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Kushibiki N, Aiba M, Midorikawa H, Komura K, Sugawara D, Shiratori Y, Kawakami N, Ogawa T, Yaguchi C, Tachikawa H. How do social networks, perception of social isolation, and loneliness affect depressive symptoms among Japanese adults? PLoS One 2024; 19:e0300401. [PMID: 38656929 PMCID: PMC11042698 DOI: 10.1371/journal.pone.0300401] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 02/26/2024] [Indexed: 04/26/2024] Open
Abstract
OBJECTIVE This study aims to elucidate the complex relationship among social isolation, loneliness, and perception of social isolation and its influence on depressive symptoms by evaluating a hypothetical model. This understanding is essential for the formulation of effective intervention strategies. METHODS We conducted an online survey on Japanese adults (N = 3,315) and used the six-item Lubben Social Network Scale to assess the size of their social networks. We employed a single question to gauge their perception of social isolation. Loneliness was assessed using the three-item UCLA Loneliness Scale, and depressive symptoms were examined using the Patient Health Questionnaire-9. Structural equation modeling was employed to test the hypothesized model. RESULTS The final model demonstrated satisfactory fit with data (χ2 (1) = 3.73; not significant; RMSEA = 0.03; CFI = 1.00; TLI = 1.00). The size of social network demonstrated a weak negative path to loneliness and depressive symptoms (β = -.13 to -.04). Notably, a strong positive association existed between perception of social isolation and loneliness (β = .66) and depressive symptoms (β = .27). Additionally, a significant positive relationship was found between loneliness and depressive symptoms (β = .40). Mediation analysis indicated that perception of social isolation and loneliness significantly intensified the relationships between social networks and depressive symptoms. CONCLUSIONS Results indicate that interventions of psychological approaches, such as cognitive-behavioral therapy, are effective in reducing the perception of social isolation and loneliness, which may lead to the prevention of depressive symptoms. Future longitudinal studies are expected to refine and strengthen the proposed model.
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Affiliation(s)
- Natsuho Kushibiki
- Department of Disaster and Community Psychiatry, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Miyuki Aiba
- Faculty of Human Sciences, Toyo Gakuen University, Bunkyo, Tokyo, Japan
| | - Haruhiko Midorikawa
- Department of Psychiatry, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
| | - Kentaro Komura
- Faculty of Humanities and Social Sciences, Hirosaki University, Bunkyo, Hirosaki, Aomori, Japan
| | - Daichi Sugawara
- Faculty of Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Yuki Shiratori
- Department of Psychiatry, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Naoaki Kawakami
- Faculty of Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Takafumi Ogawa
- Ibaraki Prefectural Medical Center of Psychiatry, Asahimachi, Kasama, Ibaraki, Japan
| | - Chie Yaguchi
- Department of Disaster and Community Psychiatry, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Hirokazu Tachikawa
- Department of Disaster and Community Psychiatry, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
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Takahashi A, Tachikawa H, Takayashiki A, Maeno T, Shiratori Y, Matsuzaki A, Arai T. Crisis-management, Anti-stigma, and Mental Health Literacy Program for University Students (CAMPUS): A preliminary evaluation of suicide prevention. F1000Res 2023; 11:498. [PMID: 37576384 PMCID: PMC10422051 DOI: 10.12688/f1000research.111002.2] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/06/2023] [Indexed: 08/15/2023] Open
Abstract
Background: University students have specific risk factors for suicide, necessitating targeted prevention programs. This preliminary study evaluated the efficacy of the Crisis-management, Anti-stigma, Mental health literacy Program for University Students (CAMPUS) for reduction of risk factors and promotion of preventative behaviors. Methods: A total of 136 medical students attended the CAMPUS as a required course at the national university in Japan. The CAMPUS consisted of a lecture and two group sessions covering mental health literacy, self-stigma, and gatekeeper efficacy (e.g., identifying and helping at-risk individuals). The students were asked to role-play based on a movie about gatekeepers and scripts about self-stigma and suicide-related issues. Participants completed questionnaires on suicidal thoughts, depression, help-seeking intentions, self-efficacy as gatekeepers, self-concealment, and self-acceptance. A total of 121 students completed the questionnaires pre- and post-program, and 107 students also responded six months later. Results: Students demonstrated significantly reduced overall suicide thoughts six months post-program compared to before the program. In addition, gatekeeper self-efficacy, help-seeking intentions for formal resources, and self-acceptance were improved in the students six month after the program. Conclusions: The CAMPUS suggested effective at reducing suicidal people and promoting preventative psychological tendencies among medial students. This study was a one-group pre post design study without control group. The CAMPUS program was delivered as a mandatory requirement to a group with relatively low suicide risk. Further studies are required to assess its suitability for the general university student population.
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Affiliation(s)
- Asumi Takahashi
- School of Welfare, Hokusei Gakuen University, Sapporo, Hokkaido, Japan
| | | | | | - Takami Maeno
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Yuki Shiratori
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Asaki Matsuzaki
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Tetsuaki Arai
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
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Tachikawa H, Matsushima M, Midorikawa H, Aiba M, Okubo R, Tabuchi T. Impact of loneliness on suicidal ideation during the COVID-19 pandemic: findings from a cross-sectional online survey in Japan. BMJ Open 2023; 13:e063363. [PMID: 37188470 PMCID: PMC10186084 DOI: 10.1136/bmjopen-2022-063363] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
OBJECTIVES We aim to reveal how loneliness relates to suicidal ideation following the onset of the COVID-19 pandemic. DESIGN Cross-sectional online survey. SETTING Community cohort study in Japan. PARTICIPANTS The second wave of a large web-based survey, Japan COVID-19 and Society Internet Survey, was conducted in February 2021, and we analysed the data of 6436 men and 5380 women who were aged 20-59 years. MAIN OUTCOME MEASURES The prevalence ratios (PRs) of suicidal ideation due to loneliness, depression, social isolation and decline in income during the pandemic and other sociodemographic and economic information were adjusted in the analysis. STATISTICAL METHODS Estimations were conducted by separating a male and female sample. The survey weight (inverse probability weighting) was applied for analyses, and a Poisson regression model was used with all the potential confounders adjected. RESULTS Overall, 15.1% of male and 16.3% of female participants were found to have had suicidal ideation during the COVID-19 pandemic. Among them, 23% of male and 20% of female participants experienced suicidal ideation for the first time. The results of the Poisson regression suggested that those who were feeling lonely had higher PRs for suicidal ideation (4.83 for men (95% CI, 3.87 to 6.16) and 6.19 for women (95% CI, 4.77 to 8.45)). The relationship between loneliness and suicidal ideation remained robust even after adjusting for depression, although there were declines in PRs. Additionally, the results showed that those who were lonely, and continued to feel lonely during the pandemic, had the highest PRs of suicidal ideation. CONCLUSION Loneliness had both direct and indirect effects on suicidal ideation mediated through depression. Those who felt lonelier during the pandemic had the highest risk of suicidal ideation. It is necessary to adopt national measures focused on providing psychological support to people who feel lonely to prevent them from taking their own lives.
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Affiliation(s)
- Hirokazu Tachikawa
- Department of Disaster and Community Psychiatry, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Midori Matsushima
- Faculty of Humanities and Social Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Haruhiko Midorikawa
- Department of Psychiatry, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
| | - Miyuki Aiba
- Faculty of Human Science, Toyo Gakuen University, Bunkyo-ku, Tokyo, Japan
| | - Ryo Okubo
- Department of Neuropsychiatry, National Hospital Organization Obihiro Hospital, Obihiro, Hokkaido, Japan
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
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Ujihara M, Tachikawa H, Takahashi A, Gen T, Cho Y. Factors Related to Psychological Distress in Suicide Prevention Supporters during the COVID-19 Pandemic. Int J Environ Res Public Health 2023; 20:4991. [PMID: 36981900 PMCID: PMC10049627 DOI: 10.3390/ijerph20064991] [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: 01/24/2023] [Revised: 03/02/2023] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
PURPOSE Psychological distress and related factors in suicide prevention supporters during the COVID-19 pandemic were clarified. METHODS A web-based survey for supporters from helplines or psychiatric institutions was conducted from May to July 2021. It included items about profession, stress and anxiety, and the Kessler Psychological Distress Scale. RESULTS 818 participants were analyzed. Psychological distress was significantly higher among healthcare workers in psychiatric institutions than among helpline volunteers. The factor most related to psychological distress in both professions was insufficient rest with overwork. Distress in helpline volunteers was related to their lack of ability to support people with suicidal thoughts and suicide attempts, excessive media coverage related to COVID-19, and trouble dealing with complainers. Distress in healthcare workers was related to their lack of ability to provide sufficient support to their clients due to infection prevention measures. CONCLUSION Psychological distress among suicide prevention supporters during the pandemic has been affected by overwork, the fact that helpline volunteers cannot be trained in suicide prevention, and the fact that healthcare workers can only provide insufficient support to their clients due to infection prevention measures. To maintain suicide prevention during pandemics, it is necessary to implement measures that are tailored to the factors of psychological distress in supporters.
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Affiliation(s)
- Masana Ujihara
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba 305-8575, Japan
- College of Nursing and Nutrition, Shukutoku University, Chiba 260-8703, Japan
| | - Hirokazu Tachikawa
- Department of Disaster and Community Psychiatry, Institute of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
| | - Asumi Takahashi
- School of Humanities, Hokusei Gakuen University, Sapporo 004-8631, Japan
| | - Towa Gen
- Department of Psychiatry, Nanao Hospital, Tokyo 191-0055, Japan
| | - Yoshinori Cho
- Department of Psychiatry, Teikyo University, Tokyo 173-8606, Japan
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Midorikawa H, Ekoyama S, Tachikawa H, Ota M, Tamura M, Takahashi T, Sekine A, Ide M, Matsuzaki A, Nemoto M, Nemoto K, Arai T. Association between behavioural and psychological symptoms of dementia and residence status in patients with Alzheimer's disease. Psychogeriatrics 2023; 23:45-51. [PMID: 36289565 DOI: 10.1111/psyg.12901] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 09/16/2022] [Accepted: 10/10/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Examining the relationship between the behavioural and psychological symptoms of dementia (BPSD) and residence status is crucial to improving BPSD and reducing the burden on caregivers. However, studies on how BPSD differ between individuals living at home and those in institutional settings are lacking. We conducted a questionnaire survey among healthcare providers (HCPs) involved in dementia care and nursing to clarify the characteristics of BPSD by residence status in patients with Alzheimer's disease (AD) living at home or in facilities. METHODS We sent questionnaires to HCPs and asked them to answer questions on up to five cases that needed treatment for BPSD and who received long-term care insurance services from 1 April 2016 to 31 March 2017. Responses were received for 371 cases, of which 130 diagnosed with AD were analyzed. The patients were divided into two groups: patients with AD living at home (home care group) and patients with AD living in facilities (facility care group). A Chi-square test was used to identify differences between the two groups. A binomial logistic regression analysis was also conducted to clarify the association between residence status and BPSD. RESULTS Of the 130 patients, 72 lived at home (home care group) and 58 resided in facilities (facility care group). None of the background factors was significantly different between the two groups. The Chi-square test indicated that sleep disturbance was significantly more common in the facility care group (60.3% in the facility care group vs. 33.3% in the home care group, P = 0.003), while the logistic regression analysis indicated that sleep disturbance was significantly associated with residence status (odds ratio: 2.529, P = 0.038). CONCLUSIONS Sleep disturbances were more frequently observed among patients with AD living in institutions than among those living in their homes.
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Affiliation(s)
- Haruhiko Midorikawa
- Department of Psychiatry, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan
| | - Saori Ekoyama
- University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan
| | - Hirokazu Tachikawa
- Department of Disaster and Community Psychiatry, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Miho Ota
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Masashi Tamura
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Takumi Takahashi
- Department of Psychiatry, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan
| | - Aya Sekine
- Department of Psychiatry, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan
| | - Masayuki Ide
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Asaki Matsuzaki
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Miyuki Nemoto
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Kiyotaka Nemoto
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Tetsuaki Arai
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan
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Midorikawa H, Tachikawa H, Kushibiki N, Wataya K, Takahashi S, Shiratori Y, Nemoto K, Sasahara S, Doki S, Hori D, Matsuzaki I, Arai T, Yamagata K. Association of fear of COVID-19 and resilience with psychological distress among health care workers in hospitals responding to COVID-19: analysis of a cross-sectional study. Front Psychiatry 2023; 14:1150374. [PMID: 37181870 PMCID: PMC10172588 DOI: 10.3389/fpsyt.2023.1150374] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 03/31/2023] [Indexed: 05/16/2023] Open
Abstract
Background It remains unclear how fear of COVID-19 and resilience are related to psychological distress based on occupations among healthcare workers (HCWs) in hospitals treating patients with COVID-19. We conducted a survey on the mental health of HCWs during the COVID-19 pandemic to determine the relationship between factors such as fear of COVID-19 and resilience as well as mental distress in each occupation of HCWs. Methods We conducted a web-based survey among HCWs at seven hospitals treating COVID-19 patients in Japan from December 24, 2020 to March 31, 2021. A total of 634 participants were analyzed, and information regarding their socio-demographic characteristics and employment status was collected. Several psychometric measures were used, including the Kessler's Psychological Distress Scale (K6), the fear of COVID-19 Scale (FCV-19S), and the Resilience Scale (RS14). Factors related to psychological distress were identified by logistic regression analysis. The association between job title and psychological scales was examined by one-way ANOVA, and t-tests were conducted to examine the association between the FCV-19S and hospital initiatives. Results It was found that nurses and clerical workers were associated with psychological distress without considering FCV-19S or RS14; in a model that included FCV-19S, FCV-19S was associated with psychological distress, but job title was not; when RS14 was considered, resilience was protective. In terms of occupation, FCV-19S was lower among physicians and higher among nurses and clerical workers, while RS14 was higher among physicians and lower among other occupations. Having access to in-hospital consultation regarding infection control as well as to psychological and emotional support was associated with lower FCV-19S. Conclusion Based on our findings, we can conclude that the level of mental distress differed by occupation and the differences in the fear of COVID-19 and resilience were important factors. In order to provide mental healthcare for HCWs during a pandemic, it is important to create consultation services that enable employees to discuss their concerns. In addition, it is important to take steps to strengthen the resilience of HCWs in preparation for future disasters.
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Affiliation(s)
| | - Hirokazu Tachikawa
- Department of Disaster and Community Psychiatry, Division of Clinical Medicine, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
- *Correspondence: Hirokazu Tachikawa,
| | - Natsuho Kushibiki
- Department of Disaster and Community Psychiatry, Division of Clinical Medicine, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Keiko Wataya
- Majors of Clinical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Sho Takahashi
- Department of Disaster and Community Psychiatry, Division of Clinical Medicine, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yuki Shiratori
- Department of Psychiatry, Division of Clinical Medicine, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Kiyotaka Nemoto
- Department of Psychiatry, Division of Clinical Medicine, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Shinichiro Sasahara
- Occupational and Aerospace Psychiatry Group, Division of Biomedical Science, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Shotaro Doki
- Occupational and Aerospace Psychiatry Group, Division of Biomedical Science, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Daisuke Hori
- Occupational and Aerospace Psychiatry Group, Division of Biomedical Science, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Ichiyo Matsuzaki
- Occupational and Aerospace Psychiatry Group, Division of Biomedical Science, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Testuaki Arai
- Department of Psychiatry, Division of Clinical Medicine, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
- Testuaki Arai,
| | - Kunihiro Yamagata
- Department of Nephrology, Division of Clinical Medicine, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
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Midorikawa H, Tachikawa H, Aiba M, Shiratori Y, Sugawara D, Kawakami N, Okubo R, Tabuchi T. Proposed Cut-Off Score for the Japanese Version of the Fear of Coronavirus Disease 2019 Scale (FCV-19S): Evidence from a Large-Scale National Survey in Japan. Int J Environ Res Public Health 2022; 20:ijerph20010429. [PMID: 36612751 PMCID: PMC9819218 DOI: 10.3390/ijerph20010429] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 10/25/2022] [Revised: 12/20/2022] [Accepted: 12/23/2022] [Indexed: 05/28/2023]
Abstract
The Fear of coronavirus disease 2019 (COVID-19) Scale (FCV-19S) is a seven-item self-administered psychological scale for measuring the fear of this disease. The scale has been widely adapted and validated worldwide. This study aimed to propose a cut-off score for the validated Japanese version of the FCV-19S. We conducted a nationwide online survey and included 26,286 respondents in the analysis. Respondents answered questions on their sociodemographic characteristics, and using the FCV-19S and six-item Kessler Psychological Distress Scale, we measured psychological distress and assessed whether the fear of COVID-19 interfered with their daily lives. A total score of ≥21 points was considered adequate to identify those with psychological distress or difficulties in daily living because of the fear of COVID-19. This cut-off score will contribute to mental health assessment during the COVID-19 pandemic.
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Affiliation(s)
- Haruhiko Midorikawa
- Department of Psychiatry, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba 305-8575, Japan
| | - Hirokazu Tachikawa
- Department of Disaster and Community Psychiatry, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba 305-8575, Japan
| | - Miyuki Aiba
- Faculty of Human Sciences, Toyo Gakuen University, 1-26-3 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - Yuki Shiratori
- Department of Psychiatry, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba 305-8575, Japan
| | - Daichi Sugawara
- Faculty of Human Sciences, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba 305-8575, Japan
| | - Naoaki Kawakami
- Faculty of Human Sciences, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba 305-8575, Japan
| | - Ryo Okubo
- Department of Neuropsychiatry, National Hospital Organization Obihiro Hospital, 18-2-16, Obihiro 080-8518, Japan
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka 541-8567, Japan
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Hamano J, Tachikawa H, Takahashi S, Ekoyama S, Nagaoka H, Ozone S, Masumoto S, Hosoi T, Arai T. Exploration of the impact of the COVID-19 pandemic on the mental health of home health care workers in Japan: a multicenter cross-sectional web-based survey. BMC Prim Care 2022; 23:129. [PMID: 35619098 PMCID: PMC9134976 DOI: 10.1186/s12875-022-01745-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 05/19/2022] [Indexed: 01/07/2023]
Abstract
Background The COVID-19 pandemic has caused home health care workers (home-HCWs) to experience anxiety. The mental health of home-HCWs and related factors during the COVID-19 pandemic have not been clarified; therefore, we aimed to investigate the status and associated factors of fear of COVID-19 infection, anxiety, and depression among home-HCWs in Japan. Methods We conducted a multicenter cross-sectional web-based anonymous survey of home-HCWs in August 2021, during the fifth wave of the pandemic in Japan. We surveyed members of facilities that provided home visit services during the COVID-19 pandemic. We measured the Japanese version of the Fear of COVID-19 scale (FCV-19S-J) and the Hospital Anxiety and Depression scale (HADS) as objective variables, and the Japanese version of the Assessment of Interprofessional Team Collaboration Scale-II (J-AITCS-II) as an explanatory variable. Results A total of 328 members of 37 facilities responded to the survey, and we ultimately analyzed 311 participants. The most frequent occupation was nurse (32.8%), followed by doctor (24.8%) and medical office staff (18.0%). The mean score of the FCV-19S-J was 16.5 ± 5.0 (7.0 – 31.0), and the prevalences of definitive anxiety and depression were 7.4% and 15.7%, respectively. Multivariate regression analysis revealed that the J-AITCS-II teamwork subscale was significantly negatively associated with FCV-19S-J, HADS-anxiety, and HADS-depression (β = -0.171, p = 0.004; β = -0.151, p = 0.012; β = -0.225, p < 0.001, respectively). Medical office staff showed significant positive associations with FCV-19S-J and HADS-depression (β = 0.219, p = 0.005; β = 0.201, p = 0.009, respectively), and medical social workers with HADS-anxiety and HADS-depression (β = -0.166, p = 0.011; β = -0.214, p < 0.001, respectively) compared with doctors. The unmet support need for expert lectures on COVID-19 was significantly positively associated with FCV-19S-J (β = 0.131, p = 0.048), and the unmet support need for support systems for psychological stress and emotional exhaustion was significantly positively associated with HADS-anxiety (β = 0.141, p = 0.022). Conclusions Fear of COVID-19 infection and depression of nurses, medical office staff, and other occupations was significantly higher than those of doctors. These findings suggest that non-physicians were more likely to be fearful and depressed during the COVID-19 pandemic; thus, it is necessary to tailor mental health support based on occupation in the home care setting.
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Sekiya T, Ogura Y, Kai H, Kawaguchi A, Okawa S, Hirohama M, Kuroki T, Morii W, Hara A, Hiramatsu Y, Hitomi S, Kawakami Y, Arakawa Y, Maruo K, Chiba S, Suzuki H, Kojima H, Tachikawa H, Yamagata K. TMPRSS2 gene polymorphism common in East Asians confers decreased COVID-19 susceptibility. Front Microbiol 2022; 13:943877. [PMID: 36532428 PMCID: PMC9748344 DOI: 10.3389/fmicb.2022.943877] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 05/14/2022] [Accepted: 10/27/2022] [Indexed: 09/29/2023] Open
Abstract
COVID-19 has a wide range of clinical presentations, and the susceptibility to SARS-CoV-2 infection and the mortality rate also vary by region and ethnicity. Here, we found that rs12329760 in the TMPRSS2 gene, a missense variant common in East Asian populations, contributes to protection against SARS-CoV-2 infection. TMPRSS2 is a protease responsible for SARS-CoV-2 entry and syncytium formation. rs12329760 (c.478G>A, p. V160M) was associated with a reduced risk of moderate symptoms. The enzymatic activity of Met160-TMPRSS2 was lower than that of Val160-TMPRSS2, and thus the viral entry and the syncytium formation of SARS-CoV-2 were impaired. Collectively, these results indicate that the genetic variation in TMPRSS2, which is common in East Asians, is one of the molecular determinants of COVID-19 susceptibility.
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Affiliation(s)
- Takeshi Sekiya
- Department of Infection Biology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yukino Ogura
- Department of Infection Biology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hirayasu Kai
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Atsushi Kawaguchi
- Department of Infection Biology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
- Transborder Medical Research Center, University of Tsukuba, Tsukuba, Japan
- Microbiology Research Center for Sustainability, University of Tsukuba, Tsukuba, Japan
| | - Shino Okawa
- College of Biological Sciences, University of Tsukuba, Tsukuba, Japan
| | - Mikako Hirohama
- Department of Infection Biology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Takahiro Kuroki
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Wataru Morii
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Akira Hara
- Department of Otorhinolaryngology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yuji Hiramatsu
- Department of Cardiovascular Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Shigemi Hitomi
- Department of Infectious Diseases, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yasushi Kawakami
- Department of Laboratory Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yoshihiro Arakawa
- Department of Medical Pharmacy, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Kazushi Maruo
- Department of Biostatistics, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Shigeru Chiba
- Department of Hematology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hiromichi Suzuki
- Department of Infectious Diseases, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hiroshi Kojima
- Ibaraki Clinical Education and Training Center, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hirokazu Tachikawa
- Division of Clinical Medicine, Department of Disaster and Community Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Kunihiro Yamagata
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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10
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Sodeyama N, Takahashi S, Aiba M, Haraguchi Y, Arai T, Tachikawa H. A Comparison of Mental Health among Earthquake, Tsunami, and Nuclear Power Plant Accident Survivors in the Long Term after the Great East Japan Earthquake. Int J Environ Res Public Health 2022; 19:14072. [PMID: 36360954 PMCID: PMC9659037 DOI: 10.3390/ijerph192114072] [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] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/25/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
Even now, ten years after the Great East Japan Earthquake (GEJE), thousands of residents of Fukushima Prefecture are still living as evacuees. To understand the mental health states and needs for psychological care of the survivors, we conducted a questionnaire survey of survivors who were evacuated from Fukushima to Ibaraki due to the nuclear power plant accident and of the residents of two areas in Ibaraki where damage was particularly severe due to the tsunami or liquefaction. Our results show that stress related to participants' hometowns and to the disaster was a risk factor for depression and post-traumatic stress among the survivors in the medium to long term in all regions examined. Other risk factors for post-traumatic stress differed by region. This study shows that in a complex disaster such as the GEJE, where damage is widespread, the causes of damage and the experiences of disaster survivors differ greatly from region to region and that risk factors for depression and post-traumatic stress among disaster survivors over the medium to long term may also differ. To provide appropriate care to disaster survivors, it is necessary to determine what is causing the risk of depression and post-traumatic stress at any given time and in specific regions.
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Affiliation(s)
- Noriko Sodeyama
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8577, Japan
| | - Sho Takahashi
- Department of Disaster and Community Psychiatry, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8577, Japan
| | - Miyuki Aiba
- Faculty of Human Sciences, Toyo Gakuen University, 1-26-3 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Yayoi Haraguchi
- College of Humanities and Social Sciences, Ibaraki University, 2-1-1 Bunkyo, Mito 310-8512, Japan
| | - Tetsuaki Arai
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8577, Japan
| | - Hirokazu Tachikawa
- Department of Disaster and Community Psychiatry, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8577, Japan
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11
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Tachikawa H, Kubo T, Gomei S, Takahashi S, Kawashima Y, Manaka K, Mori A, Kondo H, Koido Y, Ishikawa H, Otsuru T, Nogi W. Mental health needs associated with COVID-19 on the diamond princess cruise ship: A case series recorded by the disaster psychiatric assistance team. Int J Disaster Risk Reduct 2022; 81:103250. [PMID: 36032696 PMCID: PMC9391089 DOI: 10.1016/j.ijdrr.2022.103250] [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] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 07/12/2022] [Accepted: 08/11/2022] [Indexed: 06/15/2023]
Abstract
Coronavirus disease 2019 (COVID-19) infection prevention measures have led to a variety of mental health issues. Although several self-care methods have been recommended for those quarantined, evidence regarding how best to support quarantined people experiencing a mental health crisis is limited. In February 2020, the Diamond Princess cruise ship was quarantined in Yokohama port, Japan following a passenger testing positive for COVID-19. We were sent to address the mental health issues as the Disaster Psychiatric Assistance Team (DPAT). In the present study, we examined the acute mental health needs of the passengers and crew collected by the DPAT using the standard Emergency Medical Team daily reporting system. We assessed 206 cases (99 men and 107 women) with generic health issues and 127 cases (39 men and 88 women) with mental health issues. Mental health issues including disaster stress-related symptoms were as frequent as physical health events associated with COVID-19. The most significant mental health issue was anxiety, as an acute psychological reaction to the quarantine situation. Women and crews most frequently needed mental health support. Mental health improved in most clients after brief counseling. Although several passengers experienced suicidal ideation, there were no cases of actual suicide attempts during the quarantine period. This case has been regarded as a well-known public health event at the beginning of the COVID-19 era. In addition to physical health support, disaster mental health support was essential to save lives. Our findings may facilitate responses to future quarantines, accidents, and mental health crises.
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Affiliation(s)
- Hirokazu Tachikawa
- Department of Disaster and Community Psychiatry, University of Tsukuba, Japan
| | - Tatsuhiko Kubo
- Department of Public Health and Health Policy, Hiroshima University, Hiroshima, Japan
| | - Sayaka Gomei
- Department of Emergency and Critical Care Medicine, Dokkyo Medical University Saitama Medical Center, Japan
- DPAT Secretariat, Tokyo, Japan
| | - Sho Takahashi
- Department of Disaster and Community Psychiatry, University of Tsukuba, Japan
| | - Yuzuru Kawashima
- DPAT Secretariat, Tokyo, Japan
- National Hospital Organization Headquarter DMAT Secretariat, Tokyo, Japan
| | - Kazunori Manaka
- Ibaraki Prefectural Medical Center of Psychiatry, Ibaraki, Japan
| | | | - Hisayoshi Kondo
- National Hospital Organization Headquarter DMAT Secretariat, Tokyo, Japan
| | - Yuichi Koido
- National Hospital Organization Headquarter DMAT Secretariat, Tokyo, Japan
| | | | - Taku Otsuru
- National Hospital Organization, Ryukyu Hospital, Japan
| | - Wataru Nogi
- DPAT Secretariat, Tokyo, Japan
- Bifukai Hamadera Hospital, Osaka, Japan
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12
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Yumiya Y, Chimed-Ochir O, Taji A, Kishita E, Akahoshi K, Kondo H, Wakai A, Chishima K, Toyokuni Y, Koido Y, Tachikawa H, Takahashi S, Gomei S, Kawashima Y, Kubo T. Prevalence of Mental Health Problems among Patients Treated by Emergency Medical Teams: Findings from J-SPEED Data Regarding the West Japan Heavy Rain 2018. Int J Environ Res Public Health 2022; 19:11454. [PMID: 36141727 PMCID: PMC9517656 DOI: 10.3390/ijerph191811454] [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] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/09/2022] [Accepted: 09/09/2022] [Indexed: 06/16/2023]
Abstract
It is crucial to provide mental health care following a disaster because the victims tend to experience symptoms such as anxiety and insomnia during the acute phase. However, little research on mental health during the acute phase has been conducted, and reported only in terms of the temporal transition of the number of consultations and symptoms. Thus, the aim of the study was to examine how mental health care needs are accounted for in the overall picture of disaster relief and how they change over time. Using data from the Japanese version of Surveillance in Post-Extreme Emergencies and Disasters (J-SPEED), we assessed the mental health of injured and ill patients to whom Emergency Medical Teams (EMTs) were providing care during the acute period of a disaster. Approximately 10% of all medical consultations were for mental health issues, 83% of which took place within the first 2 weeks after the disaster. The findings showed that, from the start of the response period to the 19th response day, the daily proportion of mental health problems declined substantially, and then gradually increased. Such a V-shaped pattern might be helpful for identifying phase changes and supporting the development of EMT exit strategies.
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Affiliation(s)
- Yui Yumiya
- Department of Public Health and Health Policy, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Odgerel Chimed-Ochir
- Department of Public Health and Health Policy, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Akihiro Taji
- Department of Public Health and Health Policy, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Eisaku Kishita
- Hiroshima Prefectural Government Health and Welfare Affairs Bureau, Hiroshima 730-8511, Japan
| | - Kouki Akahoshi
- National Hospital Organization Headquarters DMAT Secretariat MHLW Japan, Tokyo 190-8579, Japan
| | - Hisayoshi Kondo
- National Hospital Organization Headquarters DMAT Secretariat MHLW Japan, Tokyo 190-8579, Japan
| | - Akinori Wakai
- National Hospital Organization Headquarters DMAT Secretariat MHLW Japan, Tokyo 190-8579, Japan
| | - Kayoko Chishima
- National Hospital Organization Headquarters DMAT Secretariat MHLW Japan, Tokyo 190-8579, Japan
| | - Yoshiki Toyokuni
- National Hospital Organization Headquarters DMAT Secretariat MHLW Japan, Tokyo 190-8579, Japan
| | - Yuichi Koido
- National Hospital Organization Headquarters DMAT Secretariat MHLW Japan, Tokyo 190-8579, Japan
| | - Hirokazu Tachikawa
- Department of Disaster and Community Psychiatry, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
| | - Sho Takahashi
- Department of Disaster and Community Psychiatry, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
| | - Sayaka Gomei
- Department of Emergency and Critical Care Medicine, Dokkyo Medical University Saitama Medical Center, Saitama 343-8555, Japan
- DPAT Secretariat, Tokyo 108-8554, Japan
| | - Yuzuru Kawashima
- National Hospital Organization Headquarters DMAT Secretariat MHLW Japan, Tokyo 190-8579, Japan
- DPAT Secretariat, Tokyo 108-8554, Japan
| | - Tatsuhiko Kubo
- Department of Public Health and Health Policy, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
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13
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Takahashi T, Ekoyama S, Tachikawa H, Midorikawa H, Shiratori Y, Ota M, Takahashi S, Arai T. Mental Health of Caregivers Working in Nursing Homes during the COVID-19 Pandemic. Dement Geriatr Cogn Disord 2022; 51:233-240. [PMID: 35679835 PMCID: PMC9393777 DOI: 10.1159/000524953] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 03/23/2022] [Accepted: 04/26/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION There have been numerous reports of cluster outbreaks of coronavirus disease 2019 (COVID-19) in hospitals and nursing homes. Healthcare workers fighting COVID-19 experience mental health issues. Caregivers in nursing homes experienced increased psychological distress and concern about deterioration of their mental health. We conducted a large-scale web-based survey exploring mental health among caregivers working in nursing homes during the COVID-19 pandemic with the aim of identifying their support needs. METHODS Survey participants were caregivers working at 284 nursing homes in Ibaraki prefecture, Japan. The survey period was from September 2020 to March 2021. Participants responded to a questionnaire covering gender, age, occupation, infections at facilities, infection protection, changes in nursing home users, cooperation with other medical institutions, and prejudice/discrimination. The Hospital Anxiety and Depression Scale (HADS) was used to evaluate participants' depression and anxiety. RESULTS In total, 676 participants completed the survey; 350 (52.5%) were with anxiety symptoms and 378 (56.7%) were with depressive symptoms (scores exceeding the HADS cut-off points). The risk for anxiety was associated with being care worker or social worker. The risk of anxiety or depression was high when family caregivers' mental state changed. DISCUSSION/CONCLUSION This study found that caregivers working in nursing homes were exposed to high levels of stress during the COVID-19 pandemic and were at high risk for developing depression and anxiety.
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Affiliation(s)
- Takumi Takahashi
- Division of Psychiatry, University of Tsukuba Hospital, Tsukuba, Japan,
| | - Saori Ekoyama
- Division of Psychiatry, University of Tsukuba Hospital, Tsukuba, Japan
| | - Hirokazu Tachikawa
- Division of Clinical Medicine, Department of Disaster and Community Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan,*Hirokazu Tachikawa,
| | | | - Yuki Shiratori
- Division of Clinical Medicine, Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Miho Ota
- Division of Clinical Medicine, Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Sho Takahashi
- Division of Clinical Medicine, Department of Disaster and Community Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Tetsuaki Arai
- Division of Clinical Medicine, Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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14
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Midorikawa H, Tachikawa H, Aiba M, Watanabe T, Tamiya N, Arai T. Factors associated with short and long sleep duration in older adults: Analysis of a national survey in Japan. Geriatr Gerontol Int 2022; 22:660-666. [PMID: 35844191 DOI: 10.1111/ggi.14438] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 06/20/2022] [Accepted: 06/21/2022] [Indexed: 11/29/2022]
Abstract
AIM This study aimed to clarify the association between sleep duration and various physical and psychosocial factors among older Japanese adults. METHODS Data from 295 367 households were obtained from the 2013 Comprehensive Survey of Living Conditions in Japan, a self-administered questionnaire survey. We restricted our analyses to 115 205 participants who responded to all the items required for this study. Multinomial logistic regression models examined the association between sleep duration and various factors. RESULTS Overall, 26.0% of the participants slept for <6 h, 56.0% slept for 6-8 h, and 18.0% slept for ≥8 h. Poor subjective health and mental health increased the risk of both short (poor subjective health: odds ratio [OR] 1.22, 95% confidence interval [CI] 1.17-1.27; severe mental distress: OR 2.21, 95% CI 2.04-2.40) and long (poor subjective health: OR 1.19, 95% CI 1.13-1.24; severe mental distress: OR 1.25, 95% CI 1.13-1.38) sleep duration. Many subjective symptoms, including chest, respiratory, musculoskeletal and urogenital symptoms, were associated with short sleep duration. However, only memory loss was associated with long sleep duration (OR 1.23, 95% CI 1.16-1.31). CONCLUSIONS We need to be aware that older people with short sleep duration may have various physical symptoms. Moreover, as physical and mental problems, cognitive decline and unhealthy lifestyles are associated with long sleep duration, we also need to pay attention to the living conditions of those who complain of long sleep duration. The limitations of this study were that the variables were self-reported and sleep duration was not evaluated objectively. Geriatr Gerontol Int ••; ••: ••-•• Geriatr Gerontol Int 2022; ••: ••-••.
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Affiliation(s)
| | - Hirokazu Tachikawa
- Department of Disaster and Community Psychiatry, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.,Research and Development Center for Health Services, University of Tsukuba, Ibaraki, Japan
| | - Miyuki Aiba
- Faculty of Human Sciences, Toyo Gakuen University, Tokyo, Japan
| | - Taeko Watanabe
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Nanako Tamiya
- Research and Development Center for Health Services, University of Tsukuba, Ibaraki, Japan.,Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Tetsuaki Arai
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
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15
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Hamano J, Tachikawa H, Takahashi S, Ekoyama S, Nagaoka H, Ozone S, Masumoto S, Hosoi T, Arai T. Changes in home visit utilization during the COVID-19 pandemic: a multicenter cross-sectional web-based survey. BMC Res Notes 2022; 15:238. [PMID: 35799212 PMCID: PMC9261221 DOI: 10.1186/s13104-022-06128-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/21/2022] [Indexed: 11/30/2022] Open
Abstract
Objective Home care is one of the essential community health care services; thus, identifying changes of home care utilization before and during the COVID-19 pandemic would be useful for researchers and policymaker to reconsider the home care system, the support needed for home care staff, and the collaborative system with hospitals in the COVID-19 era. We conducted a multicenter cross-sectional web-based anonymous survey of the directors of home visit facilities in Japan in August 2021. Results A total of 33 participants from 37 facilities responded to the survey. The number of patients dying at home and newly requested home visits increased during the COVID-19 pandemic (74.2%, 71.0%). One possible reason was the restricted visitation of inpatient facilities (93.5%). The underlying disease that the largest number of participants perceived as having increased compared with before the COVID-19 pandemic was cancer (51.6%). There were no significant differences in being in a rural area or the number of doctors in perceived changes in home visit utilization. Our study indicated that the director of home visit facilities thought the number of patients dying at home and newly requested home visits had increased compared with before the COVID-19 pandemic. Supplementary Information The online version contains supplementary material available at 10.1186/s13104-022-06128-7.
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Affiliation(s)
- Jun Hamano
- Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan.
| | - Hirokazu Tachikawa
- Department of Disaster and Community Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Sho Takahashi
- Department of Disaster and Community Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | | | - Hiroka Nagaoka
- Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Sachiko Ozone
- Department of Family Medicine, General Practice and Community Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Shoichi Masumoto
- Department of Family Medicine, General Practice and Community Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Takahiro Hosoi
- Department of General Medicine, Tsukuba Central Hospital, Kamikashiwada 4-58-1, Ushiku, Ibaraki, 300-1232, Japan
| | - Tetsuaki Arai
- Division of Clinical Medicine, Department of Psychiatry, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan
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16
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Takahashi A, Tachikawa H, Marutani T, Fuse-Nagase Y, Iwami T, Yamamoto Y, Moriyama T, Yasumi K. Suicide prevention measures in the national universities of Japan. Asian J Psychiatr 2022; 73:103149. [PMID: 35569364 DOI: 10.1016/j.ajp.2022.103149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 04/24/2022] [Accepted: 05/02/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Asumi Takahashi
- School of Humanities, Hokusei Gakuen University, 2-3-1 Ohyachi-Nishi, Atsubetsu-ku, Sapporo, Hokkaido 004-8631, Japan
| | - Hirokazu Tachikawa
- Department of Disaster and Community Psychiatry, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba City, Ibaraki 305-8575, Japan.
| | - Toshiyuki Marutani
- Health Support Center, Tokyo Institute of Technology, 4259 Nagatsuta-cho, Yokohama, Kanagawa 226-8503, Japan
| | - Yasuko Fuse-Nagase
- University Health Center, Ibaraki University, 2-1-1 Bunkyo, Mito, Ibaraki 310-8512, Japan
| | - Taku Iwami
- Health Services, Kyoto University, Yoshidahonmachi, Sakyo-ku, Kyoto 606-8501, Japan
| | - Yuji Yamamoto
- Health and Medical Services Center, Shiga University, 1-1-1 Banba, Hikone, Shiga 522-8522, Japan
| | - Toshiki Moriyama
- Health and Counseling Center, Osaka University, 1-17 Machikaneyama-cho, Toyonaka, Osaka 560-0043, Japan
| | - Katsuhiro Yasumi
- Health Support Center, Tokyo Institute of Technology, 2-12-1 Ookayama, Meguro-ku, Tokyo 152-8550, Japan
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17
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Kunii Y, Usukura H, Otsuka K, Maeda M, Yabe H, Takahashi S, Tachikawa H, Tomita H. Lessons learned from psychosocial support and mental health surveys during the 10 years since the Great East Japan Earthquake: Establishing evidence-based disaster psychiatry. Psychiatry Clin Neurosci 2022; 76:212-221. [PMID: 35137504 PMCID: PMC9314661 DOI: 10.1111/pcn.13339] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 01/30/2022] [Indexed: 11/27/2022]
Abstract
Post-disaster mental health and psychosocial support have drawn attention in Japan after the 1995 Great Hanshin-Awaji Earthquake, with mental health care centers for the affected communities being organized. After the catastrophe, a reconstruction budget was allocated to organize mental health care centers to provide psychosocial support for communities affected by the 2007 Chūetsu offshore earthquake, the 2011 Great East Japan Earthquake, and the 2016 Kumamoto Earthquake. There were several major improvements in post-disaster mental health measures after the Great East Japan Earthquake. The Disaster Psychiatric Assistance Team system was organized after the earthquake to orchestrate disaster response related to the psychiatric health system and mental health of the affected communities. Special mental health care efforts were drawn to the communities affected by the nuclear power plant accident through Chemical, Biological, Radiological, Nuclear, and high yield Explosives, being succeeded by measures against the coronavirus pandemic. As another new movement after the Great East Japan Earthquake, the number of surveys involving communities affected by disasters has soared. More than 10 times the number of scientific publications were made in English during the decade following the Great East Japan Earthquake, compared with the previous decades. In this review, we examined the results and issues acquired in the 10 years since the Great East Japan Earthquake, proposing evidence-based disaster psychiatry as the direction of future mental health measures related to emergency preparedness and response.
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Affiliation(s)
- Yasuto Kunii
- Department of Disaster Psychiatry, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
| | - Hitomi Usukura
- Department of Disaster Psychiatry, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
| | - Kotaro Otsuka
- Department of Neuropsychiatry, School of Medicine, Iwate Medical University, Iwate, Japan.,Department of Disaster and Community Psychiatry, School of Medicine, Iwate Medical University, Iwate, Japan
| | - Masaharu Maeda
- Department of Disaster Psychiatry, School of Medicine, Fukushima Medical University, Fukushima, Japan.,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Hirooki Yabe
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Sho Takahashi
- Department of Disaster and Community Psychiatry, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Hirokazu Tachikawa
- Department of Disaster and Community Psychiatry, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Hiroaki Tomita
- Department of Disaster Psychiatry, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan.,Department of Psychiatry, Tohoku University Hospital, Sendai, Japan.,Department of Psychiatry, Graduate School of Medicine, Tohoku University, Sendai, Japan
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18
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Ichikawa-Kaji Y, Ishizawa F, Nishiyama R, Tachikawa H, Uemura N, Moriuchi Y, Umino K, Hsiao Y, Muramatsu H, Suzuki T, Inomata A, Honda K, Moriyasu T. Development of a detector tube for rapid detection of tadalafil in adulterated dietary supplements. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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19
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Shiratori Y, Ogawa T, Ota M, Sodeyama N, Sakamoto T, Arai T, Tachikawa H. A longitudinal comparison of college student mental health under the COVID-19 self-restraint policy in Japan. Journal of Affective Disorders Reports 2022; 8:100314. [PMID: 35169765 PMCID: PMC8830143 DOI: 10.1016/j.jadr.2022.100314] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/14/2021] [Accepted: 02/05/2022] [Indexed: 12/12/2022] Open
Abstract
Background The coronavirus-19 (COVID-19) pandemic has resulted in substantial mental health problems. In addition to the fear of infection, prevention policies that result in isolation such as lockdowns or, in Japan, “self-restraint,” are associated with psychological symptoms. University students are vulnerable to emotional disorders because of the psychological challenges associated with the transition to adulthood. Therefore, we investigated changes in the mental health of university students before and during the COVID-19 pandemic. Methods We used data from depression screening conducted by the University of Tsukuba, Japan, during student health examinations. Students completed the Patient Health Questionnaire-9 (PHQ-9) and an open-ended question on stress self-coping. Results In 2020, 9.6% of students were depressed, approximately twice as many as in previous years. The paired samples Wilcoxon test showed that PHQ-9 scores were significantly higher in 2020 than in 2019; the largest effect size was for sleep difficulties. Analysis of the open-ended responses for stress coping strategies showed that physical activity and online communication were most frequently used. Limitations The 2020 survey was web-based, whereas the surveys in previous years were completed in person. Only approximately one-sixth of participants answered the open-ended question. Conclusions The percentage of students with mental health problems has doubled, and more attention to student mental health is needed. However, many students seem to be using appropriate coping measures. Education about best practices and raising awareness about establishing and maintaining sleep–wake rhythms may be useful.
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Affiliation(s)
- Yuki Shiratori
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba Japan
- University health center, University of Tsukuba Japan
| | - Takafumi Ogawa
- Majors of Clinical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba Japan
| | - Miho Ota
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba Japan
- University health center, University of Tsukuba Japan
| | - Noriko Sodeyama
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba Japan
- University health center, University of Tsukuba Japan
| | - Tohru Sakamoto
- University health center, University of Tsukuba Japan
- Department of Pulmonary Medicine, Faculty of Medicine, University of Tsukuba Japan
| | - Tetsuaki Arai
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba Japan
| | - Hirokazu Tachikawa
- University health center, University of Tsukuba Japan
- Department of Disaster and Community Psychiatry, Faculty of Medicine, University of Tsukuba Japan
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20
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Sodeyama N, Tachikawa H, Takahashi S, Aiba M, Haraguchi Y, Arai T. The Mental Health of Long-Term Evacuees outside Fukushima Prefecture after the Great East Japan Earthquake. TOHOKU J EXP MED 2022; 257:261-271. [DOI: 10.1620/tjem.2022.j038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Noriko Sodeyama
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba
| | - Hirokazu Tachikawa
- Department of Disaster and Community Psychiatry, Faculty of Medicine, University of Tsukuba
| | - Sho Takahashi
- Department of Disaster and Community Psychiatry, Faculty of Medicine, University of Tsukuba
| | - Miyuki Aiba
- Faculty of Human Sciences, Toyo Gakuen University
| | - Yayoi Haraguchi
- College of Humanities and Social Sciences, Ibaraki University
| | - Tetsuaki Arai
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba
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21
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Takagi Y, Takahashi S, Fukuo Y, Arai T, Tachikawa H. Acute-Stage Mental Health Symptoms by Natural Disaster Type: Consultations of Disaster Psychiatric Assistance Teams (DPATs) in Japan. Int J Environ Res Public Health 2021; 18:12409. [PMID: 34886143 PMCID: PMC8657282 DOI: 10.3390/ijerph182312409] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/07/2021] [Accepted: 11/22/2021] [Indexed: 11/25/2022]
Abstract
This study analyzed the support activities that the Disaster Psychiatric Assistance Team (DPAT) in Japan provided following four previous disasters (a volcanic eruption, a mudslide, a flood, and an earthquake) to identify links between the disaster type and the characteristics of acute stage mental disorders observed. Using Disaster Mental Health Information Support System database records of consultations with patients supported by the DPAT during the survey period from 2013 (when DPAT was launched) to 2016, we performed cross-tabulations and investigated significant differences using chi-squared tests. For expected values less than 5, Fisher's exact test was performed. Frequently occurring acute-stage symptoms after a disaster include anxiety, sleep problems, mood and affect, and physical symptoms. The affected population characteristics, victim attributes, severity of damage sustained, and evacuation status were the chief factors that influenced acute-stage mental health symptoms. The psychiatric symptoms detected in our study together with the results of diagnoses are important for determining the types of early interventions needed during the acute stage of a disaster. By sharing baseline mental health information, together with disaster-related characteristics highlighted in this study, mental health providers are better able to predict future possible mental disorders and symptoms.
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Affiliation(s)
- Yoshifumi Takagi
- Faculty of Humanities, Tokyo Kasei University, Tokyo 173-8602, Japan;
- Department of Disaster and Community Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan;
| | - Sho Takahashi
- Department of Disaster and Community Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan;
- Ibaraki Prefectural Medical Center of Psychiatry, Kasama 309-1717, Japan
| | - Yasuhisa Fukuo
- Disaster Psychiatric Assistance Teams (DPATs) Secretariat, Commissioned by the Ministry of Health, Labor and Welfare, Tokyo 108-8554, Japan;
- Shinkeikahamamatsu Hospital, Hamamatsu 432-8013, Japan
| | - Tetsuaki Arai
- Department of Psychiatry, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan;
| | - Hirokazu Tachikawa
- Department of Disaster and Community Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan;
- Ibaraki Prefectural Medical Center of Psychiatry, Kasama 309-1717, Japan
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22
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Midorikawa H, Tachikawa H, Taguchi T, Shiratori Y, Takahashi A, Takahashi S, Nemoto K, Arai T. Demographics Associated With Stress, Severe Mental Distress, and Anxiety Symptoms During the COVID-19 Pandemic in Japan: Nationwide Cross-sectional Web-Based Survey. JMIR Public Health Surveill 2021; 7:e29970. [PMID: 34653018 PMCID: PMC8610490 DOI: 10.2196/29970] [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: 04/27/2021] [Revised: 09/13/2021] [Accepted: 10/12/2021] [Indexed: 12/30/2022] Open
Abstract
Background With the spread of COVID-19, the deterioration of public mental health has become a major global and social problem. Objective The purpose of this study was to elucidate the relationship between the 3 mental health problems associated with COVID-19, that is, perceived stress, severe mental distress, and anxiety symptoms, and the various demographic factors, including occupation. Methods A nationwide web-based questionnaire survey was conducted in Japan from August 4 to 31, 2020. In addition to sociodemographic data, the degrees of perceived stress, severe mental distress, and anxiety symptoms associated with COVID-19 were measured. After performing a descriptive statistical analysis, factors related to stress, severe mental distress, and anxiety symptoms were analyzed using logistic regression analysis. Results A total of 8203 respondents submitted survey responses, among whom 34.9% (2861/8203) felt intense stress associated with COVID-19, 17.1% (1403/8203) were depressed, and 13.5% (1110/8203) had severe anxiety symptoms. The logistic regression analysis showed that each of the 3 mental health problems were prevalent in females, nonbinary gender, people in their 50s, 60s and older, respondents who visited psychiatrists, and those currently in psychiatric care. Severe mental distress and anxiety symptoms were associated with the number of effective lifestyle coping strategies during the lockdown period. Severe mental distress was only prevalent in teenagers and respondents in their 20s, as students tended to develop stress and severe mental distress. With regard to occupation, working in nursing care and welfare, education and research, and medical and health sectors was associated with stress; however, working in these occupations was not associated with severe mental distress and anxiety symptoms. Unemployment was associated with severe mental distress and anxiety symptoms. All 3 mental health problems were prevalent in part-time workers and those working in entertainment and arts sectors. Conclusions Gender, age, occupation, history of psychiatric visits, and stress coping mechanisms were associated with mental health during the COVID-19 pandemic, but their associations with stress, severe mental distress, and anxiety symptoms differed. In addition, the actual state of mental health varied according to the respondents’ occupation. It is necessary to consider the impact of the COVID-19 pandemic on mental health not only at the individual level but also at the occupational level.
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Affiliation(s)
- Haruhiko Midorikawa
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan.,Ibaraki Prefectural Medical Center of Psychiatry, Kasama, Japan
| | - Hirokazu Tachikawa
- Department of Disaster and Community Psychiatry, University of Tsukuba, Tsukuba, Japan
| | - Takaya Taguchi
- Ibaraki Prefectural Medical Center of Psychiatry, Kasama, Japan
| | - Yuki Shiratori
- Tsukuba University Health Center, University of Tsukuba, Tsukuba, Japan.,Department of Psychiatry, University of Tsukuba, Tsukuba, Japan
| | - Asumi Takahashi
- School of Humanities, Hokusei Gakuen University, Sapporo, Japan
| | - Sho Takahashi
- Department of Disaster and Community Psychiatry, University of Tsukuba, Tsukuba, Japan
| | - Kiyotaka Nemoto
- Department of Psychiatry, University of Tsukuba, Tsukuba, Japan
| | - Tetsuaki Arai
- Department of Psychiatry, University of Tsukuba, Tsukuba, Japan
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23
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Marutani T, Fuse-Nagase Y, Tachikawa H, Iwami T, Yamamoto Y, Moriyama T, Yasumi K. Has COVID-19 affected suicides among graduate students in Japan? Asian J Psychiatr 2021; 65:102803. [PMID: 34390982 PMCID: PMC9613852 DOI: 10.1016/j.ajp.2021.102803] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 07/31/2021] [Accepted: 08/02/2021] [Indexed: 11/16/2022]
Affiliation(s)
- Toshiyuki Marutani
- Health Support Center, Tokyo Institute of Technology, 4259 Nagatsuta-cho, Yokohama, Kanagawa, 226-8503, Japan.
| | - Yasuko Fuse-Nagase
- University Health Center, Ibaraki University, 2-1-1 Bunkyo, Mito, Ibaraki, 310-8512, Japan
| | - Hirokazu Tachikawa
- Department of Disaster and Community Psychiatry, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba City, Ibaraki, 305-8575, Japan
| | - Taku Iwami
- Health Services, Kyoto University, Yoshidahonmachi, Sakyo-ku, Kyoto, Kyoto, 606-8501, Japan
| | - Yuji Yamamoto
- Health and Medical Services Center, Shiga University, 1-1-1 Banba, Hikone, Shiga, 522-8522, Japan
| | - Toshiki Moriyama
- Health and Counseling Center, Osaka University, 1-17 Machikaneyama-cho, Toyonaka, Osaka, 560-0043, Japan
| | - Katsuhiro Yasumi
- Health Support Center, Tokyo Institute of Technology, 2-12-1 Ookayama, Meguro-ku, Tokyo, 152-8550, Japan
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24
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Fuse-Nagase Y, Marutani T, Tachikawa H, Iwami T, Yamamoto Y, Moriyama T, Yasumi K. Increase in suicide rates among undergraduate students in Japanese national universities during the COVID-19 pandemic. Psychiatry Clin Neurosci 2021; 75:351-352. [PMID: 34355847 PMCID: PMC8446983 DOI: 10.1111/pcn.13293] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 07/26/2021] [Accepted: 08/02/2021] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - Hirokazu Tachikawa
- Department of Disaster and Community Psychiatry, University of Tsukuba, Tsukuba, Japan
| | - Taku Iwami
- Health Services, Kyoto University, Kyoto, Japan
| | - Yuji Yamamoto
- Health and Medical Services Center, Shiga University, Hikone, Japan
| | | | - Katsuhiro Yasumi
- Health Support Center, Tokyo Institute of Technology, Tokyo, Japan
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25
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Inui-Yukawa M, Miyaoka H, Yamamoto K, Kamijo Y, Takai M, Yonemoto N, Kawanishi C, Otsuka K, Tachikawa H, Hirayasu Y. Effectiveness of assertive case management for patients with suicidal intent. Psychiatry Res 2021; 304:114125. [PMID: 34332432 DOI: 10.1016/j.psychres.2021.114125] [Citation(s) in RCA: 1] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 07/10/2021] [Accepted: 07/15/2021] [Indexed: 10/20/2022]
Abstract
The aim of this study was to examine the effectiveness of assertive case management intervention in preventing suicidal behaviour in self-poisoning patients. We conducted a secondary analysis of data from the ACTION-J study. Participants were self-poisoning patients with clear suicide intent admitted to emergency departments and with a primary psychiatric diagnosis (as per DSM-IV-TR axis 1). Patients were randomly assigned either to assertive case management or enhanced usual care. The primary outcome measure was the incidence of a first recurrent suicide attempt within 6 months. This study is registered at ClinicalTrials.gov (NCT00736918) and UMIN-CTR (C000000444). There were 297 self-poisoning patients in the intervention group and 295 in the control group. The primary outcome was significantly lower in the intervention group than in the control group. The incidence of a first recurrent suicide attempt within 1 and 3 months was also significantly lower in the intervention group, as was the number of overall self-harm episodes over the entire study period. Furthermore, the number of non-suicidal self-harm episodes and suicide attempts was significantly lower in the intervention group. Assertive case management is effective when promptly introduced in a hospital setting as an intervention following a suicide attempt, particularly for self-poisoning patients.
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Affiliation(s)
- Masami Inui-Yukawa
- Department of Psychiatry, Kitasato University, School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0374, Japan
| | - Hitoshi Miyaoka
- Department of Psychiatry, Kitasato University, School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0374, Japan
| | - Kenji Yamamoto
- Department of Psychiatry, Tokai University, School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
| | - Yoshito Kamijo
- Department of Emergency Medicine, Faculty of Medicine, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama 350-0495, Japan
| | - Michiko Takai
- Department of Emergency Medicine, Faculty of Medicine, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama 350-0495, Japan
| | - Naohiro Yonemoto
- Department of Neuropsychopharmacology, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashimachi, Kodaira, Tokyo 187-8553 187-8551, Japan.; Department of Public Health, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Chiaki Kawanishi
- Department of Neuropsychiatry, Sapporo Medical University Graduate School of Medicine, S-1, W-17, Chuo-ku, Sapporo 060-8556, Japan
| | - Kotaro Otsuka
- Department of Neuropsychiatry, School of Medicine, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan
| | - Hirokazu Tachikawa
- Department of Disaster and Community Psychiatry, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - Yoshio Hirayasu
- Hirayasu Hospital, 346 Kyouzuka, Urasoe, Okinawa 901-2553, Japan
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26
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Ogawa T, Tachikawa H, Shiratori Y, Sodeyama N, Taguchi T, Hori T, Arai T. Use of Blonanserin Transdermal Patch in Home Treatment of Schizophrenia: A Case Study. J Clin Psychopharmacol 2021; 41:603-605. [PMID: 34433201 DOI: 10.1097/jcp.0000000000001453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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27
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Midorikawa H, Aiba M, Lebowitz A, Taguchi T, Shiratori Y, Ogawa T, Takahashi A, Takahashi S, Nemoto K, Arai T, Tachikawa H. Confirming validity of The Fear of COVID-19 Scale in Japanese with a nationwide large-scale sample. PLoS One 2021; 16:e0246840. [PMID: 33566868 PMCID: PMC7875410 DOI: 10.1371/journal.pone.0246840] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [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: 12/01/2020] [Accepted: 01/27/2021] [Indexed: 11/23/2022] Open
Abstract
Assessing fear and anxiety regarding COVID-19 viral infection is essential for investigating mental health during this epidemic. We have developed and validated a Japanese-language version of The Fear of COVID-19 Scale (FCV-19S) based on a large, nationwide residential sample (n = 6,750) recruited through news and social media responding to an online version of the questionnaire. Data was collected from August 4-25, 2020. Results correlated with K6, GAD-7 and IES-R psychological scales, and T-tests and analysis of variance identified associated factors. All indices indicated the two-factor model emotional fear reactions and symptomatic expressions of fear a better fit for our data than a single-factor model in Confirmatory Factor Analysis (χ2 = 164.16, p<0.001, CFI 0.991, TLI = 0.985, RMSEA = 0.043). Socio-demographic factors identified as disaster vulnerabilities such as female sex, sexual minority, elderly, unemployment, and present psychiatric history associated with higher scores. However, respondent or family member experience of infection risk, or work/school interference from confinement, had greatest impact. Results suggest necessity of mental health support during this pandemic similar to other disasters.
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Affiliation(s)
- Haruhiko Midorikawa
- Majors of Clinical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tennoudai, Tsukuba, Ibaraki, Japan
| | - Miyuki Aiba
- Faculty of Human Sciences, Toyo Gakuen University, Hongo, Bunkyo, Tokyo, Japan
| | - Adam Lebowitz
- General Studies Department, Jichi Medical University, Yakushiji, Shimotsuke, Tochigi, Japan
| | - Takaya Taguchi
- Division of Clinical Medicine, Department of Disaster and Community Psychiatry, Faculty of Medicine, University of Tsukuba, Tennoudai, Tsukuba, Ibaraki, Japan
| | - Yuki Shiratori
- Department of Psychiatry, Tsukuba University Health Center, Tennoudai, Tsukuba, Ibaraki, Japan
| | - Takafumi Ogawa
- Majors of Clinical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tennoudai, Tsukuba, Ibaraki, Japan
| | - Asumi Takahashi
- Majors of Clinical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tennoudai, Tsukuba, Ibaraki, Japan
| | - Sho Takahashi
- Division of Clinical Medicine, Department of Disaster and Community Psychiatry, Faculty of Medicine, University of Tsukuba, Tennoudai, Tsukuba, Ibaraki, Japan
| | - Kiyotaka Nemoto
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Tennoudai, Tsukuba, Ibaraki, Japan
| | - Tetsuaki Arai
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Tennoudai, Tsukuba, Ibaraki, Japan
| | - Hirokazu Tachikawa
- Division of Clinical Medicine, Department of Disaster and Community Psychiatry, Faculty of Medicine, University of Tsukuba, Tennoudai, Tsukuba, Ibaraki, Japan
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28
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Shiratori Y, Tachikawa H, Nemoto K, Ide M, Sodeyama N, Tamura M, Takahashi S, Hori T, Arai T. Visualizing the Process of Disaster Mental Health Services in the Joso Flood by Network Analyses of Emails. TOHOKU J EXP MED 2020; 252:121-131. [PMID: 33028755 DOI: 10.1620/tjem.252.121] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Joso City, Ibaraki Prefecture, Japan was severely affected by flooding of the River Kinugawa in September 2015. Local psychiatric organizations immediately began providing disaster mental health services (DMHS). In post-disaster settings, DMHS involving organizational interventions by multiple regional institutions are required to support disaster victims. However, little is known about the process of coordinating multiple institutions or determining whether appropriate support has been provided. To elucidate the characteristics of communications that enable effective disaster medical team formation, we conducted network analyses of sender-recipient pairs of emails during the period of DMHS activity. The network analysis is a research method that represents various objects as a network of nodes and edges and explores their structural characteristics. We obtained 2,450 time-series emails from five core members of DMHS, including 32,865 pairs of senders and recipients. The network generated by the emails was scale-free, and its structure changed according to the phases of disaster recovery. In the ultra-acute phase, which lasted about 1 week, spreading information and recruiting people to provide disaster support was given the highest priority. In the acute phase, which lasted about 1 month, support and swift decision-making were essential for directing large numbers of staff. In the mid- to long-term phase, support for staff to share information and experience in small groups was observed. Network analyses have revealed that disaster medical teams must change their communication styles during the mission to adapt to different health needs corresponding to each post-disaster phase.
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Affiliation(s)
- Yuki Shiratori
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba
| | - Hirokazu Tachikawa
- Department of Disaster and Community Psychiatry, Faculty of Medicine, University of Tsukuba.,Department of Psychiatry, Ibaraki Prefectural Medical Center of Psychiatry
| | - Kiyotaka Nemoto
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba
| | - Masayuki Ide
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba
| | - Noriko Sodeyama
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba
| | - Masashi Tamura
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba
| | - Sho Takahashi
- Department of Disaster and Community Psychiatry, Faculty of Medicine, University of Tsukuba.,Department of Psychiatry, Ibaraki Prefectural Medical Center of Psychiatry
| | - Takafumi Hori
- Department of Psychiatry, Ibaraki Prefectural Medical Center of Psychiatry
| | - Tetsuaki Arai
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba
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29
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Takahashi A, Tachikawa H, Morita N, Aiba M, Shiratori Y, Nemoto K, Arai T. Suicide Prevention Gatekeeper Self-Efficacy Scale (GKSES). Crisis 2020; 42:128-135. [PMID: 32672521 DOI: 10.1027/0227-5910/a000698] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: To date there is no standardized scale for the evaluation of self-efficacy of gatekeeper skills. Aim: The aim of this study was to develop the Gatekeeper Self-Efficacy Scale (GKSES), which consists of nine items assessing laypersons' confidence in their own gatekeeper skills, and to confirm its reliability and validity. Method: Altogether 875 participants joined in gatekeeper training between 2010 and 2017 and completed the GKSES both before and after training. After exploratory factor analysis, we analyzed Pearson's correlation between total GKSES scores and Attitude Toward Suicide Scale subscale scores and performed one-way analysis of variance for the score differences by demographics. Results: The GKSES is a univariate scale with good fit. Total GKSES score correlated with the appropriate attitudes for suicide prevention. Self-efficacy ratings after training improved irrespective of attribute. Participants who had had contact with suicidal individuals and those who had received previous suicide prevention training had high self-efficacy ratings, while a greater improvement was seen in the ratings of participants who had not had any previous contact or training. Limitations: It is necessary to assess the GKSES using more participants across other populations. Conclusion: The GKSES is a simple and useful measure with good internal consistency and validity for self-efficacy assessment of gatekeeper skills.
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Affiliation(s)
- Asumi Takahashi
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba City, Japan
| | - Hirokazu Tachikawa
- Department of Disaster and Community Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba City, Japan
| | - Nobuaki Morita
- Department of Social Psychiatry and Mental Health, Faculty of Medicine, University of Tsukuba, Tsukuba City, Japan
| | - Miyuki Aiba
- Faculty of Human Sciences, Toyo Gakuen University, Bunkyo-ku, Japan
| | - Yuki Shiratori
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba City, Japan
| | - Kiyotaka Nemoto
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba City, Japan
| | - Tetsuaki Arai
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba City, Japan
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30
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Kawashima Y, Yonemoto N, Kawanishi C, Otsuka K, Mimura M, Otaka Y, Okamura K, Kinoshita T, Shirakawa O, Yoshimura R, Eto N, Hashimoto S, Tachikawa H, Furuno T, Sugimoto T, Ikeshita K, Inagaki M, Yamada M. Two-day assertive-case-management educational program for medical personnel to prevent suicide attempts: A multicenter pre-post observational study. Psychiatry Clin Neurosci 2020; 74:362-370. [PMID: 32166827 DOI: 10.1111/pcn.12999] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 06/14/2019] [Revised: 01/28/2020] [Accepted: 03/08/2020] [Indexed: 01/25/2023]
Abstract
AIM Suicide attempters have a high risk of repeated suicide attempts and completed suicide. There is evidence that assertive case management can reduce the incidence of recurrent suicidal behavior among suicide attempters. This study evaluated the effect of an assertive-case-management training program. METHODS This multicenter, before-and-after study was conducted at 10 centers in Japan. Participants were 274 medical personnel. We used Japanese versions of the Attitudes to Suicide Prevention Scale, the Gatekeeper Self-Efficacy Scale, the Suicide Intervention Response Inventory (SIRI), and the Attitudes Toward Suicide Questionnaire. We evaluated the effects with one-sample t-tests, and examined prognosis factors with multivariable analysis. RESULTS There were significant improvements between pre-training and post-training in the Attitudes to Suicide Prevention Scale (mean: -3.07, 95% confidence interval [CI]: -3.57 to -2.57, P < 0.001), the Gatekeeper Self-Efficacy Scale (mean: 10.40, 95%CI: 9.48 to 11.32, P < 0.001), SIRI-1 (appropriate responses; mean: 1.15, 95%CI: 0.89 to 1.42, P < 0.001), and SIRI-2 (different to the expert responses; mean: -4.78, 95%CI: -6.18 to -3.38, P < 0.001). Significant improvements were found on all Attitudes Toward Suicide Questionnaire subscale scores, except Unjustified Behavior. The effect of training was influenced by experience of suicide-prevention training and experience of working with suicidal patients. CONCLUSION The training program (which was developed to implement and disseminate evidence-based suicide-prevention measures) improved attitudes, self-efficacy, and skills for suicide prevention among medical personnel. Specialized suicide-prevention training and experience with suicidal patients are valuable for enhancing positive attitudes and self-efficacy; furthermore, age and clinical experience alone are insufficient for these purposes.
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Affiliation(s)
- Yoshitaka Kawashima
- Department of Neuropsychopharmacology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.,Clinical Psychology Course, Department of Psycho-Social Studies, School of Arts and Letters, Meiji University, Tokyo, Japan
| | - Naohiro Yonemoto
- Department of Neuropsychopharmacology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Chiaki Kawanishi
- Department of Neuropsychiatry, Graduate School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Kotaro Otsuka
- Department of Neuropsychiatry, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Yasushi Otaka
- Department of Neuropsychiatry, Nippon Medical School, Tokyo, Japan
| | - Kazuya Okamura
- Department of Psychiatry, Nara Medical University, Kashihara, Japan
| | | | - Osamu Shirakawa
- Department of Neuropsychiatry, Faculty of Medicine, Kindai University, Higashiosaka, Japan
| | - Reiji Yoshimura
- Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Nobuaki Eto
- Department of Psychiatry, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Satoshi Hashimoto
- Department of Psychiatry, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | - Hirokazu Tachikawa
- Department of Disaster and Community Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Taku Furuno
- Department of Psychiatry, Saiseikai Yokohamashi Nanbu Hospital, Yokohama, Japan
| | - Tatsuya Sugimoto
- Department of Psycho-Oncology, Shizuoka Cancer Center, Nagaizumi, Japan
| | | | - Masatoshi Inagaki
- Department of Psychiatry, Faculty of Medicine, Shimane University, Izumo, Japan
| | - Mitsuhiko Yamada
- Department of Neuropsychopharmacology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
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Midorikawa H, Tachikawa H, Nemoto K, Morita N, Shiratori Y, Endo G, Taguchi T, Arai T. Mental health of gatekeepers may influence their own attitudes toward suicide: A questionnaire survey from a suicide-prevention gatekeeper training program. Asian J Psychiatr 2020; 47:101842. [PMID: 31683194 DOI: 10.1016/j.ajp.2019.101842] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 12/26/2018] [Revised: 10/15/2019] [Accepted: 10/15/2019] [Indexed: 11/26/2022]
Abstract
AIMS We aimed to investigate the association between general mental health and attitudes toward suicide of participants in suicide-prevention gatekeeper training programs. METHODS We conducted a number of half day training seminars within a suicide prevention program addressing gatekeepers. Participants filled in two questionnaires, one measuring general health (General Health Questionnaire, GHQ-12), and one measuring attitudes towards suicide (ATTS). RESULTS The total sample size of participants was 230, of whom 115 completed questionnaires. There were no significant differences in demographic backgrounds between the good mental health (GHQ-12 ≤ 4) and the poor mental health (GHQ-12 ≥ 5) groups. The poor mental health group was more likely to think that people have the right to commit suicide. CONCLUSION There was a difference in attitudes toward suicide between the good mental health and the poor mental health groups, indicating that attention should be paid to participants' mental health when conducting suicide-prevention gatekeeper training.
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Affiliation(s)
- Haruhiko Midorikawa
- Majors of Clinical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan; Department of Psychiatry, Kurita Hospital, 505 Toyobami, Naka, Ibaraki, 311-0117, Japan
| | - Hirokazu Tachikawa
- Department of Psychiatry, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan.
| | - Kiyotaka Nemoto
- Department of Psychiatry, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Nobuaki Morita
- Department of Social Psychiatry & Mental Health, Division of Health Innovation and Nursing, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Yuki Shiratori
- Department of Psychiatry, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Go Endo
- Department of Psychiatry, Kashima Hospital, 1129-2 Hirai, Kashima, Ibaraki, 314-0012, Japan
| | - Takaya Taguchi
- Ibaraki Prefectural Medical Center of Psychiatry, 654 Asahi, Kasama, Ibaraki, 309-1717, Japan
| | - Tetsuaki Arai
- Department of Psychiatry, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan
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Midorikawa H, Tachikawa H, Aiba M, Arai T, Watanabe T, Tamiya N. Factors associated with high-risk drinking in older adults: Evidence from a national survey in Japan. Geriatr Gerontol Int 2019; 19:1260-1267. [PMID: 31696639 DOI: 10.1111/ggi.13808] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 04/11/2019] [Revised: 09/08/2019] [Accepted: 10/10/2019] [Indexed: 11/28/2022]
Abstract
AIM This study aimed to clarify the association between high-risk drinking and health outcomes (e.g. physical and psychosocial factors, including help-seeking behavior) among older Japanese adults. METHODS Data were obtained from the 2013 Comprehensive Survey of Living Conditions in Japan, which surveyed 295 367 households. We restricted analyses to 55 147 current drinkers. Multinomial logistic regression models were used to examine associations between alcohol consumption and various factors. RESULTS Overall, 35.3% of participants were in the low-risk group, 13.1% were in the at-risk group and 1.0% were in the high-risk group. Those in the at-risk and high-risk groups were more likely to be younger, male, employed and tobacco users. They were also more likely to report sleeping ≥9 h per night, and they were more likely to report unhealthy eating habits. Being in the high-risk drinking group was significantly associated with being divorced (OR 1.51, 95% CI 1.11-2.05) and having poor mental health (OR 1.57, 95% CI 1.13-1.68). The high-risk drinking group was more likely to include those who endorsed experiencing challenges without seeking aid (OR 1.87, 95% CI 1.39-2.53) or felt no need to seek aid (OR 1.39, 95% CI 1.15-1.68). CONCLUSIONS Being at high-risk for drinking is associated with poorer help-seeking behavior, suggesting a need for more aggressive outreach. Geriatr Gerontol Int 2019; 19: 1260-1267.
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Affiliation(s)
- Haruhiko Midorikawa
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Hirokazu Tachikawa
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.,Research and Development Center for Health Services, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Miyuki Aiba
- Faculty of Human Sciences, Toyo Gakuen University, Bunkyo, Tokyo, Japan
| | - Tetsuaki Arai
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Taeko Watanabe
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Nanako Tamiya
- Research and Development Center for Health Services, University of Tsukuba, Tsukuba, Ibaraki, Japan.,Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
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Miyauchi E, Ide M, Tachikawa H, Nemoto K, Arai T, Kawasaki M. A novel approach for assessing neuromodulation using phase-locked information measured with TMS-EEG. Sci Rep 2019; 9:428. [PMID: 30674902 PMCID: PMC6344580 DOI: 10.1038/s41598-018-36317-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 08/23/2018] [Indexed: 02/05/2023] Open
Abstract
Neuromodulation therapies such as electroconvulsive therapy (ECT) are used to treat several neuropsychiatric disorders, including major depressive disorder (MDD). Recent work has highlighted the use of combined transcranial magnetic stimulation and electroencephalography (TMS-EEG) to evaluate the therapeutic effects of neuromodulation; particularly, the phase locking factor (PLF) and phase locking value (PLV) can reportedly assess neuromodulation-induced functional changes in cortical networks. To examine changes in TMS-induced PLV and PLF before and after ECT, and their relationship with depression severity in patients with MDD, TMS-EEG and the Montgomery–Åsberg Depression Rating Scale (MADRS; depression severity) were implemented before and after ECT in 10 patients with MDD. Single-pulse TMS was applied to the visual and motor areas to induce phase propagation in the visuo-motor network at rest. Functional changes were assessed using PLF and PLV data. Pre-ECT TMS-induced alpha band (9–12 Hz) PLV was negatively correlated with depression severity, and increments of post-ECT from pre-ECT TMS-induced alpha band PLV were positively correlated with the reduction in depression severity. Moreover, we found a negative correlation between pre-ECT TMS-induced PLF at TMS-destination and depression severity. Finally, differences in post-ECT TMS-induced PLF peak latencies between visual and motor areas were positively correlated with depression severity. TMS-EEG-based PLV and PLF may be used to assess the therapeutic effects of neuromodulation and depressive states, respectively. Furthermore, our results provide new insights about the neural mechanisms of ECT and depression.
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Affiliation(s)
- Eri Miyauchi
- Department of Intelligent Interaction Technology, Graduate School of Systems and Information Engineering, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8573, Japan
| | - Masayuki Ide
- Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
| | - Hirokazu Tachikawa
- Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Kiyotaka Nemoto
- Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Tetsuaki Arai
- Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Masahiro Kawasaki
- Department of Intelligent Interaction Technology, Graduate School of Systems and Information Engineering, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8573, Japan.
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Lebowitz A, Tachikawa H, Aiba M, Okamoto Y, Takahashi S, Nemoto K, Arai T. Post-flood social support networks and morbidity in Jôsô City, Japan. Psychiatry Res 2019; 271:708-714. [PMID: 30791345 DOI: 10.1016/j.psychres.2018.11.073] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 01/04/2018] [Revised: 07/06/2018] [Accepted: 11/30/2018] [Indexed: 12/23/2022]
Abstract
Social support networks are considered beneficial for post-disaster survivor mental health. However, there are family and non-family networks, and support can be received or provided. Therefore, their complex contribution to wellbeing requires analysis. Researching elderly residents of Jôsô City NE of Tokyo (N = 1182 [female: n = 618], Age M = 69.76y, SD = 6.10y) who experienced severe flooding in September 2015 investigated data for mental health outcomes of depression (K6), trauma (IES-R), and existence of recent worry from evacuation and house damage. An original instrument tapped support source and direction, controlled to examine mental health symptom changes. House damage was a higher mental health predictor (ηp2 = .10-.16) than evacuation (ηp2 = .033-.093). Results indicated family social support may buffer mental health outcomes, but non-family social support may burden them. Overall support network size also indicated burdening compared to social support receiving-providing imbalance.
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Affiliation(s)
- Adam Lebowitz
- School of Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Hirokazu Tachikawa
- Department of Psychiatry, University of Tsukuba, Tsukuba, Ibaraki, Japan.
| | - Miyuki Aiba
- Faculty of Human Sciences, Toyo Gakuen University, Tokyo, Japan
| | | | - Sho Takahashi
- Department of Disaster Psychiatry, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Kiyotaka Nemoto
- Department of Psychiatry, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Tetsuaki Arai
- Department of Psychiatry, University of Tsukuba, Tsukuba, Ibaraki, Japan
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Kawanishi C, Ishii T, Yonemoto N, Yamada M, Tachikawa H, Kishimoto T, Tsujii N, Hashimoto S, Kinoshita T, Mimura M, Okubo Y, Otsuka K, Yoshimura R. Protocol for a prospective multicentre registry cohort study on suicide attempters given the assertive case management intervention after admission to an emergency department in Japan: post-ACTION-J Study (PACS). BMJ Open 2018; 8:e020517. [PMID: 30287602 PMCID: PMC6173257 DOI: 10.1136/bmjopen-2017-020517] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Suicide attempt is the most important risk factor for later suicide. A randomised-controlled, multicentre trial of postsuicide attempt case management for the prevention of further suicide attempts in Japan, named ACTION-J, has established effective interventions for prevention of suicide reattempts. The ACTION-J assertive case management intervention programme was adopted by the Japanese Ministry of Health, Labour and Welfare in 2016, when medical fees were revised. This nationwide programme is provided to patients who attempt suicide and who are admitted to emergency departments in Japan.The aim of the present study is to examine the current implementation status of the ACTION-J programme. The present study also aims to clarify which patients' and hospitals' factors affect the implementation of the programme. METHODS AND ANALYSIS This is a prospective, multicentre, patient registry cohort study. Participants will be suicide attempters admitted to the emergency departments of medical facilities with both psychiatry and emergency departments. The assertive case management programme will be delivered to participants by a case manager for up to 24 weeks, based on psychiatric diagnoses, social risks and patient needs. The core feature of the programme is to encourage patients to participate in psychiatric treatment.The primary outcome will be the proportion of patients still participating in the case management intervention at 24 weeks after registration. The secondary outcomes will include measures of the fidelity of the case management intervention. The fidelity will be evaluated using a fidelity assessment manual developed by the study group. ETHICS AND DISSEMINATION This observational study has been approved by the ethics board of Sapporo Medical University. Enrolment began in October 2016 and will continue until December 2018. Dissemination plans include presentations at scientific conferences and scientific publications. TRIAL REGISTRATION UMIN000024474.
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Affiliation(s)
- Chiaki Kawanishi
- Department of Neuropsychiatry, Sapporo Medical University Graduate School of Medicine
| | - Takao Ishii
- Department of Neuropsychiatry, Sapporo Medical University Graduate School of Medicine
| | - Naohiro Yonemoto
- Department of Biostatistics, Kyoto University School of Public Health, Kyoto, Japan
| | - Mitsuhiko Yamada
- Department of Neuropsychopharmacology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Hirokazu Tachikawa
- Department of Psychiatry, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | | | - Noa Tsujii
- Department of Neuropsychiatry, Kindai University Faculty of Medicine, Osakasayama, Japan
| | | | | | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Yoshiro Okubo
- Department of Neuropsychiatry, Japan Medical University, Tokyo, Japan
| | - Kotaro Otsuka
- Department of Neuropsychiatry, Iwate Medical University, Morioka, Japan
| | - Reiji Yoshimura
- Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Japan
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Sugiyama D, Kimura H, Tachikawa H, Iimoto T, Kawata Y, Ogino H, Okoshi M. Integrating radiation protection criteria for radioactive waste management into remediation procedures in existing exposure situations after a nuclear accident. J Radiol Prot 2018; 38:456-462. [PMID: 29235443 DOI: 10.1088/1361-6498/aaa155] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Experience after the accident at the Fukushima Daiichi nuclear power station has shown that there is a need to establish radiation protection criteria for radioactive waste management consistent with the criteria adopted for the remediation of existing exposure situations. A stepwise approach to setting such criteria is proposed. Initially, a reference level for the annual effective dose from waste management activities in the range 1-10 mSv should be set, with the reference level being less than the reference level for the ambient dose. Subsequently, the reference level for the annual effective dose from waste management activities should be reduced in one or more steps to achieve a final target value of 1 mSv. The dose criteria at each stage should be determined with relevant stakeholder involvement. Illustrative case studies show how this stepwise approach might be applied in practice.
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Affiliation(s)
- Daisuke Sugiyama
- Radiation Safety Research Center, Nuclear Technology Research Laboratory, Central Research Institute of Electric Power Industry, Tokyo 201-8511, Japan
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Sato M, Terai S, Tachikawa H, Maeda H, Yamamoto M, Tomioka N, Watanabe K, Takahashi M. Abstract P1-07-13: Obesity is associated with poor prognosis of Japanese breast cancer, especially in ER positive/HER2 negative subtype, which tendency is prominent. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p1-07-13] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Body mass index (BMI) is defined as a poor prognostic factor in breast cancer patients in western countries. Since the percentage of the overweight differs between Asian and western breast cancer patients, we do not know if breast cancer prognosis in Asia is related to obesity, the same as in western countries. Therefore, we have investigated the association between BMI and the prognosis of Japanese breast cancer patients.
Patients and Methods: This study is a retrospective analysis of the 1,924 primary Japanese female breast cancer patients with clinical stage I through III disease to have undergone surgery between January 2004 and December 2013 at the Hokkaido Cancer Center. The data of BMI were at the time of diagnosis, and stratified into 2 groups as non-Obese (BMI < 25 kg/m2), Obese (BMI ≥ 25 kg/m2). The overall survival (OS) and disease-free survival (DFS) were compared between two BMI groups using the Kaplan-Meier method and Cox hazards model.
Results: The number of non-Obese group was 1,353 (70.3%) and Obese group was 571 (29.7%) of the 1,924 patients. Six hundred and thirty two patients were in premenopausal (32.8%), 1,289 were in postmenopausal (67.0%) and 3 were unknown. The median follow-up period was 73 months. Breast cancer recurred in 239 patients (12.2%), and 204 patients died. There were 110 cases of breast cancer-related death, 48 cases of non-breast cancer death, and 46 cases of unknown as the cause of death. Patients in Obese group had shown significantly poorer OS (adjusted hazard ratio (HR) = 1.68, 95% confidence interval (CI) = 0.45 to 0.79) and DFS (HR = 1.46, 95% CI = 1.16 to 1.82). As investigating by subtype analysis, a high BMI in ER positive/HER2 negative patients was associated with a significantly worse OS (HR = 2.04, 95% CI = 1.42 to 2.92) and significantly worse DFS (HR = 1.61, 95% CI = 1.23 to 2.11). On the other hand, there was no significant interaction found between the BMI and OS or DFS in ER negative/HER2 negative patients and HER2 positive patients. Subsequently, when analysis was limited to ER positive HER2 negative, there was a difference in the degree of association between obesity and prognosis due to the difference in menopause status. In premenopausal patients with ER positive/HER2 negative cancer, Obese group had significantly poorer OS (HR = 2.83, 95%CI = 1.32 to 5.88) and significantly poorer DFS (HR = 2.41, 95%CI = 1.41 to 3.99). In postmenopausal patients, Obese group patients had significantly poorer OS (HR = 1.71, 95%CI = 1.11 to 2.58) and poorer DFS (HR = 1.35, 95%CI = 0.98 to 1.86), however. The relevance was not so large compared with that in premenopausal patients.
Conclusion: Among Japanese breast cancer patients, Obese (BMI ≥ 25 kg/m2) was one of poor prognostic factors. Specifically, obesity was associated as an extremely strong prognostic factor in ER positive/HER2 negative premenopausal patients. Since hormone therapy has been practiced in almost all ER positive breast cancers, the relationship between hormonal therapy susceptibility and obesity is noticed not only in western patients but also in Asian patients.
Citation Format: Sato M, Terai S, Tachikawa H, Maeda H, Yamamoto M, Tomioka N, Watanabe K, Takahashi M. Obesity is associated with poor prognosis of Japanese breast cancer, especially in ER positive/HER2 negative subtype, which tendency is prominent [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P1-07-13.
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Affiliation(s)
- M Sato
- NHO Hokkaido Cancer Center, Sapporo, Hokkaido, Japan
| | - S Terai
- NHO Hokkaido Cancer Center, Sapporo, Hokkaido, Japan
| | - H Tachikawa
- NHO Hokkaido Cancer Center, Sapporo, Hokkaido, Japan
| | - H Maeda
- NHO Hokkaido Cancer Center, Sapporo, Hokkaido, Japan
| | - M Yamamoto
- NHO Hokkaido Cancer Center, Sapporo, Hokkaido, Japan
| | - N Tomioka
- NHO Hokkaido Cancer Center, Sapporo, Hokkaido, Japan
| | - K Watanabe
- NHO Hokkaido Cancer Center, Sapporo, Hokkaido, Japan
| | - M Takahashi
- NHO Hokkaido Cancer Center, Sapporo, Hokkaido, Japan
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Ishii T, Tachikawa H, Shiratori Y, Hori T, Aiba M, Kuga K, Arai T. What kinds of factors affect the academic outcomes of university students with mental disorders? A retrospective study based on medical records. Asian J Psychiatr 2018; 32:67-72. [PMID: 29216609 DOI: 10.1016/j.ajp.2017.11.017] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [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: 04/20/2017] [Revised: 11/09/2017] [Accepted: 11/27/2017] [Indexed: 10/18/2022]
Abstract
AIMS University students that suffer from mental disorders seem to have difficulty graduating. Therefore, we investigated risk and protective factors of dropping out with the aim of improving such students' academic outcomes. METHODS First, we statistically compared the academic outcomes of 203 undergraduate students who received treatment in the Department of Psychiatry of the Tsukuba University Health Center to those of matched controls. Second, clinical factors of 370 mentally ill students were statistically compared between the dropout and graduate groups. RESULTS Mentally ill students experienced significantly greater difficulties graduating. Furthermore, the ratio of females and the year of study at initial consultation were significantly lower in the dropout group. However, duration of illness, social withdrawal, temporary leaves of absence, percentage of diagnosis of F2, history of truancy, CGI-S/GI score, number of suicide attempts, visits to us, family consultations with us and grade repeating were longer or greater in the dropout group. Ultimately, the number of suicide attempts, CGI-S score, social withdrawal and leaves of absence were significantly associated with dropping out. Moreover, duration of social withdrawal and leaves of absence were significantly correlated with CGI-GI score. CONCLUSION We found that the number of suicide attempts, CGI-S score, social withdrawal and extended enrollment were risk factors for dropping out, while the therapeutic effect seemed to be a protective factor. As risk factors involved states of social maladjustment, it is necessary not only to treat mental disorders, but also to provide assistance such as educational and individual support for daily living.
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Affiliation(s)
- Terumi Ishii
- Department of Psychiatry, Tsukuba University Health Center, 1-1-1, Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan; Department of Psychiatry, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennoudai, Tsukuba, Ibaraki, 305-8575 Japan.
| | - Hirokazu Tachikawa
- Department of Psychiatry, Tsukuba University Health Center, 1-1-1, Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan; Department of Psychiatry, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennoudai, Tsukuba, Ibaraki, 305-8575 Japan
| | - Yuki Shiratori
- Department of Psychiatry, Tsukuba University Health Center, 1-1-1, Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan; Department of Psychiatry, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennoudai, Tsukuba, Ibaraki, 305-8575 Japan
| | - Takafumi Hori
- Ibaraki Prefectural Medical Center of Psychiatry, 654 Asahimachi, Kasama, Ibaraki, 309-1717, Japan
| | - Miyuki Aiba
- Institute of Human Sciences, Toyo University, 2100 Kujirai, Kawagoe-shi, Saitama, 350-8585, Japan
| | - Keisuke Kuga
- Tsukuba University Health Center, 1-1-1, Tennoudai, Tsukuba, Ibaraki, 305-8575 Japan
| | - Tetsuaki Arai
- Department of Psychiatry, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennoudai, Tsukuba, Ibaraki, 305-8575 Japan
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Taguchi T, Tachikawa H, Nemoto K, Suzuki M, Nagano T, Tachibana R, Nishimura M, Arai T. Major depressive disorder discrimination using vocal acoustic features. J Affect Disord 2018; 225:214-220. [PMID: 28841483 DOI: 10.1016/j.jad.2017.08.038] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [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: 01/15/2017] [Revised: 06/01/2017] [Accepted: 08/14/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND The voice carries various information produced by vibrations of the vocal cords and the vocal tract. Though many studies have reported a relationship between vocal acoustic features and depression, including mel-frequency cepstrum coefficients (MFCCs) which applied to speech recognition, there have been few studies in which acoustic features allowed discrimination of patients with depressive disorder. Vocal acoustic features as biomarker of depression could make differential diagnosis of patients with depressive state. In order to achieve differential diagnosis of depression, in this preliminary study, we examined whether vocal acoustic features could allow discrimination between depressive patients and healthy controls. METHODS Subjects were 36 patients who met the criteria for major depressive disorder and 36 healthy controls with no current or past psychiatric disorders. Voices of reading out digits before and after verbal fluency task were recorded. Voices were analyzed using OpenSMILE. The extracted acoustic features, including MFCCs, were used for group comparison and discriminant analysis between patients and controls. RESULTS The second dimension of MFCC (MFCC 2) was significantly different between groups and allowed the discrimination between patients and controls with a sensitivity of 77.8% and a specificity of 86.1%. The difference in MFCC 2 between the two groups reflected an energy difference of frequency around 2000-3000Hz. CONCLUSIONS The MFCC 2 was significantly different between depressive patients and controls. This feature could be a useful biomarker to detect major depressive disorder. LIMITATIONS Sample size was relatively small. Psychotropics could have a confounding effect on voice.
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Affiliation(s)
- Takaya Taguchi
- Department of Psychiatry, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Japan; University of Tsukuba Hospital, Japan
| | - Hirokazu Tachikawa
- Department of Psychiatry, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Japan; Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Japan.
| | - Kiyotaka Nemoto
- Department of Psychiatry, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Japan; Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Japan
| | | | | | | | - Masafumi Nishimura
- Graduate School of Integrated Science and Technology, Shizuoka University, Japan
| | - Tetsuaki Arai
- Department of Psychiatry, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Japan; Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Japan
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Nakamine S, Tachikawa H, Aiba M, Takahashi S, Noguchi H, Takahashi H, Tamiya N. Changes in social capital and depressive states of middle-aged adults in Japan. PLoS One 2017; 12:e0189112. [PMID: 29216253 PMCID: PMC5720718 DOI: 10.1371/journal.pone.0189112] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 12/23/2016] [Accepted: 11/20/2017] [Indexed: 11/18/2022] Open
Abstract
The present study examines the relationships between changes in bonding and bridging types of social capital and depressive states among middle-aged adults in Japan using a nationally representative sample. Data was collected from a nationwide, population-based survey conducted from 2005 to 2013 in nine annual waves. A total of 16,737 middle-aged men and 17,768 middle-aged women provided data. They reported about depressive states, measured by Kessler 6 scores, and bonding and bridging types of social capital, measured by reported participation in different social activities. Latent growth modeling was conducted to examine relations between changes in bonding and bridging types of social capital and depressive states within individuals across the nine waves. The results showed that, for both men and women, increases in bonding social capital were associated with decreases in depressive states, while changes in bridging social capital were not related to changes in depressive states. In addition, the results showed that changes in bonding social capital, but not bonding social capital at the baseline, affected changes in depressive states. Future studies should take changes in social capital as an independent variable into consideration.
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Affiliation(s)
- Shin Nakamine
- Faculty of Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
- JSPS Research Fellow, Chiyoda-ku, Tokyo, Japan
- * E-mail:
| | - Hirokazu Tachikawa
- Department of Psychiatry, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Miyuki Aiba
- Faculty of Human Sciences, Toyo Gakuen University, Bunkyo-ku, Tokyo, Japan
| | - Sho Takahashi
- Department of Psychiatry, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Haruko Noguchi
- School of Political Science and Economics, Waseda University, Shinjuku-ku, Tokyo, Japan
| | | | - Nanako Tamiya
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
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Aiba M, Tachikawa H, Nakamine S, Takahashi S, Noguchi H, Takahashi H, Tamiya N. Development of social capital scale from a national longitudinal survey and examination of its validity and reliability. Nihon Koshu Eisei Zasshi 2017; 64:371-383. [PMID: 28966292 DOI: 10.11236/jph.64.7_371] [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] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Objectives Social capital consists of two subordinate concepts; first one is structural formal, structural informal, or cognitive and second one is bonding or bridging. This study was designed to develop a social capital scale using samples from a national longitudinal survey and evaluate the validity and test-retest reliability of the scale.Methods Data were collected from a nationwide panel survey, the "Longitudinal Survey of Middle-aged and Elderly Persons." Individuals aged 50-59 years living in Japan were selected by stratified random sampling in the first wave conducted in 2005. The first (n=34,240) and second (n=32,285) sets of data were used for Phase 1, and the sixth (n=26,220) and seventh (n=25,321) sets of data were used for Phase 2. In regard to first subordinate concept, the occurrence of six selected social activities with "neighborhood association" and "NPOs, or Public Interest Corporations" were calculated as the structural formal index, and the occurrence of six selected social activities with "families or friends" and "colleagues" were calculated as the structural informal index. Moreover, satisfaction with social activities (community activities, support for the elderly, and others) was used as the cognitive index. In regard to second subordinate concept, the bonding index was calculated using "families or friends," "colleagues," and "neighborhood association;" the bridging index was calculated using "NPOs or Public Interest Corporations." The diagnoses of heart disease, stroke, and cancer (yes=1, no=0) and self-rated health (1 item, 6-point scale) were used as variables for determining validity.Results We categorized social capital indices into subordinate concepts based on the construct of social capital defined by professional agreement to assess content validity. The results showed that this survey questionnaire was constructed using items that assessed all the subordinate concepts. Hierarchical Linear Modeling examined the relationship between social capital and health as assessed by diagnoses of physical disease and self-rated health to examine convergent validity, which indicated that all social capital indices had significant positive effects on self-rated health at an individual or group level. However, the diagnosis of a stroke was negatively influenced by cognitive and formal social capital indices at a group level, whereas heart disease and cancer were not significantly affected. Multilevel correlation analyses of Phase 1 (the first and second) and Phase 2 (sixth and seventh) were conducted to assess test-retest reliability, which indicated correlation coefficients of 0.392 to 0.999.Conclusion The findings of this study indicated the content validity of the scale that was developed from the national longitudinal survey. Moreover, results of Hierarchical Linear Modeling confirmed the partial convergent validity of the scale. Furthermore, multilevel correlation analyses demonstrated the adequate test-retest reliability of the scale at the group level.
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Affiliation(s)
- Miyuki Aiba
- Faculty of Human Sciences, Toyo Gakuen Universtiy
| | | | | | - Sho Takahashi
- Department of Disaster Psychiatry, Faculty of Medicine, University of Tsukuba
| | - Haruko Noguchi
- School of Political Science and Economics, Waseda University
| | | | - Nanako Tamiya
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba
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Aiba M, Tachikawa H, Fukuoka Y, Lebowitz A, Shiratori Y, Doi N, Matsui Y. Standardization of Brief Inventory of Social Support Exchange Network (BISSEN) in Japan. Psychiatry Res 2017; 253:364-372. [PMID: 28431260 DOI: 10.1016/j.psychres.2017.03.056] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 03/03/2016] [Revised: 03/22/2017] [Accepted: 03/31/2017] [Indexed: 11/16/2022]
Abstract
This study describes the Brief Inventory of Social Support Exchange Network (BISSEN) as a standardized brief inventory measuring various aspects of social support. We confirmed the reliability and validity for function and direction of support and standardized the BISSEN. For Sample 1, a stratified random sampling method was used to select 5200 residents in Japan. We conducted mail surveys and responses were retrieved from 2274 participants (collection rate 43.7%). Participants completed a questionnaire packet that included BISSEN, suicidal ideation, depression, support seeking, and Multidimensional Scale of Perceived Social Support (MSPSS). Sample 2 surveys for test-retest reliability were conducted on 23 residents at approximately two-week intervals. Participants were asked about gender, age, and BISSEN. First, we assessed the internal consistency, test-retest reliability, construct, convergent, and concurrent validity. McDonald's omega (.73-.92) and test-retest correlations (.78-.85) demonstrated adequate internal consistency and test-retest reliability. Depression, support seeking, and MSPSS were significantly correlated with all scores of BISSEN. The non-suicidal ideation group had significantly more support compared to the suicidal ideation group. Therefore, function and direction of support in BISSEN had sufficient reliability and validity. Next, we standardized BISSEN using Z-scores and percentile rank with respect to each 12 norm groups by age and gender.
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Affiliation(s)
- Miyuki Aiba
- Faculty of Human Sciences, Toyo Gakuen University, 1-26-3 Hongo,Bunkyo-ku, Tokyo, Japan.
| | | | - Yoshiharu Fukuoka
- Faculty of Health and Welfare, Kawasaki University of Medical Welfare, Kurashiki,Okayama, Japan
| | - Adam Lebowitz
- School of Medicine, Jichi Medical University, Shimotsuke,Tochigi, Japan
| | - Yuki Shiratori
- Department of Psychiatry, University of Tsukuba, Tsukuba,Ibaraki, Japan
| | - Nagafumi Doi
- Ibaraki Prefectural Medical Center of Psychiatry, Kasama,Ibaraki, Japan
| | - Yutaka Matsui
- Faculty of Human Sciences, University of Tsukuba, Tsukuba,Ibaraki, Japan
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Fu R, Noguchi H, Tachikawa H, Aiba M, Nakamine S, Kawamura A, Takahashi H, Tamiya N. Relation between social network and psychological distress among middle-aged adults in Japan: Evidence from a national longitudinal survey. Soc Sci Med 2017; 175:58-65. [DOI: 10.1016/j.socscimed.2016.12.043] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 12/10/2016] [Accepted: 12/28/2016] [Indexed: 10/20/2022]
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Inagaki M, Kawashima Y, Kawanishi C, Yonemoto N, Sugimoto T, Furuno T, Ikeshita K, Eto N, Tachikawa H, Shiraishi Y, Yamada M. Interventions to prevent repeat suicidal behavior in patients admitted to an emergency department for a suicide attempt: a meta-analysis. J Affect Disord 2015; 175:66-78. [PMID: 25594513 DOI: 10.1016/j.jad.2014.12.048] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [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: 08/04/2014] [Revised: 12/12/2014] [Accepted: 12/19/2014] [Indexed: 01/23/2023]
Abstract
BACKGROUND A huge number of patients with self-harm and suicide attempt visit emergency departments (EDs). We systematically reviewed studies and examined the effect of interventions to prevent repeat suicidal behavior in patients admitted to EDs for a suicidal attempt. METHOD We searched the databases of MEDLINE, PsychoINFO, CINAHL, and EMBASE through August 2013. Eligible studies were randomized controlled trials assessing the effects on repeat suicidal behavior of interventions initiated in suicidal patients admitted to EDs. Interventions in each trial were classified into groups by consensus. Meta-analyses were performed to determine pooled relative risks (RRs) and 95% confidence intervals (CIs) of repetition of suicide attempt for interventions in each group. RESULTS Out of 5390 retrieved articles, 24 trials were included and classified into four groups (11 trials in the Active contact and follow-up, nine in the Psychotherapy, one in the Pharmacotherapy, and three in the Miscellaneous). Active contact and follow-up type interventions were effective in preventing a repeat suicide within 12 months (n=5319; pooled RR=0.83; 95% CI: 0.71 to 0.97). However, the effect at 24 months was not confirmed (n=925; pooled RR=0.98; 95% CI: 0.76-1.22). The effects of the other interventions on preventing a repetition of suicidal behavior remain unclear. LIMITATION Caution is needed regarding the heterogeneity of the effects. CONCLUSION Interventions of active contact and follow-up are recommended to reduce the risk of a repeat suicide attempt at 12 months in patients admitted to EDs with a suicide attempt. However, the long-term effect was not confirmed.
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Affiliation(s)
| | - Yoshitaka Kawashima
- Department of Neuropsychopharmacology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Japan
| | - Chiaki Kawanishi
- Health Management and Promotion Center, Yokohama City University Graduate School of Medicine, Japan
| | - Naohiro Yonemoto
- Department of Neuropsychopharmacology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Japan
| | - Tatsuya Sugimoto
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Japan
| | - Taku Furuno
- Department of Psychiatry, National Hospital Organization Yokohama Medical Center, Japan
| | - Katsumi Ikeshita
- Department of Psychiatry, Psychiatric Institute, Nara Medical University, Japan
| | - Nobuaki Eto
- Department of Psychiatry, Faculty of Medicine Fukuoka University, Japan
| | - Hirokazu Tachikawa
- Department of Psychiatry, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Japan
| | - Yohko Shiraishi
- Department of Psychiatry, Yokohama City University School of Medicine, Japan
| | - Mitsuhiko Yamada
- Department of Neuropsychopharmacology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Japan
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Ishii T, Tachikawa H, Hori T, Ishikawa M, Hatanaka K, Aiba M, Asada T. [Effects of Mental Disorders on the Academic Outcomes of University Students--A Retrospective Study Using Medical Records from a Health Services Center]. Seishin Shinkeigaku Zasshi 2015; 117:965-977. [PMID: 27044138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Falling behind in class is a serious problem for university students as it can lead to social problems and increase the risk of suicide. Although it is common for students suffering from mental disorders to fall behind academically, there have been few studies investigating the difficulties these students face in order to graduate from university. Therefore, we investigated factors associated with dropping out of school with the purpose of creating a strategy to improve the academic outcomes of students who regularly seek psychiatric consultation. SUBJECTS We investigated undergraduate students who received consultation at Tsukuba University's Health Services Center Psychiatry Department and whose academic outcomes between the 2004 and 2013 academic years were known. METHODS Academic outcomes were obtained from Tsukuba University's grade management system by permission of the authority. The students were divided into either a graduate or dropout group depending on their academic outcomes. The medical records for both groups were retrospectively investigated, and factors that were predicted to affect academic outcomes were assessed using statistical methods. RESULTS The dropout group was younger in grade and had a greater severity of illness at initial consultation. Moreover, this group had a greater number of consultation visits, showed less cooperation with the instructor in charge, had a significantly longer duration of social with drawal and temporary leave of absence from school, and had a significantly greater number of students with grade retention. When a time factor was incorporated in the analysis, the presence of grade retention/temporary leave of absence from school and social withdrawal was significantly correlated with dropping out of school. CONCLUSION It was revealed that not only the mental disorder itself, but also psychosocial severity and the maladjusted state that occur secondary to such mental disorder influence academic outcomes. These results indicated that in order to improve academic outcomes, it is necessary not only to appropriately treat the disorder, but to also provide university community support for social maladjusted states of the students in psychiatric treatments, such as social withdrawal, educational support for daily living, individual support for daily living, and academic support, through cooperation with the educational organization.
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Endo G, Tachikawa H, Fukuoka Y, Aiba M, Nemoto K, Shiratori Y, Matsui Y, Doi N, Asada T. How perceived social support relates to suicidal ideation: a Japanese social resident survey. Int J Soc Psychiatry 2014; 60:290-8. [PMID: 23741005 DOI: 10.1177/0020764013486777] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [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] [Indexed: 11/17/2022]
Abstract
BACKGROUND The loss of social support is one of the major risk factors for suicide. However, there are few empirical studies that have examined how a person's suicide ideation relates to their social support. AIMS To examine the relationship between social support and suicidal ideation. METHODS Self-report questionnaires were sent to 2,200 randomly selected adults in Japan. The questionnaire inquired the participants about the severity of suicidal ideation, the details of current perceived social support and their degree of satisfaction with this social support. Social support and related indicators were compared among three groups of participants that varied in severity of suicidal ideation. RESULTS People in the group that had suicide ideation during their lives reported receiving significantly less support from their family and had greater feelings of dissatisfaction with that support than those in the other groups. Furthermore, people who had suicide ideation during the month immediately preceding the survey reported providing less support to their family, relatives or friends, as well as receiving less support from family than other groups, and having stronger feelings of dissatisfaction with social support. CONCLUSION Our study identified a strong relationship between the severity of suicidal ideation and perceived social support.
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Affiliation(s)
- Go Endo
- 1Department of Psychiatry, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
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Shiratori Y, Tachikawa H, Nemoto K, Endo G, Aiba M, Matsui Y, Asada T. Network analysis for motives in suicide cases: a cross-sectional study. Psychiatry Clin Neurosci 2014; 68:299-307. [PMID: 24405435 DOI: 10.1111/pcn.12132] [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: 02/07/2013] [Revised: 10/11/2013] [Accepted: 10/16/2013] [Indexed: 11/29/2022]
Abstract
AIM Suicide victims have various distresses or motives. There are few studies on how these motives toward suicide relate with each other. We used network analyses to extract the structures of correlations among the motives for suicide. METHODS We obtained datasets of suicide victims from 2007-2009 in Japan in cooperation with Ibaraki Prefectural Police Headquarters. The data were analyzed by network centrality measures and a structural analysis by block modeling. RESULTS Among the motives, depression and physical illness showed relatively high scores of 'degree centrality', whereas depression and unemployment showed relatively high scores of 'betweenness centrality'. Structural analysis by block modeling resulted in eight blocks. The most important block comprised eight motives, including conflict between parent and child, marital conflict, economic hardship, and overloaded with debt. CONCLUSION Depression and physical illness were important and priority areas for completed suicides, although these two motives had different influences on suicide behaviors. Furthermore, structural analysis revealed the important role of a block, including some familial and financial motives, which induced hopelessness. Our results suggest that it might be useful to consider the common ways in which motivations for suicide are tied together when suicide intervention is launched from a social model point of view.
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Affiliation(s)
- Yuki Shiratori
- Department of Psychiatry, Graduate School of Comprehensive Human Sciences, Ibaraki, Japan; Ibaraki Prefectural Medical Center of Psychiatry, Ibaraki, Japan
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Hori T, Ishii T, Hisanaga A, Tatsuki A, Tachikawa H, Asada T. [A case of "oneiroid Erlebnisform" influenced by the Great East Japan Earthquake]. Seishin Shinkeigaku Zasshi 2013; 115:477-484. [PMID: 23855226] [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: 06/02/2023]
Abstract
Following the Great East Japan Earthquake, although there are a growing number of reports on the care of the mental health of victims and supporters, the influence of this disaster on individuals with mental disorders has not yet been sufficiently clarified. Here, we present a case of "oneiroid Erlebnisform" (Mayer-Gross, W.), which was influenced by the disaster and relapsed one year after the earthquake. We discussed the meaning of this experience and the factors leading to recurrence in this case. A male international student in his thirties had repeatedly suffered from acute episodic alteration of consciousness. Although he had experienced anxiety just after the disaster, he showed improvement during his temporary evacuation to Western Japan. Nearly one year after the disaster, however, he relapsed, with symptoms characteristic of an oneiroid state. The patient stated that he was a fuel rod in the Fukushima nuclear power plant, and he then immersed himself in a bathtub full of water in order to avoid meltdown. According to ICD-10, the patient was diagnosed with acute polymorphic psychotic disorder without symptoms of schizophrenia (F23.0). In addition to the alteration of consciousness as the main symptom, since there was no decrease in the level of personolity function, it was also considered that the diagnosis of this case was atypical psychosis, as proposed by Mitsuda and Hatotani. In the oneiroid experience, a variety of visual hallucinations, illusions, and images had appeared one after another. We can find catastrophe and salvation as the main themes in this state, related to the disaster and nuclear accident. Unloading situation after thesis defense, insufficient sleep, poor medication adherence, and the increased frequency of earthquakes were important factors in the recurrence of the present case. To continue research in Japan after the earthquake, the decision was accompanied by anxiety for the patient. One year after the earthquake, the patient was trying to enter a doctoral program with continued anxiety over the nuclear accident. When the frequency of earthquakes increased again, the patient was taking an entrance examination. There is a possibility that the anxiety in this situation led to the recurrence. People are vulnerable to being exposed to the fear of a disaster even after experiencing relief. This situation may increase the risk of recurrence.
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Affiliation(s)
- Takafumi Hori
- Mental Health Service, Health Center, University of Tsukuba
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Doi N, Hoshi Y, Itokawa M, Yoshikawa T, Ichikawa T, Arai M, Usui C, Tachikawa H. Paradox of schizophrenia genetics: is a paradigm shift occurring? Behav Brain Funct 2012; 8:28. [PMID: 22650965 PMCID: PMC3487746 DOI: 10.1186/1744-9081-8-28] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Accepted: 04/27/2012] [Indexed: 11/10/2022]
Abstract
BACKGROUND Genetic research of schizophrenia (SCZ) based on the nuclear genome model (NGM) has been one of the most active areas in psychiatry for the past two decades. Although this effort is ongoing, the current situation of the molecular genetics of SCZ seems disappointing or rather perplexing. Furthermore, a prominent discrepancy between persistence of the disease at a relatively high prevalence and a low reproductive fitness of patients creates a paradox. Heterozygote advantage works to sustain the frequency of a putative susceptibility gene in the mitochondrial genome model (MGM) but not in the NGM. METHODS We deduced a criterion that every nuclear susceptibility gene for SCZ should fulfill for the persistence of the disease under general assumptions of the multifactorial threshold model. SCZ-associated variants listed in the top 45 in the SZGene Database (the version of the 23rd December, 2011) were selected, and the distribution of the genes that could meet or do not meet the criterion was surveyed. RESULTS 19 SCZ-associated variants that do not meet the criterion are located outside the regions where the SCZ-associated variants that could meet the criterion are located. Since a SCZ-associated variant that does not meet the criterion cannot be a susceptibility gene, but instead must be a protective gene, it should be linked to a susceptibility gene in the NGM, which is contrary to these results. On the other hand, every protective gene on any chromosome can be associated with SCZ in the MGM. Based on the MGM we propose a new hypothesis that assumes brain-specific antioxidant defenses in which trans-synaptic activations of dopamine- and N-methyl-d-aspartate-receptors are involved. Most of the ten predictions of this hypothesis seem to accord with the major epidemiological facts and the results of association studies to date. CONCLUSION The central paradox of SCZ genetics and the results of association studies to date argue against the NGM, and in its place the MGM is emerging as a viable option to account for genomic and pathophysiological research findings involving SCZ.
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Affiliation(s)
- Nagafumi Doi
- Ibaraki Prefectural Medical Center of Psychiatry, 654Asahi-machi, Kasama-shi, Ibaraki, 309-1717, Japan
| | - Yoko Hoshi
- Integrated Neuroscience Research Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya, Tokyo, 156-8506, Japan
| | - Masanari Itokawa
- Project for Schizophrenia and Affective Disorders Research, Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya, Tokyo, 156-8506, Japan
| | - Takeo Yoshikawa
- Laboratory for Molecular Psychiatry, RIKEN Brain Science Institute, 2-1Hirosawa, Wako-shi, Saitama, 351-0198, Japan
| | - Tomoe Ichikawa
- Project for Schizophrenia and Affective Disorders Research, Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya, Tokyo, 156-8506, Japan
| | - Makoto Arai
- Project for Schizophrenia and Affective Disorders Research, Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya, Tokyo, 156-8506, Japan
| | - Chie Usui
- Department of Psychiatry, Juntendo University Nerima Hospital, 3-1-10 Takanodai, Nerima-ku, Tokyo, 177-8521, Japan
| | - Hirokazu Tachikawa
- Department of Psychiatry, Graduate School of Comprehensive Human Science, Tsukuba University, Tsukuba-shi, Ibaraki, Japan
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Hori T, Tachikawa H, Ishii T, Shimada N, Takemori T, Lebowitz A, Asadas T. [An analysis of mental disorders of international students visiting the Mental Health Service at Tsukuba University Health Center]. Seishin Shinkeigaku Zasshi 2012; 114:3-12. [PMID: 22420147] [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: 05/31/2023]
Abstract
With the expected increase in the number of international students coming to Japan as part of the Ministry of Education, Culture, Sports, Science & Technology's "300,000 Foreign Student (Global 30) Plan", the demands on university mental health facilities will also increase. However, the rate of mental disorders of recent international students has not been fully evaluated. As part of an initiative to establish effective treatment measures for the mental health of international students, we investigated the present status and recent trends of these students who visited the Mental Health Service (MHS) in the Tsukuba University Health Center. The demographic characteristics, pathway, stress, and diagnosis of international students who visited the MHS from 2005 to 2010 were investigated retrospectively based on medical records. The subjects were 59 international students (15 male, 44 female; mean age: 28.4). The consultation rate of international students was significantly lower than that of Japanese students each year. Although the rate is almost stable in Japanese students (2.1-2.5%), it has increased significantly in international students, from 0.5% in 2005 to 1.4% in 2010. A larger percentage of the subjects were from Asia (66%), compared to the former Soviet Union (10%) and Europe (7%). A greater proportion of the subjects were graduate students (67%). The diagnoses were as follows: depression (34%), adjustment disorder (32%), insomnia (15%), and schizophrenia (9%). The percentage requiring emergency consultation was 24%, including the most severe cases that had to return to their home country. Sixty-nine percent of the subjects stayed in Japan for more than 1 year. Half of the subjects decided to visit the MHS themselves. The results of the present study show that the consultation rate of international students was lower than that of Japanese students in spite of the "culture shock" experienced by international students. This result is in agreement with previous reports. Among international students, however, there is a trend indicating an increase of visits to the MHS in recent years, approaching the rate for Japanese students. Preparations for emergency consultation are still important.
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Affiliation(s)
- Takafumi Hori
- Mental Health Service, Health Center, University of Tsukuba.
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