記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier BV  

DOI： 10.1016/j.ajp.2024.104260

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1002/pcn5.70001

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担当区分：責任著者   掲載種別：研究論文（学術雑誌）   出版者・発行元：Wiley  

Abstract

Background

Inattention due to attention‐deficit/hyperactivity disorder (ADHD) can lead to forgetfulness. Transient epileptic amnesia (TEA) can cause forgetfulness, similar to ADHD. We report a patient with ADHD who developed TEA.

Case Presentation

The patient was a 40‐year‐old woman with ADHD. She has been prone to forgetfulness since childhood. Two years before visiting our outpatient clinic, she had begun to occasionally forget events that had occurred several days earlier. However, she was largely unaware of the emergence of new amnestic symptoms. She had also begun to experience various other amnestic symptoms 2 months before she visited our clinic, which prompted her to visit our outpatient clinic. The combination of a detailed interview, electroencephalography (EEG) examination, and consideration of TEA enabled us to diagnose her with TEA and provide treatment accordingly. In our patient, daily forgetfulness due to ADHD delayed the recognition of new additional forgetfulness attributed to TEA.

Conclusion

Psychiatrists need to consider TEA when patients with ADHD present with changes in or exacerbation of forgetfulness.

DOI： 10.1002/pcn5.70003

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: It has been reported that patients with geriatric psychiatric disorders include many cases of the prodromal stages of neurodegenerative diseases. Abnormal 123I-2β-carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl) nortropane dopamine transporter single-photon emission computed tomography (DAT-SPECT) reveals a nigrostriatal dopaminergic deficit and is considered useful to detect dementia with Lewy bodies and Parkinson's disease as well as progressive supranuclear palsy and corticobasal degeneration. We aimed to determine the proportion of cases that are abnormal on DAT-SPECT in patients with geriatric psychiatric disorders and to identify their clinical profile. METHODS: The design is a cross-sectional study. Clinical findings of 61 inpatients aged 60 years or older who underwent DAT-SPECT and had been diagnosed with psychiatric disorders, but not neurodegenerative disease or dementia were analysed. RESULTS: 36 of 61 (59%) had abnormal results on DAT-SPECT. 54 of 61 patients who had DAT-SPECT (89%) had undergone 123I-metaiodobenzylguanidine myocardial scintigraphy (123I-MIBG scintigraphy); 12 of the 54 patients (22.2%) had abnormal findings on 123I-MIBG scintigraphy. There were no cases that were normal on DAT-SPECT and abnormal on 123I-MIBG scintigraphy. DAT-SPECT abnormalities were more frequent in patients with late-onset (55 years and older) psychiatric disorders (69.0%) and depressive disorder (75.7%), especially late-onset depressive disorder (79.3%). CONCLUSION: Patients with geriatric psychiatric disorders include many cases showing abnormalities on DAT-SPECT. It is suggested that these cases are at high risk of developing neurodegenerative diseases characterised by a dopaminergic deficit. It is possible that patients with geriatric psychiatric disorders with abnormal findings on DAT-SPECT tend to show abnormalities on DAT-SPECT first rather than on 123I-MIBG scintigraphy.

DOI： 10.1136/bmjment-2024-301042

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: People with schizophrenia have a lower colorectal screening rate than the general population. A previous study reported an intervention using case management to encourage colorectal cancer screening for patients with schizophrenia in psychiatric outpatient settings. In this feasibility study, we developed provider-level implementation strategies and evaluated the feasibility of conducting a definitive trial in terms of the penetration of the intervention assessed at the patient level. Additionally, we examined the fidelity of strategies to implement the intervention at the provider level in a routine clinical psychiatric setting. METHODS: This was a multicenter, single-arm feasibility study with medical staff at psychiatric hospitals in Japan. The provider-level implementation strategies developed in this study included three key elements (organizing an implementation team appointed by the facility director, interactive assistance using a clear guide that outlines who in the hospital should do what, and developing accessible educational materials) to overcome major barriers to implementation of the intervention and four additional elements (progress monitoring, joint meetings and information sharing among participating sites, adaptation of encouragement methods to specific contexts, and education of on-site staff), with reference to the elements identified in the Expert Recommendations for Implementing Change (ERIC). The feasibility of the strategies was evaluated by the proportion of patients who were eligible for encouragement (patients with schizophrenia aged 40, 50, or 60) who received encouragement. We set the goal of providing encouragement to at least 40% of eligible patients at each site. RESULTS: Two public and four private psychiatric hospitals in Okayama and Shimane prefectures participated in this study. Regarding fidelity, all elements of the strategies were conducted as planned. Following the procedures in the guide, each team prepared and provided encouragement according to their own facility and region. Penetration, defined as the proportion of eligible patients who received encouragement, ranged from 33.3 to 100%; five of the six facilities achieved the target proportion. CONCLUSIONS: The provider-level implementation strategies to implement encouragement were feasible in terms of penetration of the intervention assessed at the patient level. The results support the feasibility of proceeding with a future definitive trial of these strategies. TRIAL REGISTRATION: jRCT, jRCT1060220026 . Registered on 06/04/2022.

DOI： 10.1186/s43058-023-00541-0

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担当区分：筆頭著者   記述言語：英語  

DOI： 10.1016/j.schres.2023.07.006

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出版者・発行元：株式会社医学書院  

DOI： 10.11477/mf.1405207008

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担当区分：責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: To reduce cancer care disparities in people with mental illness, this study aimed to quantify psychiatric care providers' perceptions regarding issues that are insufficiently addressed or difficult to address. METHODS: Psychiatric care providers at 23 psychiatric hospitals in Japan were surveyed using mail questionnaires. Respondents were asked to rate 15 items with four categories related to insufficiencies/difficulties in cancer care for patients with mental illness on a five-point Likert scale. We analyzed the proportion of respondents who answered "insufficient/difficult" for each item. RESULTS: A total of 255 (76.3%) psychiatric care providers responded. For questions related to the skills and attitudes of psychiatric professionals, 48.3%-58.4% of respondents perceived that efforts for supporting cancer screening and treatment were insufficient. For the questions related to collaborations between cancer and psychiatric care providers, 75.3% of respondents perceived that inpatient visits between psychiatric and cancer hospitals were insufficient. For the questions related to in-psychiatric-hospital medical systems, 50.2%-87.2% of respondents perceived that support for screening, diagnosis/treatment, and palliative care for psychiatric inpatients were insufficient/difficult. 41.9%-57.4% of respondents perceived that social services in the community were insufficient. CONCLUSIONS: This study clarified the level of insufficiency/difficulty perceived by psychiatric care providers regarding issues related to cancer care for people with mental illness. Psychiatric care providers are required to have knowledge and skills in cancer screening and treatment. To improve access to cancer prevention, treatment, and palliative care, it may be helpful to establish systems to promote coordination between cancer hospitals and psychiatric hospitals.

DOI： 10.1002/pon.6143

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担当区分：筆頭著者   記述言語：日本語   出版者・発行元：(株)医学書院  

＜文献概要＞統合失調症患者は身体疾患による死亡率が一般人口と比べて高い。この身体的健康の格差を是正するために,身体疾患の予防とその後の適切な治療へのアクセスを改善することが世界的な課題となっている。そのための介入として,生活習慣に対する多職種アプローチや,身体医療と精神医療の統合を促進するコラボラティブモデルの有効性を報告する先行研究が多い。わが国の精神科臨床場面でも,このような多職種での協働的アプローチへの親和性は高いと考えられる。一方で,異なる医療保健システムにおいて開発された介入をそのまま適用できるかは不明であり,わが国の医療保健システムやステークホルダーの文脈に合った身体的健康の支援法の開発,エビデンスの確立が望まれる。本稿では,我々が取り組んでいる,かかりつけ精神科でのケースマネジメントによるがん検診勧奨法の開発研究をこの領域におけるわが国の研究の1例として紹介する。

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Eating disorders (EDs) are associated with a high mortality rate. Patients with EDs often experience severe dehydration due to food restriction and/or vomiting. Severely underweight patients are often prescribed bed rest during inpatient care to reduce their energy consumption, and they may thus develop multiple risk factors for venous thromboembolism (VTE). We compared the clinical features of ED inpatients with VTE to those of ED inpatients without VTE. Seventy-one inpatients with ED were treated at Okayama University Hospital's psychiatric ward in 2016-2020; five were experienced a VTE. Compared to the non-VTE group, the VTE group's median age and disease duration were greater and the median body mass index (BMI) was lower. The VTE group's D-dimer peak values were > 5 mg/L. Physical restraint and central venous catheter use were associated with VTE. Longer ED duration and lower BMI might be risk factors for VTE. To make inpatient treatment for ED safer, it is important to avoid the use of physical restraints and central venous catheters. Continuous D-dimer monitoring is necessary for the early detection of VTE in ED patients at high risk of VTE.

DOI： 10.18926/AMO/65142

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担当区分：筆頭著者   記述言語：日本語   出版者・発行元：(株)医学書院  

＜文献概要＞症例報告や医学研究などの学術活動は,少なくとも定められた研究倫理の指針等を遵守し,倫理的に十分配慮して行う必要がある。近年,臨床研究法の施行,個人情報保護法の改正,人を対象とする生命科学・医学系研究に関する倫理指針の施行とその後の一部改正など,学術活動にかかわる法や指針等が毎年のように更新された。これらを遵守して学術活動を行うためには,知識のアップデートを続ける必要がある。細かな規則の理解も必要であるが,その前提として背景にある研究倫理の原則,理念の理解が肝要である。

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=2023&ichushi_jid=J00749&link_issn=&doc_id=20230123050003&doc_link_id=10.11477%2Fmf.1405206818&url=https%3A%2F%2Fdoi.org%2F10.11477%2Fmf.1405206818&type=%E5%8C%BB%E6%9B%B8.jp_%E3%82%AA%E3%83%BC%E3%83%AB%E3%82%A2%E3%82%AF%E3%82%BB%E3%82%B9&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

担当区分：筆頭著者   記述言語：日本語   出版者・発行元：(株)医学書院  

＜文献概要＞エビデンスに基づく介入(evidence-based intervention:EBI)が個々の介入研究で開発・検証され,個々の研究のエビデンスを統合して診療ガイドラインなどで推奨される健康関連サービスが提示されるようになった。しかしながら,受動的なアプローチだけではEBIが日常の診療やケアに取り入れられにくく,エビデンス・プラクティスギャップが課題となっている。明らかになったエビデンスを"どのように"すれば実装できるのか,すなわちち現場の日常診療やケアに取り入れられるのかという問いに答えるために,実装科学が新しい学問領域として体系化され,注目されている。本稿では,実装科学の手法に沿って,「どのようにすれば統合失調症患者にがん検診受診を届けられるか」という問いに対して進めてきた臨床研究を事例として紹介する。

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=2023&ichushi_jid=J00749&link_issn=&doc_id=20230123050018&doc_link_id=10.11477%2Fmf.1405206833&url=https%3A%2F%2Fdoi.org%2F10.11477%2Fmf.1405206833&type=%E5%8C%BB%E6%9B%B8.jp_%E3%82%AA%E3%83%BC%E3%83%AB%E3%82%A2%E3%82%AF%E3%82%BB%E3%82%B9&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）  

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担当区分：責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: To reduce cancer care disparities, this study aimed to clarify the difficulties in cancer care for people with mental disorders as perceived by cancer care providers. METHODS: Cancer care providers at 17 designated cancer hospitals in Japan were surveyed using mail questionnaires. Respondents were asked to rate 29 items related to difficulties or insufficiencies in cancer care for patients with mental disorders on a five-point Likert scale. We analyzed the proportion of respondents who answered 'difficult/insufficient' in each item. We also calculated the proportions of responders stratified according to the presence of psychiatric support systems within their hospitals. RESULTS: A total of 388 (58.4%) cancer care providers responded. Among the issues related to 'difficulties in diagnosing and treating cancer,' support for decision-making, assessment of treatment adherence, and assessment of physical symptoms were perceived as most difficult (73.5%-81.5% of respondents). Among the issues related to 'difficulties or insufficiencies in collaboration among multidisciplinary health care providers,' the issue of advance consultation and sharing information with the patient's primary psychiatric care provider was perceived as most difficult (52.2%). Among the issues related to 'insufficiencies of in-hospital and community medical systems,' education to provide reasonable accommodation was perceived as most insufficient (47.4%). The perceived difficulties of over half of the issues varied significantly between hospitals depending on the level of psychiatric support systems. CONCLUSIONS: This study clarified the difficulties of cancer care in patients with mental disorders as perceived by cancer care providers. Some issues may be resolved by psychiatric liaison teams. This article is protected by copyright. All rights reserved.

DOI： 10.1002/pon.5992

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担当区分：責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: We examined the efficacy of case management (CM) interventions to encourage participation in colorectal cancer screening for patients with schizophrenia. This study aimed to clarify patients' acceptability of the intervention and the helpful components of the intervention. Simultaneously, the study aimed to determine the acceptability, appropriateness and feasibility of the intervention from the perspective of psychiatric care providers. STUDY DESIGN AND SETTING: This study was a secondary qualitative analysis of a mixed-method randomised controlled trial that evaluated the efficacy of the CM approach to encourage participation in cancer screening for people with schizophrenia. The intervention comprised education and patient navigation for colorectal cancer screening. Interviews were conducted with patients who received the intervention and staff from two psychiatric hospitals in Japan who delivered the intervention. PARTICIPANTS: Of the 172 patients with schizophrenia who participated in the trial, 153 were included. In addition, three out of six providers were included. DATA COLLECTION AND ANALYSIS: Using a structured interview, the case manager asked participants about patient acceptability and the helpful components of the intervention. Content analysis was conducted for the responses obtained, and the number of responses was tabulated by two researchers. For the interviews with the providers, opinions obtained from verbatim transcripts were extracted and summarised. RESULTS: Forty-three of the 56 patients perceived that the intervention was acceptable. For the intervention component, inperson counselling with an explanation of the screening process by psychiatric care providers was most frequently reported by the patients as helpful (48 of the 68 respondents). Psychiatric care providers evaluated the intervention as acceptable, appropriate and easy to understand and administer. However, providing the intervention to all patients simultaneously was considered difficult with the current human resources. CONCLUSIONS: This study showed that the CM intervention was perceived as acceptable by patients and acceptable and appropriate by psychiatric care providers. TRIAL REGISTRATION NUMBER: UMIN000036017.

DOI： 10.1136/bmjopen-2021-060621

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記述言語：日本語   出版者・発行元：(公社)日本精神神経学会  

精神症状を呈した甲状腺機能低下症の患者の15%が精神病症状を生じると報告されており,「myxedema psychosis」と呼ばれる.しかし,わが国の精神科領域での報告は数例にとどまり,十分に認知されていない可能性がある.そこで,本症例報告では,精神科におけるmyxedema psychosis鑑別の重要性を改めて強調するため,自験例の詳細な臨床像を記述したうえで,系統的レビューで得られた症状,検査所見,治療経過の特徴を整理して呈示する.症例は50歳代の女性.X-2年に橋本病と診断され,レボチロキシンで治療されていた.X年5月にレボチロキシンを自己中断後,徐々に過敏になり,幻聴に左右されて家を飛びだすようになった.同月末に不安と動悸症状でA病院を受診し,著明な甲状腺機能低下が認められたため,内科に入院した.レボチロキシンを再開し,リスペリドンも開始されたが,精神病症状の改善に乏しく,精査を拒否するため,入院第7病日に当院当科へ転院した.転院時,幻聴は改善していたが,思路障害や焦燥は残存し,甲状腺機能低下も持続していた.脳波検査では徐波が混入しており,髄液検査ではタンパクの軽度高値を認めたことから,橋本脳症の可能性も考えたが,症状が改善傾向であったため,ステロイド投与は保留し,レボチロキシンを増量し経過観察した.すると,転院第7病日までに精神病症状は消失し,転院第16病日に退院した.12月にリスペリドンを中止後も精神病症状の再燃はなかった.X+1年8月にTSHの上昇とともに精神病症状が再発したが,レボチロキシンの増量により速やかに症状は改善した.Myxedema psychosisは甲状腺ホルモン補充により抗精神病薬中止が可能と系統的レビューが示すように,本症例もレボチロキシンの補充で症状は速やかに改善した.Myxedema psychosisは抗精神病薬の中止が可能な予後良好な病態であるため,精神病症状を呈した患者の治療においては,甲状腺機能の評価を行うことが望ましい.(著者抄録)

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記述言語：英語  

DOI： 10.1016/j.ajp.2022.103124

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

RATIONALE: Depression in schizophrenia is an important symptom. We investigated whether depression and suicidal symptoms in the chronic phase are related to remote future clinical outcomes in patients with schizophrenia and whether psychotropics improved clinical outcomes. OBJECTIVES: The subjects included 462 outpatients of working age (15 to 64 years old) with schizophrenia treated at Okayama University Hospital from January 2010 to December 2011. We investigated the relationship between the Clinical Global Impression-Severity score at the last visit (average 19.2 years) and the existence of previous depression, suicidal ideas, and suicide attempts. We adjusted by several possible confounders including medical history using multiple regression analysis or logistic regression analysis. RESULTS: Of 462 patients, 168 (36.4%) presented with depression 2 years after schizophrenia onset. A history of suicidal ideas and attempts was related to worse clinical outcome. In males, a history of depression was related to worse clinical outcome, but not in females. Lithium carbonate was related to better clinical outcome in all schizophrenia patients with depression, especially in males. Treatment with antidepressants was related to better clinical outcome only in males. CONCLUSIONS: A history of depression or suicidal symptoms in the chronic phase predicted the future worse clinical outcome in patients with schizophrenia. The administration of lithium carbonate or antidepressants might be recommended, especially to male schizophrenia patients with depression.

DOI： 10.1007/s00213-022-06099-4

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1097/JCP.0000000000001527

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY  

OBJECTIVE: We examined the efficacy of a case management approach to improve participation in colorectal cancer screening among people with schizophrenia. METHODS: This was a randomized, parallel group trial. We recruited outpatients with schizophrenia aged 40 years or over from two psychiatric hospitals in Japan. Participants were randomly assigned (1:1) to treatment as usual or case management intervention plus treatment as usual using a web-based system. Attending clinicians and participants were unmasked to the allocation. Case management included education and patient navigation for colorectal cancer screening using a fecal occult blood test. Treatment as usual included direct mail government recommendations. The primary endpoint was participation in colorectal cancer screening assessed using municipal records. We also assessed the secondary endpoint of participation in other cancer screenings (lung, gastric, breast, and cervical). RESULTS: Between June 3 and September 9, 2019, 172 eligible participants were randomly assigned to the case management plus treatment as usual group (n=86) or treatment as usual group (n=86). One participant was ineligible and another withdrew consent; both were excluded from analysis. A significantly higher proportion of participants received colorectal cancer screening in the case management plus treatment as usual group than in the treatment as usual group (40 [47.1%] of 85 participants vs. 10 [11.8%] of 85 participants, P<0.0001). The proportion of lung cancer screening also increased. No serious adverse events associated with the study intervention occurred. CONCLUSION: The case management intervention to encourage participation in colorectal cancer screening was effective for patients with schizophrenia.

DOI： 10.1111/acps.13348

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY  

OBJECTIVE: It is widely assumed that there are multiple levels (from individual to policy level) of problems involving disparities in cancer care for people with mental disorders. However, few studies have comprehensively investigated issues as perceived by medical professionals. The purpose of the present study was to identify a wide range of issues in cancer care for people with mental disorders and offer corresponding solutions for both cancer care professionals and psychiatric care professionals. METHODS: We distributed open-ended questionnaires to 754 healthcare professionals in various medical facilities, including designated cancer hospitals, psychiatric hospitals, and other local healthcare/welfare facilities. Participants were asked to describe issues in cancer care for people with mental disorders. RESULTS: Of the 754 recruited professionals, 439 (58.2%) responded to the questionnaire. Sixty-one issues were extracted and categorized into 10 categories: patient factors; isolation and lack of support; obstacles to transport; socioeconomic factors; attitudes of psychiatric professionals; medical system of psychiatric hospitals; attitudes of cancer care professionals; medical system of designated cancer hospitals; regional cancer medical systems; and lack of coordination among multidisciplinary healthcare professionals. Forty-eight specific solutions were summarized into 12 goals. CONCLUSIONS: The present study widely identified issues causing disparities in cancer care for patients with mental disorders. We found that the issues extended from the patient level to the public-policy level. Our findings suggest the need for a multidisciplinary approach that includes both cancer and psychiatric care professionals to address the gap in cancer care for people with mental disorders.

DOI： 10.1002/pon.5780

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担当区分：責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

It is necessary to assess functional impairment when treating schizophrenia. The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) has been adopted as a measure of functional disability in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. This study was a secondary analysis from a cross-sectional study of health-related behaviors among patients with schizophrenia. We examined the validity and reliability of the Japanese version of the 12-item WHODAS 2.0 when self-administered by such patients. Participants were 350 outpatients with schizophrenia from a psychiatric hospital. The standard six-factor structure of the WHODAS 2.0 showed a good fit for these participants. The Cronbach's alpha coefficient was 0.858, showing good internal consistency. The WHODAS 2.0 showed moderate correlations with the modified Global Assessment of Functioning and Kessler 6 scales (r=-0.434 and 0.555, respectively). The results of this study show that the Japanese version of the 12-item self-administered WHODAS 2.0 has good internal consistency and convergent validity among patients with schizophrenia. Further exploration of the usefulness of WHODAS 2.0 in clinical settings is needed.

DOI： 10.18926/AMO/62226

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

DOI： 10.1097/YCT.0000000000000686

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.psychres.2020.113225

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記述言語：日本語   出版者・発行元：(公社)日本精神神経学会  

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1186/s12888-019-2351-9

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BMJ PUBLISHING GROUP  

INTRODUCTION: One of the reasons for the high mortality rate from cancer in people with schizophrenia is delay in diagnosis. Many studies have shown lower cancer screening rates in people with schizophrenia; however, there are no interventions for people with schizophrenia to increase cancer screening. Therefore, we developed a case management (CM) intervention to encourage participation in cancer screening. The purpose of this study was to examine the efficacy of CM to encourage participation in cancer screening for people with schizophrenia, with particular focus on colorectal cancer screening by faecal occult blood testing, compared with usual intervention (UI), namely, municipal public education. METHODS AND ANALYSIS: This is an individually randomised, parallel group trial with blinded outcome assessments. The participants will be randomly allocated to either the CM plus UI group or UI alone group in a 1:1 ratio using a web-based program at a data management centre. The primary end point of the study is participation in colorectal cancer screening in the year of intervention, which will be assessed based on municipal records. ETHICS AND DISSEMINATION: This study is performed in accordance with Ethical Guidelines for Medical and Health Research Involving Human Subjects published by Japan's Ministry of Education, Science, and Technology and the Ministry of Health, Labour, and Welfare and the modified Act on the Protection of Personal Information as well as the Declaration of Helsinki. This study was approved by the institutional ethics committee at the Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences and Okayama University Hospital on 23 April 2019 (approval number: RIN1904-003). The findings of this trial will be submitted to an international peer-reviewed journal. TRIAL REGISTRATION NUMBER: UMIN000036017.

DOI： 10.1136/bmjopen-2019-032955

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER/PLENUM PUBLISHERS  

Internet addiction (IA) has been reported as prevalent in adolescents with autism spectrum disorders (ASD) and attention-deficit hyperactivity disorder (ADHD). However, the course of IA in this population has not been elucidated. The authors performed a 2-year follow-up study including 89 out of 132 adolescents with ASD and/or ADHD in a psychiatric clinical setting who participated in the original cross-sectional study assessing IA prevalence. Within this sample of participants from both the original and the follow-up study, results showed a 2-year IA remission and incidence rate of 60% and 5%, respectively. Our findings imply that the course of IA in psychiatric populations with ASD and/or ADHD might be similar to reports from previous studies with general adolescent populations.

DOI： 10.1007/s10803-019-04169-9

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記述言語：日本語   出版者・発行元：(一社)日本総合病院精神医学会  

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記述言語：日本語   出版者・発行元：(一社)日本総合病院精神医学会  

電気けいれん療法(ECT)は、統合失調症患者においても緊張病状態や薬物治療抵抗例に対して考慮される重要な治療法である。ECTにおいて本邦で頻用される麻酔薬のpropofolは、強い抗けいれん作用を有するため、高い発作閾値が問題になるケースでは麻酔に工夫を要する。発作閾値上昇効果がないとされるketamineへの切り替え、または併用によるpropofolの減量は有効な方法の1つで、うつ病患者では抗うつ効果の増強も期待したketamineによるECTの報告が多い。一方でketamineは、その作用機序から統合失調症の精神症状を悪化させる懸念もある。今回、高い発作閾値が問題化したが、ketamineの併用によりpropofolを減量したECTで有効な発作が得られ、精神病症状の悪化を認めることなく有効かつ安全に治療し得た統合失調症の2例を経験したため報告する。(著者抄録)

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCIENCE BV  

BACKGROUND: Smoking behavior among people with serious psychological distress (SPD) has not been fully investigated in Asia, although smoking has become a public health concern worldwide. Many Western population-based studies indicate that people with psychological distress are more likely to smoke. METHODS: This study used a national representative data set from the 2010 Comprehensive Survey of Living Conditions of Japan. SPD was defined as scores ≥13 or greater on the Kessler Psychological Distress Scale (K6). Multivariate logistic regression analyses were conducted to analyze the association between SPD and current smoking in Japanese adults. RESULTS: In both men (n = 27,937) and women (n = 30,786), SPD was significantly associated with current smoking (adjusted odds ratios [95% confidence intervals]: 1.169 [1.030-1.328] for men and 1.677 [1.457-1.931] for women). Among men, SPD was significantly associated with current smoking only in people aged ≥50 years (1.519 [1.232-1.874]) and married (1.456 [1.228-1.728]). SPD was significantly associated with current smoking in women of all ages. SPD had a greater impact on current smoking for women aged 20-49 years than for those aged ≥50 years (1.832 [1.552-2.162] and 1.445 [1.099-1.900], respectively). LIMITATIONS: The cross-sectional design precludes assumptions about the direction of causality. In addition, smoking status was self-reported. CONCLUSIONS: SPD was significantly associated with current smoking in Japan and the association was much stronger for younger women. Clinical strategies are needed to reduce the prevalence of smoking among people with SPD to reduce excess mortality in this population.

DOI： 10.1016/j.jad.2018.07.008

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：TOHOKU UNIV MEDICAL PRESS  

Health care disparities among people with schizophrenia is a global concern. Our previous study revealed cancer screening rates in Japanese people with schizophrenia lower than rates of approximately 40% of the general population. However, that study was based on self-reports, which can be inaccurate, and rates did not differentiate the types of cancer screening provider (i.e., municipal screening, collective opportunistic screening, and individual opportunistic screening). This study aimed to investigate records-based cancer screening rates, focusing on participation rates of people with schizophrenia who are subject to municipal cancer screening programs. We conducted a cross-sectional study at a psychiatric hospital outpatient clinic from September to November 2016. We randomly extracted 420 potential participants from among 680 eligible patients and asked them to participate. We then selected subgroups of participants living in Okayama city who were enrolled in the National Health Insurance or Public Assistance systems and were subject to colorectal, gastric, lung, breast, or cervical cancer screening provided by Okayama city (n = 97, 96, 97, 42, and 64, respectively). Participation in cancer screenings was assessed based on local government records. Municipal cancer screening rates were as follows: 13.4% (95% confidence interval: 6.6%-20.2%) for colorectal, 7.3% (2.1%-12.5%) for gastric, 16.5% (9.1%-23.9%) for lung, 21.4% (9.0%-33.8%) for breast, and 14.1% (5.6%-22.6%) for cervical cancers. The findings demonstrated extremely low cancer screening rates among people with schizophrenia subject to municipal cancer screenings in Japan. A strategy to promote municipal cancer screening for people with schizophrenia is needed.

DOI： 10.1620/tjem.244.209

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY  

BACKGROUND: It is unclear whether individuals who have serious psychological distress (SPD) are less likely to participate in screening tests for gastric cancer, lung cancer, and other types of cancer. Of the few studies that have examined the association between SPD and participation in cancer screening, none have reported modifying effects of educational, marital, or employment status. METHODS: The authors analyzed a national representative data set from the 2010 Comprehensive Survey of Living Conditions of Japan., including individuals aged <69 years who met the national program criteria for each type of cancer screening (colorectal, gastric, and lung cancers, n = 29,926; breast cancer, n = 15,423; and cervical cancer, n = 24,735). SPD was defined as a score of 13 or greater on the Kessler 6 scale. Logistic regression analyses were conducted to examine the association between SPD and participation in cancer screening, and multivariate analyses stratified by socioeconomic status also were conducted. RESULTS: SPD was significantly associated with a lower odds ratio (OR) for participation in screening for colorectal cancer (OR, 0.743; 95% confidence interval [CI], 0.638-0.866), gastric cancer (OR, 0.823; 95% CI, 0.717-0.946), and lung cancer (OR, 0.691; 95% CI, 0.592-0.807). Only educational status significantly modified the effect of SPD on participation in these 3 types of cancer screening (P < .05). CONCLUSIONS: Individuals with SPD, especially those with lower education levels, were less likely to participate in screening for colorectal, gastric, and lung cancers. Individuals with SPD should be encouraged and supported to participate in cancer screening tests. Cancer 2018;124:555-62. © 2017 American Cancer Society.

DOI： 10.1002/cncr.31086

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1017/S147895151700116X

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY  

Aim: The influence of schizophrenic patients' functional disability on cancer screening participation worldwide is unclear. There are few findings on the disparities in schizophrenic patients' participation in cancer screening programs in Asia. The aim of this study was to investigate the screening rate and the associations between screening and symptom severity/functional disability in patients with schizophrenia.Methods: This cross-sectional study was conducted in a psychiatric hospital outpatient clinic in Japan. We recruited schizophrenic patients meeting the national program criteria for cancer screening for colorectal, gastric, lung, breast, and cervical cancer (n = 224, 223, 224, 110, and 175, respectively). Receipt of cancer screenings was assessed using a self-report questionnaire. Scores on the modified Global Assessment of Functioning (mGAF) were evaluated by participants' primary psychiatrists.Results: Rates of cancer screenings were as follows: 24.1% for colorectal, 21.5% for gastric, 30.8% for lung, 25.5% for breast, and 19.4% for cervical cancer. A multivariable logistic analysis showed that a 1-point increase in severity/disability (100 minus mGAF score) was associated with significantly lower odds ratios (OR) for receipt of cancer screenings, except for breast cancer (OR, 0.95, 95% confidence interval [CI], 0.93-0.98 for colorectal; OR, 0.96, 95% CI, 0.93-0.98 for gastric; OR, 0.95, 95% CI, 0.93-0.97 for lung; OR, 0.97, 95% CI, 0.94-1.00 for breast; and OR, 0.95, 95% CI, 0.92-0.98 for cervical cancer).Conclusion: The findings demonstrated low rates of cancer screenings in schizophrenic patients in Japan. Our study suggests the need to encourage attendance at cancer screenings, especially in schizophrenic patients with severe symptoms/functional disability.

DOI： 10.1111/pcn.12554

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER/PLENUM PUBLISHERS  

Extant literature suggests that autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD) are risk factors for internet addiction (IA). The present cross-sectional study explored the prevalence of IA among 132 adolescents with ASD and/or ADHD in a Japanese psychiatric clinic using Young's Internet Addiction Test. The prevalence of IA among adolescents with ASD alone, with ADHD alone and with comorbid ASD and ADHD were 10.8, 12.5, and 20.0%, respectively. Our results emphasize the clinical importance of screening and intervention for IA when mental health professionals see adolescents with ASD and/or ADHD in psychiatric services.

DOI： 10.1007/s10803-017-3148-7

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：OKAYAMA UNIV MED SCHOOL  

Repetitive transcranial magnetic stimulation (rTMS) has been reported to be a new treatment option for treatment-resistant depression. In Japan, there has been limited research into its feasibility, efficacy, and tolerability. We have launched a trial of rTMS for treating medication-resistant major depressive disorder and bipolar depression. We are investigating low-frequency rTMS to the right dorsolateral prefrontal cortex and traditional high-frequency rTMS to the left dorsolateral prefrontal cortex, in 20 patients. The primary outcome of the study is the treatment completion rate. This study will provide new data on the usefulness of rTMS for treatment-resistant depression in Japan.

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記述言語：日本語  

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記述言語：日本語   出版者・発行元：(株)星和書店  

精神科臨床においては慢性の便秘が問題となることが多く、巨大結腸症はその最も重度なものであり、治療に苦慮することがある。Lactuloseは単なる機械的下剤として作用するだけではなく、腸内細菌叢に働きかけることで腸管の蠕動運動を改善させるprebioticsである。今回、下剤を多剤併用しても排便が得られず難渋していた慢性期統合失調症患者の巨大結腸症に対して、lactuloseと乳酸菌製剤を追加し、副作用を認めず、良好な排便コントロールが得られた2例を経験したので報告する。(著者抄録)

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記述言語：日本語  

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記述言語：日本語   出版者・発行元：(株)星和書店  

Lamotrigineは新規の気分安定薬であるが、特にうつ病相の予防効果を有する薬剤として期待されている。我々は、lamotrigineのうつ状態への急性効果を調べるため、当院におけるlamotrigineの使用状況を調査した。対象は2008年12月上市後から2011年8月の間にうつ状態に対してlamotrigineが処方された全36例とし、診療録から後ろ向きに調査した。投与開始後8週間の改善度をClinical Global Impression-Improvement scale(CGI-I)を用いて評価した。Lamotrigineは双極性障害、単極性うつ病、その他の疾患において処方されており、うつ状態に対する急性効果を持つことが示唆された。また、双極I型>双極II型>単極性うつ病>その他の疾患の順で有効性の高い結果が得られた。Lamotrigineは双極性の強い疾患において、よりうつ状態に対する効果の高い可能性が示唆された。(著者抄録)

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：PHYSICIANS POSTGRADUATE PRESS  

DOI： 10.4088/JCP.11cr07472

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY  

Chorea-acanthocytosis (ChAc) is a rare autosomal recessive neurodegenerative disorder caused by loss of function mutations in the vacuolar protein sorting 13 homolog A (VPS13A) gene that encodes chorein. It is characterized by adult-onset chorea, peripheral acanthocytes, and neuropsychiatric symptoms. In the present study, we performed a comprehensive mutation screen, including sequencing and copy number variation (CNV) analysis, of the VPS13A gene in ChAc patients. All 73 exons and flanking regions of VPS13A were sequenced in 35 patients diagnosed with ChAc. To detect CNVs, we also performed real-time quantitative PCR and long-range PCR analyses for the VPS13A gene on patients in whom only a single heterozygous mutation was detected. We identified 36 pathogenic mutations, 20 of which were previously unreported, including two novel CNVs. In addition, we investigated the expression of chorein in 16 patients by Western blotting of erythrocyte ghosts. This demonstrated the complete absence of chorein in patients with pathogenic mutations. This comprehensive screen provides an accurate and useful method for the molecular diagnosis of ChAc. © 2011 Wiley-Liss, Inc.

DOI： 10.1002/ajmg.b.31206

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記述言語：日本語   出版者・発行元：(一社)日本総合病院精神医学会  

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記述言語：日本語   出版者・発行元：(一社)日本作業療法士協会  

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記述言語：日本語   掲載種別：記事・総説・解説・論説等（商業誌、新聞、ウェブメディア）  

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記述言語：日本語   掲載種別：記事・総説・解説・論説等（その他）  

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記述言語：日本語   出版者・発行元：メディカルレビュー社  

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記述言語：日本語   出版者・発行元：(公社)日本精神神経学会  

岡山県精神科医療センターでは,依存症専門外来,児童思春期専門外来を開設していることもあり,インターネット,スマートフォンの過剰使用を主訴に多くの中高生が家族に伴われて相談に訪れる.「インターネット依存ではないか」と著者らの外来を受診する患者には,自閉症スペクトラム障害(ASD)が疑われる例が多い.ASDは電子メディア,電子デバイス過剰使用との関連が以前から指摘されており,インターネット依存症(IA)のリスクファクターになりうる.そこで,児童思春期精神科外来におけるASDとIAの併存に対するスクリーニングや介入の必要性を検討するために,われわれは2016年に岡山県精神科医療センターの児童思春期精神科外来におけるASDとIAの併存率を調査した.その結果,児童思春期精神科外来に通院中のASDをもつ中学生の12.9%がIAと判定された.この判定割合は同時期に同年齢を対象に実施された岡山県での一般人口調査の4倍強であり,児童思春期精神科外来通院中のASD患者はIAのハイリスク集団であることが明らかになった.しかし,一般人口を対象とした他の研究でIAの自然軽快割合の高さが示されていることや,有効性が実証された児童思春期精神科外来で簡便に用いることができる介入法も開発されていないことを考慮すると,今回の結果のみから,児童思春期精神科外来に通院するASDをもつ者に対してIAのスクリーニングおよび介入を提供するべきかについては,さらなる検討が必要であろう.そこで,われわれは2016年の横断研究の参加者を対象としたコホート研究を実施し,2019年度中に論文として報告する予定でいる.これらの研究をもとに,児童思春期精神科外来通院中のASD患者におけるIAのスクリーニングおよび介入の必要性について,データに基づいて検討を重ねていきたい.(著者抄録)

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記述言語：日本語   出版者・発行元：(公社)日本精神神経学会  

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記述言語：日本語   出版者・発行元：(公社)日本精神神経学会  

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記述言語：日本語   出版者・発行元：(公社)日本精神神経学会  

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記述言語：日本語   出版者・発行元：(一社)日本サイコオンコロジー学会・日本臨床死生学会  

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記述言語：日本語   出版者・発行元：(公社)日本精神神経学会  

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記述言語：日本語   出版者・発行元：(公社)日本精神神経学会  

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記述言語：日本語   出版者・発行元：(公社)日本精神神経学会  

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記述言語：日本語   出版者・発行元：(一社)日本認知症学会  

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開催年月日： 2020年9月28日 - 2020年9月30日

記述言語：日本語   会議種別：ポスター発表  

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開催年月日： 2020年9月28日 - 2020年9月30日

記述言語：日本語   会議種別：ポスター発表  

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開催年月日： 2020年8月9日 - 2020年8月10日

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（公募）  

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記述言語：日本語   会議種別：口頭発表（一般）  

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記述言語：日本語   会議種別：口頭発表（一般）  

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記述言語：日本語   会議種別：口頭発表（一般）  

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記述言語：日本語   会議種別：ポスター発表  

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記述言語：日本語   会議種別：ポスター発表  

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記述言語：日本語   会議種別：ポスター発表  

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記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（公募）  

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記述言語：日本語   会議種別：口頭発表（一般）  

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記述言語：日本語   会議種別：口頭発表（一般）  

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記述言語：日本語  

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