Antenatal and postpartum depression in women who conceived after infertility treatment: a longitudinal study.

BACKGROUND: Although the association between a history of infertility treatment and perinatal depression has been investigated, most research has been cross-sectional and has not used diagnostic assessment tools. AIMS: This study investigates longitudinally the association between a history of infertility treatment and perinatal depression using WHO-Composite International Diagnostic Interview 3.0 (WHO-CIDI 3.0) and the Edinburgh Postnatal Depression Scale (EPDS). METHODS: This study used data (N = 2,435) from the control group of a randomised controlled trial on a sample of pregnant women. Survival analysis was used to examine the influence of infertility treatment on perinatal depressive disorder evaluated by WHO-CIDI 3.0. The EPDS scores at four time points (T1 [baseline]: 14 ± 2 weeks gestation, T2: 32 weeks gestation, T3: 1 week postpartum, T4: 3 months postpartum) were analysed using generalised mixed model analysis. RESULTS: The risk of experiencing a major depressive episode evaluated by WHO-CIDI 3.0 did not significantly differ between women conceiving through infertility treatment and those conceiving spontaneously (adjusted hazard ratio = 1.64, p = 0.109). The longitudinal analysis demonstrated that EPDS scores significantly increased at T3 and T4 among women conceiving through infertility treatment compared with those conceiving spontaneously (adjusted estimates of fixed effect from T1 to T3: 1.17, p < 0.01; from T1 to T4: 0.71, p = 0.022). CONCLUSION: Women conceiving through infertility treatment were not found to have a higher risk of diagnosable perinatal depressive disorder than those conceiving naturally. However, a history of infertility treatment can marginally increase sub-clinical postpartum depressive symptoms.

Effects of brief family psychoeducation on family caregiver burden of people with schizophrenia provided by psychiatric visiting nurses: a cluster randomised controlled trial.

BACKGROUND: The purpose of this study was to examine the effects of a brief family psychoeducation (BFP) programme provided by psychiatric visiting nurses on caregiver burden of family caregivers of people with schizophrenia through a cluster randomised controlled trial (cRCT). METHODS: The study was a two-arm, parallel-group cRCT. Forty-seven psychiatric visiting nurse agencies were randomly allocated to the BFP programme group (intervention group) or treatment as usual group (TAU; control group). Caregivers of people with schizophrenia were recruited by psychiatric visiting nurses using a randomly ordered list. The primary outcome was caregiver burden, measured using the Japanese version of the Zarit Burden Interview. Outcome assessments were conducted at baseline, 1-month follow-up, and 6-month follow-up. Intention-to-treat analysis was conducted to examine the effects of the BFP programme on caregiver burden. RESULTS: Thirty-four psychiatric visiting nurse agencies and 83 family caregivers of people with schizophrenia participated in the study. The participant attrition rate was less than 20%. Adherence to the program was 100%. Compared with TAU group, the BFP programme group had decreased caregiver burden. However, this improvement was not significant at 1-month follow-up (adjusted mean difference [aMD] = 0.27, 95% CI = - 5.48 to 6.03, p = 0.93, d = 0.01) or 6-month follow-up (aMD = - 2.12, 95% CI = - 7.80 to 3.56, p = 0.45, d = 0.11). CONCLUSIONS: The BFP programme provided by psychiatric visiting nurses did not achieve significant decreases in caregiver burden. This result may be attributed to the difficulty in continuing the research due to the COVID-19 pandemic, which prevented us from achieving the targeted sample size necessary to meet the statistical power requirements, as well as to the participation of caregivers with relatively low burden. However, the program had the advantage of high adherence to treatment plan. Further studies should be conducted with a larger sample size and a more diverse sample that includes caregivers with a higher care burden. TRIAL REGISTRATION: The study protocol was registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN000038044) on 2019/09/18.

Effects of the Mental Health Supporter Training Program on mental health-related public stigma among Japanese people: A pretest/posttest study.

Aim: The Mental Health Supporter Training Program is a national project conducted in Japan. This study aimed to determine the effects on mental health-related stigma, mental health literacy, and knowledge about mental health difficulties and support techniques among program participants. Methods: The target population was local residents of a wide range of generations in Japan. Outcomes were assessed at baseline (T1), immediately postintervention (T2), and at the 6-month follow-up (T3). A mixed model for repeated-measures conditional growth model analyses were employed to examine the effects of the intervention over time (T1, T2, T3). We also calculated effect sizes using Cohen's d. Results: The program had a significantly favorable pooled effect on the Japanese version of the Reported and Intended Behaviour Scale score after adjusting for covariates (reported behavior [t = 3.20, p = 0.001]; intended behavior [t = 8.04, p < 0.001]). However, when compared at each time point, only intended behavior from T1 to T2 showed a significant difference (t = 8.37, p < 0.001). Significant pooled effects were found for mental health literacy (knowledge: t = 19.85, p < 0.001; attitude: t = 15.02, p < 0.001), knowledge of mental health (t = 28.04, p < 0.001), and psychological distress (t = -2.41, p = 0.016). Conclusion: The results suggest that the program might be effective for improving intended, but not reported, behavior in the short term and for improving mental health literacy, knowledge of mental health, and psychological distress.

Effects of expanded adverse childhood experiences including school bullying, childhood poverty, and natural disasters on mental health in adulthood.

The study aimed to examine the association of expanded adverse childhood experiences (ACEs) with psychological distress in adulthood. The data from nation-wide online cohort was used for analysis. Community dwelling adults in Japan were included. The ACEs was assessed by 15 items of ACE-J, including childhood poverty and school bullying. Severe psychological distress was determined as the score of Kessler 6 over 13. Multivariable logistic regression analysis was conducted, by using sample weighting. A total of 28,617 participants were analyzed. About 75% of Japanese people had one or more ACEs. The prevalence of those with ACEs over 4 was 14.7%. Those with ACEs over 4 showed adjusted odds ratio = 8.18 [95% CI 7.14-9.38] for severe psychological distress. The prevalence of childhood poverty was 29% for 50-64 year old participants and 40% of 65 or older participants. The impact of childhood poverty on psychological distress was less than other ACEs in these age cohorts. Bullying was experienced 21-27% in young generations, but 10% in 65 or older participants. However, the impact on psychological distress in adulthood was relatively high in all age groups. ACEs have impacted mental health for a long time. Future research and practice to reduce ACEs are encouraged.

Inequality on the frontline: A multi-country study on gender differences in mental health among healthcare workers during the COVID-19 pandemic.

Healthcare workers (HCWs) were at increased risk for mental health problems during the COVID-19 pandemic, with prior data suggesting women may be particularly vulnerable. Our global mental health study aimed to examine factors associated with gender differences in psychological distress and depressive symptoms among HCWs during COVID-19. Across 22 countries in South America, Europe, Asia and Africa, 32,410 HCWs participated in the COVID-19 HEalth caRe wOrkErS (HEROES) study between March 2020 and February 2021. They completed the General Health Questionnaire-12, the Patient Health Questionnaire-9 and questions about pandemic-relevant exposures. Consistently across countries, women reported elevated mental health problems compared to men. Women also reported increased COVID-19-relevant stressors, including insufficient personal protective equipment and less support from colleagues, while men reported increased contact with COVID-19 patients. At the country level, HCWs in countries with higher gender inequality reported less mental health problems. Higher COVID-19 mortality rates were associated with increased psychological distress merely among women. Our findings suggest that among HCWs, women may have been disproportionately exposed to COVID-19-relevant stressors at the individual and country level. This highlights the importance of considering gender in emergency response efforts to safeguard women's well-being and ensure healthcare system preparedness during future public health crises.

Factors associated with satisfaction and perceived helpfulness of mental healthcare: a World Mental Health Surveys report.

BACKGROUND: Mental health service providers are increasingly interested in patient perspectives. We examined rates and predictors of patient-reported satisfaction and perceived helpfulness in a cross-national general population survey of adults with 12-month DSM-IV disorders who saw a provider for help with their mental health. METHODS: Data were obtained from epidemiological surveys in the World Mental Health Survey Initiative. Respondents were asked about satisfaction with treatments received from up to 11 different types of providers (very satisfied, satisfied, neither satisfied nor dissatisfied, somewhat dissatisfied, very dissatisfied) and helpfulness of the provider (a lot, some, a little, not at all). We modelled predictors of satisfaction and helpfulness using a dataset of patient-provider observations (n = 5,248). RESULTS: Most treatment was provided by general medical providers (37.4%), psychiatrists (18.4%) and psychologists (12.7%). Most patients were satisfied or very satisfied (65.9-87.5%, across provider) and helped a lot or some (64.4-90.3%). Spiritual advisors and healers were most often rated satisfactory and helpful. Social workers in human services settings were rated lowest on both dimensions. Patients also reported comparatively low satisfaction with general medical doctors and psychiatrists/psychologists and found general medical doctors less helpful than other providers. Men and students reported lower levels of satisfaction than women and nonstudents. Respondents with high education reported higher satisfaction and helpfulness than those with lower education. Type of mental disorder was unrelated to satisfaction but in some cases (depression, bipolar spectrum disorder, social phobia) was associated with low perceived helpfulness. Insurance was unrelated to either satisfaction or perceived helpfulness but in some cases was associated with elevated perceived helpfulness for a given level of satisfaction. CONCLUSIONS: Satisfaction with and perceived helpfulness of treatment varied as a function of type of provider, service setting, mental status, and socio-demographic variables. Invariably, caution is needed in combining data from multiple countries where there are cultural and service delivery variations. Even so, our findings underscore the utility of patient perspectives in treatment evaluation and may also be relevant in efforts to match patients to treatments.

Association between discrimination and subsequent psychotic experiences in patients with COVID-19: A cohort study.

Although cross-sectional studies have suggested that discrimination has a negative impact on the mental health of patients with COVID-19, no cohort studies with longitudinal data have established a causal relationship. Therefore, this study aimed to investigate the association between COVID-19-related discrimination and subsequent psychotic experiences in individuals who had contracted the disease. Secondary outcomes were PTSD symptoms, psychological distress, and suicidal ideation. We utilized inverse probability weighting and marginal structural models with robust standard errors to analyze the association, accounting for confounders and loss to follow-up. In a sensitivity analysis, we evaluated the robustness of the estimates to potential unmeasured confounding by analyzing E-values. Of 7760 participants who had contracted COVID-19, 5971 were included after excluding those with missing sociodemographic data. Of these, 1736 (29.1 %) reported experiencing COVID-19-related discrimination. Of the 2559 participants who completed the study, 253 (9.9 %) reported having at least one psychotic experience. Participants who reported experiencing any COVID-19-related discrimination showed a higher risk of subsequent psychotic experiences compared with participants without such discrimination (risk difference 6.6 %, 95 % CI 4.0 %-9.9 %; risk ratio 1.82, 95 % CI 1.42-2.47). A negative impact was also found in suicidal ideation, PTSD symptoms, and psychological distress. E-values demonstrated the robustness of some of the observed associations to unmeasured confounding. The study found that COVID-19-related discrimination was associated with subsequent psychotic experiences and other mental health outcomes in individuals who had contracted the disease. A study focusing on prevention strategies, such as an anti-discrimination campaign, is warranted.

Development and validation of the Japanese version of the Bedtime Procrastination Scale (BPS-J).

BACKGROUND: The average sleep duration of Japanese people is shorter than that of people from other countries, and bedtime procrastination is suspected to be one of the factors contributing to this issue. This study aimed to develop and validate the Japanese version of the Bedtime Procrastination Scale (BPS-J). METHODS: The BPS-J was developed through procedures including the translation and back-translation of the scale, cognitive interviews with 100 participants who reported having experiences of being diagnosed with insufficient sleep syndrome (ISS) or receiving treatment for ISS using open-ended online questionnaires, and expert checking. To investigate the scale's validity and reliability, an online survey was conducted with daytime workers aged 20 - 65 years without a history of sleep disorders other than ISS. Half the participants were retested using the same survey after 14 days. Participants' responses to the Brief Self-Control Scale (BSCS), General Procrastination Scale (GPS), and Munich ChronoType Questionnaire (MCTQ), and data on sleep-related variables such as sleep duration on workdays and the days per week of fatigue or sleep loss, sex, and age, were collected. RESULTS: We analyzed data from 574 participants to assess scale validity. We then analyzed data from 280 participants to determine test-retest reliability. Confirmatory factor analyses revealed that the two-factor model without Item 2 was most suitable for the BPS-J, unlike other language versions. Regardless of the full-item model or the model with Item 2 eliminated, sufficient reliability and significant correlations with the BSCS, GPS, MCTQ, and sleep-related variables such as sleep duration per night on work days, days per week of feeling fatigued, and days per week of sleep loss were observed. Logistic and linear regressions showed that the relationships between the BPS-J, sleep-related variables, and MCTQ were maintained after adjusting for sex and age. CONCLUSION: The BPS-J had sufficient validity and reliability. Further, eliminating Item 2 from the original version of the BPS strengthened the ability to survey Japanese daytime workers.

Age of victimization and moderating role of social support for the relationship between school-age bullying and life satisfaction in middle-age.

AIMS: This study aimed to examine whether the moderating role of social support on the negative association between school-age bullying victimization and life satisfaction in middle-age was different by age of victimization. METHODS: A longitudinal study was conducted using data collected at the ages of 7, 11 and 50 years in the 1958 British birth cohort (N = 18,558). Frequency of bullying victimization (never, sometimes, or frequently) was assessed by parental interviews at ages seven and 11. A self-reported questionnaire assessed life satisfaction and perceived social support (instrumental and emotional) at age 50. To determine the moderating effect of social support on the association between bullying victimization and life satisfaction, hierarchical multiple linear regression analyses were conducted in which two interaction terms, victimization at age seven by social support and victimization at age 11 by social support, were simultaneously entered into the models. RESULTS: Among 5304 respondents subjected to the statistical analysis, 34% had bullying victimization at age 7 years; 23% had bullying victimization at age 11 years. Instrumental support significantly buffered the effect of frequent victimization at age 11 (ß = 0.03, p = 0.03) and significantly deteriorated the effect of frequent victimization at age 7 years (ß = -0.04, p = 0.01), after adjusting for childhood confounders. No significant moderating effect was observed for emotional support. CONCLUSIONS: Instrumental support in middle-age may more effectively buffer the effect of late school-age victimization than of early school-age victimization, while both effect sizes were small and additional research is needed.

Successful Termination of Insulin Therapy in Transient Neonatal Diabetes Mellitus.

A sensor-augmented pump (SAP) therapy is used to treat neonatal diabetes mellitus (NDM). We treated a case for which SAP therapy was successful and prevented hypoglycemia. The patient was a baby boy who was small for his gestational age. He had hyperglycemia at 4 days of age, and a diagnosis of NDM had previously been made at another hospital. A continuous intravenous insulin infusion was initiated. At 29 days of age, the patient was transferred to our hospital for further treatment. SAP therapy was initiated at 39 days, which was successful and prevented hypoglycemia. Gradually, blood glucose levels improved. The insulin infusion was stopped to determine if any potential pump issues arose prior to discharge; the patient's blood glucose level did not increase. The decision was therefore made to discharge the patient from the hospital at 58 days of age with discontinued insulin. After discharge, genetic analysis showed hypomethylation on one of the alleles within 6q24, leading to a diagnosis of 6q24-related diabetes mellitus. Although almost all 6q24-related NDM cases are transient, no evidence exists for the appropriate timing of insulin discontinuation. Retrospective continuous glucose monitoring (CGM) analysis showed improved standard deviation (SD) values as well as improved blood glucose variability. This experience suggested SD values of CGM may be used as an index for tapering and discontinuing insulin in SAP therapy. However, future collaborative studies at other centers that focus on SD values as a guide for insulin discontinuation in SAP are required.

Mental Health Reform Processes and Service Delivery Shift From the Hospital to the Community in Belgium and Hong Kong.

Aim: We aimed to illustrate and compare the processes of mental health policies aiming at a service delivery shift from the hospital to the community using implementation science, and to identify important implementation strategies. Methods: This study had a comparative case study design. The cases were the Belgian mental health reform, and the person-centered model of mental health in Hong Kong, China. Several documentary sources were reviewed, including the published literature and websites. Data on policy processes were extracted, analyzed using directed content analysis, and categorized into constructs of the conceptual model for evidence-informed policy formulation and implementation arranged for the mental health policy. Results: Several similarities were identified in the strategies for active implementation and dissemination; official staff allocation, and training to the community psychiatric services, an approach to adjust the number of psychiatric hospital beds, and promoting collaboration between health care sectors and social welfare sectors. Under distinct social contexts, differences were found in all processes. Conclusions: Each of the described policy processes can serve as a model for countries in similar social contexts seeking to shift their psychiatric service delivery. Furthermore, our findings suggest widely applicable implementation strategies for policies aiming at a service delivery shift.

Association between adverse childhood experience and unintended pregnancy among Japanese women: a large-scale cross-sectional study.

Unintended pregnancy (UP) can negatively impact the health of mothers, children, and families. While Adverse Childhood Experiences (ACEs) are increasingly known to affect sexual health, the influence on pregnancy intention is not fully understood. This study examines the relationship between ACEs and UP and explores other related factors, using 5049 pregnant and postpartum women data from the Japan COVID-19 and Society Internet Survey (JACSIS). We measured participants' pregnancy intentions, ACEs, family functioning, and social network size. Logistic regression analysis provided odds ratios and 95% confidence intervals (CI). The prevalence of UP was approximately 16.5% (n = 893). Cumulative ACEs were consistently associated with UP, even after adjusting for intermediate variables in adulthood. The odds ratio for UP with a single ACE was 1.00 (CI: 0.82-1.21) but rose significantly with multiple ACEs: 1.39 (CI: 1.10-1.76) with double, 1.38 (CI: 1.02-2.86) with triple, and 1.81 (CI: 1.37-2.39) with more. Additionally, bad family functioning and lack of social networks emerged as contributors to UP. In conclusion, this study showed that ACEs are potentially correlated with UP. A deeper understanding of the transition from childhood experiences to UP is important for health interventions, necessitating further investigation.

Euthymia scale as a protective factor for depressive symptoms: a one-year follow-up longitudinal study.

OBJECTIVES: This study aimed to examine whether a high score on the euthymia scale (ES) predicts a low incidence of depressive symptoms one year later. METHODS: The baseline online survey was conducted in February 2020, and a follow-up survey was done in February 2021. Japanese over 20 years old were enrolled. Respondents who answered both baseline and follow-up, and without depressive symptoms at baseline were included in the analysis. The euthymia scores at baseline was measured by the 10 items of the Japanese version of the ES. Depressive symptoms at follow-up were determined if participants showed either depressive feelings or anhedonia. The odds ratio (OR) was calculated using multivariate logistic regression analysis, adjusting for age, gender, marital status, educational attainment, and clinical visit for depressive episode before the baseline survey. RESULTS: The total of 624 participants were analyzed. A total of n = 63 (10.1%) presented depressive symptom at follow-up. A high ES score significantly predicted a lower incidence of depressive symptoms, after adjusting for covariates (aOR = 0.81 [95% confidence interval: 0.72-0.89]). Using the cutoff score retrieved from this data, a high ES score (7 or more) showed the same tendency, compared to a low ES score (< 7) (aOR = 0.46 [0.25-0.83]). CONCLUSIONS: This study suggests the predictive usefulness of euthymia for subsequent depressive symptoms. Further investigation is needed by employing rigid diagnostic criteria.

Reliability and validity of the Japanese version of the Professional Fulfillment Index among healthcare professionals: A validation study.

OBJECTIVES: Translation of the Professional Fulfillment Index (PFI) into Japanese would be more useful than the currently developed scales for appropriately measuring burnout and professional fulfillment in healthcare professionals. This study aimed to develop the Japanese version of the PFI and examine its internal consistency, structural validity, and convergent validity in healthcare professionals. METHODS: Healthcare professionals in Japan were recruited online. The survey was conducted from October to November 2022. Internal consistency was tested using Cronbach's α. Structural validity was tested using confirmatory factor analysis (CFA) and exploratory factor analysis (EFA). Convergent validity was tested using Pearson's correlation coefficients, which were calculated between each score of the PFI scale and burnout (the Japanese Burnout Scale: JBS), depressive symptoms (the Patient Health Questionnaire-9), and QOL (the General Health Questionnaire-12). RESULTS: The Cronbach's alpha was .91 in professional fulfillment, .80 in burnout: work exhaustion, .90 in burnout: interpersonal disengagement, and .89 in burnout: total score. Confirmatory factor analysis demonstrated a modest fit, and EFA yielded a three-factor structure the same as the original PFI. The all three subscales and total score of burnout were significantly correlated with the scores of all the scales (p < .001; e.g., burnout: work exhaustion correlated emotional exhaustion in JBS, r = .71). CONCLUSIONS: The Japanese version of the PFI demonstrated acceptable high internal consistency, structural validity, and convergent validity of the scale with a three-factor structure the same as in the original PFI. The Japanese version of PFI proved to be reliable and valid for use in healthcare professionals.

Risk factors of paternal perinatal depression during the COVID-19 pandemic in Japan.

PURPOSE: The study aims to investigate risk factors of paternal perinatal depression during the COVID-19 pandemic. METHODS: We conducted an online cross-sectional study of 473 prenatal fathers and 1246 postnatal fathers in August 2021. We applied a modified Poisson regression to estimate relative risk ratios of possible factors for paternal perinatal depression (measured by Edinburgh Postnatal Depression Scale), sequentially introducing the following factors into the model: individual factors, interpersonal factors, obstetric/pediatric factors, and service utilization factors. RESULTS: Prenatal fathers with the following risk factors were at an increased risk for having depressive symptoms: adverse childhood experiences (risk ratio; RR 1.61), past depression (RR 1.63), fear of COVID-19 (RR 2.09), lower social support (RR 1.91), low family resources (RR 1.95), and intimate partner violence (IPV) victimization (RR 1.29). Postnatal fathers having the following risk factors were at an increased risk for having depressive symptoms: past depression (RR 1.67), fear of COVID-19 (RR 1.26), low family resources (RR 1.85), IPV victimization. (RR 1.18), and preterm birth (RR 1.18). CONCLUSION: The study showed risk factors such as past history of depression, high fear of COVID-19, low family functionality, and IPV victimization were associated with perinatal depressive symptoms. The findings should contribute to future directions of interventions for paternal perinatal mental health.

Adverse childhood experiences and living in the socially deprived areas in adulthood: a cross-sectional study of the nationwide data in Japan.

OBJECTIVES: This study aimed to examine whether having adverse childhood experiences (ACEs) was associated with living in a deprived area in adulthood. METHODS: The cross-sectional study was conducted by using nation-wide data in 2022 of the Japan COVID-19 and Society Internet Survey (JACSIS). Participants were community dwelling people 18 years or older. ACEs were assessed by Japanese version of 15-items ACE measurement tool (ACE-J). Living condition was measured by Area Deprived Index (ADI) and Densely Inhabited District (DID) based on zip code. Multivariable logistic regression to analyze the associations between ADI and ACE 4 + was conducted, controlling for individual-level factors, such as age, sex, marital status, and education, as an additional analysis. RESULTS: The total of 27,916 participants were included in the analysis. The prevalence of emotional neglect, childhood poverty, and school bullying were 38.2%, 26.5%, 20.8%, respectively. 75% of the population had one or more ACE(s). The number of ACEs was associated with significantly higher risk of living in deprived area in the adulthood (p = 0.001). ACEs were not associated with living in density area. The association between ADI and ACEs 4 + was non-significant after controlling the individual-level factors. CONCLUSION: People with higher number of ACEs tend to live in deprived areas in adulthood. Policy makers in highly deprived areas can apply the trauma-informed approach for the community care and support, which is critical to mitigating deficit perspectives and facilitating comprehensive support for those with ACEs.

Cardiac tamponade during pembrolizumab treatment in a patient with ovarian cancer: a case report.

We present the case of a 39-year-old woman with platinum-resistant ovarian cancer who was treated with pembrolizumab. After five cycles of pembrolizumab treatment, she suddenly developed cardiac tamponade with a pleural effusion. The malignant pericardial and pleural effusion had increased, while the other malignant lesions had diminished in size. After pericardial and pleural drainage, no re-accumulation occurred. Pembrolizumab was continued and the patient did not have tumor progression for > 20 months. In some patients with pembrolizumab-induced cardiac tamponade, continuation of pembrolizumab treatment may be possible if other lesions decrease in size and the pericardial effusion can be controlled after drainage.

The Effect of the Rice Endosperm Protein Hydrolysate on the Subjective Negative Mood Status in Healthy Humans: A Randomized, Double-Blind, and Placebo-Controlled Clinical Trial.

The rice endosperm protein (REP) hydrolysate containing the following rice endosperm protein derived oligopeptides QQFLPEGQSQSQK, LPEGQSQSQK, and pEQFLPEGQSQSQK (a N-terminal pyroglutamate residue-modified peptide) reportedly showed an antidepressant-like effect in an animal model. We investigated the effect of the REP hydrolysate on healthy humans who self-reported mental fatigue with subjectively low vigor. Seventy-six participants (age: 20-64 years) were randomly allocated to two groups. The influence of the REP hydrolysate on the mood state was evaluated in two studies: single intake (Study 1) and repeated intake over 4 weeks (Study 2). A salivary stress marker, Chromogranin A (CgA), was measured in Study 1. The single intake of the REP hydrolysate significantly improved the Profile of Mood Status 2nd edition for adults (POMS 2) subscale of Tension-Anxiety. Additionally, the salivary CgA concentrations were remarkably reduced after the single intake of the REP hydrolysate. Though a single intake of the REP hydrolysate did not significantly influence the other subscales and the TMD of the POMS 2 and the Euthymia Scale, both the subjective and objective results supported the possible effect of the REP hydrolysate on reducing anxiety and nervousness. No significant positive effects on the subjective mood state (Euthymia Scale and POMS 2) and sleep quality (Insomnia Severity Index) were observed in the trial setting employed for Study 2. In conclusion, a single intake of REP hydrolysate might help relax the subjective feelings of tension and anxiety. The effectiveness of repeated REP hydrolysate intake needs to be tested in a different clinical setting.