大渓 俊幸

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).

治療中の疾患がない本学学生で本研究に同意が得られた87名(男性52名、女性35名)を対象に、個人属性、体組成、腹部エコー所見、臨床検査値などについて調査し、ALT高値に影響を与える因子、脂肪肝に影響を与える因子について、それぞれ多変量解析を行った。結果、ALT高値に有意な影響を与える因子として「性別(男性)」と「体脂肪率(25%以上)」が抽出され、脂肪肝に有意な影響を与える因子として「毎週の運動習慣」が抽出された。腸内細菌叢解析を行い、「脂肪肝の有無」を含む諸因子との関連性について解析した結果、「脂肪肝の有無」で菌叢構成に有意な違いは認められず、「運動習慣の有無」で菌叢構成や菌の多様性に有意な違いが認められた。

本学では、毎年入学時に実施している定期接種歴の調査に、2022年度は臨時接種である新型コロナワクチン接種歴を加えて調査した。今回、2022年度学部入学生2439名のうち、予防接種記録を提出し、かつ本研究に同意が得られた2278名を対象に、新型コロナワクチン接種状況について検討した。同年4月2日時点で2回以上接種していたのは2027名(89.0%)で、接種回数の内訳は3回接種者が155名(全体の6.8%)、2回接種が1872名(82.2%)、1回接種が12名(0.5%)であった。2回以上の接種率を学部別にみると、看護学部が最も高く93.8%、最も低いのは理学部の82.1%であった。3回接種率は医学部が最も高く13.8%であった。

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。

PURPOSE: Most previous studies that described associations between adult attention-deficit/hyperactivity disorder (ADHD) and sociodemographic characteristics were focused on individuals diagnosed with ADHD, and few studies investigated ADHD traits in the general population. Additionally, some workers, who experienced no problems while at university and successfully graduated from university, developed ADHD traits after finding employment. This study described associations between ADHD traits and sociodemographic characteristics among Japanese workers who were university graduates. PATIENTS AND METHODS: Participants were randomly selected workers (n=1240) from across Japan who completed a self-administered online survey. ADHD traits were measured using an adult ADHD Self-report Scale, with scoring rules applied to reflect the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria. Information was collected on sociodemographic characteristics including sex, age, socioeconomic status, working time, and health-related behaviors. We performed partial correlation analysis to estimate trend associations and used analysis of covariance to compare adjusted averages. This model was adjusted for all variables. RESULTS: Males had higher levels of ADHD traits than females (p = 0.001), and younger age was associated with higher levels of ADHD traits (p < 0.001). Workers with low incomes had higher levels of ADHD traits than workers with high incomes (p = 0.009). More frequent consumption of midnight meals was associated with higher levels of ADHD traits (p < 0.001), although there were no differences for breakfast, lunch, and dinner. Those who did not get enough rest from sleep had higher levels of ADHD traits (p = 0.007). CONCLUSION: Results for high levels of ADHD traits among workers were consistent with previous studies for adults diagnosed with ADHD, even though all participants had successfully graduated from university. Assessment of these ADHD traits may support prevention of health deterioration related to these ADHD traits.

<p>Purpose: To examine the reliability and validity of the Camouflaging Autistic Traits Questionnaire–Japanese version (CAT-Q-J). Methods: Self-report questionnaires were administered to 204 adults with and 410 adults without autism. Test–retest reliability was confirmed via another survey administered after two weeks.Results: The overall CAT-Q-J showed good reliability, correlating approximately with other scales, supporting its convergent validity. However, a few subscales had insufficient reliability and validity. Exploratory factor analyses showed three factors similar to the original in non-autistic sample (plus a factor comprising reversed items). For the autistic sample, three factors partially differed from the original. Conclusion: Despite acceptable consistency, reliability, and validity at an overall level, the CAT-Q-J should be used with caution.</p>

本学における2020年度の学生職員健診は、身体診察を省いた最小限の健診を実施した。2021年度に通常どおりの健診を再開するにあたり、適切な感染予防策について検討を行い、扇風機を用いた方法を導入した。事前に室内の空気の流れを流体数値シミュレーションによって可視化し、換気効率の最適化を図った。扇風機の配置位置は、人の移動において密になりうる箇所とし、送風方向が健診会場奥の出口に向かうように配置した。2021年4～5月に学生職員健診を実施し、後日Covid-19陽性が判明した学生が1名いたが、健診由来のクラスターを発生させることなく安全に遂行しえた。

学生の中には大学生活に適応することができず、抑鬱状態になる自閉スペクトラム症(ASD)者が少なからず存在する。このようなケースでは鬱病との鑑別が難しいことがしばしばあり、ASD者への対応をする際には、診断が適切でないと治療的介入を行ったときの効果に影響を及ぼすことがある。そこで今回、鬱病が併存しているASD者と、鬱病の併存がないASD者(ASD者)、定型発達者の違いを明らかにし、治療的介入をしたときに得られる変化との関係について検討した。SASSを用いた社会適応度の比較では、ASD者と鬱病を併存するASD者は定型発達者に比べてスコアが有意に低く、ASD者と鬱病を併存するASD者との間に有意差はなかった。NIRSを用いて前頭側頭部における言語流暢性課題中の脳賦活の大きさを測定すると、ASD者と鬱病を併存するASD者は定型発達者よりも広範な部位で脳賦活の大きさが減少しており、特に鬱病を併存するASD者は併存しないASD者よりも右腹外側前頭前野における脳賦活の大きさが有意に減少していた。このことからNIRSによる脳活動の測定は、ASD者だけでなく、鬱病を併存するASD者を診断するための補助となる可能性が示唆された。

Individuals with high levels of autistic traits are at a high risk of experiencing depressive symptoms, and are also vulnerable to job stress. This study aimed to identify which combination of autistic traits and type of job stress are related to depressive symptoms. Participants comprised 992 workers from different regions of Japan. Autistic traits, depressive symptoms, and job stress were measured using the Autism-Spectrum Quotient, K6 scale, and Job Content Questionnaire, respectively. Logistic regression was performed to estimate the odds ratio and 95% confidence interval. Workers with high autistic traits scores reported significantly more depressive symptoms for all job stress types, especially high job demand. Depressive symptoms differed according to autistic traits and job stress. In workers with high autistic trait subscale scores, those with active job stress reported more depressive symptoms than those with high strain job stress, except for the "poor imagination" trait. This is contrary to previous reports that the active stress type is generally less associated with depressive symptoms than the high-strain stress type. To prevent depressive symptoms in workers with high autistic trait scores, it is important to understand which combination of autistic traits and type of job stress contribute to depressive symptoms.

Major depression is one of the most common mental health problems worldwide. More than one-third of patients suffer from treatment-resistant depression (TRD). In this study, we explored the feasibility of group compassion-focused therapy (CFT) for TRD using a randomized controlled trial with two parallel groups. Eighteen participants were randomly allocated to the intervention group (CFT and usual care) and control group (usual care alone) and a participant in each group withdrew. Participants in the intervention group received a 1.5-h session every week for 12 weeks. The effects of the intervention on the participants' scores were calculated using a linear mixed model. There was a larger reduction in their depressive symptoms and fears of compassion for self and a greater increase in their compassion for self compared to the control group participants. The reliable clinical indices showed that in the CFT (intervention) group, three of nine participants recovered (33%), two improved (22%), two recovered but non-reliably (22%), and the condition of two remained unchanged (22%). These findings indicate adequate feasibility of group CFT for TRD in Japanese clinical settings. Clinical trial registration: [https://clinicaltrials.gov/], identifier [UMIN 000028698].

<title>Abstract</title><sec> <title>Objective</title> Psychological problems associated with isolation and mistrust are common among young adults with autism spectrum disorder (ASD). Schema therapy (ST) has recently been shown to be effective against chronic personality problems of various mental disorders, including personality disorders. This pilot clinical trial aimed to explore the feasibility and acceptability of ST in young adults with high-functioning ASD. </sec><sec> <title>Results</title> Following the intervention, a significant reduction in early maladaptive schemas and improvements in quality of life and social adjustment were observed. ST may be feasible and is applicable to young adults with HF-ASD. <italic>Trial registration</italic> UMIN000014535; registered on July 11, 2014 </sec>

本研究の目的は、大学内での新型コロナウイルス感染拡大防止に有効な学生・教職員健康観察システムを構築し、大学における健康観察の意義と課題を考察することである。アンケートツールであるMicrosoft Formsを活用し、個人は番号化することで匿名化、日々の健康観察ができるシステムを構築した。本学の学生・教職員のうち風邪症状を有する者、海外からの帰国者、感染者との濃厚接触者の健康観察を実施した。2020年3月11日から10月15日までに健康観察を実施した336名(学生199名、教職員137名)を対象に検討を行った。新規健康観察者数が多かったのは、3月下旬から4月上旬の2週間で79名(全健康観察者の23.5%)、9月末からの3週間で49名(全健康観察者の14.6%)であった。学生の入構制限解除前後で、風邪症状を有する学生の健康観察者数が週平均3.8名から9.3名と増加した。健康観察者の症状発現日から報告日までの日数は平均3.5日(中央値2日)で、総合安全衛生管理機構に連絡を入れ健康観察が開始されていた。10月15日現在、新型コロナウイルスPCR検査陽性となった者は、検査した39名中1名で大学内でのクラスター発生は見られていない。感染症流行時における学生・教職員の健康観察システムを構築し健康観察を実施することにより、学生・教職員の健康状態を効率良くリアルタイムに把握することができた。また、学生・教職員の感染予防意識を高め、学内の関係部署との連携を通して感染拡大防止に繋がったと考えられる。(著者抄録)

本研究の目的は、大学内での新型コロナウイルス感染拡大防止に有効な学生・教職員健康観察システムを構築し、大学における健康観察の意義と課題を考察することである。アンケートツールであるMicrosoft Formsを活用し、個人は番号化することで匿名化、日々の健康観察ができるシステムを構築した。本学の学生・教職員のうち風邪症状を有する者、海外からの帰国者、感染者との濃厚接触者の健康観察を実施した。2020年3月11日から10月15日までに健康観察を実施した336名(学生199名、教職員137名)を対象に検討を行った。新規健康観察者数が多かったのは、3月下旬から4月上旬の2週間で79名(全健康観察者の23.5%)、9月末からの3週間で49名(全健康観察者の14.6%)であった。学生の入構制限解除前後で、風邪症状を有する学生の健康観察者数が週平均3.8名から9.3名と増加した。健康観察者の症状発現日から報告日までの日数は平均3.5日(中央値2日)で、総合安全衛生管理機構に連絡を入れ健康観察が開始されていた。10月15日現在、新型コロナウイルスPCR検査陽性となった者は、検査した39名中1名で大学内でのクラスター発生は見られていない。感染症流行時における学生・教職員の健康観察システムを構築し健康観察を実施することにより、学生・教職員の健康状態を効率良くリアルタイムに把握することができた。また、学生・教職員の感染予防意識を高め、学内の関係部署との連携を通して感染拡大防止に繋がったと考えられる。(著者抄録)

OBJECTIVE: This study aimed to validate the Sick, Control, One stone, Fat, and Food (SCOFF) questionnaire in relation to the Eating Disorders Examination Questionnaire (EDE-Q) and to examine the appropriateness of a question concerning weight loss among Japanese university students. The psychometric properties of the two Japanese versions were determined among 649 Japanese college students. The original version (SCOFF-O) employed the original item 3, whereas the revised version (SCOFF-2.5) modified the item to "Have you recently lost more than 2.5 kg within three months?" Validity was tested relative to EDE-Q. RESULTS: The test-retest reliabilities of SCOFF-O and SCOFF-2.5 were 0.52 and 0.57, while the correlations of SCOFF-O and SCOFF-2.5 with EDE-Q were r = 0.53 and r = 0.56. The sensitivity and specificity of SCOFF-O were 65.2 and 89.7, and those of SCOFF-2.5 were 69.5 and 86.5, respectively. There were significant correlations between the question concerning losing 2.5 kg and the EDE-Q subscales. The Japanese version of SCOFF-2.5 is an appropriate tool for the early screening of eating disorders among Japanese university students.

本学のメンタルヘルス相談室に2020年7月〜10月に来室した学生のうち、精神障害の診断で継続的なカウンセリングが必要となった20名(障害あり群)と、精神障害の診断基準を満たさず1回のカウンセリングで改善した12名(障害なし群)を対象とし、各種尺度を用いて群間比較を行った。尺度は、「FCV-19S」(新型コロナウイルス感染症に対する恐怖尺度)、「BDI-II」(抑うつ症状の有無と程度の評価尺度)、「YBOCS」(強迫観念と強迫行為の重症度の評価尺度)、「AQ」(自閉症傾向の評価尺度)、「SASS」(社会適応能力の評価尺度)、「SCOFF」(摂食障害スクリーニング)、「大学生活の変化により生じている支障の評価尺度」を用いた。障害あり群はなし群に比べて、AQ下位尺度の「コミュニケーション」とSASS下位尺度の「対人関係」が有意に不良であり、また「メディア授業により生じた支障」の程度が有意に高かった。

In clinical settings, autism spectrum disorder (ASD) with comorbid depression is often difficult to diagnose, and should be considered in treatment. However, to our knowledge, no functional imaging study has examined the difference between ASD adolescents with and without comorbid depression. We aimed to compare the characteristics and prefrontal brain function of ASD with and without depression in order to identify a biological marker that can be used to detect the difference. Twenty-eight drug-naïve adolescents with ASD (14 ASD with and 14 ASD without depression) and 14 age- and gender-matched adolescents with typical development were evaluated using several variables. These included intelligence quotient, autism quotient, depression severity using the Beck Depression Inventory 2nd edition (BDI-II), and level of social functioning using the Social Adaptation Self-evaluation Scale (SASS). In addition, frontotemporal hemodynamic responses during a verbal fluency task (VFT) were measured using functional near-infrared spectroscopy (fNIRS). The ASD group, including both of the ASD with and ASD without depression groups, showed smaller hemodynamic responses than the typical development group in portions of the left dorsolateral prefrontal cortex (DLPFC), bilateral ventrolateral prefrontal cortex (VLPFC) and anterior part of the temporal cortex (aTC) during the VFT. Moreover, the smaller hemodynamic responses in the right VLPFC during the VFT in the ASD group were associated with the worse BDI-II and SASS scores. Furthermore, the ASD with depression group showed smaller hemodynamic responses in the right VLPFC during the VFT than the ASD without depression group in a direct comparison. Adolescents with ASD showed reduced activation in broad frontotemporal regions during a cognitive task compared with those with typical development. More specifically, the right VLPFC activation reflected the level of self-estimated depression and social functioning in the ASD subjects, and could be used to discriminate between ASD adolescents with and without depression.

Purpose: In clinical settings, diagnosing comorbid depression in individuals with autism spectrum disorder (ASD) is often difficult. Neuroimaging studies have reported reduced activation of frontal and temporal regions during emotional face recognition task (EFRT) in ASD and depression. However, to the best of our knowledge, no study has examined differences in frontotemporal activation during EFRT between ASD with and without comorbid depression. We aimed to compare the frontotemporal hemodynamic responses to the EFRT in ASD with and without depression and to find clues to help in discriminating the characteristics between them. Patients and Methods: In 24 drug-naïve young adults with ASD (12 with depression [ASD-Dep(+)] and 12 without depression [ASD-Dep(-)]) and 12 with typical development (TD), frontotemporal hemodynamic responses during an EFRT were measured using functional near-infrared spectroscopy (fNIRS). Results: The ASD groups showed reduced activation during EFRT than the TD group in the right ventrolateral prefrontal cortex (VLPFC). Moreover, the ASD-Dep(+) group showed reduced activation during EFRT than the ASD-Dep(-) group in the right anterior temporal cortex (aTC), and reduced activation than the TD group in the left VLPFC. Conclusion: The observed results might reflect reduced regional activation in ASD and ASD with comorbid depression.

It is a serious problem when people with mental disorders avoid, delay, discontinue, or do not use treatment and support, despite the existence of evidence-based treatment and support methods. In this study, we aimed to clarify the factor structure of BACE v3, a scale to measure barriers to accessing mental health care, and to examine its reliability and validity among Japanese people with mental disorders. An online survey with 268 participants, 20 years old and over, who had received care from mental health services in the past 12 months was conducted. Exploratory and confirmatory factor analysis (EFA and CFA) were used to examine the structure of the BACE v3. Internal consistency and test-retest reliability of all subscales were examined. Convergent validity [correlation of one of the subscales of the BACE v3, the treatment stigma subscale with the Stigma Scale for Receiving Psychological Help (SSRPH) and with the Internalized Stigma of Mental Illness Scale (ISMI)] was assessed. EFA identified two factors (treatment stigma and non-stigma), and the results suggested that the factor structure of the Japanese version of BACE v3 was similar to the original 2-factor structure. Regarding the CFA result, the goodness-of-fit indices showed marginal fit (root mean square error of approximation = 0.087; Tucker-Lewis index = 0.842; standardized root mean square residual = 0.078; comparative fit index = 0.86). The internal consistency of the treatment stigma subscale was α = 0.90, and the intraclass correlation coefficient was 0.76 (confidence interval: 0.70-0.81). The internal consistency of the non-stigma subscale was α = 0.83, and the intraclass correlation coefficient was 0.64 (confidence interval: 0.56-0.71). The score of the treatment stigma subscale was significantly and positively correlated with the SSRPH and ISMI. Thus, the BACE v3 has acceptable consistency, reliability and validity for the assessment of barriers to accessing mental health care including treatment stigma among people with mental disorders in Japan.

<title>Abstract</title> <sec> <title>Background</title> One aim of an autism spectrum disorder (ASD) diagnosis is to obtain special support for the disorder, though this does not guarantee practical support. We developed a psychoeducational program using cognitive-behavioral therapy (CBT) and Aware and Care for my Autistic Traits (ACAT) for Japanese adolescents with high-functioning ASD and their parents. </sec> <sec> <title>Methods</title> This multisite study is a randomized controlled trial. In total, 24 participants will be assigned to the ACAT group and 24 to the treatment-as-usual (TAU) group. The ACAT group will receive a weekly 100-min session for 6 weeks, regular medical care, and one follow-up session. In this ongoing clinical trial, we will compare the scores of the measures recorded in the pre- and post-intervention stages between the ACAT and TAU groups. A total of 41 patients out of a target of 48 have participated in the trial to date. The primary outcome measure is the Autism Knowledge Questionnaire. Secondary outcome measures include Barriers to Access to Care Evaluation 3rd Edition, the Strengths and Difficulties Questionnaire, the Vineland Adaptive Behavior Scales second edition, the Parenting Resilience Elements Questionnaire, the General Health Questionnaire 12, and the Depression Self-Rating Scale for Children assessments, as well as an electroencephalographic recording. </sec> <sec> <title>Discussion</title> It is expected that participants in the ACAT group will significantly increase their self-understanding and awareness of ASD symptoms compared to those in the TAU group. Additionally, the ACAT group is expected to exhibit improved social adaptation and mental health if children and parents are able to better understand the ASD characteristics through sessions. This intervention will contribute to the establishment of an effective evidence-based treatment strategy for adolescents with ASD. </sec> <sec> <title>Trial registration</title> UMIN Register <ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://upload.umin.ac.jp/cgi-open-bin/icdr/ctr_view.cgi?recptno=R000034036">000029851</ext-link>. Registered on January 06, 2018 </sec>

近年、ウイルス性肝炎が減少している一方で、飲酒や肥満といった生活習慣を背景とした肝障害(非アルコール性脂肪性肝疾患など)が増加しており、健診ではBMI正常で肥満ではないがALT(Alanine transaminase)が高い症例をしばしば経験する。このことに関して、非肥満者におけるALT高値には体重増加(20歳時と比べた増加)が影響を与えるという仮説を立て、検証を行った。方法は、40歳以上の本学職員の健診データを用い、ALT>30に影響する因子について二項ロジスティック回帰分析により解析するとともに、BMI高値に影響する因子、体重増加(20歳時と比べて10kg以上の増加)に影響する因子について同様の解析を行った。また、BMI 30以上の学生のデータと比較検討した。その結果、20歳時と比べて10kg以上の体重増加はALT高値に影響する独立した因子であることが示された。

全国大学保健管理協会関東甲信越地方部会保健看護分科会千葉支部が実施している勉強会(千葉支部会)の1997年から2018年までの会議録と、千葉支部会作成の20周年記念CD-ROM(情報交換データ集)をもとに、千葉支部会の参加校数や開催内容について分析した。また、千葉支部メーリングリスト登録アドレス(27大学45名)宛に質問紙をメールで送信し、「大学規模(学生数)」「保健管理担当看護職の雇用形態」「千葉支部会の参加理由」などについて回答を求めた。結果、千葉支部会の参加校数は、1998年が県内40校中11校(28%)、2018年が県内47校中17校(36%)、22年間の平均参加校数は14.8校であり、7校は一度も参加していなかった。開催内容は「講演」と「情報交換」が主であった。メールによる調査には26名から回答が得られ、雇用形態は常勤17名(65%)、非常勤・パート8名(31%)、その他1名であった。千葉支部会の参加理由(複数回答)は「情報交換できる」90%、「他者と顔見知りになれる」85%、「疑問や問題が解決できる」80%などであった。

本学では平成28年から、学生健診で行うWeb問診の中にメンタルの問題に関する項目を導入した。今回、精神的な問題が学生生活にもたらす影響を明らかにするため、Web問診の結果をもとに、精神障害の有無と「学業」「社会生活」「家族内のコミュニケーションや役割」「社会適応」との関係について検討した。方法は、Web問診で精神症状があると回答した者、または精神的な問題のために「学業」「社会生活」「家族内のコミュニケーションや役割」のいずれかで中等度以上の支障をきたしていると回答した者を対象とし、M.I.N.I.精神疾患簡易構造化面接法(MINI)を一部改編して作成した自記式質問票と、SCOFF、AQ10、SDISS、SASSからなるWeb問診を行った。MINIを改編した質問票では鬱病エピソード・躁病エピソード・全般性不安障害・パニック障害・社交不安障害・PTSD・強迫性障害・統合失調症、SCOFFでは摂食障害、AQ10では自閉症スペクトラム障害の評価を行い、各々診断基準を満たす回答をした者について、SDISSの「学業」「社会生活」「家族内のコミュニケーションや役割」とSASS(社会適応)のスコアを集計した。その結果、鬱病エピソード、社交不安障害、パニック障害の診断基準を満たした群では「学業」「社会生活」「家族内のコミュニケーションや役割」とも支障をきたしている程度が高く、社会適応も悪かった。

自閉症スペクトラム症に対する認知行動療法(CBT)の効果予測指標についての予備的研究として、ASDである大学生17名(男性10名、女性7名)と定型発達者17名(男性10名、女性7名)を対象に、CBTや通常の治療(TAU)による脳機能の変化として、流暢性課題(VFT)施行中の脳活動を近赤外分光法により測定するとともに、状態評価として、全体的評定尺度(GAF)、社会的適応自己評価尺度などを用いた測定を行った。その結果、ASD群と定型発達群の比較では、ASD群では全体的な機能や社会適応が低下して支障をきたしており、認知機能の柔軟性を評価するVFT施行時にみられる脳活動が小さかった。また、ASDの学生でみられるVFT施行時の脳活動の大きさと、CBTとTAUの併用によりもたらされるGAFスコアの改善の間には正の相関がみられたことから、VFT施行時の脳活動の大きさが、TAUに加えてCBTを行うことによりもたらされる治療効果の予測指標となる可能性が示唆された。

Although smaller gray matter volumes (GMV) in the prefrontal cortex (PFC) in schizophrenia and bipolar disorder have been reported cross-sectionally, there are, to our knowledge, no reports of longitudinal comparisons using manually drawn, gyrally based ROI, and their associations with symptoms. The object of this study was to determine whether first-episode schizophrenia (FESZ) and first-episode affective psychosis (FEAFF) patients show initial and progressive PFC GMV reduction in bilateral frontal pole, superior frontal gyrus (SFG), middle frontal gyrus (MFG), and inferior frontal gyrus (IFG) and examine their symptom associations. Twenty-one FESZ, 24 FEAFF and 23 healthy control subjects (HC) underwent 1.5T MRI with follow-up imaging on the same scanner ~ 1.5 years later. Groups were strikingly different in progressive GMV loss. FESZ showed significant progressive GMV loss in the left SFG, bilateral MFG, and bilateral IFG. In addition, left MFG and/or IFG GMV loss was associated with worsening of withdrawal–retardation and total BPRS symptoms scores. In contrast, FEAFF showed no significant difference in GMV compared with HC, either cross-sectionally or longitudinally. Of note, FreeSurfer run on the same images showed no significant changes longitudinally.

We combined diffusion tension imaging (DTI) of prefrontal white matter integrity and neuropsychological measures to examine the functional neuroanatomy of human intelligence. Healthy participants completed the Wechsler Adult Intelligence Scale-Third Edition (WAIS-III) along with neuropsychological tests of attention and executive control, as measured by Trail Making Test (TMT) and Wisconsin Card Sorting Test (WCST). Stochastic tractography, considered the most effective DTI method, quantified white matter integrity of the medial orbital frontal cortex (mOFC) and rostral anterior cingulate cortex (rACC) circuitry. Based on prior studies, we hypothesized that posterior mOFC-rACC connections may play a key structural role linking attentional control processes and intelligence. Behavioral results provided strong support for this hypothesis, specifically linking attentional control processes, measured by Trails B and WCST perseverative errors, to intelligent quotient (IQ). Hierarchical regression results indicated left posterior mOFC-rACC fractional anisotropy (FA) and Trails B performance time, but not WCST perseverative errors, each contributed significantly to IQ, accounting for approximately 33.95-51.60% of the variance in IQ scores. These findings suggested that left posterior mOFC-rACC white matter connections may play a key role in supporting the relationship of executive functions of attentional control and general intelligence in healthy cognition. (C) 2016 Published by Elsevier Ltd on behalf of IBRO.

Background: The lowering of the age of onset and chronicity have been key problems related to eating disorders (EDs). As the proportion of teens in the estimated onset ages has increased, it has become important to detect students with EDs and to clarify how they can be supported. Though epidemiological surveys of Yogo teachers (school nurse/health science teachers) have been conducted to inquire about the number of such students, none of these were done according to ED type based on DSM-5. Thus, we conducted a wide area survey in Japan with the goal of proposing a better framework of support for Yogo teachers in their efforts to care for students with EDs. Methods: A questionnaire survey organized by ED type (based on DSM-5) was administered to Yogo teachers working at elementary/junior high/senior high/special needs schools in four prefectures of Japan in 2015, and 1,886 responses were obtained. Based on the results, the encounter rates (the proportion of Yogo teachers who had encountered a student with an ED) were calculated, and factors that could affect the rates were examined by logistic regression analysis. Results: The order of the encounter rates of the ED types was as follows: Anorexia Nervosa (AN) &gt; Bulimia Nervosa (BN) &gt; Avoidant/Restrictive Food Intake Disorder (ARFID) &gt; Binge Eating Disorder (BED) &gt; Others. The factors significantly affecting the rates were "location, school type, number of students, experience years, and AN knowledge" for AN, "school type, experience years, and BN knowledge" for BN, "school type, experience years, and BED knowledge" for BED, "location, experience years, and ARFID knowledge" for ARFID, and "school type, experience years, and Others knowledge" for Others. Conclusions: Because the encounter rate of AN was the highest, providing support for AN would be the most effective. Moreover, one factor that affected the encounter rate of all ED types was ED knowledge. In addition to this, senior high schools had the highest encounter rates for AN, BN and BED, and special needs schools had the highest rates for Others. These findings imply that, in order to detect and support ED students at an early stage, it is necessary to offer knowledge of the most prevalent ED types to Yogo teachers at the corresponding school type.

Background: Many studies have focused on the decreasing age of onset of eating disorders (EDs). Because school-age children with EDs are likely to suffer worse physical effects than adults, early detection and appropriate support are important. The cooperation of Yogo teachers is essential in helping these students to find appropriate care. To assist Yogo teachers, it is helpful to clarify the encounter rates (the proportion of Yogo teachers who have encountered ED students) and kinds of requested support (which Yogo teachers felt necessary to support ED students). There are no studies that have surveyed the prevalence rates of ED children by ED type as defined by the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), nor were we able to find any quantitative study surveying the kinds of support Yogo teachers feel helpful to support ED students. Methods: A questionnaire survey was administered to 655 Yogo teachers working at elementary/junior high/senior high/special needs schools in Chiba Prefecture. The questionnaire asked if the respondents had encountered students with each of the ED types described in DSM-5 (anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), avoidant/restrictive food intake disorder (ARFID), and other types of EDs (Others)), and the kinds of support they felt necessary to support these students. The encounter rates and the kinds of requested were obtained and compared, taking their confidence intervals into consideration. Results: The encounter rates for AN, BN, BED, ARFID, and Others were 48.4, 14.0, 8.4, 10.7, and 4.6 %, respectively. When classified by school type, AN, BN, BED, and ARFID had their highest encounter rates in senior high schools. Special needs schools had the highest rate for Others. The support most required for all ED types was "a list of medical/consultation institutions." Conclusions: Our results have clarified how to support Yogo teachers in the early detection and support of ED students. We found that the encounter rate of AN was the highest, and that it is effective to offer " a list of medical/consultation institutions" to junior and senior high schools where the encounter rates for AN are high.

Methamphetamine abuse and dependence, frequently accompanied by schizophrenia-like psychotic symptoms [methamphetamine-associated psychosis (MAP)], is a serious public health problem worldwide. Few studies, however, have characterized brain dysfunction associated with MAP, nor investigated similarities and differences in brain dysfunction between MAP and schizophrenia. We compared prefrontal cortical activity associated with stop-signal inhibitory task in 21 patients with MAP, 14 patients with schizophrenia and 21 age- and gender-matched healthy controls using a 52-channel near-infrared spectroscopy (NIRS) system. Both the MAP and the schizophrenia groups showed significantly reduced activation in the bilateral ventrolateral prefrontal cortex compared with controls; however, only the MAP group showed reduced activation in the frontopolar prefrontal cortex. The MAP group demonstrated significant positive correlations between task performance and hemodynamic responses in the bilateral ventrolateral, polar and left dorsolateral regions of the prefrontal cortex. The MAP and schizophrenia groups demonstrated a significant difference in the relationship of impulsivity to hemodynamic changes in the bilateral premotor cortex. These findings characterize similarities and differences in prefrontal cortical dysfunction between psychosis associated with methamphetamine and schizophrenia. The reduced hemodynamic changes in the bilateral ventrolateral prefrontal cortex suggest a common underlying pathophysiology of MAP and schizophrenia, whereas those in the frontopolar prefrontal cortex point to an impaired state that is either inherent or caused specifically by methamphetamine use.

We examined intelligence and memory in 25 healthy participants who had both prior magnetic resonance imaging (MRI) of gray matter volumes of medial orbital frontal cortex (mOFC) and rostral anterior cingulate cortex (rACC), along with diffusion tensor imaging (DTI) of posterior and anterior mOFC-rACC white matter microstructure, as assessed by fractional anisotropy (FA). Results showed distinct relationships between these basic structural brain parameters and higher cognition, highlighted by a highly significant correlation of left rACC gray matter volume with memory, and to a lesser extent, though still statistically significant, correlation of left posterior mOFC-rACC FA with intelligence. Regression analyses showed that left posterior mOFC-rACC connections and left rACC gray matter volume each contributed to intelligence, with left posterior mOFC-rACC FA uniquely accounting for between 20.43 and 24.99 % of the variance in intelligence, in comparison to 13.54 to 17.98 % uniquely explained by left rACC gray matter volume. For memory, only left rACC gray matter volume explained neuropsychological performance, uniquely accounting for a remarkably high portion of individual variation, ranging from 73.61 to 79.21 %. These results pointed to differential contributions of white mater microstructure connections and gray matter volumes to individual differences in intelligence and memory, respectively.