研究者業績
基本情報
- 所属
- 千葉大学 大学院医学研究院 教授(兼任)子どものこころの発達教育研究センター センター長(兼任)医学部附属病院認知行動療法センター センター長
- 学位
- 博士(医学)(千葉大学)
- ORCID ID
https://orcid.org/0000-0002-6741-9338- J-GLOBAL ID
- 200901032108001922
- researchmap会員ID
- 1000357274
- 外部リンク
研究分野
1委員歴
5-
2024年7月 - 現在
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2024年6月 - 現在
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2016年7月 - 2022年7月
受賞
1-
2001年
論文
467-
PCN reports : psychiatry and clinical neurosciences 4(1) e70082 2025年3月AIM: Somatic symptom disorder (SSD) is prevalent in primary healthcare settings and is often challenging to diagnose and treat. This study examined the neurodevelopmental and personality traits of individuals with probable SSD. METHODS: This cross-sectional study utilized anonymous online surveys. In this study, individuals with a score of 23 or higher on the Somatic Symptom Disorder-B Criteria Scale (SSD-12) were defined as having probable SSD, and individuals with no somatic symptoms and who scored 0 were defined as the healthy control (HC) group. We compared groups regarding neurodevelopmental traits, personality traits, depression, and anxiety using self-report questionnaires and analysis of covariance. In addition, we examined the association between neurodevelopmental traits, emotional problems, and SSD in the probable SSD group using structural equation modeling. RESULTS: A total of 491 people with probable SSD and 532 age- and sex-matched HCs were analyzed. The scores for somatic symptom severity, depression, generalized anxiety, health anxiety, attention deficit/hyperactivity disorder traits, autism spectrum disorder traits, personality traits, and personality disorder traits showed significant differences between the probable SSD group and the HC group. In the probable SSD group, neurodevelopmental traits positively and directly affected emotional problems and SSD. CONCLUSION: Most neurodevelopmental and personality traits were associated with probable SSD. When approaching patients suspected of having SSD, clinicians may consider not only somatic symptoms, but also neurodevelopmental traits, personality traits, depression, and anxiety.
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Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association 34(2) 108217-108217 2024年12月28日OBJECTIVE: Non-verbal Screening Test for Aphasia and Dysarthria scores correlate with post-stroke cognitive function; however, their correlations with activities of daily living dependency and home discharge (cognitive function-associated outcomes) remain unclear. We investigated the correlation of these scores with activities of daily living dependency and home discharge outcomes. MATERIALS AND METHODS: Disability levels and functional outcomes of 278 inpatients with brain injury (age: 72.8 ± 13.0 years) were evaluated using the modified Rankin Scale. Patients were grouped according to activities of daily living dependency (independent [n = 96; modified Rankin Scale score≤2]) and non-home discharge (n = 126) status. Factors predicting home discharge were analyzed using univariate and multivariate logistic regression analyses. RESULTS: Cognitive impairment was more prevalent in the activities of daily living-dependent group than in the independent group (odds ratio: 6.34 [95 % confidence interval: 3.57-11.52]; p < 0.001) and in the non-home discharge than in the home discharge group (2.78 [1.65-4.73]; p < 0.001). Non-verbal test scores correlated moderately with activities of daily living independence and home discharge. Age, modified Rankin Scale score, cognitive impairment, and the Screening Test for Aphasia and Dysarthria scores were significantly associated with home discharge in univariate analyses. Only modified Rankin Scale and non-verbal test scores were significantly associated with home discharge in multivariate analysis (p < 0.001). CONCLUSIONS: Non-verbal test scores were significantly associated with activities of daily living independence and home discharge in patients with stroke. The non-verbal test, being less influenced by communicative disorders, offers a novel tool for estimating cognitive function.
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子どものこころと脳の発達 15(1) 63-69 2024年12月児童生徒の自殺予防に係る取組として,WEBでの子どものストレスチェックを推進している.現時点で,学校長,教頭,副校長,学年主任,担任等が職員会議,教育相談部会で子どものストレスチェックの実施の情報共有を行い,教育相談担当教員が中心となり,実施する学校が多い.今後は,2次予防の健康診断のように学校医が養護教諭とともに,1次予防の子どものストレスチェックを実施する形や保健体育の教員が保健体育の「心身の相関とストレス」単元等の授業の中でアクティブ・ラーニングとして活用する形も期待している.ストレス対処法である認知行動療法を活用し,不登校の児童生徒等が登校再開する際の3次予防として,復帰支援,再発予防にも取り組むべきである.政策提言として,いじめの認知件数のように,高ストレス児童生徒の認知件数を全国の小・中・高等学校及び特別支援学校から文部科学省がデータ収集し,自殺対策に活用していただきたいと考えている.(著者抄録)
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JMIR formative research 2024年11月28日BACKGROUND: Background: Cognitive behavioral therapy for psychosis (CBTp) is not widespread enough in clinical practice, although evidence has been presented. OBJECTIVE: Objective: The purpose of this study was to explore whether one-on-one CBTp using video-conference (vCBTp) was more effective than usual care (UC) treatment alone in improving psychiatric symptoms in patients with schizophrenia attending outpatient clinics. METHODS: Methods: In this exploratory randomized controlled trial, patients with schizophrenia and schizoaffective disorders who were still taking medication in an outpatient clinic were randomly assigned to either the vCBTp plus UC group (n=12) or the UC group (n=12). The vCBTp was conducted once a week, with each section lasting for 50 min, for a total of seven sessions in real-time and one-on-one format remotely using a loaned tablet computer (iPad). The primary outcome was the Positive and Negative Syndrome Scale (PANSS) total score, which measures the difference in the mean change from baseline at week 0 to post-test at week 8. RESULTS: Results: There were 24 participants in the study. There were no significant differences between the two groups at baseline. With regard to significant differences between the two groups on the primary outcome, the mean change in PANSS total score from baseline to week 8 in the vCBTp plus UC group was -9.5 (95% CI -12.09 to -6.91); the mean change in the UC alone group was 6.9 (95% CI 1.54 to 12.30). The difference between the two groups was significant at P<.001. In addition, significant improvements were observed in the subscales of positive (P<.001) and negative (P=.004) symptoms and general psychopathology (P<.001). Significant differences were also observed in the secondary outcomes of the General Anxiety Disorder (GAD-7, P=.042) and the EuroQol 5-dimensions 5-lines (EQ-5D-5L, P=.005). There were no dropouts and no serious adverse events in this study. CONCLUSIONS: Conclusions: A total of seven remote vCBTp sessions conducted in the vCBTp plus UC group could be safely administered to patients with schizophrenia. They were also observed to be effective for psychiatric symptoms, general anxiety, and quality of life (QoL). However, because of the observed worsening of scores in the UC group, caution is required in interpreting significant differences between the two groups. This approach is expected to improve accessibility to CBTp for outpatients with schizophrenia and social anxiety about transportation use and financial and physical burdens related to transportation, and to contribute to promoting CBTp acceptability by compensating for the shortage of implementers. CLINICALTRIAL: Trial Registration: University Hospital Medical Information Network Clinical Trials Registry: UMIN000043396; https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000049544. INTERNATIONAL REGISTERED REPORT: RR2-DOI: 10.1136/bmjopen-2022-069734.
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BMC psychiatry 24(1) 806-806 2024年11月14日BACKGROUND: School-based cognitive behavioral therapy (CBT) programs could contribute toward preventing anxiety disorders in children. However, setting aside class time for such programs is difficult. Internet-based CBT (I-CBT) is an efficient way to provide CBT. However, studies on I-CBT for anxiety prevention remain scarce, including I-CBT for school-based universal prevention programs. Therefore, we developed an e-learning version of a school-based anxiety-prevention CBT program, "Journey of the Brave," which was effective in Japan, to make it more flexible and accessible. This study evaluated its feasibility. METHODS: We conducted a single-arm study based on 44 parents and children. Children aged 10-12 years took the e-learning program at home. Parents and children responded to a questionnaire three times: before the learning (Pre), after the learning (Post), and three months later (FU: Follow-up). Feasibility was comprehensively evaluated through dropout rates, satisfaction and learning records, and changes in scores on psychological scales assessing anxiety symptoms, emotion-regulation skills, and children's emotional and behavioral problems. RESULTS: Of the 44 children, 42 started the e-learning, and 32 continued it (dropout rate of 23.8%). Furthermore, 83.9% of the children and 96.8% of the parents responded "agree" or "somewhat agree" regarding overall satisfaction. The parent-rated Spence Children's Anxiety Scale(SCAS) (SCAS-P) showed a significant decrease between Pre and FU (p = 0.014, 95% CI = (-9.22, -0.84)); however, the child-rated SCAS (SCAS-C) reduction was not significant (p = 0.08). The Emotion‑Regulation Skills Questionnaire (ERSQ) also increased significantly between Pre and FU (p = 0.045, 95% CI = (0.18, 18.31)). The Total Difficulties Score of the Strengths and Difficulties Questionnaire(SDQ) decreased significantly from Pre to Post (p = 0.025, 95% CI = (-3.62, -0.19)); however, it was not significantly different between Pre and FU (p = 0.67). CONCLUSION: The e-learning version showed low dropout rates and high satisfaction ratings from parents and children. Moreover, this study did not rule out the possibility that the program reduced children's anxiety and improved their emotional-regulation skills. Therefore, its potential and feasibility were indicated. TRIAL REGISTRATION: UMIN, UMIN000049182, Registered 11 October 2022.
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medRxiv : the preprint server for health sciences 2024年11月7日Previous studies have suggested that alterations in white matter (WM) microstructure are implicated in suicidal thoughts and behaviours (STBs). However, findings of diffusion tensor imaging (DTI) studies have been inconsistent. In this large-scale mega-analysis conducted by the ENIGMA Suicidal Thoughts and Behaviours (ENIGMA-STB) consortium, we examined WM alterations associated with STBs. Data processing was standardised across sites, and resulting WM microstructure measures (fractional anisotropy, axial diffusivity, mean diffusivity and radial diffusivity) for 25 WM tracts were pooled across 40 cohorts. We compared these measures among individuals with a psychiatric diagnosis and lifetime history of suicide attempt (n=652; mean age=35.4±14.7; female=71.8%), individuals with a psychiatric diagnosis but no STB (i.e., clinical controls; n=1871; mean age=34±14.8; female=59.8%), and individuals with no mental disorder diagnosis and no STB (i.e., healthy controls; n=642; mean age=29.6±13.1; female=62.9%). We also compared these measures among individuals with recent suicidal ideation (n=714; mean age=36.3±15.3; female=66.1%), clinical controls (n=1184; mean age=36.8±15.6; female=63.1%), and healthy controls (n=1240; mean age= 31.6±15.5; female=61.0%). We found subtle but statistically significant effects, such as lower fractional anisotropy associated with a history of suicide attempt, over and above the effect of psychiatric diagnoses. These effects were strongest in the corona radiata, thalamic radiation, fornix/stria terminalis, corpus callosum and superior longitudinal fasciculus. Effect sizes were small (Cohen's d < 0.25). Recent suicidal ideation was not associated with alterations in WM microstructure. This large-scale coordinated mega-analysis revealed subtle regional and global alterations in WM microstructure in individuals with a history of suicide attempt. Longitudinal studies are needed to confirm whether these alterations are a risk factor for suicidal behaviour.
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Child psychiatry and human development 2024年9月9日The Parent Overprotection Measure (POM) is a promising scale to measure parent overprotection toward a child from the parent's perspective. However, no Japanese translation of the scale has been developed, and whether the POM can be applied to a Japanese population is unknown. This study translated the POM into Japanese and examined its psychometric properties. Parents of 380 children aged 4 to 7 years (including 190 mothers and 190 fathers) completed online questionnaires. Exploratory and confirmatory factor analyses (CFA) indicated that the Japanese translation of the POM has a bi-factor structure, including one general factor (general overprotection) and two specific factors (care/attention and control/prevention). The measurement invariance of reports from mothers' and fathers' perspectives was confirmed by multiple group CFA. The McDonald's Omega was acceptable for all factors, but the general overprotection factor explained most scale variance. Pearson's correlation coefficients were more than .20 between the control/prevention factor and child anxiety symptoms in both mother and father reports. The correlation between the control/prevention factor and parent anxiety according to fathers' reports also exceeded .20. These results provided the factor structure and supported the reliability of the POM among a Japanese population; however, further investigation of the validity of the scale is needed.
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Brain connectivity 2024年8月13日BACKGROUND: Generalized anxiety disorder (GAD) and social anxiety disorder (SAD) are distinguished by whether anxiety is limited to social situations. However, reports on the differences in brain functional networks between GAD and SAD are few. Our objective is to understand the pathogenesis of GAD and SAD by examining the differences in resting brain function between patients with GAD and SAD and healthy controls (HCs). METHODS: This study included 21 patients with SAD, 17 patients with GAD, and 30 HCs. Participants underwent psychological assessments and resting-state functional magnetic resonance imaging (rsfMRI). Whole-brain analyses were performed to compare resting-state functional connectivity (rsFC) among the groups. Additionally, logistic regression analysis was conducted on the rsFC to identify significant differences between GAD and SAD. RESULTS: Patients with SAD and GAD had significantly higher rsFC between the bilateral postcentral gyri and bilateral amygdalae/thalami than HCs. Compared with patients with SAD, those with GAD had significantly higher rsFC between the right nucleus accumbens and bilateral thalami and between the left nucleus accumbens and right thalamus. RsFC between the left nucleus accumbens and right thalamus positively correlated with state anxiety in patients with SAD and GAD, respectively. In addition, logistic regression analysis revealed that the right nucleus accumbens and the right thalamus connectivity could distinguish SAD from GAD. CONCLUSIONS: GAD and SAD were distinguished by the right nucleus accumbens and the right thalamus connectivity. Our findings offer insights into the disease-specific neural basis of SAD and GAD.
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Journal of affective disorders 2024年7月12日BACKGROUND: Studies comparing the brain functions of major depressive disorder (MDD) and social anxiety disorder (SAD) at the regional and network levels remain scarce. This study aimed to elucidate their pathogenesis using neuroimaging techniques and explore biomarkers that can differentiate these disorders. METHODS: Resting-state fMRI data were collected from 48 patients with MDD, 41 patients with SAD, and 82 healthy controls. Differences in the amplitude of low-frequency fluctuations (ALFF) among the three groups were examined to identify regions showing abnormal regional spontaneous activity. A seed-based functional connectivity (FC) analysis was conducted using ALFF results as seeds and different connections were identified between regions showing abnormal local spontaneous activity and other regions. The correlation between abnormal brain function and clinical symptoms was analyzed. RESULTS: Patients with MDD and SAD exhibited similar abnormal ALFF and FC in several brain regions; notably, FC between the right superior frontal gyrus (SFG) and the right posterior supramarginal gyrus (pSMG) in patients with SAD was negatively correlated with depressive symptoms. Furthermore, patients with MDD showed higher ALFF in the right SFG than HCs and those with SAD. LIMITATION: Potential effects of medications, comorbidities, and data type could not be ignored. CONCLUSION: MDD and SAD showed common and distinct aberrant brain function patterns at the regional and network levels. At the regional level, we found that the ALFF in the right SFG was different between patients with MDD and those with SAD. At the network level, we did not find any differences between these disorders.
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BMJ open 14(6) e081205 2024年6月25日INTRODUCTION: Insomnia is a common health problem and cognitive-behavioural therapy (CBT) is recommended as a treatment. As there is a critical shortage of CBT-trained therapists, we developed a digital CBT application (IIIP MED: Sleepy Med) as Software as a Medical Device for insomnia. This paper describes the study protocol for an exploratory randomised controlled trial (RCT) to evaluate effectiveness and safety of our developed digital CBT (dCBT) for 5 weeks compared with zolpidem tartrate for patients with insomnia disorder. METHODS AND ANALYSIS: This proposed multicentre exploratory RCT will be conducted at the outpatient clinic of Chiba University Hospital, Akita University Hospital and Yoyogi Sleep Disorder Center, Japan. The study population comprises two parallel groups (dCBT and zolpidem) consisting of 15 participants each (n=30 in total) diagnosed with insomnia disorder who remain symptomatic at 4 weeks after sleep hygiene education. We will evaluate the effectiveness at baseline, week 5 (post-intervention) and week 10 (follow-up). The primary outcome will be the change of subjective sleep onset latency at week 5 from baseline. Secondary outcomes include sleep-related outcomes, such as objective sleep onset latency measured by mobile electroencephalography, functional improvement during the daytime and quality of life. ETHICS AND DISSEMINATION: Ethics approval was granted by the Institutional Review Board of Chiba University Hospital (K2023001). All participants will be required to provide written informed consent. Results will be published in international journals. TRIAL REGISTRATION NUMBER: jRCT2032230353.
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BMC primary care 25(1) 219-219 2024年6月18日BACKGROUND: It is unclear how primary care physicians manage insomnia after the introduction of novel hypnotics such as orexin receptor antagonists and melatonin receptor agonists. This Web-based questionnaire survey aimed to examine treatment strategies for insomnia in Japanese primary care practice. METHODS: One-hundred-and-seventeen primary care physicians were surveyed on the familiarity of each management option for insomnia on a binary response scale (0 = "unfamiliar"; 1 = "familiar") and how they managed insomnia using a nine-point Likert scale (1 = "I never prescribe/perform it"; 9 = "I often prescribe/perform it"). Physicians who were unfamiliar with a management option were deemed to have never prescribed or performed it. RESULTS: Regarding medication, most physicians were familiar with novel hypnotics. Suvorexant was the most used hypnotic, followed by lemborexant and ramelteon. These novel hypnotics averaged 4.8-5.4 points and 4.0-4.7 points for sleep onset and sleep maintenance insomnia, respectively. By contrast, most benzodiazepines were seldom used below two points. Regarding psychotherapy, only approximately 40% of the physicians were familiar with cognitive behavioral therapy for insomnia (CBT-I) and they rarely implemented it, at an average of 1.5-1.6 points. More physicians were familiar with single-component psychotherapies (i.e., relaxation, sleep restriction therapy, and stimulus control) compared to CBT-I, and 48-74% of them implemented it slightly more often, with scores ranging from 2.6 to 3.4 points. CONCLUSION: This study suggests that Japanese primary care physicians seldom use CBT-I to treat insomnia. In addition, they use novel sleep medications more frequently than benzodiazepines in terms of pharmacotherapy. The use and availability of CBT-I in Japanese primary care might be facilitated by: educating primary care physicians, implementing brief or digital CBT-I, and/or developing collaborations between primary care physicians and CBT-I specialists.
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JMIR Pediatrics and Parenting 2024年5月16日
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Psychological medicine 1-14 2024年3月19日BACKGROUND: Previous research on the changes in resting-state functional connectivity (rsFC) in anorexia nervosa (AN) has been limited by an insufficient sample size, which reduced the reliability of the results and made it difficult to set the whole brain as regions of interest (ROIs). METHODS: We analyzed functional magnetic resonance imaging data from 114 female AN patients and 135 healthy controls (HC) and obtained self-reported psychological scales, including eating disorder examination questionnaire 6.0. One hundred sixty-four cortical, subcortical, cerebellar, and network parcellation regions were considered as ROIs. We calculated the ROI-to-ROI rsFCs and performed group comparisons. RESULTS: Compared to HC, AN patients showed 12 stronger rsFCs mainly in regions containing dorsolateral prefrontal cortex (DLPFC), and 33 weaker rsFCs primarily in regions containing cerebellum, within temporal lobe, between posterior fusiform cortex and lateral part of visual network, and between anterior cingulate cortex (ACC) and thalamus (p < 0.01, false discovery rate [FDR] correction). Comparisons between AN subtypes showed that there were stronger rsFCs between right lingual gyrus and right supracalcarine cortex and between left temporal occipital fusiform cortex and medial part of visual network in the restricting type compared to the binge/purging type (p < 0.01, FDR correction). CONCLUSION: Stronger rsFCs in regions containing mainly DLPFC, and weaker rsFCs in regions containing primarily cerebellum, within temporal lobe, between posterior fusiform cortex and lateral part of visual network, and between ACC and thalamus, may represent categorical diagnostic markers discriminating AN patients from HC.
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Internet Interventions 35 100725-100725 2024年3月
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Autism in Adulthood 2024年2月26日
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BioPsychoSocial medicine 18(1) 5-5 2024年2月21日BACKGROUND: Feeding and eating disorders are severe mental disorders that gravely affect patients' lives. In particular, patients with anorexia nervosa (AN) or bulimia nervosa (BN) appear to have poor social cognition. Many studies have shown the relationship between poor social cognition and brain responses in AN. However, few studies have examined the relationship between social cognition and BN. Therefore, we examined which brain regions impact the ability for social cognition in patients with BN. METHODS: We used task-based functional magnetic resonance imaging (fMRI) to examine brain responses during a social cognition task and the Reading Mind in the Eyes Test (RMET). During the fMRI, 22 women with BN and 22 healthy women (HW) took the RMET. Participants also completed the eating disorder clinical measures Bulimic Investigatory Test, Edinburgh (BITE) and Eating Disorders Examination Questionnaire (EDE-Q), the Patient Health Questionnaire (PHQ-9) measure of depression; and the Generalized Anxiety Disorder (GAD-7) measure of anxiety. RESULTS: No difference was observed in the RMET scores between women with BN and HW. Both groups showed activation in brain regions specific to social cognition. During the task, no differences were shown between the groups in the BOLD signal (p < 0.05, familywise error corrected for multiple comparisons). However, there was a tendency of more robust activation in the right angular gyrus, ventral diencephalon, thalamus proper, temporal pole, and middle temporal gyrus in BN (p < 0.001, uncorrected for multiple comparisons). Moreover, HW showed a positive correlation between RMET scores and the activation of two regions: medial prefrontal cortex (mPFC) and anterior cingulate cortex (ACC); however, no significant correlation was observed in women with BN. CONCLUSIONS: While activation in the mPFC and ACC positively correlated to the RMET scores in HW, no correlation was observed in BN patients. Therefore, women with BN might display modulated neural processing when thinking of others' mental states. Further examination is needed to investigate neural processing in BN patients to better understand their social cognition abilities. TRIAL REGISTRATION: UMIN, UMIN000010220. Registered 13 March 2013, https://rctportal.niph.go.jp/s/detail/um?trial_id=UMIN000010220.
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Molecular Psychiatry 2024年2月7日Abstract White matter pathways, typically studied with diffusion tensor imaging (DTI), have been implicated in the neurobiology of obsessive-compulsive disorder (OCD). However, due to limited sample sizes and the predominance of single-site studies, the generalizability of OCD classification based on diffusion white matter estimates remains unclear. Here, we tested classification accuracy using the largest OCD DTI dataset to date, involving 1336 adult participants (690 OCD patients and 646 healthy controls) and 317 pediatric participants (175 OCD patients and 142 healthy controls) from 18 international sites within the ENIGMA OCD Working Group. We used an automatic machine learning pipeline (with feature engineering and selection, and model optimization) and examined the cross-site generalizability of the OCD classification models using leave-one-site-out cross-validation. Our models showed low-to-moderate accuracy in classifying (1) “OCD vs. healthy controls” (Adults, receiver operator characteristic-area under the curve = 57.19 ± 3.47 in the replication set; Children, 59.8 ± 7.39), (2) “unmedicated OCD vs. healthy controls” (Adults, 62.67 ± 3.84; Children, 48.51 ± 10.14), and (3) “medicated OCD vs. unmedicated OCD” (Adults, 76.72 ± 3.97; Children, 72.45 ± 8.87). There was significant site variability in model performance (cross-validated ROC AUC ranges 51.6–79.1 in adults; 35.9–63.2 in children). Machine learning interpretation showed that diffusivity measures of the corpus callosum, internal capsule, and posterior thalamic radiation contributed to the classification of OCD from HC. The classification performance appeared greater than the model trained on grey matter morphometry in the prior ENIGMA OCD study (our study includes subsamples from the morphometry study). Taken together, this study points to the meaningful multivariate patterns of white matter features relevant to the neurobiology of OCD, but with low-to-moderate classification accuracy. The OCD classification performance may be constrained by site variability and medication effects on the white matter integrity, indicating room for improvement for future research.
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Psychiatry and Clinical Neurosciences Reports 3:e170 2024年2月 査読有り
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Molecular Autism 15(1) 2024年1月4日Abstract Background To examine the relationship between social camouflage and mental health in Japanese autistic adults and make an international comparison with a sample from the UK. Methods This study analysed secondary data of participants with a self-reported diagnosis of autism from Japan (N = 210; 123 men and 87 women) and the UK (N = 305; 181 women, 104, men, and 18 nonbinary). The relationships between the quadratic term of the Camouflaging Autistic Traits Questionnaire and mental health scales, including depression and anxiety, were assessed. Results The UK sample showed linear relationships, whereas the Japanese sample showed significant nonlinear relationships. The quadratic terms of the Camouflaging Autistic Traits Questionnaire slightly explained generalised anxiety (β = .168, p = .007), depression (β = .121, p = .045), and well-being (β = − .127, p = .028). However, they did not explain the association between social anxiety and the Camouflaging Autistic Traits Questionnaire. Limitations Participants had self-reported diagnoses, and while the autism-spectrum quotient provides a cut-off value for screening, it does not enable confirming diagnoses. Mean scores of the Japanese version of the Camouflaging Autistic Traits Questionnaire were lower as compared to the original CAT-Q, which implies that the social camouflage strategy types used by autistic people in Japan and the UK could differ. The cross-sectional design limits causal inferences. Conclusion In the UK, more social camouflage was associated with poorer mental health scores, whereas too little or too much social camouflage was associated with a low mental health score in Japan. The Japanese population is seemingly less aware of and educated on autistic characteristics and considers ‘average’ behaviour a good thing. This could influence Japanese autistic people’s social camouflage use, differing from that of autistic people in the UK. The differences in the relationship between social camouflage and mental health between Japan and the UK could be associated with national-level divergence regarding the culture of autism.
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Frontiers in neuroscience 18 1449673-1449673 2024年Hedgehog signaling is a highly conserved pathway that plays pivotal roles in morphogenesis, tumorigenesis, osteogenesis, and wound healing. Previous investigations in patients with Gorlin syndrome found low harm avoidance traits, and increased volumes in the cerebrum, cerebellum, and cerebral ventricles, suggesting the association between brain morphology and the constitutive hyperactivation of hedgehog signaling, while the changes of regional brain volumes in upregulated hedgehog signaling pathway remains unclear so far. Herein, we investigated comprehensive brain regional volumes using quantitative structural brain MRI, and identified increased volumes of amygdala, striatum, and pallidum on the global segmentation, and increased volumes of the lateral and medial parts of the central nucleus of the amygdala on the detail segmentation in Ptch heterozygous deletion mice. Our data may enhance comprehension of the association between brain morphogenic changes and hyperactivity in hedgehog signaling.
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Open Journal of Psychiatry 14(04) 334-346 2024年
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Ethics, Medicine and Public Health 32 100966-100966 2024年
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Work (Reading, Mass.) 77(2) 573-587 2024年BACKGROUND: Emergency service workers have highly stressful occupations; the stressors encountered can contribute to the development of mental disorders such as depression, anxiety, and posttraumatic stress disorder (PTSD). OBJECTIVE: The present study used a conceptual model and survey to identify variables influencing the association between probable PTSD and quality of life (QOL) in emergency service workers. METHOD: PTSD was assessed using the Impact of Event Scale-Revised. QOL was assessed using the Medical Outcomes Study 36-Item Short-Form Health Survey. Path analysis was used to determine whether stress-coping (Brief Coping Orientation to Problems Experienced [Brief COPE] scores), social support (Multidimensional Scale of Perceived Social Support [MSPSS] scores), and resilience (Connor-Davidson Resilience Scale scores) explain the association between probable PTSD and QOL among 220 emergency service workers in Japan. RESULTS: Impact of Event Scale-Revised scores were significantly positively associated with Brief COPE Active coping scores and significantly negatively associated with MSPSS scores. Brief COPE Active coping and MSPSS scores were significantly positively associated with Connor-Davidson Resilience Scale scores, which were in turn significantly positively associated with Medical Outcomes Study 36-Item Short-Form Health Survey scores. CONCLUSION: Active coping in response to stressful situations is important for maintaining good mental health among emergency service workers. Active coping and social support may strengthen resilience, and resilience may improve QOL. Screening for mental health and QOL should include simultaneous assessment of stress-coping, social support, and resilience. Although the findings of this cross-sectional study are important, it could not confirm a causal relationship between PTSD and QOL.
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Journal of Affective Disorders Reports 14 100626-100626 2023年12月
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Molecular psychiatry 28(10) 4320-4320 2023年10月
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BMC psychiatry 23(1) 681-681 2023年9月19日OBJECTIVE: This study aimed to measure the level of psychological injury caused by work-related stress as well as the severity of depression among workers. METHOD: First, we conducted an online survey and recruited 500 workers diagnosed with depression or adjustment disorder to investigate what type of stress they experienced within six months before onset. Second, we conducted another online survey and recruited 767 participants who experienced some form of work-related stress. All the participants were classified into four groups by whether or not they were diagnosed with depression and whether or not they quit their jobs due to work-related stress. We used the Impact of Event Scale-Revised (IES-R) to measure psychological injury caused by work-related stressful events and the Patient Health Questionnaire (PHQ)-9 to assess the severity of depression. RESULTS: In study 1, 62.4% of workers diagnosed with depression or adjustment disorder experienced work-related stress within six months before onset. In study 2, the IES-R mean scores were 40.7 (SD = 23.1) for Group A (workers with depression and quit their jobs) and 36.67 (SD = 23.4) for Group B (workers with depression but stayed at their jobs), with both exceeding the cut-off point (24/25) of PTSD (Post-Traumatic Stress Disorder), while the mean score of Group C (workers who did not have depression but quit their jobs because of work-related stress) was 20.74 (SD = 21.2), and it was 13.89 (SD = 17.4) for Group D (workers who had work-related stress but stayed at their jobs), with both of them below the cut-off point of PTSD. The total scores of IES-R of Group A and Group B were significantly higher than those of Group C and Group D(p < 0.001). There was a significant positive correlation between the scores of IES-R and PHQ-9 for all four groups (r = 0.708). CONCLUSIONS: This study suggests that it is necessary to measure not only depressive symptoms but also the level of psychological injury resulting from stressful events in the workplace to assess workers with depression.
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2023年9月18日<p>Background: Imagery rescripting (IR) is a technique used in cognitive-behavioral therapy and schema therapy, the treatment process of which has not been empirically verified despite being implemented for various mental disorders. This study aims to examine the experiential process of patients who undergo IR.Methods: Schema therapy sessions were video-recorded with the consent of five patients with chronic depression. Two raters adopted the task analysis protocol to analyze the videos of seven IR sessions.Results: The following experiential process common among successful sessions with the patients was revealed: (1) recalling the episode of an adverse childhood experience, (2) expressing anger and dissatisfaction with the behavior of others during the adverse experience, (3) expressing needs that were not met during the adverse experience, (4) expressing hurt feelings due to needs that were not met during the adverse experience, (5) expressing complex emotions due to fulfillment of needs, and (6) having a sense of relief, attachment, or self-compassion. The behavioral markers of each step were identified as well.</p>
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Psychiatry and Clinical Neurosciences Reports 2(3) 2023年9月18日Abstract Aim The spread of the novel coronavirus infection (coronavirus disease 2019 [COVID‐19]) has caused behavioral changes and mental illness in patients and their attendants during its early phase. The present study aimed to examine the association between precautionary behaviors against COVID‐19 and psychosocial factors in outpatients with pre‐existing disease and their attendants. Methods We conducted a cross‐sectional paper‐based questionnaire survey in Chiba University Hospital on 1019 patients and 513 attendants, and a web‐based questionnaire survey in Japan on 3981 individuals from the general population. We evaluated the participants' anxiety about COVID‐19, depression, health anxiety, and precautionary behaviors. Results Regarding knowledge and anxiety about COVID‐19, the protective factors for the high precautionary behaviors group were knowledge of COVID‐19 (odds ratio [OR] = 1.178, 95% confidence interval [CI]: 1.099–1.263), anxiety about the spread of COVID‐19 (OR = 1.348, 95% CI: 1.243–1.461), and anxiety about infecting someone with COVID‐19 (OR = 1.135, 95% CI: 1.039–0.239). Regarding psychosocial factors, the protective factors for the high precautionary behaviors group were patients (OR = 1.759, 95% CI: 1.056–2.929), their attendants (OR = 3.892, 95% CI: 1.416–10.700), health anxiety (OR = 2.005, 95% CI: 1.451–2.772), and nondepression states (OR = 1.368, 95% CI: 1.004–1.864). Conclusion Our findings suggest that patients and their attendants may perform high precautionary behaviors. Health anxiety and nondepression states may be associated with high precautionary behaviors.
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BMJ open 13(9) e069734 2023年9月11日INTRODUCTION: Cognitive behavioural therapy for psychosis (CBTp) has demonstrated effectiveness in reducing positive symptoms, improving depression, enhancing coping skills and increasing awareness of illness. However, compared with cognitive behavioural therapy for depression and anxiety, the spread of CBTp in clinical practice is minimal. The present study designed a randomised controlled trial (RCT) research protocol to evaluate whether real-time remote video-conference CBTp (vCBTp) could facilitate access to psychosocial interventions and effectively improve symptoms compared with usual care (UC) for patients with schizophrenia. METHODS AND ANALYSIS: This exploratory RCT will consist of two parallel groups (vCBTp+UC and UC alone) of 12 participants (n=24) diagnosed with schizophrenia, schizoaffective disorder or paranoid disorder, who remain symptomatic following pharmacotherapy. Seven 50-min weekly vCBTp interventions will be administered to test efficacy. The primary outcome will be the positive and negative syndrome scale score at week 8. The secondary outcome will be the Beck Cognitive Insight Scale to assess insight, the Patient Health Questionnaire-9 to assess depression, the Generalised Anxiety Disorder-7 to assess anxiety, the 5-level EuroQol 5-dimensional questionnaire to assess quality of life and the Impact of Event Scale-Revised to assess subjective distress about a specific stressful life event. We will take all measurements at 0 weeks (baseline) and at 8 weeks (post-intervention), and apply intention-to-treat analysis. ETHICS AND DISSEMINATION: We will conduct this study in the outpatient department of Cognitive Behavioral Therapy Center at Chiba University Hospital. Further, all participants will be informed of the study and will be asked to sign consent forms. We will report according to the Consolidated Standards of Reporting Trials. TRIAL REGISTRATION NUMBER: UMIN000043396.
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BMC psychiatry 23(1) 661-661 2023年9月7日BACKGROUND: Autistic people demonstrate focused interests, sensitivity to sensory stimulation, and, compared with the general population, differences in social communication and interaction. We examined whether a combination of the Awareness and Care for My Autistic Traits (ACAT) program and treatment-as-usual is more effective than only treatment-as-usual in increasing the understanding of autistic attributes, reducing treatment stigma, and improving mental health and social adaptation among autistic adolescents and their parents/guardians. METHODS: Forty-nine adolescents and their parents/guardians were randomly assigned to either a combination of ACAT and treatment-as-usual or only treatment-as-usual. The combined group received six weekly 100-minute ACAT sessions, while the treatment-as-usual group received no additional intervention. The primary outcome was the change in understanding of autistic attributes (Autism Knowledge Quiz-Child), administered from pre- to post-intervention. The secondary outcomes included the change in Autism Knowledge Quiz-Parent, reduced treatment stigma, and improved mental health and social adaptation among autistic adolescents and their parents/guardians. A primary outcome measure scale was scored by assessors who were blind to the group assignment. RESULTS: The combined group (both autistic adolescents and their parents/guardians) showed an increase in Autism Knowledge Quiz scores compared to those in the treatment-as-usual group. Autistic adolescents in the combined group also demonstrated a decrease in treatment-related stigma and an improvement in general mental health compared to those in the treatment-as-usual group, while there were no group differences in the change in social adaptation. For parents/guardians, there were no group differences in the change in treatment-related stigma, general mental health, adaptive skills, or attitudes toward their children. CONCLUSIONS: The ACAT program could be an effective treatment modality to increase the understanding of autistic attributes among both autistic adolescents and their parents/guardians. The ACAT program positively affects self-understanding, reduces treatment stigma, and stabilizes behavioral issues for autistic adolescents as a part of mental health measures, but it does not effectively reduce treatment barriers or improve mental health for parents/guardians. Further research should consider whether additional support for parents/guardians could be beneficial. TRIAL REGISTRATION: The study was registered in UMIN (UMIN000029851, 06/01/2018).
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BMC psychiatry 23(1) 657-657 2023年9月6日The purposes of the current study are two-fold. Study 1 aimed to examine the psychometric properties of the Spence Children's Anxiety Scale (SCAS) in a Taiwanese sample. Study 2 aimed to explore the immediate and follow-up effects of Journey of the Brave Counseling Program (JBCP) on children's' anxiety, well-being, and life adjustment. A review and suggestions were provided for future research and practitioners in educational and counseling fields as reference. In Study 1, the pilot study included 150 to 200 children between ages 11 and 12 in Taoyuan City. In Study 2, we conducted a pretest-posttest nonequivalent groups quasi-experimental design. The participants in this stage were 16 children in an elementary school in Taoyuan City, between ages 11 and 12. After obtaining consent forms from the participants' guardians, we randomly assigned these participants to an experimental group (N = 8) and a control group (N = 8). The experimental group received a 40-minute JBCP session weekly for ten weeks. The control group received a 40-minute career exploration small group counseling weekly for ten weeks. We administered the SCAS, Psychological Well-Being Scale, and School Life Adjustment Scale in the pretest, posttest, and follow-up test to measure change of anxiety, well-being, and life adjustment of the participants. In addition, the current study implemented some qualitative data, such as group progress notes, group member feedback questionnaires, and semi-structured interviews with participants' homeroom teachers as supplementary data to clarify the effects of the JBCP. In Study 1, we found that the SCAS had a good validity and reliability for Taiwanese children. The results of Study 2 indicated that the JBCP had immediate and follow-up effects on the separation anxiety in the experimental group. With the pretest impact eliminated, the immediate and follow-up effects on overall anxiety in the experimental group were better than those on the control group. However, even though the immediate and follow-up effects of the JBCP on the experimental group were better than the control group but were not significant. Besides, the group member feedback questionnaires and participants' homeroom teachers all indicated that the experimental group participants had positive attitude toward the JBCP, and they also positively improved their emotions and interpersonal relationships with others.
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Neuropsychopharmacology Reports 43(3) 288-309 2023年9月 査読有り
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Medicine 102(27) e34253 2023年7月7日Cognitive behavioral therapy (CBT) is known to improve chronic pain management. However, past studies revealed only small to moderate benefits in short-term results, and long-term follow-up studies are lacking. This study aimed to follow an integrated CBT program's effectiveness 1.5 years after its completion. This observational study was the follow-up on the data collected from our CBT sessions conducted under 3 different studies in 2018 to 2019. Seven assessment items (Numerical Rating Scale, Pain Catastrophizing Scale [PCS], Pain Disability Assessment Scale [PDAS], Patient Health Questionnaire-9 items, Generalized Anxiety Disorder 7, European quality of life 5-dimensions 5-level, and Beck Depression Inventory [BDI]) were statistically analyzed. Thematic analysis was conducted in semi structured interviews. PCS ( F = 6.52, P = .003), PDAS ( F = 5.68, P = .01), European quality of life 5-dimensions 5-level ( F = 3.82, P = .03), and BDI ( F = 4.61, P = .01) exhibited significant changes ( P < .05), confirmed by pairwise t test, revealing a moderate to large effect size. From post-treatment to follow-up, all scores showed no significant changes ( P > .1). In the qualitative study, the analysis revealed 3 subthemes: "Autonomy," "Understanding of yourself and pain," and "Acceptance of pain." Our study suggests that integrated CBT may reduce the scores of PCS, PDAS and BDI, and this effect lasts for at least 1 year. Identified themes support the relevance of mitigative factors in managing chronic pain.
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Psychiatry and Clinical Neurosciences Reports 2(3) 2023年6月28日Abstract Aim Clinicians face difficulties in making treatment decisions for unspecified anxiety disorder due to the absence of any treatment guidelines. The objective of this study was to investigate how familiar and how often primary care physicians use pharmacological and nonpharmacological approaches to manage the disorder. Methods A survey was conducted among 117 primary care physicians in Japan who were asked to assess the familiarity of using each treatment option for unspecified anxiety disorder on a binary response scale (0 = “unfamiliar,” 1 = “familiar”) and the frequency on a nine‐point Likert scale (1 = “never used,” 9 = “frequently used”). Results While several benzodiazepine anxiolytics were familiar to primary care physicians, the frequencies of prescribing them, including alprazolam (4.6 ± 2.6), ethyl loflazepate (3.6 ± 2.4), and clotiazepam (3.5 ± 2.3), were low. In contrast, certain nonpharmacological options, including lifestyle changes (5.4 ± 2.3), coping strategies (5.1 ± 2.7), and psychoeducation for anxiety (5.1 ± 2.7), were more commonly utilized, but to a modest extent. When a benzodiazepine anxiolytic drug failed to be effective, primary care physicians selected the following management strategies to a relatively high degree: differential diagnosis (6.4 ± 2.4), referral to a specialist hospital (5.9 ± 2.5), lifestyle changes (5.2 ± 2.5), and switching to selective serotonin reuptake inhibitor (5.1 ± 2.4). Conclusion Primary care physicians exercise caution when prescribing benzodiazepine anxiolytics for unspecified anxiety disorder. Nonpharmacological interventions and switching to SSRI are modestly employed as primary treatment options and alternatives to benzodiazepine anxiolytics. To ensure the safe and effective treatment of unspecified anxiety disorder in primary care, more information should be provided from field experts.
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BMJ Open 13(6) e070157-e070157 2023年6月23日Introduction Neuroimaging studies on attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) have demonstrated differences in extensive brain structure, activity and network. However, there remains heterogeneity and inconsistency across these findings, presumably because of the diversity of the disorders themselves, small sample sizes, and site and parameter differences in MRI scanners, and their overall pathogenesis remains unclear. To address these gaps in the literature, we will apply the travelling-subject approach to correct site differences in MRI scanners and clarify brain structure and network characteristics of children with ADHD and ASD using large samples collected in a multi-centre collaboration. In addition, we will investigate the relationship between these characteristics and genetic, epigenetic, biochemical markers, and behavioural and psychological measures. Methods and analysis We will collect resting-state functional MRI (fMRI) and T1-weighted and diffusion-weighted MRI data from 15 healthy adults as travelling subjects and 300 children (ADHD, n=100; ASD, n=100; and typical development, n=100) with multi-dimensional assessments. We will also apply data from more than 1000 samples acquired in our previous neuroimaging studies on ADHD and ASD. Ethics and dissemination The study protocol has been approved by the Research Ethics Committee of the University of Fukui Hospital (approval no: 20220601). Our study findings will be submitted to scientific peer-reviewed journals and conferences.
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Neuropsychopharmacology reports 43(2) 188-194 2023年6月AIMS: Treatment guidelines with respect to unspecified anxiety disorder have not been published. The aim of this study was to develop a consensus among field experts on the management of unspecified anxiety disorder. METHODS: Experts were asked to evaluate treatment choices based on eight clinical questions concerning unspecified anxiety disorder using a nine-point Likert scale (1 = "disagree" to 9 = "agree"). According to the responses from 119 experts, the choices were categorized into first-, second-, and third-line recommendations. RESULTS: Benzodiazepine anxiolytic use was not categorized as a first-line recommendation for the primary treatment of unspecified anxiety disorder, whereas multiple nonpharmacological treatment strategies, including coping strategies (7.9 ± 1.4), psychoeducation for anxiety (7.9 ± 1.4), lifestyle changes (7.8 ± 1.5), and relaxation techniques (7.4 ± 1.8), were categorized as first-line recommendations. Various treatment strategies were categorized as first-line recommendations when a benzodiazepine anxiolytic drug did not improve anxiety symptoms, that is, differential diagnosis (8.2 ± 1.4), psychoeducation for anxiety (8.0 ± 1.5), coping strategies (7.8 ± 1.5), lifestyle changes (7.8 ± 1.5), relaxation techniques (7.2 ± 1.9), and switching to selective serotonin reuptake inhibitors (SSRIs) (7.0 ± 1.8). These strategies were also highly endorsed when tapering the dosage of or discontinuing benzodiazepine anxiolytic drugs. There was no first-line recommendation regarding excusable reasons for continuing benzodiazepine anxiolytics. CONCLUSIONS: The field experts recommend that benzodiazepine anxiolytics should not be used as a first-line option for patients with unspecified anxiety disorder. Instead, several nonpharmacological interventions and switching to SSRIs were endorsed for the primary treatment of unspecified anxiety disorder and as alternatives to benzodiazepine anxiolytics.
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Molecular psychiatry 2023年5月2日Current knowledge about functional connectivity in obsessive-compulsive disorder (OCD) is based on small-scale studies, limiting the generalizability of results. Moreover, the majority of studies have focused only on predefined regions or functional networks rather than connectivity throughout the entire brain. Here, we investigated differences in resting-state functional connectivity between OCD patients and healthy controls (HC) using mega-analysis of data from 1024 OCD patients and 1028 HC from 28 independent samples of the ENIGMA-OCD consortium. We assessed group differences in whole-brain functional connectivity at both the regional and network level, and investigated whether functional connectivity could serve as biomarker to identify patient status at the individual level using machine learning analysis. The mega-analyses revealed widespread abnormalities in functional connectivity in OCD, with global hypo-connectivity (Cohen's d: -0.27 to -0.13) and few hyper-connections, mainly with the thalamus (Cohen's d: 0.19 to 0.22). Most hypo-connections were located within the sensorimotor network and no fronto-striatal abnormalities were found. Overall, classification performances were poor, with area-under-the-receiver-operating-characteristic curve (AUC) scores ranging between 0.567 and 0.673, with better classification for medicated (AUC = 0.702) than unmedicated (AUC = 0.608) patients versus healthy controls. These findings provide partial support for existing pathophysiological models of OCD and highlight the important role of the sensorimotor network in OCD. However, resting-state connectivity does not so far provide an accurate biomarker for identifying patients at the individual level.
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Frontiers in psychiatry 14 1168100-1168100 2023年4月17日 査読有りPurpose: There is a lack of evidence regarding answers for clinical questions about treating insomnia disorder. This study aimed to answer the following clinical questions: 1) how to use each hypnotic and non-pharmacological treatment differently depending on clinical situations and 2) how to reduce or stop benzodiazepine hypnotics using alternative pharmacological and non-pharmacological treatments. Methods: Experts were asked to evaluate treatment choices based on 10 clinical questions about insomnia disorder using a nine-point Likert scale (1=“disagree” to 9=“agree”). The responses of 196 experts were collected, and the answers were categorized into first-, second-, and third-line recommendations. Results: The primary pharmacological treatment, lemborexant (7.3±2.0), was categorized as a first-line recommendation for sleep initiation insomnia, and lemborexant (7.3±1.8) and suvorexant (6.8±1.8) were categorized as the first-line recommendations for sleep maintenance insomnia. Regarding non-pharmacological treatments for primary treatment, sleep hygiene education was categorized as the first-line recommendation for both sleep initiation (8.4±1.1) and maintenance insomnia (8.1±1.5), while multicomponent cognitive behavioral therapy for insomnia was categorized as the second-line treatment for both sleep initiation (5.6±2.3) and maintenance insomnia (5.7±2.4). When reducing or discontinuing benzodiazepine hypnotics by switching to other medications, lemborexant (7.5±1.8) and suvorexant (6.9±1.9) were categorized as first-line recommendations. Conclusion: Expert consensus indicates that orexin receptor antagonists and sleep hygiene education are recommended as first-line treatments in most clinical situations to treat insomnia disorder.
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Journal of the American Academy of Child & Adolescent Psychiatry 62(4) 403-414 2023年4月
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CAMPUS HEALTH 60(1) 279-281 2023年3月本学では、2020年度の前期は新型コロナの影響で入構制限があったため学生健診の実施時期や方法を変更せざるをえなかったが、2021年度は例年どおりの形で健診とWEB問診を行うことができた。今回、新型コロナ流行の影響下で学生が抱えるメンタルヘルスの問題を明らかにするため、流行が拡大する前年の2019年度から、感染拡大が始まってから1年後となる2021年度までのWEB問診データを分析した。WEB問診では、まずスクリーニング目的にWEB上でMINI精神疾患簡易構造化面接法日本語版およびその中のMINIスクリーンを改編した質問項目と、自閉症スペクトラム指数(AQ)の45番目の項目(他の人の考えを理解することは苦手だ)について症状の有無を尋ねた。そして、「症状あり」と回答した学生に、MINI精神疾患簡易構造化面接法を改編した質問項目と、SCOFF、AQ10日本語版、SASS、SDISSを改編した質問項目に加え、「学業に支障をきたす要因」と「コミュニケーションに支障をきたす要因」について回答を求めた。分析の結果、スクリーニング用の質問項目で「症状あり」と回答した学生の割合は、「うつ病エピソード」を除く全ての項目で2019年度に比べて2020年度に低下し、2021年度にはほぼ2019年度のレベルに戻っていた。MINI精神疾患簡易構造化面接法を改編した質問項目、SCOFF、AQ10で基準以上の症状があった学生の割合とSASSスコアには、明らかな経年的変化はみられなかった。
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Neuropsychology 37(3) 315-329 2023年3月OBJECTIVE: A major limitation of current suicide research is the lack of power to identify robust correlates of suicidal thoughts or behavior. Variation in suicide risk assessment instruments used across cohorts may represent a limitation to pooling data in international consortia. METHOD: Here, we examine this issue through two approaches: (a) an extensive literature search on the reliability and concurrent validity of the most commonly used instruments and (b) by pooling data (N ∼ 6,000 participants) from cohorts from the Enhancing NeuroImaging Genetics Through Meta-Analysis (ENIGMA) Major Depressive Disorder and ENIGMA-Suicidal Thoughts and Behaviour working groups, to assess the concurrent validity of instruments currently used for assessing suicidal thoughts or behavior. RESULTS: We observed moderate-to-high correlations between measures, consistent with the wide range (κ range: 0.15-0.97; r range: 0.21-0.94) reported in the literature. Two common multi-item instruments, the Columbia Suicide Severity Rating Scale and the Beck Scale for Suicidal Ideation were highly correlated with each other (r = 0.83). Sensitivity analyses identified sources of heterogeneity such as the time frame of the instrument and whether it relies on self-report or a clinical interview. Finally, construct-specific analyses suggest that suicide ideation items from common psychiatric questionnaires are most concordant with the suicide ideation construct of multi-item instruments. CONCLUSIONS: Our findings suggest that multi-item instruments provide valuable information on different aspects of suicidal thoughts or behavior but share a modest core factor with single suicidal ideation items. Retrospective, multisite collaborations including distinct instruments should be feasible provided they harmonize across instruments or focus on specific constructs of suicidality. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Behavioural and cognitive psychotherapy 51(3) 1-6 2023年2月3日BACKGROUND: Guided parent-delivered cognitive behavioural therapy (GPD-CBT) is an effective low-intensity treatment for childhood anxiety disorder in Western countries and can increase access to evidence-based psychological therapies. AIM: This study aimed to examine its feasibility in a Japanese sample. METHOD: Twelve children with anxiety disorders and their parents participated in the study, and ten children and parents completed the program. Participants were assessed at pre-, post- and one-month follow-up using a diagnostic interview for anxiety disorders, self- and parent-report measures for anxiety, depression, parental behaviour, and parental anxiety. RESULTS: Four children (40% of completers) were free from their primary diagnoses immediately following the brief treatment, and seven children (70%) at the one-month follow-up. Changes in disorder severity, child and parent reported anxiety symptoms, and child reported depression symptoms were consistent with those found in Western trials of GPD-CBT and of Japanese trials of more intensive CBT for child anxiety disorders that involves both the child and the parent. Moderate increases were also found in child reported parental autonomy behaviours; however, there were only small changes in parent self-reported anxiety. CONCLUSION: These results support the potential of GPD-CBT to increase access to evidence-based treatments for anxiety disorders in Japanese children.
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病院 82(2) 136-138 2023年2月1日
MISC
551-
PSYCHOTHERAPY AND PSYCHOSOMATICS 93 102-102 2024年8月
書籍等出版物
15担当経験のある科目(授業)
5-
認知行動療法学 (連合大学院小児発達学研究科)
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メンタルヘルスサポート学 (千葉大学大学院医学研究院)
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認知行動生理学 (千葉大学大学院医学研究院)
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生理学 (千葉大学医学部)
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行動科学 (千葉大学医学部)
所属学協会
5共同研究・競争的資金等の研究課題
37-
日本学術振興会 科学研究費助成事業 2024年4月 - 2027年3月
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日本学術振興会 科学研究費助成事業 基盤研究(B) 2022年4月 - 2027年3月
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日本学術振興会 科学研究費助成事業 基盤研究(C) 2022年4月 - 2027年3月
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日本学術振興会 科学研究費助成事業 2023年4月 - 2026年3月
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日本学術振興会 科学研究費助成事業 2023年4月 - 2026年3月