Clarification of Psychiatric Nurses Intentions and Analysis Contents in Observing Schizophrenia Patient

The Journal of Medical Investigation : JMI


Examining Factors Associated with Dynapenia/Sarcopenia in Patients with Schizophrenia: A Pilot Case-Control Study


A study on Relationship between Psychological Well-being and Menstrual -Associated Symptoms in Female University Students

女子大学生の心理的健康感と月経随伴症状の関連の検討

Female-specific menstrual-associated symptoms are regarded as a factor to lower psychological well-being. The purpose of the current study was to clarify the relationship between psychologocal well-being and menstrual-associated symptoms. We conducted an anonymous survey using self-report questionnaires, in which the MOS 36-Item Short-Form Health Survey version1.2 (SF-36) and the Menstrual Distress Questionnaire (MDQ) were administered to 382 female university students in order to evaluate health-related quality of life and menstrual-associated symptoms respectively. Data from 311 subjects were analyzed to investigate the relationship between the two scales before, during and after menstruation and in strong and weak menstrual-associated symptoms groups. There were significant negative correlations between the SF-36 subscale `vitality' and the MDQ subscale `negative affect' before and during menstruation. In the strong menstrual-associated symptoms group, significant negative correlations were found between subscales of the SF-36 and the MDQ before, during and after menstruation, suggesting that psychological symptoms of menstrual-associated symptoms might influence their physical and psychological quality of life. We concludes that to examine coping methods in order to reduce psychological symptoms and to provide individualized education are necessary.


Relationship between quality of life and clinical factors in inpatients with schizophrenia

The purpose of this study was to clarify the relationship between quality of life (QOL) and clinical factors in inpatients with schizophrenia. Subjects were 50 hospitalized patients with schizophrenia. Their mean age was 56.48 (Standard Deviation=11.93) years. Japanese version of the schizophrenia Quality of Life Scale (JSQLS) and Subjective Well-being under Neuroleptic drug Treatment Short form, Japanese version (SWNS-J) were used to assess subjective QOL, and Mini Mental State Examination-Japanese was used to evaluate cognitive function. Japanese version of the Calgary Depression Scale for Schizophrenia (JCDSS), Brief Psychiatric Rating Scale, and Drug-Induced Extrapyramidal Symptoms Scale were used to assess depression severity, psychotic symptoms, and drug-induced extrapyramidal symptoms, respectively. Stepwise regression analyses were conducted to find factors influencing JSQLS and SWNS-J. JCDSS was a predictor of two scales of JSQLS, and JCDSS also predicted SWNS-J Total and it's two subscales. However, other clinical factors were not related to JSQLS and SWNS-J. The results indicate that treating depressive symptoms may lead to improvement of subjective QOL in inpatients with schizophrenia. J. Med. Invest. 69 : 80-85, February, 2022.


Usefulness of 2D Video Analysis for Evalution of Shoulder Range of Motion during Upper Limb Exercise in Patients with Psychiatric Disorders

Aging and its associated problems related to movement impacts the care of people with psychiatric disorders. This study sought to clarify the usefulness of 2D video analysis for evaluating shoulder range of motion (ROM) during upper limb exercises in patients with psychiatric disorders. Subjects (N=54) were patients with psychiatric disorders categorized as the following:having either a high or low activities of daily living (ADL) score using the Barthel Index;experiencing shoulder ROM limitation, and whether or not compensatory movements were exhibited. Compensatory movement was also considered in patients with Parkinsonism, cerebrovascular disease, and cognitive dysfunction. Shoulder joint ROM was measured using a goniometer and active ROM was captured using ImageJ. No significant difference between passive ROM measured by a goniometer and active ROM measured by ImageJ considering disease groups, ADL level, and shoulder ROM limitation was found. Factoring in compensatory movements, however, significant differences were found between passive and active ROM:existence compensatory movement group, left side (z=-2.30, p=0.02);nonexistence compensatory movement group, right side (z=-2.63, p<0.001). Image-evaluating devices help assess ROM in patients with psychiatric disorders, enhancing the development of physical rehabilitation programs to regain critical ADL, sustaining self-care capabilities. J. Med. Invest. 69 : 70-79, February, 2022.


Differences in Male Climacteric Symptoms by Aging Males Symptoms Scale and Coping Strategies with Aging among Rotating Night Shift Workers


Characteristics of psychiatric nurses observation techniques for psychopathological symptoms

The purpose of this study was to clarify characteristics of psychiatric nurses' observation techniques for psychopathological symptoms. The subjects were 21 psychiatric nurses and 20 nursing students who had finished their practicum in psychiatric nursing. Using a non-contact eye-tracking analysis system, we compared quantitatively their radial motion while they were observing psychopathological symptoms of a schizophrenia simulation patient. The radial motion of them was recorded while they were observing a video of a simulated patient presenting psychopathological symptoms, and the recording was analyzed by the eye-tracking system. The investigator set the important observation areas and determined the sum of the fixation time and the number of fixations in the areas. Differences between psychiatric nurses and nursing students were tested using the Mann-Whitney U-test. The results revealed a significant difference in observation of the upper limbs area with a median of 7147.90 msec for nurses group and a median of 2447.54 msec for students group (U = 98.00, p = 0.01). The finding suggests that nurses tend to pay more attention to patient's upper limbs to be cautious about possible violence and to find agitation caused by psychopathological symptoms, extrapyramidal adverse effects, and scars caused by self-mutilation. J. Med. Invest. 68 : 271-275, August, 2021.


Practical issues in Developing Natural Language Processing Applications for Healthcare Robot Motivation of Older Persons Physical Rehabilitation

International Journal of Advanced Intelligence (IJAI)


Differences in Male Climacteric Symptoms and Lifestyle Depending on the Duration of Working among Rotating Night Shift Workers


Predictors of life skills in people with schizophrenia

Objective : The purpose of the present study is to examine clinical factors related to life skills in people with schizophrenia. Method : The participants were 51 stabilized outpatients with schizophrenia. Their mean age was 38.91 (SD = 10.73) years. Life skills were assessed using the Life skills profile (LSP). Cognitive function was evaluated with the Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery (MCCB). Clinical symptoms were assessed using the Positive and Negative Syndrome scale (PANSS), the Calgary Depression Scale for Schizophrenia (CDSS) and the Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS). Results : Cognitive function was not correlated with the LSP scores at all. Among clinical symptoms, scores of the PANSS positive and negative syndrome scales, the CDSS, and the DIEPSS had negative correlations with the LSP total score and the subscales. Stepwise regression analyses showed that the CDSS and PANSS negative syndrome scale scores were independent predictors of the LSP total score and two of the subscales. Conclusions : These results indicate that cognitive function is not associated with life skills but clinical symptoms such as depressive and negative symptoms have considerable impacts on life skills in people with schizophrenia. J. Med. Invest. 67 : 75-82, February, 2020.


Relation between oral condition and internal use condition of psychotropic drugs of patients with chronic schizophrenia during hospitalization : Cross-sectional survey at a psychiatric hospital with dentistry

慢性期統合失調症入院患者の口腔保健状態と抗精神病薬および biperiden内服状況との関係:歯科を有する単科精神科病院における横断的調査


Differences in male climacteric symptoms with aging among rotating night shift workers

The aim of this study was to clarify the actual status of male climacteric symptoms in rotating night shift workers and how to cope with the symptoms. We planned a self-administered questionnaire survey in male rotating night shift workers. Male climacteric symptoms were evaluated by using the Aging Males' Symptoms (AMS) scale. Of 1891 questionnaires that were sent, 1561 were collected. There were significant differences in total AMS scores among the age groups. In all age groups, there were high proportions of men with increased need for sleep and often feeling tired (64.9%) and decrease in muscular strength (60.7%). There were significant differences in AMS scores for somatic symptoms between men in their 20 s and those in their 40 s or 50 s and between men in their 30 s and those in their 50 s and in AMS scores for sexual symptoms between men in their 20 s and those in their 30 s, 40 s, 50 s or 60 s, between men in their 30 s and those in their 40 s, 50 s or 60 s and between men in their 40 s and those in their 50 s or 60 s. Significant age-dependent differences are found in somatic symptoms and sexual symptoms in rotating night shift workers.


Clinical factors influencing resilience in patients with anorexia nervosa

This study was to elucidate clinical factors influencing resilience in anorexia nervosa (AN) patients. Twenty female patients with AN (median age =30.0 years, quartile deviation =6.8) and 40 female healthy controls (HCs) (median age =30.0 years, quartile deviation =8.6) participated in the present study. Resilience was assessed with the Connor- Davidson resilience scale (CD-RISC). Clinical symptoms were evaluated with the structured interview guide for the Hamilton depression rating scale (SIGH-D) and the eating disorder inventory-2 (EDI-2). Scores of the CD-RISC in the AN group were lower than those in the HC group, and the SIGH-D score in the AN group was higher than that in the HC group. Scores of interoceptive confusion, interpersonal difficulty and negative self-image subscales of the EDI-2 negatively correlated with the CD-RISC score. Moreover, stepwise regression analysis showed that negative self-image score was an independent predictor of the CD-RISC score. These results suggest that among these clinical factors including psychopathologies, self-dissatisfaction and feeling of being rejected by others are the most important influencing factors on an AN patients' resilience.


Relationship between social and cognitive functions in people with schizophrenia

The purpose of the present study was to examine clinical factors related to social function in people with schizophrenia. The participants were 55 stabilized outpatients with schizophrenia. Their mean age was 39.36 (SD =10.65) years. Social function was assessed using the Quality of Life Scale (QLS). Cognitive function was evaluated with the Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery (MCCB). Clinical symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS), the Calgary Depression Scale for Schizophrenia, and the Drug-Induced Extrapyramidal Symptoms Scale. Neither the MCCB cognitive domain score nor composite score was correlated with the QLS scores. However, of the 10 MCCB subtests, the Trail Making Test Part A and the Brief Assessment of Cognition in Schizophrenia-Symbol Coding (BACS-SC) scores were positively correlated with the QLS scores. Among clinical variables, especially the PANSS negative syndrome scale score had a strong negative correlation with the QLS scores. Stepwise regression analyses showed that the PANSS negative syndrome scale score was an independent predictor of the QLS scores, and although the BACS-SC score predicted the QLS common objects and activities subscale score, the association was not so strong compared to the PANSS negative syndrome scale score. These results indicate that speed of processing evaluated by BACS-SC could predict some aspect of social function but negative symptoms have a much stronger impact on global social function in people with schizophrenia.


Clinical factors influencing quality of life in anorexia nervosa patients


Functional Independence Measure を用いて評価した統合失調症患者の基本的な社会生活機能と臨床諸要因との関連


Impaired central coherence in patients with anorexia nervosa

The purpose of this study was to investigate the characteristics of central coherence in patients with anorexia nervosa (AN). 22 female patients with AN (median age = 31.50 (QD = 8.13) years) and 33 female healthy controls (HC) (median age = 28.00 (QD = 8.50) years) participated in the study. Their central coherence was assessed with the Rey Complex Figure Task (RCFT). Clinical symptoms were evaluated with the Beck Depression Inventory-II and the State-Trait Anxiety Inventory-Form JYZ. The results showed that AN patients' Central Coherence Index and accuracy scores in copy, 3-min delayed recall and 30-min delayed recall tasks of the RCFT were significantly lower than those of HC. Moreover, the significant differences in Central Coherence Index score in copy task and accuracy scores in 3-min delayed recall and 30-min delayed recall tasks remained when the effects of depression, anxiety and starvation were eliminated statistically. These findings may explain some characteristics of AN patients such as focusing on local rather than global picture in their perception of body or life.


Influence of cognitive function on quality of life in anorexia nervosa patients

The purpose of this study was to elucidate determinants of quality of life (QOL) in anorexia nervosa (AN) patients. Twenty-one female patients with AN participated in the study. QOL was assessed with the 36-Item Short Form Health Survey (SF-36), and cognitive function was evaluated using the Wisconsin Card Sorting Test Keio version, the Rey Complex Figure Test, and the Social Cognition Screening Questionnaire. Clinical symptoms were evaluated with the Beck Depression Inventory-II, the State-Trait Anxiety Inventory-Form JYZ (STAI-JYZ), and the Maudsley Obsessive Compulsive Inventory. The Difficulty Maintaining Set score of the Wisconsin Card Sorting Test Keio version was negatively correlated to the SF-36 Physical Component Summary. Scores of the Beck Depression Inventory-II and the STAI-JYZ State and Trait were negatively correlated to the SF-36 Mental Component Summary (MCS), and the Central Coherence Index 30-min Delayed Recall score of the Rey Complex Figure Test was positively correlated with the MCS. Stepwise regression analysis showed that the Difficulty Maintaining Set score was an independent predictor of the Physical Component Summary and scores for Central Coherence Index 30-min Delayed Recall and the STAI-JYZ Trait-predicted MCS. These results suggest that not only trait anxiety but also poor central coherence and impaired ability to maintain new rule worsen AN patients' QOL.


認知行動療法的介入が有効であった心因性難聴の事例

認知行動療法的介入が有効であった心因性難聴の事例

Japanese Journal of Child and Adolescent Psychiatry

児童青年精神医学とその近接領域


Impaired social cognition in anorexia nervosa patients

The purpose of this study was to investigate the characteristics of social cognition in patients with anorexia nervosa (AN). Eighteen female patients with AN (mean age =35.4±8.6 years) and 18 female healthy controls (HC) (mean age =32.8±9.4 years) participated in the study. Their social cognition was assessed with the Social Cognition Screening Questionnaire (SCSQ). The results showed that total score of the SCSQ and scores of theory of mind and metacognition were significantly lower in AN group than those in HC group. Moreover, significant differences in theory of mind, metacognition, and total score of the SCSQ remained when the effects of depression, anxiety, and starvation were eliminated statistically. These results suggest that patients with AN may have difficulty inferring other people's intention and also monitoring and evaluating their own cognitive activities. Therefore, these features may explain some aspects of the pathology of AN.


Prioritizing Patient Assessment Data (PAD) Using the Japanese Psychiatric Nursing Assessment Classification System (PsyNACS)©


Clinical correlates associated with basic ability of social life in schizophrenia inpa-tients


Relationship between cognitive function and employment in Japanese schizophrenia patients


Risk factors for refeeding hypophosphatemia in Japanese inpatients with anorexia nervosa.

Refeeding in patients with anorexia nervosa (AN) is associated with a risk of refeeding syndrome, which is a disruption in metabolism with a variety of features including hypophosphatemia. We evaluated the risk factors for refeeding hypophosphatemia (RH) during nutritional replenishment in Japanese patients with AN. We retrospectively examined clinical data for 99 female inpatients (mean age 30.9 ± 10.7 years; range, 9 - 56 years). RH (phosphate < 2.3 mg/dL) occurred within 4.8 ± 3.7 days of hospital admission and was still observed at 28 days after admission in 21 of the 99 cases (21.2%). Oral or intravenous phosphate was given to some patients to treat or prevent RH. Patients with RH had a significantly lower body mass index, were older, and had higher blood urea nitrogen than those without RH. Severe complications associated with RH were recorded in only one patient who showed convulsions and disturbed consciousness at Day 3 when her serum phosphate level was 1.6 mg/dL. The significant risk factors for RH that we identified were lower body mass index, older age, and higher blood urea nitrogen at admission. No significant difference in total energy intake was seen between the RH and no RH groups, suggesting that RH may not be entirely correlated with energy intake. Precisely predicting and preventing RH is difficult, even in patients with AN who are given phosphate for prophylaxis. Thus, serum phosphate levels should be monitored for more than 5 days after admission.

The International Journal of Eating Disorders


The Development of the Japanese Psychiatric Nursing Assessment Classification System (PsyNACS©)


Changes of levels of depression and qaulity of life after short-term cognitive behavioral educational program for adolescent students in health class

The purpose of the present study was to evaluate the changes of levels of depression and quality of life in adolescent students after receiving short-term cognitive behavioral educational program in health class for stress management. Subjects were 176 middle school students aged 12 to 14 years. They completed the Depression Self-Rating Scale for Children (DSRS-C) and the Revised Children Quality of Life Questionnaire (Kiddo-KINDL(R)) before, after and 6-months after the program. The three-session program consisted of psychoeducation and learning skills of cognitive restructuring and problem solving. The total scores of the DSRS-C and the Kiddo-KINDL(R) in all subjects did not significantly change after the completion of program. However, as for the high risk group (score of the DSRS-C≥16), significant improvement in the two scales was found after the program. Especially, depression level in the high risk group significantly decreased and the improvement was maintained 6-months later. These results suggest that this type of approach may be effective for adolescents with high risk of depression in terms of improving not only depressive symptom but also quality of life. J. Med. Invest. 62: 204-208, August, 2015.

The Journal of Medical Investigation : JMI


The Effect of a Psycho-Educational Program on Psychiatric Symptoms, Drug Attitude and Treatment Satisfaction of Patients with Schizophrenia


Meta-analyses of Blood Homocysteine Levels for Gender and Genetic Association Studies of the MTHFR C677T Polymorphism in Schizophrenia.

Previous studies suggest that elevated blood homocysteine levels and the methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism are risk factors for schizophrenia. However, the effects of gender and MTHFR C677T genotypes on blood homocysteine levels in schizophrenia have not been consistent. We first investigated whether plasma total homocysteine levels were higher in patients with schizophrenia than in controls with stratification by gender and by the MTHFR C677T genotypes in a large cohort (N = 1379). Second, we conducted a meta-analysis of association studies between blood homocysteine levels and schizophrenia separately by gender (N = 4714). Third, we performed a case-control association study between the MTHFR C677T polymorphism and schizophrenia (N = 4998) and conducted a meta-analysis of genetic association studies based on Japanese subjects (N = 10 378). Finally, we assessed the effect of plasma total homocysteine levels on schizophrenia by a mendelian randomization approach. The ANCOVA after adjustment for age demonstrated a significant effect of diagnosis on the plasma total homocysteine levels in all strata, and the subsequent meta-analysis for gender demonstrated elevated blood homocysteine levels in both male and female patients with schizophrenia although antipsychotic medication might influence the outcome. The meta-analysis of the Japanese genetic association studies demonstrated a significant association between the MTHFR C677T polymorphism and schizophrenia. The mendelian randomization analysis in the Japanese populations yielded an OR of 1.15 for schizophrenia per 1-SD increase in plasma total homocysteine. Our study suggests that increased plasma total homocysteine levels may be associated with an increased risk of schizophrenia.


Occupational stress and its related factors among university teachers in Japan


Measuring quality of sleep and autonomic nervous function in healthy Japanese women


Optimal needle insertion length for intramuscular injection of risperidone long-acting injectable (RLAI)


Factors associated with discharge of long-term inpatients with schizophrenia in Japan: a retrospective study

Deinstitutionalization for people with mental disorders has only begun to be implemented in Japan. The purpose of this retrospective study was to examine factors associated with discharge for long-term patients with schizophrenia. Seventy patients were judged capable of discharge with psychiatric rehabilitation (special staff service). As a result of rehabilitation efforts, 37 patients were discharged and 33 patients remained in the hospital. Significant differences were found in age, level of family agreement about patient's disability, and length of the special staff service. These factors might be important to predict patients' potential for discharge.


Clinical correlates associated with cognitive dysfunction in people with schizophrenia.


Retrospective study of Japanese patients with schizophrenia treated with aripiprazole.

Aim. The purpose of this retrospective study was to evaluate changes in clinical indicators which influence the quality of life (QOL) of patients with schizophrenia treated by antipsychotic therapy before and after switching to aripiprazole. Methods. A retrospective chart review of 27 patients diagnosed with schizophrenia and who were switched from one antipsychotic to aripiprazole was performed. Clinical indicators about the daily dosage of antipsychotics and antiparkinsonian drugs, psychiatric condition, and glucose/lipid metabolism, clinical evaluation by nursing observation were used to measure the responsiveness of subjects to aripiprazole. Results. Of the 27 subjects, 14 responded to the switch to aripiprazole with significant improvement of the Brief Psychiatric Rating Scale (BPRS) score (P = 0.04), significant decrease in dosage of antipsychotics in 71% of patients (P = 0.03), and tendency toward reduction in dosage of antiparkinsonian drugs (P = 0.07) and body mass index (BMI) (P = 0.06). However, 8 of 27 subjects had a significant increase in lipid levels after switching to aripiprazole (P = 0.01). Conclusion. QOL for subjects who responded to the switch to aripiprazole improved as indicated by lower doses of antipsychotic and antiparkinson medications, improvement in BPRS score, and a decrease in BMI. Results indicate little influence on patient's QOL.


Quality of life and its predictors in people with schizophrenia.

The author reviewed measurement of quality of life (QOL) of schizophrenia patients and the clinical factors related to their QOL. As schizophrenia patients were thought to be unable to assess their own QOL because of their cognitive impairment, objective QOL measures had been frequently used. However, nowadays, there is general agreement that symptomatically stabilized patients could assess their QOL by themselves. Therefore, researchers gradually have become interested in subjective QOL measure. Although most researchers often evaluate schizophrenia patients' QOL using only subjective or objective QOL measure, considering the fact that there is a discrepancy between the two types of measures, it is recommended to use both of them as complementary measures. As for clinical factors related to lowered QOL, several studies reported that depressive symptom was most associated with lowered subjective QOL, negative symptom was strongly related to lowered objective one and poor life skill was associated with both. Moreover, several studies found that cognitive dysfunctions in some cognitive domains were related to lowered objective QOL but the effects of them were much smaller than those of negative symptoms. It is suggested that improving depressive and negative symptoms and life skills may contribute to enhancement of QOL of schizophrenia patients.


Criterion and Construct Validity of the Cogstate Schizophrenia Battery in Japanese Patients with Schizophrenia

The CogState Schizophrenia Battery (CSB), a computerized cognitive battery, covers all the same cognitive domains as the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery but is briefer to conduct. The aim of the present study was to evaluate the criterion and construct validity of the Japanese language version of the CSB (CSB-J) in Japanese patients with schizophrenia. Forty Japanese patients with schizophrenia and 40 Japanese healthy controls with matching age, gender, and premorbid intelligence quotient were enrolled. The CSB-J and the Brief Assessment of Cognition in Schizophrenia, Japanese-language version (BACS-J) were performed once. The structure of the CSB-J was also evaluated by a factor analysis. Similar to the BACS-J, the CSB-J was sensitive to cognitive impairment in Japanese patients with schizophrenia. Furthermore, there was a significant positive correlation between the CSB-J composite score and the BACS-J composite score. A factor analysis showed a three-factor model consisting of memory, speed, and social cognition factors. This study suggests that the CSB-J is a useful and rapid automatically administered computerized battery for assessing broad cognitive domains in Japanese patients with schizophrenia.


PSYCHOMS:COMPUTER MANAGED NURSING-CARE PLANNING SYSTEM AND COMPUTERIZED QUALITY MANAGEMENT OF NURSING OUTCOME


Quality of life and cognitive dysfunction in people with schizophrenia

The main purpose of the present study was to examine the relationship between quality of life (QOL) and cognitive dysfunction in schizophrenia. Subjects were 61 stabilized outpatients. Quality of life and cognitive function were assessed using the Quality of Life Scale (QLS) and the Brief Assessment of Cognition in Schizophrenia (BACS), respectively. Clinical symptoms were evaluated with the Positive and Negative Syndrome Scale (PANSS) and the Calgary Depression Scale for Schizophrenia (CDSS). The BACS composite score and the BACS Verbal memory score were positively correlated with the QLS total score and two subscales. The BACS Attention and speed of information processing score had positive correlation with the QLS total and all the subscales scores. The PANSS Positive and Negative syndrome scores also had significant correlations with the QLS total score and all of the subscales. In addition, the CDSS score was negatively correlated with the QLS total score and some of the subscales. Stepwise regression analysis showed that the BACS Attention and speed of information processing score was an independent predictor of the QLS total score but it was less associated with the QLS than the PANSS Negative syndrome score and the CDSS score. The results suggest that negative and depressive symptoms are important factors on patients' QOL and also support the view that cognitive performance provides a determinant of QOL in patients with schizophrenia.

Progress in Neuro-Psychopharmacology & Biological Psychiatry


The relationship between psychological comfort space and self-esteem in people with mental disorders

The purpose of this study was to demonstrate a causal model of the sense of having psychological comfortable space that is call 'ibasho' in Japanese and self-esteem in people with mental disorders who had difficulty in social activities. The subjects were 248 schizophrenia patients who were living in the community and receiving day care treatment. Data were collected from December 2007 to April 2009 using the Scale for the Sense of ibasho for persons with mentally ill (SSI) and the Rosenberg Self-Esteem Scale (RSES), and analyzed for cross-validation of construct validity by conducting covariance structure analysis. A relationship between the sense of having comfortable space and self-esteem was investigated. Multiple indicator models of the sense of having psychological comfortable space and self-esteem were evaluated using structural equation modeling. Furthermore, the SSI scores were compared between the high- and low-self-esteem groups. The path coefficient from the sense of having comfortable space to self-esteem was significant (0.80). High-self-esteem group scored significantly higher in the SSI subscales, 'the sense of recognizing my true self' and 'the sense of recognizing deep person-to-person relationships' than the low-self-esteem group. It was suggested that in order to help people with mental disorders improve self-esteem, it might be useful to support them in a way they can enhance the sense of having comfortable space.

The Journal of Medical Investigation : JMI


Psychological features of pregnant women predisposing to depressive state during the perinatal period

周産期の抑うつに影響を与える心理特性に関する検討


Support for people with both alcohol dependency and affective disorder, and their families

アルコール依存症と感情障害を抱える人とその家族への支援

アルコール依存症と感情障害の関係性は以前から指摘されている．アルコール依存症とうつ病は，自殺企図者の精神障害の内訳の半数を占め，それらが合併した場合には自殺の危険性を一層高める．また，アルコール依存症治療において，患者がうつ症状を呈している場合，再飲酒のリスクが高くなり治療の継続を妨げる原因となりうる．そのため，うつ病の治療にも注意を払うことが求められる．さらに，家族からの支援はアルコール依存症患者の断酒を継続するなどの治療において重要な役割を果たしている．しかし，患者の断酒の継続に注意を払いすぎるあまり，それがストレスとなり患者の問題飲酒を助長することになったり，家族自身がさまざまな悩みを抱え苦しんだりすることが考えられ，家族への支援もとても重要となる．加えて，親がアルコール依存症である場合，子どもも将来アルコール依存症となる危険性が高くなるなど，子どもに与える影響も大きい．そこで医師，看護師，ソーシャルワーカーが支援に関わることや自助グループを活用することが重要となる．本総説ではアルコール依存症と感情障害の関係と治療方法，アルコール依存症と感情障害を抱える患者とその家族への支援に焦点を当て，包括的な支援のありかたを検討した．

JNI : The Journal of Nursing Investigation


リスパダールコンスタ専用針を用いた筋肉注射手技の正確性 中臀筋への確実な筋肉注射に必要な注射針の検討

The Japanese Journal of Psychiatric Nursing


Clinical pathway focused on team care of the behavioral and psychological symptoms of dementia BPSD and family support

認知症に伴う行動障害と精神症状(BPSD)の改善および家族支援に焦点をあてた認知症のためのクリニカルパスの検討

Japanese Journal of Geriatric Psychiatry


Gene expression and association analyses of the phosphodiesterase 4B (PDE4B) gene in major depressive disorder in the Japanese population.

The phosphodiesterase 4B (PDE4B) interacts with disrupted-in-schizophrenia 1 (DISC1), which is a known genetic risk factor for schizophrenia, bipolar disorder and major depressive disorder (MDD). PDE4B is also important in the regulation of cAMP signaling, a second messenger implicated in learning, memory, and mood. In this study, we determined mRNA expression levels of the PDE4B gene in the peripheral blood leukocytes of patients with MDD and control subjects (n = 33, each). Next we performed two-stage case-controlled association analyses (first set; case = 174, controls = 348; second set; case = 481, controls = 812) in the Japanese population to determine if the PDE4B gene is implicated in MDD. In the leukocytes, a significantly higher expression of the PDE4B mRNA was observed in the drug-naïve MDD patients compared with control subjects (P < 0.0001) and the expression of the MDD patients significantly decreased after antidepressant treatment (P = 0.030). In the association analysis, we observed significant allelic associations of four SNPs (the most significant, rs472952; P = 0.002) and a significant haplotypic association (permutation P = 0.019) between the PDE4B gene and MDD in the first-set samples. However, we could not confirm these significant associations in the following independent second-set of samples. Our results suggest that the PDE4B gene itself does not link to MDD but the elevated mRNA levels of PDE4B might be implicated in the pathophysiology of MDD.

American Journal of Medical Genetics. Part B, Neuropsychiatric Genetics


Construction and reliability of the Japanese version of the Adolescent Egocentrism-Sociocentrism(AES) scale and its preliminary application in the Japanese university students

In recent years, the problem of interpersonal relationships has been reported to be associated with various adolescent psychiatric problems. Egocentrism is one factor related to the problem of interpersonal relationships. The Adolescent Egocentrism-Sociocentrism (AES) scale is used to assess egocentrism in Western countries, but no such scale has been developed in Japan. The purpose of our current study was to develop the Japanese version of the AES scale and investigate the relationship between the egocentrism assessed by the AES scale and the self-consciousness assessed by the Japanese version of the self-consciousness scale. The original version of the AES scale was first translated into Japanese using the forward-backward method and examined for factorial reliability and validity. The results demonstrated that the Japanese version of the AES scale shows adequate factorial reliability and validity, but different from the original version the "egocentrism personal fable" subscale which measures the feeling that oneself is special and unique was not extracted in the Japanese version. We found a moderate correlation between the non-social focuses of the AES scale and the public self-consciousness subscale of the self-consciousness scale. This correlation suggests that a strong attention of others' view on oneself results in the avoidance of others. The Japanese version of the AES scale can examine egocentrism adequately together with sociocentrism and non-social focuses. As this scale is self-reporting and easy to complete, it may have practical utility in a clinical setting.


Predictors of subjective and objective quality of life in outpatients with schizophrenia.

AIM: In recent years, greater attention has been given to quality of life (QOL) in schizophrenia and several studies reported that negative and depressive symptoms and cognitive dysfunction are related to patient QOL. But because a variety of QOL measures have been used in the previous studies, there seems to be no unanimous predictors for subjective and objective QOL. The purpose of the present study was to elucidate the relationship between clinical variables and subjective and objective QOL in outpatients with schizophrenia, using schizophrenia disease-specific QOL measures. Particular attention was paid to cognitive function as a predictor of QOL. METHODS: Schizophrenia symptoms of the Positive and Negative Syndrome Scale (PANSS) were divided into five factors: positive factor, negative factor, cognitive factor, emotional discomfort, and hostility. The study sample consisted of 84 schizophrenia outpatients. Subjective and objective QOL were assessed with Schizophrenia Quality of Life Scale (SQLS) and the Quality of Life Scale (QLS), respectively. RESULTS: Subjective QOL correlated significantly with emotional discomfort, positive factor, negative factor, extrapyramidal symptoms and cognitive factor, while objective QOL correlated with negative factor, cognitive factor, emotional discomfort, extrapyramidal symptoms, and dose of antipsychotics. Total score and three of four subscales in the QLS correlated significantly with cognitive factor, while cognitive factor had a significant correlation with only one of three scales of SQLS. Stepwise regression showed that subjective QOL was significantly predicted by emotional discomfort and extrapyramidal symptoms, while negative factor was the most important predictor of objective QOL. CONCLUSION: Cognitive dysfunction had a greater influence on objective QOL than subjective QOL. Treating depressive and negative symptoms and extrapyramidal symptoms might contribute to enhanced subjective and objective QOL.


Positive association of the PDE4B (phosphodiesterase 4B) gene with schizophrenia in the Japanese population.

The phosphodiesterase 4B (PDE4B) gene is located at 1p31, a susceptibility region for schizophrenia (SZ). Moreover, PDE4B interacts with DISC1, which is a known genetic risk factor for SZ. Recently, it was reported that the PDE4B gene is associated with SZ in Caucasian and African American populations. In this study, case-controlled association analyses were performed in the Japanese population to determine if the PDE4B gene is implicated in SZ. Thirteen single nucleotide polymorphisms (SNPs) were analyzed in 444 schizophrenic patients and 452 control subjects. Three SNPs (rs2180335, rs910694 and rs472952) were significantly associated with SZ after applying multiple test correction (p=0.039, 0.004 and 0.028). In addition, a significant association was found between specific haplotypes (rs2180335 and rs910694) and SZ (permutation p=0.001). Our result suggests that variations at the PDE4B locus may play a significant role in the etiology of SZ in the Japanese population.


Subjective and objective quality of life, levels of life skills, and their clinical determinants in outpatients with schizophrenia.

The purpose of the present study is to investigate the relationships among subjective and objective quality of life (QOL), and levels of life skills, and their clinical determinants in outpatients with schizophrenia by using schizophrenia disease-specific QOL measures. Data collected from 64 outpatients were analyzed. Subjective QOL was measured with the Schizophrenia Quality of Life Scale (SQLS) and objective QOL with the Quality of Life Scale (QLS). Patients' family members completed the Life Skills Profile (LSP). Clinical symptoms were also assessed with several scales including the Brief Psychiatric Rating Scale (BPRS) and the Calgary Depression Scale for Schizophrenia (CDSS). Only the motivation/energy scale, but not the other scales of the SQLS, correlated with the QLS. The LSP rated by the family showed significant correlations with both the SQLS and the QLS. The CDSS score predicted each scale of the SQLS, and the BPRS negative symptoms score predicted the QLS. The LSP was predicted by the BPRS negative symptoms score and the CDSS score independently. These results indicate that the patient's QOL could be predicted by the life skills measured by a family member and suggest that active treatment for depressive and negative symptoms might be recommended to improve the patient's QOL and life skills.


Differences in waveforms of cerebral evoked potentials among healthy subjects, schizophrenics, manic-depressives and epileptics.

The differences in the waveform of Cerebral EP (Evoked Potential)s; SEP, VEP and AEP, among healthy subjects, schizophrenics, manic-depressives and epileptics were investigated. In 585 subjects of both sexes comprising these diagnostic groups, 6 channels of EPs, each 2 channels for each sensory modality, were recorded simultaneously/parallelly from each subject, without assigning a mental task. Then, waveforms of the g-m (group mean) EPs of each diagnostic group were superimposed for inspection. Peak latencies and inter-peak amplitudes of individual EPs were statistically tested among (ANCOVA) and between (Scheffe's multiple comparison test) these diagnostic groups for each channel (modality), and for each sex. The waveforms of g-m EPs of each diagnostic group differed from each other. The differences of latencies and inter-peak amplitudes among these diagnostic groups attained to the significant level (P<0.05), with more significant differences between healthy subjects and each of these pathological diagnostic groups than between each of these pathological diagnostic groups, for each sex. Thus the differences in the waveform of EPs among these diagnostic groups were confirmed even taking the effect of medication on EPs into consideration. These results might suggest the existence of a waveform for individual EPs specific to each of these diagnostic groups, for each sex.

The Journal of Medical Investigation : JMI


Survey on Community Resident's Attitudes and Images for Mentally Handicapped Person and Mental Disorder

住民の精神障害者に対する意識調査:精神障害者との出会いの経験と精神障害者に対するイメージ

BACKGROUND: The mental health care and welfare have shifted from hospital care to the community care. Stigma and discrimination with mental health problems have been identified as major obstacles for this plan. AIM: The purpose of this study was to clarify community attitudes and images for mentally handicapped person of the people living in a small community. METHOD: A mail survey was conducted in the area covered by A health center in B prefecture. The candidate 600 residents (2.2% of all residents) who live in B County were selected (age range: 20-60 y.o.). Participants comprised 293 respondents (recovery ratio: 48.8%). RESULTS: About 50% of respondents who are in 20's and 30's answered that they became aware of mentally handicapped persons when they were between elementary school to high school age. The general tendency at that time was negative including "he/she has changed badly" (19.9%) and "he/she is fearful" (15.8%). On the other hand, positive images were less than ten percents including "he/she is not different from an ordinary person"(5.5%), "he/she is friendly personality" (2.3%). The mentally handicapped persons who respondents usually met were only with dementia. CONCLUSION: The images about mental illness at school ages are important. Any intervention aimed at changing attitudes to mentally ill people in the community should be targeted to children. It is also important to make an opportunity of warm interaction between people with mental disorders and community residents in the psychiatric hospital, a rehabilitation institution, etc.

スティグマと疎外が精神疾患の治療と精神障害者の社会復帰を妨げていることが,精神保健上の問題として明らかにされている.地域住民の精神障害者との出会いの経験と精神障害者に対するイメージについて明らかにする目的で,郵送法による質問紙調査を行った.その結果,20代と30代の回答者の約50%が,精神障害者を意識した時期が小学校から高校であったと回答した.その当時の精神障害者のイメージは,否定的イメージが多かった.またその内容は,「変わっている」「こわい」が上位にあり,「普通の人と変わらない」は1割以下であった.回答者らが,実際に会ったことのある精神障害者は認知症のみであった.精神保健福祉施策は入院医療から地域ケアへと移行している.したがって,精神障害者やその障害について地域住民が理解する機会を我々は増やしていかなければならない.今後は,さらに若い年代から病院や施設等で精神障害者と日常的に交流を持てるような,ふれあいの場を作ることが重要である.また若い年代に対する精神障害者や精神障害に対する固定観念やスティグマを緩和ないし減少させるためのさらなる啓発活動が求められることが示唆された.


Survey on community resident's experiential knowledge of mental disorders and reaction to people with mental disorders

地域住民の精神障害関連の行事への参加と精神障害者に対する意識調査

Background : It is essential for mentally disabled persons who live in the community to be understood and cooperated by local residents. Aim : This study investigated the relationship between the participation of the residents to the event held in the psychiatric hospital and their attitudes towards mentally handicapped persons. The research objective is to find the method to the residents for promoting an understanding of mental disorders. Method : A mail survey was conducted in the area covered by the B health center in A prefecture. The candidate600 residents(2 2% of all residents)who live in B county were selected(age range : 20-60 y.o.). Participants comprised 293 respondents(recovery ratio : 48 8%). Comparison was carried out by the respondents who joined or did not join the event held in the psychiatric hospital. Results : Their understanding of mental disorders is relatively high in the participants. Most of them are willing to do something for mentally disabled persons' social rehabilitation. Ten percent of all respondents would choose `can't go along with mentally handicapped persons' social rehabilitation support'. Conclusion : The results suggest that the provision of the opportunity for personal contact with mentally handicapped persons are important for improving the educational activity of the public about mental illnesses and considered to be important measures for promoting the acceptance and support of the mentally handicapped persons by the local residents.

精神障害者が地域で生活するためには地域住民の理解と協力が不可欠である．精神障害者が参加する行事への住民の参加度と精神障害者に対する意識に加え，彼らとのつきあい方との関係を明らかにし，さらに，それによって精神障害および精神障害者に対する理解を促進するための住民への啓発方法を検討することが本報告の目的である．A県のB保健所の管轄区域の住民600人を対象とした郵送法による質問紙調査を行った．回収率は48．8%(293人)であった．地域住民のなかで精神障害者が参加する行事に参加した経験のある人は，1)精神障害への認識度が高かった，2)精神障害者の社会復帰のために「何か役に立ちたい」と思っている人が多かった，一方で3)精神障害者の社会復帰への支援に，協力できないと回答した人は全回答者の1割しかいなかった．精神障害者が地域で生活するために必要なものは「地域住民の精神障害についての関心と理解そして精神障害者に対する支援である」と，住民自らが感じていた．住民を巻き込んだ体験的啓発活動の実践が，精神障害者に対する理解や支援を拡大させることになるということが示唆された．

JNI : The Journal of Nursing Investigation


The Influence of Obsessive Compulsive Symptoms on Quality of Life among the Female Nursing Staffs

女性看護職の強迫傾向が主観的QOLに及ぼす影響

Background: The influence of obsessive compulsive symptoms on subjective Quality of Life (QOL) among the woman nursing staff has been scarcely studied. Subject and methods: We examined the correlations of the scores on the Toronto Alexithiymia Scale (TAS-20) with the scores on the Maudsley Obsessive Compulsive Inventory (MOCI). We also assessed the influence of obsessive compulsive symptoms measured by the MOCI or depressive symptoms by the Zung Self-rating Depression Scale (SDS) on subjective QOL by the Brief Version of World Health Organization Quality of Life Assessment (WHO-QOL26) in the staff of 221 female nursing at a general hospital. The correlations of the MOCI or the SDS scores with the WHO-QOL26 total (t-QOL) and the domain scores ("physical", "psychological", "social", and "environmental" domains) were assessed by Spearman rank-correlations. Results: The TAS-20 total scores and the subfactor scores of "Difficulty identifying feelings", and "Difficulty describing feelings" positively correlated with the MOCI scores. Spearman rank-correlations showed negative correlations of the t-QOL with the MOCI and the SDS scores. The MOCI scores revealed significant negative correlations with "physical" and "psychological" but no correlation with "social" and "environmental", though the SDS scores showed significant negative correlations with each domain. The MOCI scores revealed significant negativecorrelations with the t-QOL only in the group in their twenties but the SDS scores showed significant negative correlations with the t-QOL in the group ranging from twenties to fifties. Only in over-fifties-group the MOCI scores revealed positive correlations with "social" domain. Conclusions: Among Japanese female nursing staff in the present study, alexithiymia by the TAS-20 affects on obsessive compulsive symptoms by the MOCI. Both obsessive compulsive symptoms and depressive symptoms had negative effects on their subjective QOL. While depressive symptoms showed negative correlations withsubjective QOL in each age bracket and on each domain, obsessive compulsive symptoms had negative correlations on the subjective QOL only in the younger age group and just on subjective "physical" and "psychological" well-beings. Obsessive compulsive symptoms would improve subjective "social" functioning in the mature age group.

看護職は高い専門性や自律性を求められると同時に,確認や清潔などの徹底も要求される.職場適応障害や燃え尽き症候群など心身医学的治療を要する症状を訴える者も多い.女性看護職に対する質問紙調査では強迫傾向が指摘される.われわれは,心身医学的見地より女性看護職の強迫傾向を検討し,強迫傾向と抑うつ度がQuality of Life (QOL)に与える影響の違いを比較した.自己記入式質問紙MOCI邦訳版(Maudsley Obsessional Compulsive Inventory)による強迫傾向群は16.3%と多かった.心身症患者の心理的特徴とされるアレキシサイミア(失感情症:alexithiymia)傾向は,強迫傾向に有意な相関を示した.アレキシサイミアの中でも「感情の同定困難因子」が,強迫傾向の「確認」「優柔不断」「疑惑」の高さと関係していた.抑うつ度は年齢層やQOL構成項目に限定されず,主観的QOLの低さと相関した.しかし強迫傾向は,若年女性看護職では「身体的領域」「心理的領域」の主観的QOLの低さと相関し,熟年看護職においては「社会的関係」の主観的QOLの高さと相関し,年齢や主観的QOLの領域により異なる影響をもたらす可能性が示唆された.若年看護職は強迫傾向と同時にアレキシサイミア傾向も高く,アレキシサイミアの中でも感情の同定困難と主観的QOLの低さとが関係していた.今後,このような若年看護職に対する心理的サポートをどのようなかたちで,どのような方法で行っていくのかが問われ,心身医学的検討が待たれるところである.

Japanese Journal of Psychosomatic Medicine


Clinical Features of Patients with Obsessive-compulsive Disorder showing Different Pharmacological Responses

強迫性障害の薬物応答性と臨床特徴について


Effect of antipsychotic replacement with quetiapine on the symptoms and quality of life of schizophrenic patients with extrapyramidal symptoms.

Replacement of antipsychotic drugs with quetiapine (QTP) was tried in a naturalistic setting in chronic schizophrenic patients who still showed moderate psychiatric symptoms and either showed extrapyramidal symptoms (EPS) or took anti-parkinson drugs for the EPS. QTP was added on and gradually increased while the previous drugs were tapered and discontinued whenever possible. Clinical symptoms, objective and subjective QOL, and EPS were measured before and 6 months after QTP addition, using Brief Psychiatric Rating Scale (BPRS), Quality of Life Scale (QLS), Schizophrenia Quality of Life Scale (SQLS) and Drug-Induced Extrapyramidal Symptom Scale (DIEPSS), respectively. Twenty-one patients completed the trial and received the assessment. It was found that replacement with QTP-improved clinical symptoms, objective and subjective QOL and EPS. This improvement was equally observed in not only patients who switched to QTP monotherapy (n = 11) but also patients who took QTP together with reduced small doses (4.4 +/- 4.3 mg/day) of previous drugs (n = 11). The results suggest that replacement with QTP improves symptoms as well as objective and subjective QOL in a subgroup of schizophrenia.


Subjective and objective measures of quality of life have different predictors for people with schizophrenia.

This study investigated the relationship between subjective and objective quality of life and assessed predictors in people with schizophrenia. The study population consisted of 99 stabilized outpatients with schizophrenia (DSM-IV) who had been regularly receiving outpatient treatment at the Department of Psychiatry, The Tokushima University Hospital. Subjective and objective quality of life were estimated using the Schizophrenia Quality of Life Scale and the Quality of Life Scale, respectively. Psychiatric symptoms were also measured with the Brief Psychiatric Rating Scale and the Calgary Depression Scale for Schizophrenia. Scores on the Schizophrenia Quality of Life Scale Motivation and Energy scales significantly correlated with the Quality of Life Scale total scores -.40 (p <.001), and with the scores on Interpersonal Relations subscale -.42 (p <.001), Instrumental Role subscale -.28 (p = .005), Intrapsychic Foundations subscale -.39 (p<.001), and Common Objects and Activities subscale -.25 (p =.014). The Schizophrenia Quality of Life Scale Psychosocial scale significantly correlated with only the Quality of Life Scale total score -.20 (p =.05), and there was no significant correlation between the scores on the Schizophrenia Quality of Life Scale Symptoms and Side-effects scales and the Quality of Life Scale. Stepwise regression analyses showed that the Calgary Depression Scale for Schizophrenia score was the most important predictor of each scale of the Schizophrenia Quality of Life Scale, and the Brief Psychiatric Rating Scale Negative Symptoms score was the most important predictor of the Quality of Life Scale total score and each subscale. These results suggest that subjective and objective quality of life have different predictors and should be considered as separate and complementary outcome variables.


Brain-derived neurotrophic factor (BDNF) Val66Met polymorphism in schizophrenia is associated with age at onset and symptoms.

Brain-derived neurotrophic factor (BDNF) is a neurotrophic factor that promotes several functions of neurons and modulates neurotransmissions. It has been reported that there are alterations of BDNF levels in schizophrenic brains and that BDNF gene expressional changes would be responsible for the etiology of schizophrenia. Recent studies have shown that a variation of BDNF gene (Val66Met polymorphism) affects the function of neurons, and is associated with several neurological and psychiatrical disorders. We investigated the relationship between BDNF Val66Met polymorphism and the onset age as well as levels of clinical symptoms in 159 of chronic schizophrenia in-patients diagnosed by DSM-IV. The mean onset ages were 27.5+/-9.5 for BDNF Val/Val, 25.5+/-7.4 for BDNF Val/Met and 22.9+/-6.0 for BDNF Met/Met and this polymorphism was significantly associated with age at onset (P=0.023). The mean Brief Psychiatric Rating Scale scores (BPRS) were significantly different among those three groups (P=0.003). No significant differences were demonstrated comparing the BDNF genotype distributions of positive and negative family history (P=0.21). Our investigation indicates that the BDNF gene Val66Met polymorphism is related to the onset age of schizophrenia and the levels of clinical symptoms that remain after long-term antipsychotic treatment.


自生思考に対して特異な対処行動を示した統合失調症の1例

自生思考に対して特異な対処行動を示した統合失調症の1例


Central pontine myelinolysis associated with a hypoglycemic coma in anorexia nervosa


女子大学生の月経前緊張症

女子大学生の月経前緊張症


Fluvoxamine induced complex partial seizure in the treatment of bulimia nervosa


低Na血症を認めなかったにもかかわらず中心性橋髄鞘崩壊症を合併した摂食障害の1例


精神科臨床における下肢深部静脈血栓症

精神科臨床における下肢深部静脈血栓症


バルプロ酸が用量依存的に病相予防効果を発揮した双極性感情障害の1症例

バルプロ酸が用量依存的に病相予防効果を発揮した双極性感情障害の1症例


Lithium投与中の甲状腺中毒症(無痛性甲状腺炎)

Lithium投与中の甲状腺中毒症(無痛性甲状腺炎)


Temperament,character,and eating attitudes in japanese college women

精神分裂病と本態性パーキンソン病は，前者が脳内ドパミンの過剰仮説により説明されることが多く，後者がドパミン欠乏により生ずることにより，互いに相反する疾患として一般的には理解され，合併することはないと考えられている．しかし，筆者らはその治療経過から，全く相反する疾患として捉える根拠がないことを，その発症機制についての検討を加えて報告した．


Olanzapineにより知覚変容発作を来した統合失調症の1症例

Olanzapineにより知覚変容発作を来した統合失調症の1症例


Silent thyroiditis associated with short-term lithium therapy


Personality profiles in patients with eating disorders

The present review focused on the personality profiles of patients with eating disorders. Studies using the Structured Clinical Interview for DSM-III-R Personality Disorder showed high rates of diagnostic co-occurrence between eating disorders and personality disorders. The most commonly observed were histrionic, obsessive-compulsive, avoidant, dependent and borderline personality disorders. Studies using the Cloninger's personality theory suggested that high Harm Avoidance might be relevant to the pathology of anorexia nervosa and high Novelty Seeking and Harm Avoidance to bulimia nervosa. Moreover, high Self-Directedness was suggested to be associated with favorable outcome in bulimia nervosa. The assessment of personality in a cross-sectional study, however, might be influenced by the various states of the illness. Therefore, a sophisticated longitudinal study will be required to advance this area of research.

The Journal of Medical Investigation : JMI


Radiofrequency catheter ablation enabled antipsychotic treatment in a schizophrenic patient with idiopathic ventricular tachycardia


Traits of irrational beliefs related to eating problems in Japanese college women.

This study focused on the relation of irrational beliefs and Body Mass Index (BMI) to inappropriate eating attitudes in Japanese college women. A total of 110 nonclinical subjects completed the Japanese Irrational Belief Test (JIBT) and the Japanese version of the Eating Attitudes Test (EAT). The JIBT subscale of 'self expectation' had significant positive correlations with the EAT total score and the subscales of 'obsession with eating', 'dieting' and 'obese-phobia'. The JIBT subscale of 'dependence' had a significant positive correlation with the EAT subscale of 'obsession with eating'. BMI score showed significant positive correlations with the EAT total score and the subscales of 'dieting' and 'obesephobia'. The present results suggest that characteristic irrational beliefs are associated with inappropriate eating attitudes, suggesting that clarifying and then modifying the irrationality may be a useful method of preventive intervention in nonclinical young women with eating problems.


引きこもりを特徴とする対人恐怖症の治療経験

引きこもりを特徴とする対人恐怖症の治療経験

Japanese Journal of Psychiatric Treatment


頑固な食行動障害に fluvoxamine が奏効した最重度精神遅滞を伴う非定型自閉症の1例


Gender differences of the influential factors on the mental health condition of teachers in the A university.


Effectiveness of nursing interviews using concordance skills aimed at acquisition of self-confidence toward community life for long-stay patients with schizophrenia not wishing to be discharged

退院を望まない長期入院統合失調症患者に対する地域生活の自信獲得に向けたコンコーダンス・スキルを活用した看護面接の効果

In the present study, we conducted nursing interviews using concordance skills (CS interviews) aimed at acquisition of self-confidence toward community life for two long-stay patients with schizophrenia who did not wish to be discharged from psychiatric hospital, and evaluated the effectiveness of CS interviews. Case A was a woman in her 70s who was diagnosed with schizophrenia at around age of 17 years and had been institutionalized for approximately 30 years since her ninth admission. Case B was a man in his 30s who was diagnosed with schizophrenia at around age of 22 years and had been admitted 15 times due to auditory hallucination, delusions, suffers a relapse, has been in hospital for two years and six months since his latest admission. As a result of interviews, scores on the Self-Efficacy for Community Life Scale improved from 150 to 160 points for Case A and from 66 to 82 points for Case B. In the Case A, the Global Assessment of Functioning (GAF) score was 35 with no changes before and after intervention. In the case B, GAF score improved from 25 to 35, before and after six months intervention. These findings suggest that CS interviews are effective for promoting self-confidence toward community life among long-stay patients and useful for providing support without exacerbating the severity of psychiatric symptoms or functional level of long-stay patients during the stage in which they nurture the dreams and hopes to be discharged.


Relationship between Body Mass Index and Assessment Variables of Intramuscular Injection part of a Gluteal Region

Proceedings of the Sixth International Conference on Information(Info13)


精神障害者のためのコンコーダンス・モデルに基づいた新しい看護面接

精神障害者のためのコンコーダンス・モデルに基づいた新しい看護面接

Mental health measures in Japan are moving from hospitalization-centered care to community-based care. With the demand for changes in the functions of psychiatric hospitals and clinics, the role of nurses is growing. The primary role of nursing is to enable each and every individual to maintain a healthy life, which involves providing those individuals with assistance to maximize their vitality and healing capacity and enable them to exploit those abilities as best they can. In order to practice such nursing interview, following basic concepts are useful : (1) It should be based on a concordance model ; (2) It should set opportunities to promote remarks from mentally ill individuals and utilize concordance skills that elicit their thoughts ; and (3) It should utilize the Strengths Assessment Sheet that focuses on lifestyle including the abilities, environment, and hopes of mentally ill individuals. In this article, we describe a proposed new nursing interview framework based on a concordance model for people with mental disorders.


総合大学に勤務する教員・研究者を対象にした職務状況とメンタルヘルスに関する実態調査


対話による認知症高齢者の自律神経系への影響

対話による認知症高齢者の自律神経系への影響

認知症高齢者と健常者が対話を行う際に，話しの受け手である認知症高齢者の自律神経系にどのような影響があるのかを評価することが目的である．調査協力者はA 介護老人保健施設に入所している認知症高齢者14 名(平均年齢89.43 ± 3.98 才，男性2 名女性12 名，長谷川式簡易知能評価スケールの平均得点は11.79 ± 4.37 点)である．調査協力者と研究者が対話を行い，対話前後の収縮期血圧，拡張期血圧，脈拍，唾液アミラーゼ活性値，体温，SpO2 を測定した．心電図は実験開始とともに記録を開始し，実験終了まで継続して記録した．全ての指標で有意差はみられなかった．しかし，対話前後で唾液アミラーゼ活性値が9 名で低下していた．交感神経機能の指標であるLF/HF は4 名で対話中に上昇し，対話後に低下していた．副交感神経機能の指標であるHF は5 名で対話中に減少していた．認知症高齢者との対話の効果を評価するための生理評価指標として，唾液アミラーゼ活性値，LF/HF が挙げられる資料を得たと考えられた．また日中に効果的な対話を行うことは，認知症高齢者の自律神経活動を，日中は交感神経活動が優位で夜間は副交感神経活動が優位に働くという健常者に類似した自律神経活動に誘導する一助となる資料を得たと考えられた．

香川大学医学部看護学科紀要

香川大学医学部看護学科紀要


退院支援施設入所後1年が経過した精神障害者の生活能力

退院支援施設入所後1年が経過した精神障害者の生活能力

研究目的は，退院促進支援により退院し，退院支援施設で生活した精神障害者の生活能力を明らかにし，看護のあり方を検討することである．調査対象者は，施設入所後1年が経過した長期入院であった精神障害者17名(男性12名，女性5名)で，平均年齢は，52．5歳，平均入院期間は11．3年であった．データ収集は，調査対象者一人ずつに約20分程度の半構成的面接を行った．その結果，逐語録から255のラベルが得られ，11のサブカテゴリーに分類された．これらから「自分自身のペースに合わせた生活リズムの獲得」，「病気を悪化させないための自己管理」，「施設退所後の生活のための心の準備」，「良好な対人関係の構築」という4つのカテゴリーが抽出された．これらの結果から，施設利用者は自分なりのペースで社会復帰に向けての準備をしながら，着実に生活能力を身につけていることが示唆された．

JNI : The Journal of Nursing Investigation


アリピプラゾールの特徴，利点をふまえた看護のポイント

アリピプラゾールの特徴，利点をふまえた看護のポイント

The Japanese Journal of Psychiatric Nursing


統合失調症患者の主観的QOLと家族による生活技能評価との関連の検討

統合失調症患者の主観的QOLと家族による生活技能評価との関連の検討

Annual Report of Mitsubishi Pharma Research Foundation


統合失調症外来患者のQOLに影響を及ぼす諸要因に関する検討

統合失調症外来患者のQOLに影響を及ぼす諸要因に関する検討


新規非定型抗精神病薬による統合失調症の症状とQOLの改善に関する検討

新規非定型抗精神病薬による統合失調症の症状とQOLの改善に関する検討