Factors Associated With Work Engagement of Nurses During the Fifth Wave of the COVID-19 Pandemic in Japan: Web-Based Cross-Sectional Study

BACKGROUND

The COVID-19 pandemic has brought to light the prevalence of mental health issues among nurses. Work engagement (WE) is a concept that describes work-related positive psychological states and is of importance within mental health measures. There is, however, a lack of research on factors associated with the WE of nurses during the COVID-19 pandemic.

OBJECTIVE

We aimed to determine which factors are associated with WE among nurses during the COVID-19 pandemic using the job demands-resources (JD-R) model as a framework.

METHODS

A web-based cross-sectional survey was conducted among nurses working in acute care and psychiatric institutions in the prefectures of Chiba and Tokyo in Japan. The survey period occurred between August 8 and September 30, 2021, during a time when the number of patients with a positive COVID-19 infection increased. The 3-item version of the Utrecht Work Engagement Scale (UWES-3) was used to measure WE. Factors such as age, gender, years of experience, affiliated ward, COVID-19-related stress, financial rewards from the government and hospital, encouragement from the government and patients, and workplace social capital were assessed. A total of 187 participants were included in the final analysis. Multiple regression analysis was performed to examine the factors related to WE. Partial regression coefficients (B), 95% CI, and P values were calculated.

RESULTS

The mean overall score for the UWES-3 was 3.19 (SD 1.21). Factors negatively associated with UWES-3 were COVID-19-related stress on work motivation and escape behavior (Β -0.16, 95% CI -0.24 to -0.090; P<.001), and factors positively associated with UWES-3 were affiliation of intensive care units (Β 0.76, 95% CI 0.020-1.50; P=.045) and financial rewards from the government and hospital (Β 0.40, 95% CI 0.040-0.76; P=.03).

CONCLUSIONS

This study examined factors related to WE among nurses during the COVID-19 pandemic using the JD-R model. When compared with findings from previous studies, our results suggest that nurses' WE was lower than before the COVID-19 pandemic. Negative motivation and escape behaviors related to COVID-19 were negatively associated with WE, while there were positive associations with financial rewards from the government and hospital and affiliation with an intensive care unit. Further research into larger populations is needed to confirm these findings.

Relationships Between Childhood Bullying/Domestic Violence Experience and Insomnia among Employees in Japan

OBJECTIVE

Traumatic childhood experiences such as domestic violence and bullying have been reported to be associated with insomnia in adulthood. However, little evidence is available for the long-term effects of childhood adversity on workers' insomnia worldwide. Our objective was to examine whether childhood experiences of bullying and domestic violence are associated with insomnia in workers in adulthood.

METHODS

We used survey data from a cross-sectional study of the Tsukuba Science City Network in Tsukuba City, Japan. Workers aged 20 to 65 years (4509 men and 2666 women) were targeted. Binomial logistic regression analysis was performed with the Athens Insomnia Scale as the objective variable.

RESULTS

Binomial logistic regression analysis showed that childhood bullying and domestic violence experience of childhood bullying and domestic violence were associated with insomnia. As for the experience of domestic violence, the higher the time of experience, the higher the odds ratio of insomnia.

CONCLUSIONS

It may be useful to focus on childhood traumatic experiences regarding insomnia in workers. In the future, objective sleep time and sleep efficiency should be evaluated using an activity meter and other methods to verify the effects of bullying and domestic violence experiences.

Relationships Between Childhood Bullying/Domestic Violence Experience and Insomnia among Employees in Japan

OBJECTIVE

Traumatic childhood experiences such as domestic violence and bullying have been reported to be associated with insomnia in adulthood. However, little evidence is available for the long-term effects of childhood adversity on workers' insomnia worldwide. Our objective was to examine whether childhood experiences of bullying and domestic violence are associated with insomnia in workers in adulthood.

METHODS

We used survey data from a cross-sectional study of the Tsukuba Science City Network in Tsukuba City, Japan. Workers aged 20 to 65 years (4509 men and 2666 women) were targeted. Binomial logistic regression analysis was performed with the Athens Insomnia Scale as the objective variable.

RESULTS

Binomial logistic regression analysis showed that childhood bullying and domestic violence experience of childhood bullying and domestic violence were associated with insomnia. As for the experience of domestic violence, the higher the time of experience, the higher the odds ratio of insomnia.

CONCLUSIONS

It may be useful to focus on childhood traumatic experiences regarding insomnia in workers. In the future, objective sleep time and sleep efficiency should be evaluated using an activity meter and other methods to verify the effects of bullying and domestic violence experiences.

A high sense of coherence can mitigate suicidal ideation associated with insomnia

BACKGROUND

The present study aimed to investigate whether insomnia is associated with suicidal ideation (SI) among Japanese workers by conducting a multi-level analysis with sense of coherence (SOC) as a random effect.

PARTICIPANTS AND PROCEDURE

A cross-sectional survey was conducted among 19,481 workers in Tsukuba, Japan. Data from 7,175 participants aged 20-65 years were included in the analysis. The Athens Insomnia Scale (AIS) was used as the independent variable, and SI over the past year was used as the dependent variable. SOC was measured using the five-point SOC-13 scale, and socioeconomic and health factors were investigated as covariates. Participants were divided into three groups (low, medium, and high) based on their SOC scores. Multilevel logistic regression analysis was performed to calculate odds ratios (OR) and 95% confidence intervals (95% CI).

RESULTS

In the high-SOC group, only one person had SI. In a multi-level logistic analysis that excluded the high SOC group, insomnia was found to be associated with SI (OR = 2.26, 95% CI [1.75, 2.93]). Furthermore, the AIS sub-items "Final awakening earlier than desired" (OR = 1.26, 95% CI [1.05, 1.50]) and "Sense of well-being during the day" (OR = 1.63, 95% CI [1.34, 1.99]) were associated with SI. 8.95% or 11% of the variation in the presence or absence of SI was found to be explained by differences between SOC groups.

CONCLUSIONS

The study highlights that insomnia is associated with SI, and that high SOC may reduce SI even under insomnia. Future longitudinal studies are needed to confirm whether high SOC reduces SI due to insomnia.

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

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.

Relationships between sleep efficiency and lifestyle evaluated by objective sleep assessment: SLeep Epidemiology Project at University of Tsukuba

Objectively measured sleep efficiency has recently been shown to be associated with health problems. Although several factors have previously been reported to be associated with sleep efficiency, most of these studies were conducted on older or younger adults, and the factors associated with sleep efficiency in healthy workers remain unknown. The aim of this study was to investigate the relationship between sleep efficiency and lifestyle factors using sleep measurement data recorded by an activity meter worn by workers. In total, 693 workers (male, 43.6%; mean age, 42.7 ± 11.3 years) were recruited from five offices in 2017. Sleep was measured over the period of 1 week by actigraphy. Workers' attributes, lifestyle habits, and occupational stress were identified using a questionnaire, and the association of sleep efficiency with lifestyle, occupational stress, and attributes was explored by logistic regression analysis. A logistic regression analysis using attributes and occupational stress as adjustment variables revealed that "longer sleeping hours on weekends than on weekdays" [odds ratios (OR), 0.66; 95% confidence interval (CI), 0.47-0.94], "water ingestion at bedtime" [OR, 2.09; 95% CI, 1.28-3.41], and "smartphone use at bedtime" [OR, 1.90; 95% CI, 1.28-2.83] were associated with decreased sleep efficiency. This study found that lifestyle habits were associated with sleep efficiency among workers. It is necessary to verify whether intervention in these lifestyle habits would contribute to the improvement of sleep efficiency in future studies.

Prevalence, characteristics, and psychological outcomes of workplace cyberbullying during the COVID-19 pandemic in Japan: a cross-sectional online survey

Background

The rapid introduction of teleworking due to the coronavirus disease 2019 pandemic has led to concerns about increases in cyberbullying (CB) worldwide. However, little is known about workplace CB in non-Western countries. The first objective was to clarify the prevalence and characteristics regarding workplace CB victimization in Japan. The second objective was to demonstrate the psychological outcomes of CB victimization in combination with traditional bullying (TB).

Methods

We conducted an anonymous, cross-sectional, Internet-based survey targeting regular employees in Japan (N = 1200) in January 2021. We investigated CB victimization using the Inventory of Cyberbullying Acts at Work and TB victimization by using the Short Negative Act Questionnaire. Possible explanatory factors for TB/CB victimization were sociodemographic variables, personality trait, chronic occupational stress, organizational climate, and gratitude at work. We also measured psychological distress, insomnia, and loneliness to assess adverse effects of workplace bullying. Two-step cluster analysis was used in determining the patterns combined with TB and CB victimization. Hierarchical binomial logistic regression analysis was used.

Results

In total, 8.0% of employees reported experiencing CB on a weekly basis. CB victimization was associated with younger age, managerial position, higher qualitative workload, and active information dissemination via the Internet, and frequency of teleworking. Three clusters based on TB and CB victimization patterns were identified: those who belong to the first cluster suffered neither from TB and CB (81.0%), the second cluster suffered only from TB (14.3%), and the third cluster suffered from both TB and CB (4.8%). The third cluster exhibited higher odds ratios (ORs) and 95% confidence intervals (CIs) for psychological distress (OR = 12.63, 95% CI = 4.20–38.03), insomnia (OR = 6.26, 95% CI = 2.80–14.01), and loneliness (OR = 3.24, 95% CI = 1.74–6.04) compared to the first cluster.

Conclusions

These findings firstly clarify the prevalence and correlated factors of CB victimization among employees in Japan. Further, we showed that psychological wellbeing can be impaired by the coexistence of TB and CB. Our research could be the first step to develop the effective countermeasures against workplace CB.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13481-6.

Morning preference is associated with subjective happiness among Japanese female workers: A moderation analysis by sleep characteristics from the SLEPT study

Research on mental health in working populations has predominantly focussed on negative outcomes, while studies on the positive aspects of life remain very limited, especially in Japan. Although morningness has recently been considered a factor for being happy, the role of sleep characteristics as it relates to the association between morningness and happiness has not been substantiated. The aim of this study is to investigate the associations between diurnal preference and level of subjective happiness in healthy, full-time, daytime workers in Japan. We also tested the moderation effect of sleep parameters on the relationship between diurnal preference and subjective happiness. This is an exploratory analysis from the cross-sectional data of the SLeep Epidemiology Project at the University of Tsukuba (SLEPT Study). Subjective happiness was evaluated using a single-item question. Diurnal preference was assessed using the Morningness-Eveningness Questionnaire (MEQ), in which higher scores indicate greater tendency to have morning preference. The participants underwent assessment of sleep parameters for 7 consecutive days using a waist-worn actigraphy device and kept a sleep diary. Sleep parameters investigated were subjective sleep quality, sleep disturbance, daytime sleepiness, weekend oversleep, total sleep time, sleep onset time, wake time, and sleep efficiency. A total of 205 males (average 42.6 ± 10.4 years) and 272 females (41.1 ± 9.8 years) were eligible for analysis. Hierarchical liner regression analysis was used to show the relationships of subjective happiness with MEQ score, and the sleep parameters. Further, moderation analysis was conducted by adding the interaction between MEQ score and the sleep parameters. After adjusting for age, psychological distress, self-rated health, and occupational stress, we found that subjective happiness was significantly associated with higher MEQ score and sleep efficiency but only in female. The moderating role of sleep parameters was not found. We discussed the implications of the obtained results and a possible strategy to maintain and improve subjective happiness of female workers who have evening preference.

Comparison of predicted psychological distress among workers between artificial intelligence and psychiatrists: a cross-sectional study in Tsukuba Science City, Japan

OBJECTIVES

Psychological distress is a worldwide problem and a serious problem that needs to be addressed in the field of occupational health. This study aimed to use artificial intelligence (AI) to predict psychological distress among workers using sociodemographic, lifestyle and sleep factors, not subjective information such as mood and emotion, and to examine the performance of the AI models through a comparison with psychiatrists.

DESIGN

Cross-sectional study.

SETTING

We conducted a survey on psychological distress and living conditions among workers. An AI model for predicting psychological distress was created and then the results were compared in terms of accuracy with predictions made by psychiatrists.

PARTICIPANTS

An AI model of the neural network and six psychiatrists.

PRIMARY OUTCOME

The accuracies of the AI model and psychiatrists for predicting psychological distress.

METHODS

In total, data from 7251 workers were analysed to predict moderate and severe psychological distress. An AI model of the neural network was created and accuracy, sensitivity and specificity were calculated. Six psychiatrists used the same data as the AI model to predict psychological distress and conduct a comparison with the AI model.

RESULTS

The accuracies of the AI model and psychiatrists for predicting moderate psychological distress were 65.2% and 64.4%, respectively, showing no significant difference. The accuracies of the AI model and psychiatrists for predicting severe psychological distress were 89.9% and 85.5%, respectively, indicating that the AI model had significantly higher accuracy.

CONCLUSIONS

A machine learning model was successfully developed to screen workers with depressed mood. The explanatory variables used for the predictions did not directly ask about mood. Therefore, this newly developed model appears to be able to predict psychological distress among workers easily, regardless of their subjective views.

Protein intake in inhabitants with regular exercise is associated with sleep quality: Results of the Shika study

STUDY OBJECTIVES

Although associations between sleep quality and environmental factors and nutrient intake have been reported, interactions between these factors have not been elucidated in detail. Therefore, this cross-sectional study examined the effects of regular exercise and nutrient intake on sleep quality using the Pittsburgh Sleep Quality Index (PSQI), which is the most frequently used index for sleep evaluation.

METHODS

The participants included 378 individuals aged 40 years or older living in Shika Town, Ishikawa Prefecture. Of these individuals, 185 met the inclusion criteria. The participants completed a self-administered questionnaire assessing lifestyle habits and frequency and duration of exercise, the PSQI, and the brief-type self-administered diet history questionnaire (BDHQ) on nutrient intake.

RESULTS

A two-way analysis of covariance on regular exercise and PSQI scores indicated that protein intake (17.13% of energy) was significantly higher in the regular exercise and PSQI ≤10 groups than in the non-regular exercise or PSQI ≥11 groups (p = 0.002). In a multiple logistic regression analysis with PSQI scores (≤10 and ≥11), protein intake was a significant independent variable in any of the models adjusted for confounding factors such as age, sex, body mass index, current smoker, and current drinker (OR: 1.357, 95% CI: 1.081, 1.704, p = 0.009) in the regular exercise group but not in the non-regular exercise group.Conclusions We identified a positive relationship between sleep quality and protein intake in the regular exercise group. These findings suggest that regular exercise at least twice a week for 30 minutes or longer combined with high protein intake contributes to good sleep quality.

Prefrontal activation while listening to a letter of gratitude read aloud by a coworker face-to-face: A NIRS study

Near-infrared spectroscopy (NIRS) is a non-invasive functional brain imaging technique. NIRS is suitable for monitoring brain activation during social interactions. One of the omnipresent social interactions for employees is saying thank you and being thanked. It has been demonstrated that expressing and receiving gratitude leads to employees’ well-being and performance. To date, there have been no neuroimaging studies that monitor brain activity when receiving gratitude. Thus, we designed an experiment using NIRS to monitor brain function while listening to a letter of gratitude read by a coworker. We hypothesized that listening to a letter of gratitude read aloud by a co-worker in a face-to-face setting would have different effects on PFC activity than listening to a conversation about a neutral topic. We recruited 10 pairs of healthy right-handed employees. They were asked to write a letter of gratitude to their partner 1 week before the experiment. In the experiment, each pair sat face-to-face and read their letters aloud to each other. We evaluated changes in mood state before and after the experiment. NIRS was measured in each participant while they listened to their peers in the experimental condition (gratitude letter) and control condition (talking about the weather and date). The results suggested that negative mood state decreased after the experiment. Moreover, there were interaction effects between conditions and periods. Although further studies are needed to confirm the interpretation, our findings suggested that experience of being thanked was accompanied by prefrontal cortex activation.

School Ijime (Bullying) Experience Is a Possible Risk Factor for Current Psychological Distress among Science City Workers: A Cross-Sectional Study in Tsukuba, Japan

Early-life adversities are considered to have long-term impact on health. There have been many studies regarding the experience of being bullied and its harmful psychological influence, but such influence on workers remains to be investigated in Japan. We therefore aimed to examine the prevalence of workers with experiences of being bullied or bullying others during childhood and adolescence and to clarify the relation between those experiences and current psychological distress. A cross-sectional study using an anonymous self-report web questionnaire was conducted in November 2017. The study population was 19,481 workers belonging to the Tsukuba Science City Network, and we analyzed the data of 6,015 participants (3,715 men and 2,300 women, aged between 20 years and 59 years). The percentages of participants with experiences of being bullied were 51.5% for men and 56.2% for women; those with experiences of bullying others were 36.5% of men and 29.4% of women. Relations between experiences of bullying and psychological distress were assessed using Chi-squared tests. Logistic regression analyses with psychological distress as an objective variable and experiences of bulling as explanatory variables were performed using those who had no bulling experiences as control. In both men and women, experiences of being bullied were significantly associated with psychological distress after adjustment socioeconomic factors (the odds ratios were 1.26 for men (95% CI = 1.05-1.52) and 1.72 for women (95% CI = 1.39-2.13)). Consideration of past social experiences, such as being bullied, is useful for mental health management among workers reporting psychological distress.

Non-Regular Employment Status Is Associated with Psychological Distress among Young Researchers: A Cross-Sectional Study in Tsukuba, Japan

Non-regular employment is increasing and its mental health impact is a globally important problem. In Japan, non-regularly employed researchers are increasing, especially within young age groups, because employment quotas were not sufficiently expanded against rapid increasing number of doctorate holders. It is therefore important to understand the relationship between non-regular employment and mental health. The significance of our research is to contribute to the improvement of researchers' mental health by clarifying the influence of employment status on psychological distress. We conducted a cross-sectional, web-based survey in 2017 via an anonymous, self-administered questionnaire distributed to workers in Tsukuba Science City, Japan. The survey questionnaire items included employment status, psychological distress, occupational stress, sex, age, and income. We analyzed 2,762 valid responses in two categories (1,850 regular employment, 912 non-regular employment) and two subcategories based on age according to the definition of "young researcher" by the Ministry of Health, Labor and Welfare (20-39 years vs. 40-59 years). Psychological distress was defined as a total K6 score of 5 or greater. Binomial logistic regression was used to calculate odds ratios and 95% confidence intervals for psychological distress. Non-regular employment was significantly associated with psychological distress in the age 20-39 group but not in the age 40-59 group. At the age 20-39 group, a negative association was shown between psychological distress and reward from work (i.e., pride in their job, ability utilization, and sense of accomplishment). Support to increase psychological work rewards may be important in reducing psychological distress for young non-regularly employed researchers.

Association between flourishing mental health and occupational stress among workers of Tsukuba Science City, Japan: a cross-sectional study

Background

Flourishing, defined as the coexistence of hedonic and eudaimonic well-being, is the most favorable end of the mental health spectrum. A growing body of evidence has demonstrated the association between flourishing mental health and favorable work-related outcomes. However, epidemiology of flourishing mental health is scarce in Japan. Moreover, the relationship between flourishing mental health and occupational stress has not been elaborated. Therefore, the aim of this study was to elucidate (1) the prevalence of flourishing mental health and (2) the association between flourishing mental health and occupational stress among Japanese workers.

Methods

The present survey was conducted in from February to March 2017 via an anonymous, self-administered, and web-based questionnaire among workers in Tsukuba Science City, Japan. Mental Health Continuum Short Form was used to assess flourishing mental health. We performed binomial logistic regression analyses to calculate the adjusted odds ratios (AOR) and 95% confidence intervals (CI) of occupational stress for flourishing mental health, controlling for sociodemographic factors.

Results

A total of 7012 respondents (4402 men, 2610 women) were analyzed. The overall prevalence of flourishing mental health among the respondents was 12.4%. Full-time (permanent) workers were less likely to be flourishing. Reward from work (AOR = 2.34, 95% CI = 2.04–2.68), support from colleagues and superiors (AOR = 1.67, 95% CI = 1.44–1.94), and workload (AOR = 1.19, 95% CI = 1.05–1.36) were positively associated with flourishing mental health, whereas mental workload (AOR = 0.65, 95% CI = 0.57–0.75) was inversely associated with flourishing mental health.

Conclusions

The findings of the present study shed light on the association between flourishing mental health and occupational stress.

Relationship between suicidal ideation and family problems among young callers to the Japanese crisis hotline

Previous studies have reported an association between family relationships and suicidal behavior, and found that people with high suicidal ideation are not likely to consult with others about their distress. An effective consulting service is therefore necessary for such individuals. Crisis hotlines are effective for reducing suicide risk, but their associated suicide ideation rate and odds ratio of family problems children remain unclear. The present study investigated the suicidal ideation rate and odds ratio of callers under 20 years of age (N = 24,333) with family problems to the Japanese crisis hotline in 2012. There were 5,242 (21.5%), 18,061 (74.2%), and 1,030 (4.2%) calls related to family problems, other problems, and both, respectively. The suicidal ideation rate and odds ratio of callers with family problems were 2.2% and 0.426, respectively. This result suggested that callers with family problems have a significantly lower rate and odds ratio for suicidal ideation compared with others. However, some associations with a high suicide ideation rate were found for individual items among callers with family problems such as abuse (20.4%), family breakdown (16.1%), and domestic violence (10.6%). Further studies are needed to understand the suicidal ideation of callers with family problems and develop more effective preventive strategies.

Relationship between workplace social capital and suicidal ideation in the past year among employees in Japan: a cross-sectional study

Background

A growing body of evidence has demonstrated the associations between social capital and health. In residential or geographical areas, social capital has attracted attention for its protective effects against suicide. However, to this date, the relationship between social capital and suicidal ideation is not fully elaborated in the occupational setting. Therefore, the aim of the present study was to examine the association between workplace social capital and suicidal ideation in the past year among employees in Japan.

Methods

A cross-sectional, web-based survey was conducted in February/March 2017 via an anonymous self-administered questionnaire distributed to workers in Tsukuba Science City, Japan. Binomial logistic regressions were used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for suicidal ideation in the past year, controlling for age group, marital status, educational attainment, and annual household income. The results were shown stratified by sex and occupation.

Results

In total, 7255 of 19,481 workers responded, out of which we could analyze 6325 responses (4030 men, 2295 women). The prevalence of suicidal ideation in the past year was 5.9% for men and 7.8% for women. Low workplace social capital was statistically significantly associated with suicidal ideation both for men (OR = 2.57, 95% CI = 1.72–3.83) and for women (OR = 1.75, 95% CI = 1.15–2.66), compared with high workplace social capital after controlling for socioeconomic factors.

Conclusion

Higher workplace social capital was associated with a reduced risk of suicidal ideation in the past year. Promoting workplace social capital could contribute to preventing suicide among employees in Japan.

Stress of working abroad: a systematic review

Purpose

Many companies target international markets to expand their business. Companies need to manage international teams with a wide variety of skills, knowledge and values to run their business effectively; however, there are many issues of acculturation stress. Not only business travellers and expatriates, but also immigrant workers have issues adjusting to foreign culture. The aim of the present study is to identify the stress factors affecting foreign-born workers via a systematic review.

Methods

The systematic review was conducted using PubMed, PsycINFO, Embase and Cochrane Library databases. Articles on the subject of workers living abroad, such as immigrants, expatriates and business travellers, were included. The risk of bias in the included articles was assessed using the Cochrane Collaboration’s tool for assessing risk of bias for randomised controlled trials (RCTs), RoBANS for non-RCT studies, and CASP for qualitative studies.

Results

For the systematic review, 45 out of 14,994 articles were analysed. Six components, communication, cultural differences in the workplace, daily life, relationships with family and colleagues, financial problems and social inequality, were extracted.

Conclusion

Foreign-born workers are suffering from acculturation and occupational stress. The results of the present study can help greatly with understanding of the stress structure of working abroad.

Electronic supplementary material

The online version of this article (10.1007/s00420-018-1333-4) contains supplementary material, which is available to authorized users.

Characteristics of Telephone Crisis Hotline Callers with Suicidal Ideation in Japan

Hotline callers do not always have suicidal ideation and previous studies have noted that the rate of such callers is limited. Crisis hotline counselors must be able to identify high-risk callers in order to provide appropriate support. This study investigated the characteristics of Japanese crisis hotline callers in 2012 (N = 541,694) and is the first to analyze crisis hotline data for all parts of Japan over 1 year. About 14% of the callers had suicidal ideation and 6% had a history of attempted suicide. The odds ratio for suicidal ideation among those with a history of attempted suicide was 15.5. The suicidal ideation rate was much smaller compared to previous studies in other countries. There is a psychological barrier that must be broken for high-risk people to use support hotlines. In addition, attempted suicide is a strong exclusive predisposing factor for death due to suicide; therefore, counselors should pay careful attention to callers with a history of attempted suicide. The characteristics of Japanese crisis hotline callers and the features of suicidal ideation revealed in the present study are expected to be useful in developing telephone crisis hotline strategies.

Absenteeism due to mental health problems and systems for return to work: an internet-based unmatched case-control study

PURPOSE

The aim of this study was to investigate the risk factors for absenteeism due to mental health problems with regard to company characteristics and systems for return to work in Japan.

METHODS

This was an Internet-based unmatched case-control study. Two hundred and fifty-eight workers who experienced over 28 days of sick leave due to mental health problems (cases) and 258 workers who have not taken sick leave (controls) were recruited. Company characteristics and the awareness and presence of systems for return to work were analysed as indicators of absenteeism.

RESULTS

A total of 501 workers were included in the analysis. Females were less likely to experience absenteeism when adjustments were made for both the awareness and presence of systems [odds ratio (OR) = 0.51 and 0.41, respectively]. Large companies showed an increased risk of having absentee workers than small companies. The awareness of a gradual resumption system and the presence of a sick pay system were related to absenteeism (OR = 2.75 and 2.40, respectively).

CONCLUSIONS

The awareness and presence of systems for return to work are related to the long-term absenteeism. The predictors of sex and company size are also related to the experience of the long-term absenteeism. To understand the effect of systems for return to work on absenteeism due to mental problems, further studies are needed.

The associations between lifestyles and mental health using the General Health Questionnaire 12-items are different dependently on age and sex: a population-based cross-sectional study in Kanazawa, Japan

OBJECTIVES

The aim of this study was to examine potential differences of the associations between mental health and lifestyle factors across a wide range of age.

METHODS

In August/September 2011, data were collected from 4693 males (age 51.6 ± 19.5) and 5678 females (age 52.4 ± 19.4) living in Kanazawa, Japan. A cross-sectional community-based survey was conducted with self-administered questionnaire including the General Health Questionnaire (GHQ) 12-item version, sociodemographic, and lifestyle factors. Associations between the GHQ scores and other variables were examined using two-way analysis of variance (ANOVA) followed by multiple comparisons and logistic regression stratified by age and gender.

RESULTS

Multiple comparisons indicated that people aged 20-39 or 40-64 had higher GHQ scores than older aged. The two-way ANOVA revealed significant interaction between body mass index and age group, and between exercise and age group. Overweight or underweight males aged 40-64 had poorer mental health than those at normal weight. In the elderly, being underweight was significantly associated with poor mental health. There were no significant effects of exercise on mental health for young adults. The logistic regression showed significant negative effects of short-time sleep in adults.

CONCLUSIONS

The associations between mental health and lifestyles differ across age groups. Further study is needed to reveal effects of aging on lifestyle and mental health with a longitudinal design.

Risk Factors for Suicidal Ideation Among Telephone Crisis Hotline Callers in Japan

BACKGROUND

Telephone hotlines are a widely used type of suicide prevention program.

AIMS

The aim of this study was to clarify the risk factors for suicidal ideation by investigating its association with a number of characteristics among telephone hotline callers.

METHOD

Data were collected over a 10-year period from a total of 246,595 calls to Inochi No Denwa, a telephone crisis hotline in Ibaraki, Japan, and subsequently analyzed. Odds ratios for suicidal compared with nonsuicidal ideation were also calculated.

RESULTS

About 6% of the calls to the hotline were suicide related, and about 2% of the callers had attempted suicide in the past. Odds ratios for suicidal ideation increased during winter, but no daily tendencies were evident. Those whose problems were related to their way of life were at the highest risk of suicidal ideation, followed by those with health-related concerns.

CONCLUSION

We were able to identify risk factors for suicidal ideation based on an analysis of enormous amounts of data from a telephone crisis hotline in Japan. Knowledge of these risk factors is expected to lead to improvements in suicide prevention programs.

Parental bonding during childhood affects stress-coping ability and stress reaction

An online survey examined the effects of parental bonding during childhood on adult workers' stress-coping ability (Sense of Coherence) and stress reactions (General Health Questionnaire and Self-Rating Depression Scale). Participants who completed the questionnaire were grouped into optimal bonding and poor bonding groups. Analyses of covariance by gender with age as a covariate were conducted for the Sense of Coherence, General Health Questionnaire, and Self-Rating Depression Scale scores for 9525 participants. For both genders, the scores of the poor bonding group were significantly lower for the Sense of Coherence and significantly higher for the General Health Questionnaire and Self-Rating Depression Scale compared to those of the optimal bonding group.

Relationship between sickness presenteeism and awareness and presence or absence of systems for return to work among workers with mental health problems in Japan: an Internet-based cross-sectional study

OBJECTIVES

The objective of this study was to clarify the relationship between sickness presenteeism and the degree of awareness of company regulations regarding financial compensation for absenteeism.

METHODS

An Internet-based survey of 258 full-time workers who had more than 28 days of sickness absence due to mental health problems was conducted. Workers were categorized as having either low or high sickness presenteeism, and awareness and presence or absence of systems for return to work and duration of financial compensation were compared between groups.

RESULTS

The following factors were significantly related to high sickness presenteeism based on logistic regression analyses: working for a private company (odds ratio [OR]=2.57; 95% confidence interval [CI]=1.10-5.99); recognition of a gradual resumption system (OR=3.89, 95% CI=1.02-14.81); and awareness regarding the duration of financial compensation (OR=1.04, 95% CI=1.01-1.07).

CONCLUSIONS

No relationship was found between mental sickness presenteeism and presence or absence of systems for return to work in our multivariate analysis; however, a relationship was apparent between sickness presenteeism and characteristics of the workers' companies. These results are expected to contribute to research involving human resources and occupational health.

Psychological approach of occupational health service to sick leave due to mental problems: a systematic review and meta-analysis

PURPOSE

The effects of interventions by occupational health services on sick leave prompted by psychiatric disorders were examined with respect to intervention method and the number of sick leave days.

METHODS

The intervention methods used by occupational health services were systematically reviewed by searching three databases and manual searching. A meta-analysis of the number of sick leave days comparing the intervention group [intervention + care as usual (CAU)] and control group (CAU alone) was performed. In addition, subanalyses were conducted for the duration until sick-listed workers' return to work after sick leave (Subgroup 1) and the number of non-sick-listed workers' total sick leave days (Subgroup 2).

RESULTS

Ten studies were extracted and integrated, and the subjects were subsequently sorted into the intervention group (n = 434, 322, and 756 in subgroup 1, subgroup 2, and total, respectively) and control group (n = 413, 385, and 798 in subgroup 1, subgroup 2, and total, respectively). All studies employed an intervention method of problem-solving treatment or cognitive behavioral therapy (CBT). There were no significant differences between the intervention and control groups in subgroup 1 or 2. However, the combined intervention group had significantly fewer total sick leave days than the combined control group (mean difference -6.64 days, 95% CI -12.68 to -0.59, I(2) = 0%).

CONCLUSIONS

The combined study of sick-listed and non-sick-listed workers indicates occupational health services implement problem-solving treatment or CBT interventions, which can shorten total sick leave duration.

[Study of the relationship between incidence of sick leave due to mental health failure and work rules about sick leave]

OBJECTIVES

This study examined the relationships among the support system for return to work, work rules about sick leave, and incidence of sick leave due to mental health failure.

METHODS

A questionnaire was distributed to 150 workplaces with a history of use of the occupational health promotion center of a certain prefecture. The questionnaire asked about the number and duration of sick leaves due to mental health failure, the support system for return to work, and work rules about sick leave.

RESULTS

A significant correlation between the number of permanent staff and maximum period of sick leave was found (r=0.489, p<0.001), as well as a significant correlation between the number of permanent staff and the period of monetary compensation during sick leave (r=0.315, p=0.031). In addition, in 9 workplaces with more than 1,000 permanent staff, a significant correlation between the period of monetary compensation period during sick leave and incidence of sick leave was found (r=0.670, p=0.048), as well as a significant correlation between the period of monetary compensation during sick leave and the average length of sick leave (r=0.866, p<0.001).

CONCLUSIONS

The results of this study suggest the possibility that monetary compensation is associated with the duration of sick leave due to mental health failure. Hereafter, to construct a support system for mental health, consideration of the effect of monetary compensation appears to be required.

The effect of stress-related factors on mental health status among resident doctors in Japan

OBJECTIVES

This study was designed to investigate how the interaction between the ability of medical residents (doctors in postgraduate training) to cope with stress and their working conditions might affect their level of job-related stress.

METHODS

A self-administered questionnaire was distributed to 549 first-year medical residents at 38 postgraduate education hospitals in Japan, 1-2 months after the start of clinical training. The questionnaires contained the 29-item Sense of Coherence (SOC) Scale, the Brief Scales for Job Stress (BSJS), the 12-item General Health Questionnaire (GHQ-12) and questions on basic conditions such as working hours. Sense of coherence is an important concept from the viewpoint of salutogenesis theory and influences stress recognition style. People with a strong SOC have a high ability to cope with stress.

RESULTS

The mean +/- standard deviation (SD) score on the SOC Scale was 134.5 +/- 20.5. All participants were classified into three groups according to their SOC Scale scores. Although the objective working conditions of the three groups were statistically similar, the group with the weakest SOC Scale score showed poorer mental health status (p < 0.05) and scored lower for 'reward from work' compared with the groups with stronger SOC scores (p < 0.05). The weaker SOC group also scored higher for 'mental workload' and 'problems in personal relationships' than the other two groups (p < 0.05). Moreover, the weak SOC group scored less for 'support from colleagues and superiors' than the strong SOC group (p < 0.05). A stepwise multiple regression analysis for GHQ-12 score was conducted (R(2) = 0.45). 'Sleep time', 'workload', 'mental workload' and 'problems in personal relationships' were positively correlated with GHQ-12 scores. 'Reward from work' was negatively correlated with GHQ-12 scores.

CONCLUSIONS

Residents' mental health was associated not only with working conditions, but also with their attitudes towards those working conditions. Enhancing residents' sense of 'reward from work' might be important in reducing their reactions to stress.

Association between altered systemic inflammatory interleukin-1beta and natural killer cell activity and subsequently agitation in patients with Alzheimer disease

OBJECTIVE

Alzheimer's disease (AD) is a neurodegenerative disorder that is the most common cause of dementia in the elderly and is frequently accompanied by emotional disorder, including agitation. Although evidence of neuroendocrine immune and inflammatory functions during emotional changes has been accumulated, the pathogenic mechanisms in the development of agitation accompanied by AD remain to be elucidated.

METHODS

To clarify the involvement of neuroendocrine and immune and inflammatory systems in agitation in AD, we examined agitation levels, circadian rhythms of behavior, cortisol, interleukin-1beta (IL-1beta), and natural killer cell activity (NKCA) in controls without dementia and 16 AD patients who were recognized to be easily agitated in their nursing homes. These behavioral and blood indicators were assessed according to the progress of the stage of agitation in 16 AD patients (stable, pre-agitation, and agitation stages).

RESULTS

Elevations in night behavior and blood cortisol, IL-1beta and an reduced blood NKCA level in the evening were observed not only in the agitation stage, but also when stable in AD patients as compared to the control. Increased IL-1beta and decreased NKCA occurred in both the morning and evening in pre-agitation and agitation stages in AD.

CONCLUSIONS

The increased IL-1beta and decreased NKCA with the progress of agitation in AD suggest that inflammation produces agitation and aggravates AD.

The association of sense of coherence and coping profile with stress among research park city workers in Japan

Via a large scale cross-sectional study among Japanese white color workers, the authors aimed to elucidate: (1) the distributions of Sense of Coherence (SOC), which reflect stress coping abilities, (2) the distributions of the Brief Scale for Coping Profile (BSCP) which reflect coping profiles for stressors; (3) and the association between SOC and BSCP. Anonymous self-administered questionnaires were sent to 20,742 employees at educational and research institutions in Tsukuba Research Park City. A total of 12,009 (57.9%) workers completed and returned the questionnaire; 10,317 workers without missing data were analyzed. SOC scale scores and BSCP subscale scores differed by gender, age, and other demographic features. Among the BSCP subscales, workers whose SOC scale scores were higher tended to adopt a problem-focused coping profile, whereas workers whose SOC scale scores were lower adopted an emotion-focused coping profile. The coping profile that workers adopted depended on their background and demographic characteristics. Stronger SOC allowed one to adopt a problem-focused coping profile that allows for better coping with work-related stressors.

Genotypes and Haplotypes of CCR2 and CCR3 Genes in Japanese Cedar Pollinosis

Whole genome scan analyses have revealed that the chromosomal region 3p21.3, which contains a gene cluster of the CC chemokine receptor, is possibly critical for the pathogenesis of allergic inflammation. Japanese cedar pollinosis is mediated by a type I allergy and induces seasonal rhinitis and conjunctivitis in humans as the most common form of hay fever in spring in Japan, although the candidate genes for cedar pollinosis remain to be elucidated. We sequenced CCR1, CCR2, CCR3, CCR5, and CCXCR1 using the PCR restriction fragment length polymorphism method in subjects with cedar pollinosis and controls. We found 8 polymorphisms of A111G, Arg127Cys and Arg252Gln in CCXCR1, T885C in CCR1, Val64Ile and T780C in CCR2, T51C in CCR3 and Arg223Gln in CCR5. The transmission disequilibrium test using 60 children with pollinosis and their parents and an association study using unrelated adult subjects (151 patients and 157 controls) showed a significant association of 64Ile in CCR2 and 51C in CCR3 with cedar pollinosis. The frequency of haplotype 64Ile/780C/51C in pollinosis was significantly higher than in controls. Our results suggest that CCR2 and CCR3 genes are candidate genes for Japanese cedar pollinosis.

[Survival after surgical resection for stage IV non-small cell lung cancer]

We analyzed 20 patients with stage IV non-small cell lung cancer operated from 1988 to 2003. Fourteen out of 20 were cases with pulmonary metastasis (pm2). The prognosis of patients with pm2 was better than that of those with distant organ metastasis. In pm2 patients, the survival rate of cases without lymph node metastases was higher than those with lymph node metastases. It is suggested that in cases of pm2 without lymph node metastases, surgical operation is possibly effective treatment of choice.

Physiological involvement of placental endothelin-1 and prostaglandin F2alpha in uteroplacental circulatory disturbance in pregnant rats exposed to heat stress

Several studies suggest that heat stress affects placental functions including uteroplacental circulation, subsequently leading to pregnancy failure and birth weight reduction. To clarify the involvement of endothelin and placental prostaglandin (PG) systems in the uteroplacental circulation during heat stress, we examined the effects of i.v. administration of the endothelin receptor antagonist bosentan and the cyclooxygenase inhibitor indomethacin on uteroplacental blood flow and on placental PGE2 and PGF2alpha levels and their 13,14-dyhydro-15-keto-metabolites (PGEM and PGFM, respectively) in heat-exposed or non-heat-exposed pregnant rats. The administration of bosentan or indomethacin did not change uteroplacental blood flow in non-heat-exposed pregnant rats. In contrast, heat reduced uteroplacental blood flow in pregnant rats, but the reduction was reversed by the administration of bosentan or indomethacin before heat exposure. Heat did not change placental PGE2 or PGEM levels, but in pregnant rats it increased placental PGF2alpha and PGFM levels, which were reversed by bosentan or indomethacin. Our results suggest that the activation of placental endothelin receptor and PGF2alpha systems are involved in the uteroplacental circulatory disturbances produced by heat. PGF2alpha systems activated by heat may be involved in the vasoconstricting effects of endothelin-A and -B receptors during heat exposure.

Association of Single Nucleotide Polymorphisms in the Eosinophil Peroxidase Gene with Japanese Cedar Pollinosis

BACKGROUND

Japanese cedar pollinosis is the most common form of hay fever in spring in Japan. We have previously demonstrated that single nucleotide polymorphism Pro358Leu of exon 7 in the eosinophil peroxidase (EPO) gene is associated with cedar pollinosis, although the association has not been confirmed by analysis of the whole gene in a different population.

METHODS

We sequenced all exons of the EPO gene in 60 children with pollinosis and their parents using the PCR-restriction fragment length polymorphism method.

RESULTS

We found 8 polymorphisms, Ile40Met, Gln122His, Arg202Arg (A660G), Asn303Asn (C909T), Arg326Pro, Arg326His, Pro358Leu, and Asn572Ty, in the EPO gene. As a result of the transmission disequilibrium test, we recognized significant transmissions of 202Arg (660G) in exon 6 in addition to 358Leu of exon 7 in the EPO gene of affected children.

CONCLUSIONS

Our results might indicate that polymorphisms of the EPO gene are associated with Japanese cedar pollinosis.

Group interactions in SFINCSS-99: lessons for improving behavioral support programs

Human factors can significantly influence successful mission completion of prolonged space missions such as ISS expeditions or future Mars missions. This paper describes group dynamics and group interactions during SFINCSS-99, a very unique international long-term confinement study in a space mission analog environment. Many interpersonal or inter-group conflicts occurred, and these caused the early retirement of a Japanese subject. This paper cites examples of these conflicts, and analyzes their causes with our results. The international cooperation to extract lessons learned, which could be used to refine behavioral support programs for the ISS or similar international studies, is also introduced.

Enhancement of a sense of coherence and natural killer cell activity which occurred in subjects who improved their exercise habits through health education in the workplace

We have previously demonstrated that a sense of coherence (SOC), a candidate for a mediating stress factor, is involved in natural killer cell activity (NKCA) reduced in smokers, whereas the relationship among exercise, NKCA and SOC is unclear. To clarify the effects of exercise on SOC and NKCA, we examined the changes in SOC and NKCA before and after health education to encourage exercise. Of one-hundred and one male office workers who received the health education for one year, 27 improved, 65 were unchanged and 9 had deteriorated exercise habits. The repeated measures analysis of variance showed that SOC in workers with improvement in the exercise habit were increased more significantly by the health education than those in workers without improvement (p<0.05). Although the change in NKCA produced by health education was recognized to be significantly different in those who had never smoked from that in current smokers (p<0.05), multiple regression analysis demonstrated that improvement in health practice significantly contributed to increases in both SOC (p<0.01) and NKCA (p<0.05) in never smokers, independently of other psychological factors. These results suggest that subjects with improvement in exercise enhance NKCA through increased SOC in never smokers.

High contribution contrast between the genes of eosinophil peroxidase and IL-4 receptor α-chain in Japanese cedar pollinosis

BACKGROUND

Japanese cedar pollinosis is the most common form of hayfever in Japan in spring and has remarkably increased since 1960.

OBJECTIVE

We sought to clarify the candidate genes for cedar pollinosis using a case-control study.

METHODS

After diagnosing 351 subjects on the basis of an intradermal test, nasal provocation test, and questionnaire regarding nasal and conjunctival symptoms, we determined the blood-specific IgE values and genotypes of eosinophil peroxidase (EPO) and interleukin-4 receptor alpha-chain (IL4RA) in 145 patients with pollinosis and 206 healthy subjects, including 75 healthy subjects with higher specific IgE values.

RESULTS

We found significant differences in the frequencies of Pro358Leu in EPO and of Ile50Val and Glu375Ala in IL4RA between patients and healthy subjects. There was a significantly higher frequency of 358Leu in EPO in patients than in healthy subjects showing a higher specific IgE value. In contrast, we recognized significant changes in the prevalence of Ile50Val and Glu375Ala in IL4RA in healthy subjects with a normal IgE value compared with those in healthy subjects with a higher specific IgE value. The relationship between EPO polymorphisms and the onset of symptoms was exactly opposite that for IL4RA.

CONCLUSIONS

These results suggest that Pro358Leu in EPO is strongly involved in the development of cedar pollinosis. Ile50Val and Glu375Ala in IL4RA seem to be related to cedar pollen sensitization. Subjects with Ile50 or Glu375 might develop cedar pollinosis with increased exposure to cedar pollen.

Blood endothelin-1 and cold-induced vasodilation in patients with primary Raynauld's phenomenon and workers with vibration-induced white finger

AIM

Cold water-immersion induces vasoconstriction with an elevation of blood endothelin-1, which is a potent vasoconstrictor peptide, in patients with primary Raynaud's phenomenon (PRP). However, physiological involvement of endothelin-1 in cold-induced vasodilation (CIVD) remains to be elucidated.

METHODS

We monitored changes of finger blood flow during cold water (10 degrees C) immersion and assayed blood endothelin-1 in 7 PRP patients and 7 workers with vibration-induced white finger (VWF) and in the respective control subjects.

RESULTS

While significant reductions in finger blood flow at 2 min after the immersion were observed in PRP patients and VWF workers, its elevation at 4 min, which was considered to reflect CIVD, was recognized only in PRP patients. In healthy controls, blood endothelin-1 increased at 4 min and returned to the basal level immediately after the immersion. The increase in blood endothelin-1 at 4 min in PRP patients was greater than that in controls, and continued even after the immersion. Conversely, the increase neither at 4 min nor after immersion was seen in VWF workers. Local vascular changes produced by repetitive vibration may be responsible for the attenuated CIVD and unchanged blood endothelin-1 during cold water-immersion in VWF workers.

CONCLUSION

Our results showing elevated blood endothelin-1 during and after immersion in PRP contrast with that in VWF suggesting that endothelin-1 is related to sympathetic hyperactivity which is more involved in PRP rather than VWF. It seems unlikely that endothelin-1 is functionally or directly associated with CIVD.

Nonthermal effects of mobile-phone frequency microwaves on uteroplacental functions in pregnant rats

Exposure to high-density microwaves can cause detrimental effects on the testis, eye, and other tissues, and induce significant biologic changes through thermal actions. To examine nonthermal effect of continuous wave (CW) 915MHz microwaves used in cellular phones, we compared the effects of microwaves with those of heat. Thirty-six pregnant rats were assigned to six groups: rats exposed to microwaves at 0.6 or 3mW/cm(2) incident power density at 915MHz for 90min, rats immersed in water at 38 or 40 degrees C, which induces about the same increase in colonic temperature of 1.0 or 3.5 degrees C as 0.6 or 3mW/cm(2) microwaves, respectively; rats immersed in water at 34 degrees C, which is considered to be thermoneutral; and control rats. We identified significant differences in the uteroplacental circulation, and in placental endocrine and immune functions between pregnant rats immersed in water at 34 and 38 degrees C, but not between rats immersed at 38 degrees C and those exposed to microwaves at 0.6mW/cm(2). By contrast, we observed significant decreases in uteroplacental blood flow and estradiol in rats exposed to microwaves at 3mW/cm(2) as compared with those immersed in water at 40 degrees C. These results suggest microwaves at 0.6mW/cm(2) at 915MHz, equal to a specific absorption rate (SAR) of 0.4W/kg, which is the maximum permissible exposure level recommended by the American National Standards Institute (ANSI), do not exert nonthermal effects on blood estradiol and progesterone, on splenic natural killer cell activity, on the uteroplacental circulation.

Acute-phase treatment in general hospitals: clinical psychopharmacologic evaluation in first-episode schizophrenia patients

A case-control study was conducted to investigate possible predictors of response to antipsychotic treatment in acute schizophrenic patients. During a 14-month period, 13 female first-episode schizophrenic patients were included. According to their antipsychotic treatment response 8 weeks after admission, they were placed in either a good-response group (n = 8) or poor-response group (n = 5). Scores of the two groups differed on several items of the Positive and Negative Syndrome Scale (PANSS) at baseline and during the following 8 weeks. At baseline, the maximum scores for Conceptual disorganization, Poor rapport, Passive/apathetic social withdrawal, and Stereotyped thinking in the good-response group were lower than the corresponding minimum scores in the poor-response group. Furthermore, minimum improvements after 1 week in scores for excitement in the good-response group were higher than the maximum improvements in the corresponding scores of the poor-response group. These PANSS items might serve as simple and rapid predictors of treatment resistance. In addition, Lack of judgment and insight significantly improved by 1 week, and further improved by 5 weeks in the good-response group. This suggests that treatment in the good-response group will be optimal if provided during a hospital stay of appropriate length.

Involvement of the serotonergic system in orexin-induced behavioral alterations in rats

We have demonstrated involvement of the serotonergic system in orexin-induced behavioral responses in rats. Orexin-A and -B (hypocretin-1 and -2) significantly increased total locomotor activity when administered centrally. They also induced behavioral alterations; increasing grooming, face washing and wet dog shaking in rats. Haloperidol inhibited orexin-induced hyperlocomotion and these behavioral alterations. Serotonin antagonists, ritanserin and metergoline, did not attenuate orexin-induced hyperlocomotion but partly inhibited orexin-induced behavioral alterations. These results suggest that the dopaminergic system might be involved in orexin-induced hyperlocomotion, while both the serotonergic system as well as the dopaminergic system might be involved in orexin-induced behavioral responses.

Mental health of scientific researchers. I. Characteristics of job stress among scientific researchers working at a research park in Japan

In order to clarify the characteristics of job stress in scientific researchers, a self-administered questionnaire survey for 16,330 workers was carried out at Tsukuba Research Park City, Japan. The data of 7,063 (43%) workers aged 20-59 years old were analyzed, and the characteristics of job stress in 3,290 scientific researchers were compared with those of 1,799 technicians and 1,849 clerks. The researchers perceived higher quantitative and qualitative workload, greater job control (job decision latitude), and greater reward from work, than did the other two job groups. In addition, young male researchers received a large amount of support from their coworkers, while middle-aged male researchers perceived difficulty in personal relationships with their coworkers. From the viewpoints of the demand-control-support model and the effort-reward imbalance model, the researchers, particularly men, were typically occupied in active jobs, and the large amount of effort required for their work seemed to be balanced by greater reward from work. Compared with male researchers, however, female researchers perceived lesser job demand, lesser job control, and lesser reward from work. The working environment of female researchers may be related to the so-called career stress of working women. The mental health status of these scientific researchers should be examined directly in a future study.