Affiliation(s)
- Tsuyoshi Sasaki
- Department of Child Psychiatry, Chiba University Hospital, Japan; Department of Psychiatry, Chiba University Graduate School of Medicine, Japan.
| | - Kenji Hashimoto
- Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, Japan
| | - Yasunori Oda
- Department of Psychiatry, Chiba University Graduate School of Medicine, Japan
| | - Tamaki Ishima
- Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, Japan
| | - Tsutomu Kurata
- Department of Child Psychiatry, Chiba University Hospital, Japan
| | - Junpei Takahashi
- Department of Child Psychiatry, Chiba University Hospital, Japan
| | - Yu Kamata
- Department of Psychiatry, Chiba University Graduate School of Medicine, Japan
| | - Hiroshi Kimura
- Department of Psychiatry, Chiba University Graduate School of Medicine, Japan
| | - Tomihisa Niitsu
- Department of Psychiatry, Chiba University Graduate School of Medicine, Japan
| | - Hideki Komatsu
- Department of Psychiatry, Chiba University Graduate School of Medicine, Japan
| | - Masatomo Ishikawa
- Department of Psychiatry, Chiba University Graduate School of Medicine, Japan
| | - Tadashi Hasegawa
- Department of Psychiatry, Chiba University Graduate School of Medicine, Japan
| | - Akihiro Shiina
- Department of Child Psychiatry, Chiba University Hospital, Japan
| | - Tasuku Hashimoto
- Department of Psychiatry, Chiba University Graduate School of Medicine, Japan
| | - Nobuhisa Kanahara
- Division of Medical Treatment and Rehabilitation, Chiba University Center for Forensic Mental Health, Japan
| | - Tetsuya Shiraishi
- Department of Psychiatry, Chiba University Graduate School of Medicine, Japan
| | - Masaomi Iyo
- Department of Child Psychiatry, Chiba University Hospital, Japan; Department of Psychiatry, Chiba University Graduate School of Medicine, Japan; Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, Japan; Division of Medical Treatment and Rehabilitation, Chiba University Center for Forensic Mental Health, Japan
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Shiina A, Iyo M, Hirata T, Igarashi Y. Audit study of the new hospitalization for assessment scheme for forensic mental health in Japan. World J Psychiatry 2015; 5:234-242. [PMID: 26110125 PMCID: PMC4473495 DOI: 10.5498/wjp.v5.i2.234] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2014] [Revised: 02/06/2015] [Accepted: 04/02/2015] [Indexed: 02/05/2023] Open
Abstract
AIM: To clarify the components of hospitalization for assessment (HfA) and the management changes from the beginning of the scheme to the present.
METHODS: This study is composed of two surveys. In 2013 survey, we created two paper questionnaires (facility and case questionnaires) for psychiatrists working in psychiatric hospitals accepting HfA patients. Questionnaires were sent to 205 hospitals that were identified as accepting the HfA cases, and responses were requested via mail. The facility questionnaire was designed to clarify the following specifications and characteristics of each facility: the facility organizer (public sector or private hospital), and the number of beds, psychiatrists, psychiatric nurses, occupational therapists, psychiatric social workers, psychotherapists, public health nurses, and patients treated through HfA during the survey period. The case questionnaire was then used to collect data of the patients under HfA based on the Medical Treatment and Supervision (MTS) Act who were discharged between July 1, 2012 and June 30, 2013. Gathered information included: legal information of each case, demographic data, past history of the offenders, issued offense and the relationship to the victim, information regarding past psychiatric testimonies, psychiatric diagnoses, contents of the treatment during HfA, information regarding seclusion and restraint during the HfA, the verdict of the District Court panel, and so forth. Next, we compared those results with relevant data obtained in 2007. The 2007 survey comprised data of HfA patients from July 15, 2005 (the date the MTS Act was enforced) to January 15, 2007.
RESULTS: We obtained 171 cases, approximately a half of whole contemporary cases of HfA, from 134 facilities, of which 46 were national, prefectural, or semi-official hospitals, and 88 were private hospitals, in 2013 survey. The majority of subjects were male, schizophrenic, and experienced previous psychiatric treatment. The most frequent type of the offense was injury, followed by arson. Most of the subjects were medicated, and a few cases took psychotropic injection during the HfA. The frequency of injection was decreased in 2013 (χ2 = 7.54, df = 1, P = 0.006) than in 2007. Psychiatric testimony was more likely to be conducted in 2013 (χ2 = 8.56, df = 1, P = 0.004). The examiner psychiatrist was more likely to belong to the HfA facility to which the patient was hospitalized (χ2 = 5.32, df = 1, P = 0.02). Hospitalization orders were more frequently selected in 2013 (χ2 = 19.76, df = 3, P < 0.001), although the characteristics of the subjects had not changed.
CONCLUSION: Although the management of HfA has improved in recent years, structural problems remain.
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Shiina A, Kanahara N, Sasaki T, Oda Y, Hashimoto T, Hasegawa T, Yoshida T, Iyo M, Hashimoto K. An Open Study of Sulforaphane-rich Broccoli Sprout Extract in Patients with Schizophrenia. Clin Psychopharmacol Neurosci 2015; 13:62-7. [PMID: 25912539 PMCID: PMC4423155 DOI: 10.9758/cpn.2015.13.1.62] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 09/30/2014] [Accepted: 10/02/2014] [Indexed: 12/29/2022]
Abstract
Objective Schizophrenia is a mental disorder characterized by severe cognitive impairment. Accumulating evidence suggests a role for oxidative stress in the pathophysiology of schizophrenia. Sulforaphane (SFN) extracted from broccoli sprout is an agent with potent anti-oxidant and anti-inflammatory activity. In this study, we attempted to evaluate the effect of SFN on cognitive impairment in medicated patients with schizophrenia. Methods We recruited a total of 10 outpatients with schizophrenia, all of whom gave informed consent. Participants took 3 tablets of SFN, consisting of 30 mg of SFN-glucosinolate per day, for 8 weeks. Clinical symptoms using the Positive and Negative Syndrome Scale (PANSS) and cognitive function using the Japanese version of CogState battery were evaluated at the beginning of the study and at week 8. Results A total of 7 patients completed the trial. The mean score in the Accuracy component of the One Card Learning Task increased significantly after the trial. However, we detected no other significant changes in participants. Conclusion This result suggests that SFN has the potential to improve cognitive function in patients with schizophrenia.
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Affiliation(s)
- Akihiro Shiina
- Department of Child Psychiatry, Chiba University Hospital, Chiba, Japan.,Division of Law and Psychiatry, Chiba University Center for Forensic Mental Health, Chiba, Japan
| | - Nobuhisa Kanahara
- Division of Medical Treatment and Rehabilitation, Chiba University Center for Forensic Mental Health, Chiba, Japan
| | - Tsuyoshi Sasaki
- Department of Child Psychiatry, Chiba University Hospital, Chiba, Japan
| | - Yasunori Oda
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Tasuku Hashimoto
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Tadashi Hasegawa
- Department of Psychiatry, Chiba University Hospital, Chiba, Japan
| | | | - Masaomi Iyo
- Department of Child Psychiatry, Chiba University Hospital, Chiba, Japan.,Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan.,Department of Psychiatry, Chiba University Hospital, Chiba, Japan.,Chiba University Center for Forensic Mental Health, 8Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, Chiba, Japan
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25
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Imai A, Hayashi N, Shiina A, Sakikawa N, Igarashi Y. Factors associated with violence among Japanese patients with schizophrenia prior to psychiatric emergency hospitalization: a case-controlled study. Schizophr Res 2014; 160:27-32. [PMID: 25458570 DOI: 10.1016/j.schres.2014.10.016] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 09/09/2014] [Accepted: 10/07/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Numerous studies have examined a wide range of risk factors associated with violence among patients with schizophrenia. However, risk factors linked to different socio-cultural backgrounds remain unclear. OBJECTIVE The objectives were to investigate factors associated with violence among Japanese patients with schizophrenia prior to emergency hospitalizations and to compare them with factors found in studies on other populations. METHODS We recruited 420 Japanese patients with schizophrenia who had committed violent acts immediately prior to emergency admission to a psychiatric hospital in Tokyo, during the period 1986 to 2005. Cases were compared with controls (non violent hospitalized patients with schizophrenia) matched for gender, age and admission year. All medical records were reviewed retrospectively. Inter-rater reliability tests of assessment were performed. Conditional logistic regression analysis was used to identify factors associated with violence. RESULTS The symptoms of gross excitement, prior violence, auditory hallucinations, systematization of delusions, incoherence of speech, delusions of reference, TCO symptoms, living with others and long duration of illness were found to be associated with violence. In contrast, antisocial traits such as substance abuse and antisocial episodes were not recognized as significant violence-associated factors. CONCLUSION Violence among Japanese patients with schizophrenia was strongly associated with elements of schizophrenia itself, rather than antisocial traits. This study highlighted associated factors for violence among Japanese patients with schizophrenia which differ distinctly from associated factors in other countries. This result demonstrates that future studies assessing the risk of violence among patients with schizophrenia need to consider cultural and racial differences in cohorts.
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Affiliation(s)
- Atsushi Imai
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan; Division of Law and Psychiatry, Center for Forensic Mental Health, Chiba University, Chiba, Japan.
| | - Naoki Hayashi
- Department of Psychiatry, Teikyo University School of Medicine, Tokyo Japan
| | - Akihiro Shiina
- Department of Psychiatry, Chiba University Hospital, Chiba, Japan
| | - Noriko Sakikawa
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan
| | - Yoshito Igarashi
- Division of Law and Psychiatry, Center for Forensic Mental Health, Chiba University, Chiba, Japan
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Kimura H, Kanahara N, Komatsu N, Ishige M, Muneoka K, Yoshimura M, Yamanaka H, Suzuki T, Komatsu H, Sasaki T, Hashimoto T, Hasegawa T, Shiina A, Ishikawa M, Sekine Y, Shiraishi T, Watanabe H, Shimizu E, Hashimoto K, Iyo M. A prospective comparative study of risperidone long-acting injectable for treatment-resistant schizophrenia with dopamine supersensitivity psychosis. Schizophr Res 2014; 155:52-8. [PMID: 24667073 DOI: 10.1016/j.schres.2014.02.022] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Revised: 01/30/2014] [Accepted: 02/23/2014] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Dopamine supersensitivity psychosis (DSP) is considered to be one cause of treatment-resistant schizophrenia (TRS). The authors investigated the efficacy of risperidone long-acting injections (RLAI) in patients with TRS and DSP. METHOD This is a multicenter, prospective, 12-month follow-up, observational study that included unstable and severe TRS patients with and without DSP. 115 patients with TRS were recruited and divided into two groups according to the presence or absence of DSP which was judged on the basis of the clinical courses and neurological examinations. RLAI was administered adjunctively once every 2weeks along with oral antipsychotics. We observed changes in scores for the Brief Psychiatric Rating Scales (BPRS), Clinical Global Impression-Severity of Illness (CGI-S), Global Assessment of Functioning Scale (GAF), and Extrapyramidal Symptom Rating Scale (ESRS) during the study. Of the assessed 94 patients, 61 and 33 were categorized into the DSP and NonDSP groups, respectively. RESULTS While baseline BPRS total scores, CGI-S scores and GAF scores did not differ, the ESRS score was significantly higher in the DSP group compared with the NonDSP group. Treatment significantly reduced BPRS total scores and CGI-S scores, and increased GAF scores in both groups, but the magnitudes of change were significantly greater in the DSP group relative to the NonDSP group. ESRS scores were also reduced in the DSP group. Responder rates (≥20% reduction in BPRS total score) were 62.3% in the DSP group and 21.2% in the NonDSP group. CONCLUSIONS It is suggested that DSP contributes to the etiology of TRS. Atypical antipsychotic drugs in long-acting forms, such as RLAI, can provide beneficial effects for patients with DSP. CLINICAL TRIALS REGISTRATION UMIN (UMIN000008487).
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Affiliation(s)
- Hiroshi Kimura
- Department of Psychiatry, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuou-ku, Chiba-shi, Chiba 260-8670, Japan
| | - Nobuhisa Kanahara
- Department of Psychiatry, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuou-ku, Chiba-shi, Chiba 260-8670, Japan; Division of Medical Treatment and Rehabilitation, Center for Forensic Mental Health, Chiba University, 1-8-1 Inohana, Chuou-ku, Chiba-shi, Chiba 260-8670, Japan.
| | - Naoya Komatsu
- Department of Psychiatry, Dowa-kai Chiba Hospital, 2-508 Hasama-cho, Funabashi-shi, Chiba 274-0822, Japan
| | - Minoru Ishige
- Department of Psychiatry, Satsuki-kai Sodegaura-satsukidai Hospital, 5-21 Nagaura-ekimae, Sodegaura-shi, Chiba 299-0246, Japan
| | - Katsumasa Muneoka
- Department of Psychiatry, Gakuji-kai Kimura Hospital, 6-19 Higashihon-machi, Chuou-ku, Chiba-shi, Chiba 260-0004, Japan
| | - Masayuki Yoshimura
- Department of Psychiatry, Doujin-kai Kisaradzu Hospital, 2-3-1 Iwane, Kisaradzu-shi, Chiba 292-0061, Japan
| | - Hiroshi Yamanaka
- Department of Psychiatry, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuou-ku, Chiba-shi, Chiba 260-8670, Japan; Department of Psychiatry, Chiba Psychiatric Medical Center, 5 Toyosuna, Mihama-ku, Chiba-shi, Chiba 261-0024, Japan
| | - Tomotaka Suzuki
- Department of Psychiatry, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuou-ku, Chiba-shi, Chiba 260-8670, Japan; Department of Psychiatry, Koutoku-kai Sato Hospital, 948-1 Kunugizuka, Nanyo-shi, Yamagata 999-2221, Japan
| | - Hideki Komatsu
- Department of Psychiatry, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuou-ku, Chiba-shi, Chiba 260-8670, Japan; Department of Psychiatry, Choshi-Kokoro Clinic, 1-48-8 Shinsei-cho, Choshi-shi, Chiba 288-0056, Japan
| | - Tsuyoshi Sasaki
- Department of Psychiatry, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuou-ku, Chiba-shi, Chiba 260-8670, Japan
| | - Tasuku Hashimoto
- Department of Psychiatry, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuou-ku, Chiba-shi, Chiba 260-8670, Japan
| | - Tadashi Hasegawa
- Department of Psychiatry, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuou-ku, Chiba-shi, Chiba 260-8670, Japan
| | - Akihiro Shiina
- Department of Psychiatry, Chiba University Hospital, 1-8-1 Inohana, Chuou-ku, Chiba-shi, Chiba 260-8670, Japan
| | - Masatomo Ishikawa
- Department of Psychiatry, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuou-ku, Chiba-shi, Chiba 260-8670, Japan
| | - Yoshimoto Sekine
- Division of Medical Treatment and Rehabilitation, Center for Forensic Mental Health, Chiba University, 1-8-1 Inohana, Chuou-ku, Chiba-shi, Chiba 260-8670, Japan; Department of Psychiatry, Choshi-Kokoro Clinic, 1-48-8 Shinsei-cho, Choshi-shi, Chiba 288-0056, Japan
| | - Tetsuya Shiraishi
- Department of Psychiatry, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuou-ku, Chiba-shi, Chiba 260-8670, Japan
| | - Hiroyuki Watanabe
- Department of Psychiatry, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuou-ku, Chiba-shi, Chiba 260-8670, Japan; Department of Psychiatry, Asahi Hosipital, I-1326, Asahi-shi, Chiba 289-2511, Japan
| | - Eiji Shimizu
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuou-ku, Chiba-shi, Chiba 260-8670, Japan
| | - Kenji Hashimoto
- Division of Clinical Neuroscience, Center for Forensic Mental Health, Chiba University, 1-8-1 Inohana, Chuou-ku, Chiba-shi, Chiba 260-8670, Japan
| | - Masaomi Iyo
- Department of Psychiatry, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuou-ku, Chiba-shi, Chiba 260-8670, Japan
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Shiina A, Iyo M, Yoshizumi A, Hirabayashi N. Recognition of change in the reform of forensic mental health by clinical practitioners: a questionnaire survey in Japan. Ann Gen Psychiatry 2014; 13:9. [PMID: 24678884 PMCID: PMC3974740 DOI: 10.1186/1744-859x-13-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Accepted: 03/24/2014] [Indexed: 11/12/2022] Open
Abstract
In Japan, new legislation regarding forensic mental health, namely, the Act on Medical Care and Treatment for Persons Who Have Caused Serious Cases under the Condition of Insanity (Medical Treatment and Supervision Act (MTS Act)) was enforced in 2005, although community mental health care remains largely unchanged. We surveyed local clinical psychiatrists by questionnaire to gather information on the influence of the MTS Act on clinical mental health practice. We sent a paper questionnaire to almost all the psychiatrists in the Chiba prefecture, 56% of whom (N = 306) responded. The participants felt that the MTS Act had minimal direct impact on community mental health care. However, some relatively new schemes such as a multiple disciplinary team approach or supervised outpatient care are given more attention than before. These results suggest that this new forensic mental health legislation may assist in the spread of new paradigms into clinical practice.
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Affiliation(s)
- Akihiro Shiina
- Department of Psychiatry, Chiba University Hospital, Chiba 260-0877, Japan.
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28
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Every-Palmer S, Brink J, Chern TP, Choi WK, Hern-Yee JG, Green B, Heffernan E, Johnson SB, Kachaeva M, Shiina A, Walker D, Wu K, Wang X, Mellsop G. Review of psychiatric services to mentally disordered offenders around the Pacific Rim. Asia Pac Psychiatry 2014; 6:1-17. [PMID: 24249353 DOI: 10.1111/appy.12109] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Accepted: 10/13/2013] [Indexed: 12/17/2022]
Abstract
This article was commissioned to collate and review forensic psychiatric services provided in a number of key Pacific Rim locations in the hope that it will assist in future dialogue about service development. The Board of the Pacific Rim College of Psychiatrists identified experts in forensic psychiatry from Australia, Canada, China, Hong Kong, Japan, Russia, Singapore, Taiwan, and the US. Each contributor provided an account of issues in their jurisdiction, including mental health services to mentally disordered offenders in prison, competence or fitness to stand trial, legal insanity as a defense at trial, diminished responsibility, and special forensic services available, including forensic hospitals and community forensic mental health services. Responses have been collated and are presented topic by topic and country by country within the body of this review. The availability of mental health screening and psychiatric in-reach or forensic liaison services within prisons differed considerably between countries, as did provisioning of community forensic mental health and rehabilitation services. Diversion of mentally disordered offenders to forensic, state, or hybrid hospitals was common. Legal constructs of criminal responsibility (insanity defense) and fitness to stand trial ("disability") are almost universally recognized, although variably used. Disparities between unmet needs and resourcing available were common themes. The legislative differences between contributing countries with respect to the mental health law and criminal law relating to mentally disordered offenders are relatively subtle. The major differences lie in operationalizing and resourcing forensic services.
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Sasaki T, Hashimoto K, Tachibana M, Kurata T, Okawada K, Ishikawa M, Kimura H, Komatsu H, Ishikawa M, Hasegawa T, Shiina A, Hashimoto T, Kanahara N, Shiraishi T, Iyo M. Tipepidine in children with attention deficit/hyperactivity disorder: a 4-week, open-label, preliminary study. Neuropsychiatr Dis Treat 2014; 10:147-51. [PMID: 24493927 PMCID: PMC3908907 DOI: 10.2147/ndt.s58480] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Tipepidine (3-[di-2-thienylmethylene]-1-methylpiperidine) has been used solely as a nonnarcotic antitussive in Japan since 1959. The safety of tipepidine in children and adults has already been established. It is reported that tipepidine inhibits G-protein-coupled inwardly rectifying potassium (GIRK)-channel currents. The inhibition of GIRK channels by tipepidine is expected to modulate the level of monoamines in the brain. We put forward the hypothesis that tipepidine can improve attention deficit/hyperactivity disorder (ADHD) symptoms by modulating monoaminergic neurotransmission through the inhibition of GIRK channels. The purpose of this open-label trial was to confirm whether treatment with tipepidine can improve symptoms in pediatric patients with ADHD. SUBJECTS AND METHODS This was a 4-week, open-label, proof-of-efficacy pilot study for pediatric subjects with ADHD. Ten pediatric ADHD subjects (70% male; mean age, 9.9 years; combined [inattentive and hyperactive/impulsive] subtype, n=7; inattentive subtype, n=3; hyperimpulsive subtype, n=0) received tipepidine hibenzate taken orally at 30 mg/day for 4 weeks. All subjects were assessed using the ADHD Rating Scale IV (ADHD-RS), Japanese version, and the Das-Naglieri Cognitive Assessment System (DN-CAS), Japanese version. RESULTS A comparison of baseline scores and 4-week end-point scores showed that all the ADHD-RS scores (total scores, hyperimpulsive subscores, and inattentive subscores) improved significantly (P<0.001). Furthermore, a comparison of baseline DN-CAS total scores and 4-week end-point scores showed a mild trend of improvement (P=0.093). Tipepidine was well tolerated, with no patients discontinuing medication because of side effects. CONCLUSION Our pilot study suggests that tipepidine therapy may prove to be an effective alternative treatment for pediatric patients with ADHD. Nonetheless, more detailed randomized, double-blind trials are needed to confirm tipepidine's efficacy.
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Affiliation(s)
- Tsuyoshi Sasaki
- Department of Child Psychiatry, Chiba University Hospital, Chiba, Japan ; Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Kenji Hashimoto
- Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, Chiba, Japan
| | - Masumi Tachibana
- Department of Child Psychiatry, Chiba University Hospital, Chiba, Japan
| | - Tsutomu Kurata
- Department of Child Psychiatry, Chiba University Hospital, Chiba, Japan
| | - Keiko Okawada
- Department of Child Psychiatry, Chiba University Hospital, Chiba, Japan
| | - Maki Ishikawa
- Department of Child Psychiatry, Chiba University Hospital, Chiba, Japan
| | - Hiroshi Kimura
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Hideki Komatsu
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Masatomo Ishikawa
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Tadashi Hasegawa
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Akihiro Shiina
- Department of Child Psychiatry, Chiba University Hospital, Chiba, Japan
| | - Tasuku Hashimoto
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Nobuhisa Kanahara
- Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, Chiba, Japan
| | - Tetsuya Shiraishi
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Masaomi Iyo
- Department of Child Psychiatry, Chiba University Hospital, Chiba, Japan ; Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan ; Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, Chiba, Japan
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30
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Sasaki T, Hashimoto K, Tachibana M, Kurata T, Kimura H, Komatsu H, Ishikawa M, Hasegawa T, Shiina A, Hashimoto T, Kanahara N, Shiraishi T, Iyo M. Tipepidine in adolescent patients with depression: a 4 week, open-label, preliminary study. Neuropsychiatr Dis Treat 2014; 10:719-22. [PMID: 24833905 PMCID: PMC4015794 DOI: 10.2147/ndt.s63075] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Tsuyoshi Sasaki
- Department of Child Psychiatry, Chiba University Hospital, Chiba, Japan ; Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Kenji Hashimoto
- Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, Chiba, Japan
| | - Masumi Tachibana
- Department of Child Psychiatry, Chiba University Hospital, Chiba, Japan
| | - Tsutomu Kurata
- Department of Child Psychiatry, Chiba University Hospital, Chiba, Japan
| | - Hiroshi Kimura
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Hideki Komatsu
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Masatomo Ishikawa
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Tadashi Hasegawa
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Akihiro Shiina
- Department of Child Psychiatry, Chiba University Hospital, Chiba, Japan
| | - Tasuku Hashimoto
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Nobuhisa Kanahara
- Division of Medical Treatment and Rehabilitation, Chiba University Center for Forensic Mental Health, Inohana, Chiba, Japan
| | - Tetsuya Shiraishi
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Masaomi Iyo
- Department of Child Psychiatry, Chiba University Hospital, Chiba, Japan ; Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan ; Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, Chiba, Japan ; Division of Medical Treatment and Rehabilitation, Chiba University Center for Forensic Mental Health, Inohana, Chiba, Japan
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31
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Okita K, Shiina A, Nakazato M, Iyo M. Tandospirone, a 5-HT1A partial agonist is effective in treating anorexia nervosa: a case series. Ann Gen Psychiatry 2013; 12:7. [PMID: 23497393 PMCID: PMC3606595 DOI: 10.1186/1744-859x-12-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Accepted: 03/04/2013] [Indexed: 12/24/2022] Open
Abstract
This case report details the therapeutic effects of tandospirone on two patients with anorexia nervosa, one with the restricting subtype (ANR), and another with the binge-eating/purging subtype (ANBP). A 22-year-old female patient with ANR and a 23-year-old female patient with ANBP were treated successfully with the 5-HT1A partial agonist tandospirone. After treatment, not only did both patients gain weight, they also showed improved scores on the Eating Disorder Examination Questionnaire. In addition, a 6-month follow-up showed maintenance of these effects. In this disorder, tandospirone may be an effective drug for long-term use with good patient compliance.
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Affiliation(s)
- Kyoji Okita
- Department of Psychiatry, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8677, Japan.
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Niitsu T, Fujisaki M, Shiina A, Yoshida T, Hasegawa T, Kanahara N, Hashimoto T, Shiraishi T, Fukami G, Nakazato M, Shirayama Y, Hashimoto K, Iyo M. A randomized, double-blind, placebo-controlled trial of fluvoxamine in patients with schizophrenia: a preliminary study. J Clin Psychopharmacol 2012; 32:593-601. [PMID: 22926591 DOI: 10.1097/jcp.0b013e3182664cfc] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Cognitive impairments in schizophrenia are associated with suboptimal psychosocial performance. Several lines of evidence have suggested that endoplasmic reticulum protein sigma-1 receptors were involved in cognitive impairments in patients with schizophrenia and that the sigma-1 receptor agonist fluvoxamine was effective in treating cognitive impairments in animal models of schizophrenia and in some patients with schizophrenia. A randomized, double-blind, placebo-controlled, parallel trial of fluvoxamine adjunctive therapy in patients with schizophrenia was performed. A total of 48 patients with chronic schizophrenia were enrolled. Subjects were randomly assigned to an 8-week administration of add-on fluvoxamine (n = 24, titrated up to 150 mg/d) or placebo (n =24) in a total 12-week double-blind trial. The primary outcome measure was the Cambridge Neuropsychological Test Automated Battery (CANTAB), assessing visual memory, working memory, attention, and executive function. The secondary outcome measures were the Positive and Negative Syndrome Scale, the Scale for the Assessment of Negative Symptoms, the Quality of Life Scale, and the Montgomery-Åsberg Depression Rating Scale. Fluvoxamine was well tolerated. No significant time × group interaction effects were observed in the scores of the CANTAB, Positive and Negative Syndrome Scale, Scale for the Assessment of Negative Symptoms, Quality of Life Scale, or the Montgomery-Åsberg Depression Rating Scale. However, in secondary analyses, the change from baseline to end point on the Spatial Working Memory strategy score (executive function) of CANTAB improved in the fluvoxamine group. This study suggests no major benefit of fluvoxamine adjunctive therapy to improve cognitive impairments in patients with schizophrenia. Nevertheless, a further study using a large sample size will be needed to confirm the secondary analyses findings.
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Affiliation(s)
- Tomihisa Niitsu
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
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Yoshida T, Ishikawa M, Niitsu T, Nakazato M, Watanabe H, Shiraishi T, Shiina A, Hashimoto T, Kanahara N, Hasegawa T, Enohara M, Kimura A, Iyo M, Hashimoto K. Decreased serum levels of mature brain-derived neurotrophic factor (BDNF), but not its precursor proBDNF, in patients with major depressive disorder. PLoS One 2012; 7:e42676. [PMID: 22880079 PMCID: PMC3411809 DOI: 10.1371/journal.pone.0042676] [Citation(s) in RCA: 197] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Accepted: 07/10/2012] [Indexed: 12/25/2022] Open
Abstract
Background Meta-analyses have identified serum levels of brain-derived neurotrophic factor (BDNF) as a potential biomarker for major depressive disorder (MDD). However, at the time, commercially available human ELISA kits are unable to distinguish between proBDNF (precursor of BDNF) and mature BDNF because of limited BDNF antibody specificity. In this study, we examined whether serum levels of proBDNF, mature BDNF, and matrix metalloproteinase-9 (MMP-9), which converts proBDNF to mature BDNF, are altered in patients with MDD. Methodology/Principal Findings Sixty-nine patients with MDD and 78 age- and gender-matched healthy subjects were enrolled. Patients were evaluated using 17 items on the Structured Interview Guide for the Hamilton Depression Rating Scale. Cognitive impairment was evaluated using the CogState battery. Serum levels of proBDNF, mature BDNF, and MMP-9 were measured using ELISA kits. Serum levels of mature BDNF in patients with MDD were significantly lower than those of normal controls. In contrast, there was no difference in the serum levels of proBDNF and MMP-9 between patients and normal controls. While neither proBDNF nor mature BDNF serum levels was associated with clinical variables, there were significant correlations between MMP-9 serum levels and the severity of depression, quality of life scores, and social function scores in patients. Conclusions/Significance These findings suggest that mature BDNF may serve as a biomarker for MDD, and that MMP-9 may play a role in the pathophysiology of MDD. Further studies using larger sample sizes will be needed to investigate these results.
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Affiliation(s)
- Taisuke Yoshida
- Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, Chiba, Japan
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Masatomo Ishikawa
- Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, Chiba, Japan
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Tomihisa Niitsu
- Research Center for Child Mental Development, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Michiko Nakazato
- Research Center for Child Mental Development, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Hiroyuki Watanabe
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Tetsuya Shiraishi
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Akihiro Shiina
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Tasuku Hashimoto
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Nobuhisa Kanahara
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Tadashi Hasegawa
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Masayo Enohara
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Atsushi Kimura
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Masaomi Iyo
- Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, Chiba, Japan
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Kenji Hashimoto
- Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, Chiba, Japan
- * E-mail:
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34
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Arai E, Arai M, Uchiyama T, Higuchi Y, Aoyagi K, Yamanaka Y, Yamamoto T, Nagano O, Shiina A, Maruoka D, Matsumura T, Nakagawa T, Katsuno T, Imazeki F, Saeki N, Kuwabara S, Yokosuka O. Subthalamic deep brain stimulation can improve gastric emptying in Parkinson's disease. Brain 2012; 135:1478-85. [PMID: 22522940 DOI: 10.1093/brain/aws086] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
It is established that deep brain stimulation of the subthalamic nucleus improves motor function in advanced Parkinson's disease, but its effects on autonomic function remain to be elucidated. The present study was undertaken to investigate the effects of subthalamic deep brain stimulation on gastric emptying. A total of 16 patients with Parkinson's disease who underwent bilateral subthalamic deep brain stimulation were enrolled. Gastric emptying was expressed as the peak time of (13)CO(2) excretion (T(max)) in the (13)C-acetate breath test and was assessed in patients with and without administration of 100-150 mg levodopa/decarboxylase inhibitor before surgery, and with and without subthalamic deep brain stimulation at 3 months post-surgery. The pattern of (13)CO(2) excretion curve was analysed. To evaluate potential factors related to the effect of subthalamic deep brain stimulation on gastric emptying, we also examined the association between gastric emptying, clinical characteristics, the equivalent dose of levodopa and serum ghrelin levels. The peak time of (13)CO(2) excretion (T(max)) values for gastric emptying in patients without and with levodopa/decarboxylase inhibitor treatment were 45.6 ± 22.7 min and 42.5 ± 13.6 min, respectively (P = not significant), thus demonstrating levodopa resistance. The peak time of (13)CO(2) excretion (T(max)) values without and with subthalamic deep brain stimulation after surgery were 44.0 ± 17.5 min and 30.0 ± 12.5 min (P < 0.001), respectively, which showed that subthalamic deep brain stimulation was effective. Simultaneously, the pattern of the (13)CO(2) excretion curve was also significantly improved relative to surgery with no stimulation (P = 0.002), although the difference with and without levodopa/decarboxylase inhibitor was not significant. The difference in peak time of (13)CO(2) excretion (T(max)) values without levodopa/decarboxylase inhibitor before surgery and without levodopa/decarboxylase inhibitor and subthalamic deep brain stimulation after surgery was not significant, although motor dysfunction improved and the levodopa equivalent dose decreased after surgery. There was little association between changes in ghrelin levels (Δghrelin) and changes in T(max) values (ΔT(max)) in the subthalamic deep brain stimulation trial after surgery (r = -0.20), and no association between changes in other characteristics and ΔT(max) post-surgery in the subthalamic deep brain stimulation trial. These results showed that levodopa/decarboxylase inhibitor did not influence gastric emptying and that subthalamic deep brain stimulation can improve the dysfunction in patients with Parkinson's disease possibly by altering the neural system that controls gastrointestinal function after subthalamic deep brain stimulation. This is the first report to show the effectiveness of subthalamic deep brain stimulation on gastrointestinal dysfunction as a non-motor symptom in Parkinson's disease.
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Affiliation(s)
- Eiji Arai
- Department of Medicine and Clinical Oncology (K1), Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chiba-City, Japan.
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35
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Niitsu T, Shirayama Y, Matsuzawa D, Hasegawa T, Kanahara N, Hashimoto T, Shiraishi T, Shiina A, Fukami G, Fujisaki M, Watanabe H, Nakazato M, Asano M, Kimura S, Hashimoto K, Iyo M. Associations of serum brain-derived neurotrophic factor with cognitive impairments and negative symptoms in schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2011; 35:1836-40. [PMID: 21930178 DOI: 10.1016/j.pnpbp.2011.09.004] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2011] [Revised: 08/25/2011] [Accepted: 09/05/2011] [Indexed: 11/29/2022]
Abstract
Brain-derived neurotrophic factor (BDNF) may be involved in the pathophysiology of schizophrenia. The aim of this study was to examine the associations of serum BDNF levels with the cognition and clinical characteristics in patients with schizophrenia. Sixty-three patients with schizophrenia and 52 age- and sex-matched healthy controls were examined with neuropsychological tests. Serum BDNF levels were determined by enzyme-linked immunosorbent assay (ELISA). There were no significant differences in serum BDNF levels between normal controls and patients with schizophrenia. Serum BDNF levels of normal controls showed negative correlations with verbal working memory, but this was not the case with schizophrenic patients. Meanwhile, serum BDNF levels of schizophrenic patients showed positive correlations with the scores of the Scale for the Assessment of Negative Symptoms (SANS) and the Information subtest scores of Wechsler Adult Intelligence Scale Revised (WAIS-R). Serum BDNF levels are related with the impairment of verbal working memory and negative symptoms in patients with schizophrenia.
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Affiliation(s)
- Tomihisa Niitsu
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
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36
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Shiina A, Fujisaki M, Nagata T, Oda Y, Suzuki M, Yoshizawa M, Iyo M, Igarashi Y. Expert consensus on hospitalization for assessment: a survey in Japan for a new forensic mental health system. Ann Gen Psychiatry 2011; 10:11. [PMID: 21473787 PMCID: PMC3080841 DOI: 10.1186/1744-859x-10-11] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2010] [Accepted: 04/08/2011] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND In Japan, hospitalization for the assessment of mentally disordered offenders under the Act on Medical Care and Treatment for the Persons Who Had Caused Serious Cases under the Condition of Insanity (the Medical Treatment and Supervision Act, or the MTS Act) has yet to be standardized. METHODS We conducted a written survey that included a questionnaire regarding hospitalization for assessment; the questionnaire consisted of 335 options with 9 grades of validity for 60 clinical situations. The survey was mailed to 50 Japanese forensic mental health experts, and 42 responses were received. RESULTS An expert consensus was established for 299 of the options. Regarding subjects requiring hospitalization for assessment, no consensus was reached on the indications for electroconvulsive therapy (ECT) or for confronting the offenders regarding their offensive behaviors. CONCLUSIONS The consensus regarding hospitalization for assessment and its associated problems were clarified. The consensus should be widely publicized among practitioners to ensure better management during the hospitalization of mentally disordered offenders for assessment.
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Affiliation(s)
- Akihiro Shiina
- Department of Psychiatry, Chiba University Hospital, Chiba, Japan.,Division of Law and Psychiatry, Chiba University Center for Forensic Mental Health, Chiba, Japan
| | - Mihisa Fujisaki
- Department of Psychiatry, Chiba University Hospital, Chiba, Japan.,Division of Law and Psychiatry, Chiba University Center for Forensic Mental Health, Chiba, Japan
| | - Takako Nagata
- National Center Hospital of Neurology and Psychiatry, Tokyo, Japan
| | | | | | | | - Masaomi Iyo
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yoshito Igarashi
- Division of Law and Psychiatry, Chiba University Center for Forensic Mental Health, Chiba, Japan
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37
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Haraguchi T, Fujisaki M, Shiina A, Igarashi Y, Okamura N, Fukami G, Shiraishi T, Nakazato M, Iyo M. Attitudes of Japanese psychiatrists toward forensic mental health as revealed by a national survey. Psychiatry Clin Neurosci 2011; 65:150-7. [PMID: 21414090 DOI: 10.1111/j.1440-1819.2010.02180.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM In Japan, a new comprehensive forensic mental health service was established and enforced in 2005. However, the shortage of psychiatrists dedicated to this service is a problem. Therefore, we investigated the attitudes of general psychiatrists in Japan toward this field in order to develop measures for dealing with this issue. METHODS Questionnaires were sent to 3205 psychiatric facilities in Japan in January 2007. The questions explored the experience of the respondents with forensic evaluations; the respondents' recognition of, experience with, and attitude toward the Medical Treatment and Supervision (MTS) Act; and attitudes toward forensic mental health in general. RESULTS The data of 1770 respondents were analyzed in this study. Three main findings were obtained: psychiatrists generally had little experience with criminal responsibility evaluations, and a small percentage of psychiatrists tended to have conducted the majority of these evaluations; although psychiatrists widely recognized the enactment of the MTS Act, they were not sufficiently familiar with the details of the MTS Act; and in spite of a reluctance to address forensic mental health issues, the respondents harbored a general interest in these topics. CONCLUSIONS Despite a general interest, general psychiatrists in Japan tend to possess insufficient knowledge of this subspecialty and lack experience in and opportunities to work in this subspecialty. The reluctance of psychiatrists to work in forensic mental health might be partly responsible for this situation. These results suggest that the enrichment of education systems for forensic psychiatry is necessary for the development of forensic psychiatry in Japan.
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Affiliation(s)
- Tadashi Haraguchi
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
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38
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Shiina A, Shirayama Y, Niitsu T, Hashimoto T, Yoshida T, Hasegawa T, Haraguchi T, Kanahara N, Shiraishi T, Fujisaki M, Fukami G, Nakazato M, Iyo M, Hashimoto K. A randomised, double-blind, placebo-controlled trial of tropisetron in patients with schizophrenia. Ann Gen Psychiatry 2010; 9:27. [PMID: 20573264 PMCID: PMC2901366 DOI: 10.1186/1744-859x-9-27] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2010] [Accepted: 06/24/2010] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Cognitive deficits in schizophrenia are associated with psychosocial deficits that are primarily responsible for the poor long-term outcome of this disease. Auditory sensory gating P50 deficits are correlated with neuropsychological deficits in attention, one of the principal cognitive disturbances in schizophrenia. Our studies suggest that the alpha7 nicotinic acetylcholine receptor (alpha7 nAChR) agonist tropisetron might be a potential therapeutic drug for cognitive deficits in schizophrenia. Therefore, it is of particular interest to investigate the effects of tropisetron on the cognitive deficits in patients with schizophrenia. METHODS A randomised, placebo-controlled trial of tropisetron in patients with schizophrenia was performed. A total of 40 patients with chronic schizophrenia who had taken risperidone (2 to 6 mg/day) were enrolled. Subjects were randomly assigned to a fixed titration of tropisetron (n = 20, 10 mg/day) or placebo (n = 20) in an 8-week double-blind trial. Auditory sensory gating P50 deficits and Quality of Life Scale (QLS), Cambridge Neuropsychological Test Automated Battery (CANTAB), and Positive and Negative Syndrome Scale (PANSS) scores were measured. RESULTS In all, 33 patients completed the trial. Tropisetron was well tolerated. Administration of tropisetron, but not placebo, significantly improved auditory sensory gating P50 deficits in non-smoking patients with schizophrenia. The score on the rapid visual information processing (sustained visual attention) task of CANTAB was significantly improved by tropisetron treatment. Total and subscale scores of PANSS were not changed by this trial. QLS scores in the all patients, but not non-smoking patients, were significantly improved by tropisetron trial. CONCLUSIONS This first randomised, double-blind, placebo-controlled trial supports the safety and efficacy of adjunctive tropisetron for treatment of cognitive deficits in schizophrenia.
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Affiliation(s)
- Akihiro Shiina
- Department of Psychiatry, Chiba University Hospital, Chiba, Japan
| | - Yukihiko Shirayama
- Department of Mental Health, Teikyo University Chiba Medical Center, Chiba, Japan
| | - Tomihisa Niitsu
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Tasuku Hashimoto
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Taisuke Yoshida
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Tadashi Hasegawa
- Department of Psychiatry, Chiba University Hospital, Chiba, Japan
| | - Tadashi Haraguchi
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Nobuhisa Kanahara
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Tetsuya Shiraishi
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Mihisa Fujisaki
- Department of Psychiatry, Chiba University Hospital, Chiba, Japan
| | - Goro Fukami
- Department of Psychiatry, Chiba University Hospital, Chiba, Japan
| | - Michiko Nakazato
- Department of Psychiatry, Chiba University Hospital, Chiba, Japan
| | - Masaomi Iyo
- Department of Psychiatry, Chiba University Hospital, Chiba, Japan
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Kenji Hashimoto
- Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, Chiba, Japan
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39
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Iyo M, Shiina A, Matsubara S, Kawada K, Yoshikawa A, Mibe Y, Hata M, Fukushima H, Iwasaki Y, Komiya H, Komiyama T, Haebara Y, Shinoda M, Sasaki H, Hazama K, Satake N. [Understanding of the actual state and optimization of psychiatric care to hasten hospital discharge]. Seishin Shinkeigaku Zasshi 2009; 111:1165-1170. [PMID: 20044830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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40
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Iyo M, Shirayama Y, Watanabe H, Fujisaki M, Miyatake R, Fukami G, Shiina A, Nakazato M, Shiraishi T, Ookami T, Hashimoto K. Fluvoxamine as a sigma-1 receptor agonist improved cognitive impairments in a patient with schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2008; 32:1072-3. [PMID: 18262707 DOI: 10.1016/j.pnpbp.2008.01.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2007] [Revised: 01/08/2008] [Accepted: 01/08/2008] [Indexed: 11/21/2022]
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41
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Shiina A, Nakazato M, Mitsumori M, Koizumi H, Shimizu E, Fujisaki M, Iyo M. An open trial of outpatient group therapy for bulimic disorders: combination program of cognitive behavioral therapy with assertive training and self-esteem enhancement. Psychiatry Clin Neurosci 2005; 59:690-6. [PMID: 16401245 DOI: 10.1111/j.1440-1819.2005.01438.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The purposes of this study were to examine the therapeutic efficacy of combined group cognitive behavioral therapy (CGCBT) and to explore the characteristics of the patients who failed to complete it. Our group cognitive behavioral therapy combined with assertiveness training for alexithymia and self-esteem enhancement therapy were attended over a 10-week period. Twenty-five participants were enrolled in the study. The clinical symptoms were assessed before and after treatment, using rating scales including the Eating Disorder Inventory-2, the Bulimic Investigatory Test, Edinburgh, the Toronto Alexithymia Scale, the Rosenberg Self-Esteem Scale, and Global Assessment of Functioning. Sixteen participants (64%) completed the CGCBT program. Completion of the CGCBT resulted in significant improvements in reducing binge-eating behavior and improving social functioning. Eight patients (32%) significantly improved using the Clinical Global Impression Change (CGI-C). Stepwise logistic regression analysis of the results indicated that a lower age (P=0.04) and psychiatric comorbidity (P=0.06) were predictors of dropout from the CGCBT program. Our CGCBT program is a promising first-line treatment for bulimic outpatients. Lower age and the presence of comorbidity had effects on dropout rates.
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Affiliation(s)
- Akihiro Shiina
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
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42
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Nakazato M, Hashimoto K, Shiina A, Koizumi H, Mitsumoti M, Imai M, Shimizu E, Iyo M. No changes in serum ghrelin levels in female patients with bulimia nervosa. Prog Neuropsychopharmacol Biol Psychiatry 2004; 28:1181-4. [PMID: 15610931 DOI: 10.1016/j.pnpbp.2004.06.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/29/2004] [Indexed: 11/24/2022]
Abstract
It has been reported that fasting plasma ghrelin levels may play a role in the pathophysiology of eating disorders. In this study, the authors examined whether serum levels of ghrelin were altered in the patients with bulimia nervosa (BN). We enrolled 18 female patients with BN, and 21 age-matched female controls for this study. Eating-related psychopathology, depressive symptoms were evaluated by using the Bulimic Investigatory Test, Edinburgh (BITE) and the 17-item Hamilton Depression Rating Scale (HDRS). Serum levels of ghrelin were measured by Ghrelin enzyme immunoassay kit. There were no significant differences in serum ghrelin levels between the patients with BN and normal controls. Furthermore, the authors did not found correlation between serum ghrelin levels and clinical parameters in the patients with BN. Our study suggests that serum ghrelin levels in the patients with BN were indistinguishable from normal controls. Therefore, it is unlikely that ghrelin plays a role in the pathophysiology of BN.
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Affiliation(s)
- Michiko Nakazato
- Department of Psychiatry, Chiba University Graduate School of Medicine, Inohana 1-8-1, Chiba City, Chiba 260-8670, Japan.
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43
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Sakurai A, Oka S, Sekine J, Tanaka H, Nagasawa Y, Numao Y, Masuda S, Hasegawa K, Matsunaga T, Kimura Y, Fukuda K, Nakayama N, Matsumoto K, Akabane T, Shiina A, Kobayashi K, Yaginuma T, Hosoda S. Changes of ischemic heart disease in Utsunomiya, Japan, over 10 years: a survey of primary care physicians. Jpn Circ J 1998; 62:675-9. [PMID: 9766706 DOI: 10.1253/jcj.62.675] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
A total of 502 patients presenting in Utsunomiya city and its suburbs during a 10-year period were studied to determine the clinical features of ischemic heart disease and to identify coronary risk factors. The male/female ratio was 1.21, but the ratio decreased with increasing age. The duration of chest pain showed a continuous spectrum between angina and infarction, with a short duration of chest pain not being useful for excluding the diagnosis of myocardial infarction. Hypertension was more common than hypercholesterolemia in this study, although the prevalence of the latter increased slightly with time, along with the shift towards a modernized occupational pattern. Smoking was a more important risk factor for ischemic heart disease in younger individuals than in the elderly, and diabetes mellitus was highly associated with the development of myocardial infarction. The incidence of radiologically diagnosed cardiac hypertrophy and aortic calcification decreased over time. These changes may have resulted in part from improved blood pressure control and the development of new anti-hypertensive and cholesterol-lowering agents.
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Affiliation(s)
- A Sakurai
- Tochigi Ischemic Heart Disease Research Group, Japan
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44
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Mitsuhashi T, Shiina A, Kuroda T, Yamasawa M, Fujita T, Suzuki O, Seino Y, Nishinaga M, Shimada K. Predicting the severity of coronary lesions by the continuous recording method of exercise two-dimensional echocardiography. J Am Soc Echocardiogr 1995; 8:703-9. [PMID: 9417214 DOI: 10.1016/s0894-7317(05)80385-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We estimated the severity of coronary artery disease by the continuous-recording method of exercise two-dimensional echocardiography (Ex.2DE) in 56 patients with angiographically significant coronary artery stenosis ( > 50% diameter narrowing) who had undergone both Ex.2DE and coronary angiography. Patients were divided into two groups on the basis of findings of coronary angiography: group 1 had 50% to 89% stenosis (n = 24) and group 2 had 90% or greater stenosis (n = 32). The sensitivity and specificity of Ex.2DE for the detection of ischemic segments were 82% and 88%, respectively in the overall patient population. The sensitivity was 67% in group 1 and 94% in group 2. Hyperkinesis occurred at the beginning of exercise in 21 (88%) of 24 patients in group 1 and 15 (47%) of 32 patients in group 2 (p < 0.05). Our findings demonstrated that patients who did not show hyperkinesis at the beginning of exercise had more severe coronary artery disease. Careful observation of serial wall motion during exercise by the continuous-recording method may provide important information about myocardial ischemia.
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Affiliation(s)
- T Mitsuhashi
- Department of Cardiology, Jichi Medical School, Tochigi-Ken, Japan
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45
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Hojo Y, Kuroda T, Yamasawa M, Miyashita H, Seino Y, Mitsuhashi T, Sekiguchi H, Shiina A, Shimada K. Polysplenia accompanied by major cardiovascular anomalies with prolonged survival. Intern Med 1994; 33:357-9. [PMID: 7919623 DOI: 10.2169/internalmedicine.33.357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
A 52-year-old female with polysplenia accompanied by major cardiovascular anomalies (a ventricular septal defect, atrial septal defect, persistent left superior vena cava, absent inferior vena cava with a hemiazygos connection and visceral heterotaxia) is reported. She underwent successful surgical treatment and showed prolonged survival.
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Affiliation(s)
- Y Hojo
- Department of Cardiology, Jichi Medical School, Tochigi
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46
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Masuyama J, Yoshio T, Takeda A, Shiina A, Kano S. [Long-term retrospective study of patients with connective tissue diseases accompanied by pulmonary hypertension]. Ryumachi 1993; 33:29-36. [PMID: 8493582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
To determine clinical and serological features that are related with the prognosis of connective tissue diseases with pulmonary hypertension (PH), we studied a long-term prognosis of 14 patients (4 SLE, 1 PSS, 3 MCTD, 2 primary Sjögren's syndrome, and 5 OL) accompanied by PH. The patients were divided into three groups; group A (4 cases) that is alive for 5-12 years until present, group B (6 cases) in which PH was the main cause of death, and group C (4 cases) was dead of pulmonary fibrosis and pericardial tamponade. No significant difference was observed in background connective tissue diseases among the three groups. However, the mean ages at the onset of PH was obviously younger in group B (25.7 yrs.) than both in group A (38.3 yrs.) and in group C (42.0 yrs.) (group A vs group B, p < 0.02, and group B vs group C, p < 0.05). Sudden death occurred in 5 of the 6 in group B, whereas it was not observed either in group A or in group C. Also, the interval between onset of PH and death was shorter in group B (1.3 yrs.) than in group C (3.5 yrs.). The incidence of digital necrosis and pericardial effusion was higher in group B (83% and 83%, respectively) than both in group A (0% and 25%, respectively) and in group C (25% and 40%, respectively). A large amount of pericardial effusion was detected in 4 of 5 cases in group B. The incidence of digital necrosis between group A and group B was significantly different (p < 0.05, Fisher's test).(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- J Masuyama
- Division of Clinical Immunology, Jichi Medical School, Tochigi
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47
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Kuroda T, Shiina A, Tsuruda K, Yamasawa M, Mitsuhashi T, Tsuruya Y, Seino Y, Fujita T, Suzuki O, Natsume T. Assessment of hypertensive heart by 2-dimensional echocardiography in mass screening. Jpn Circ J 1991; 55:365-76. [PMID: 1828509 DOI: 10.1253/jcj.55.365] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Two-dimensional echocardiography (2DE) was used in the mass screening of 3,017 participants (1,195 males, 1,822 females, mean age 59) living in 13 areas in Japan. The 2DE findings of left ventricular hypertrophy (LVH) and LV function were compared with the presence and severity of hypertension (Ht). Out of 1,100 patients who had an evident history of Ht above 160/95 mmHg (Ht group), 298 patients (27.4%) were complicated by LVH. In contrast, LVH was also recognized in 60 (11.2%) of 535 borderline Ht cases and in 87 (6.3%) of 1,382 normotension cases. LVH cases in the Ht group were divided into 3 groups: mild (220: 73.8%), moderate (63: 21.2) and severe (15: 5.0). Asymmetric septal hypertrophy (ASH) was recognized in 111 patients (37.2%) of the 298 LVH cases. The prevalence of ASH in these LVH patients was higher according to the severity of the LVH: mild LVH = 31%, moderate LVH = 51% and severe LVH = 67%. The prevalence of LVH was higher in males than in females. This was especially apparent in the moderate to severe LVH groups and also noted to be higher according to the increase of mean blood pressure. The prevalence of mild to moderate LVH was significantly higher in the poorly-controlled group than in the well-controlled group. In contrast, no significant difference in prevalence of severe LVH was noted between the well-controlled and poorly-controlled groups. The prevalence of LV dysfunction was significantly greater in moderate or severe LVH groups than in non or mild LVH groups. It tended to be higher in the poorly-controlled group compared with the well-controlled group. The regression of LVH was frequently detected in the well-controlled group by the follow-up study. We conclude that 2DE observation of LV performance in mass screening will be extremely valuable in the long term follow-up of Ht patients.
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Affiliation(s)
- T Kuroda
- Department of Cardiology, Jichi Medical School, Japan
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48
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Yamasawa M, Shiina A, Yaginuma T. [Doppler echocardiographic evaluation of regurgitation of valves]. Kokyu To Junkan 1990; 38:133-9. [PMID: 2320794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- M Yamasawa
- Department of Cardiology, Jichi Medical School
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49
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Kuroda T, Shiina A, Tsuruda K, Fujita T, Yamasawa M, Mitsuhashi T, Suzuki O, Yaginuma T, Hosoda S. [Mass screening of cardiovascular disorders by two-dimensional echocardiography]. J Cardiol 1989; 19:933-43. [PMID: 2534926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
We used two-dimensional echocardiography (2-D echo) for the mass screening of 2,673 subjects for cardiovascular disorders (1,032 men, 1,641 women, aged 23-95 years with a mean age of 59), who lived in 12 rural areas in Japan. In 1,665 of the 2,673 subjects (62.3%), cardiac abnormalities were recognized. Three major abnormalities included sclerotic aortic (33.0%) and mitral valves (21.8%), and left ventricular (LV) hypertrophy (15.9%). Apparent pericardial effusion (54 cases), mitral valve prolapse (44 cases), and dilated cardiomyopathy (4 cases) were incidentally found in this study. Prevalence of the abnormalities insidiously increased with age (below 49 years: 39%, and above 80 years: 97%), and this was apparently higher in men than in women. The abnormal findings which were significantly higher in men were the sclerotic aortic valves, LV hypertrophy and dysfunction, the prevalence of which was particularly high in ages 40-79, but it became nearly equal beyond 80 years of age. These results may indicate a sexual difference in the influence of age on the cardiovascular system. It was concluded that 2-D echo is helpful for primary screening and prevention of cardiovascular disorders.
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Affiliation(s)
- T Kuroda
- Department of Cardiology, Jichi Medical School, Kawachi
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50
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Kuroda T, Shiina A, Suzuki O, Fujita T, Noda T, Tsuchiya M, Yaginuma T, Hosoda S. Prediction of prognosis of patients with idiopathic dilated cardiomyopathy: a comparison of echocardiography with cardiac catheterization. Jpn J Med 1989; 28:180-8. [PMID: 2733242 DOI: 10.2169/internalmedicine1962.28.180] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The prognostic values of indices obtained by M-mode and two-dimensional echocardiography (Echo) and by cardiac catheterization (Cathe) were assessed in patients with idiopathic dilated cardiomyopathy. Fifty-one patients with this disorder (38 males and 13 females) were studied for an average of 4.2 years. Of those, 24 died of cardiac causes during follow-up. The overall 5-year survival rate was 49%. Significant differences between the surviving patients and the patients who died were noted in the following indices measured by Cathe: left ventricular end-diastolic volume (LVEDV), left ventricular end-diastolic pressure (LVEDP), ejection fraction (EF), and the cardiac index (CI). The 5-year survival rate in patients with the following index values measured by Cathe at the initial examination were: LVEDV greater than or equal to 150 ml/M2 - 29%; LVEDP greater than 12 mmHg - 35%, EF less than 30% - 21%, and CI less than 3.0 L/min/M2 - 29%. In contrast, the 5-year survival rate in patients with the following parameter values measured by Echo were: left ventricular end-diastolic dimension greater than or equal to 45 mm/M2 - 16%; left atrial dimension greater than or equal to 25 mm/M2 - 12%; ejection fraction less than 30% - 31%; and a relative wall thickness (a ratio of left ventricular posterior wall thickness to left ventricular end-diastolic dimension) less than or equal to 0.12 - 9%. In assessing the cumulative survival rate, the indices provided by Echo revealed similar values when compared with those obtained by Cathe. The relative wall thickness determined by Echo would be the most reliable parameter for forecasting the 5-year survival rate.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- T Kuroda
- Department of Cardiology, Jichi Medical School, Tochigi, Japan
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