Psychological distress in an earthquake-devastated area with pre-existing high rate of suicide.

On 12 March 2011 an earthquake devastated the Matsunoyama and Matsudai districts of Tokamachi City, Niigata, Japan. These areas had high pre-existing suicide rates, especially among the elderly. We investigated whether mental health status became worse among the sufferers 5 months after the earthquake, and what kind of factors were implicated in any changes. A 15-item questionnaire that tapped earthquake-related variables and the Kessler 10 Psychological Distress Scale to measure psychological distress were distributed to 1923 residents aged over 40 years. The mean age (S.D.) of the total 1731 respondents (male, 805; female, 926) was 68.2 (13.1) years. Of these, we assessed K10 scores from 1346 respondents. The mean scores (S.D.) for K10 and K6 (six selected items from the K10) were 5.8 (6.3) and 3.4 (3.9), respectively. Among the respondents, 9.1% and 3.2% obtained a score of K10 ≥15 and K6 ≥13, respectively. These scores showed slightly higher psychological distress, especially among the elderly, in comparison with existing community-based data. Categorical regression analysis revealed significant and relatively strong effects of initial psychological impact, decrease in sleep hours, advanced age, and decrease in interpersonal relationships within the community on the K10 score. The last item suggests the importance of socio-environmental factors in post-disaster mental health.

Personality and resilience associated with perceived fatigue of local government employees responding to disasters.

OBJECTIVES: According to some newspapers, concerns are growing over the health of local government employees in the Great East Japan Earthquake disaster areas. Concerns were consistently present after the Hanshin-Awaji and Niigata-Chuetsu earthquakes but not studied analytically. METHODS: Municipal employees responding to the disasters after an earthquake and floods answered a questionnaire about the degrees of workload, fatigue, psychological distress, resilience and personality traits. RESULTS: Two-thirds of the employees suffered fatigue and psychological distress, which were significantly correlated with workload but inversely correlated with emotional stability personality traits and psychological resilience. CONCLUSIONS: Together with substantial workload, individual differences in emotional stability and to lesser degree in resilience were found to have an impact on perceived fatigue. These individual factors should be considered as potential mediators of distresses among local government employees responding to disasters.

Early psychological distress among sufferers after the 2011 Northern Nagano Prefecture Earthquake.

We surveyed 3078 sufferers in Tsunan (Niigata), an intermediate and mountainous area of Japan, after the 2011 Northern Nagano Prefecture Earthquake. More subjects reported fear of the earthquake or related anxiety symptoms and insomnia in Tsunan than in the control group. Female sex and older age were found to be risk factors for poor psychological outcome. Those with risk factors should be carefully followed up.

A comparison of diagnostic tools for Sjögren syndrome, with emphasis on sialography, histopathology, and ultrasonography.

OBJECTIVE: The present study examined the reliability and correlation of sialography, salivary gland biopsy, and ultrasonography for Sjögren syndrome (SS) and evaluated the usefulness of ultrasonography as a diagnostic tool for SS compared with sialography and histopathology. STUDY DESIGN: Seventy-three patients who underwent sialography, ultrasonography, and salivary gland biopsy were included in this study. The study evaluated the diagnostic reliability and correlation of each kind of examination with SS. RESULTS: There was a statistically significant difference in the sensitivities of sialography and histopathology, in the specificities of sialography and ultrasonography, and in the accuracies of sialography and both ultrasonography and histopathology. The correlation coefficient (r) between sialography and ultrasonography was significantly higher than the others and indicated a good correlation. CONCLUSIONS: Ultrasonography can be used as a diagnostic tool for SS, with its advantage of noninvasiveness and ease of use.

Diagnostic classification and demographic features in 283 patients with somatoform disorder.

A total of 283 patients with somatoform disorder (SFD) seen in a psychiatry clinic were surveyed and their diagnostic subtypes, demographic features, and comorbidities, analyzed. The results indicate that: (i) SFD comprises 5.8% of first-visit outpatients; (ii) undifferentiated SFD (USFD) and SFD not otherwise specified (SFD-NOS) account for the majority of patients; (iii) there are 1.7-fold more women than men; (iv) age of onset is lower in patients with somatization disorder or body dysmorphic disorder and higher in patients with hypochondriasis or pain disorder; (v) the mean number of years of education was 11.2 years; and (vi) comorbid illness were seen in 24.8% of patients, and included mood disorder, anxiety disorder, and personality disorder, as well as borderline intellectual functioning and mental retardation. The data indicate that the majority of patients with SFD are given a diagnosis of residual category, such as USFD or SFD-NOS, and that the age of onset varies depending on the diagnostic subtype. SFD was more frequently seen in women, associated with comorbidities.

Clinical features and treatment outcome in Japanese patients with social anxiety disorder: chart review study.

The lifetime prevalence of social anxiety disorder (SAD) is high at 3-13%, but there have been only limited reports investigating the clinical features of this disorder in a large number of Japanese patients. The authors have conducted a retrospective, chart review study of 52 patients with SAD and obtained the following results. (i) The proportion of SAD in first visit outpatients at the Department of Psychiatry, Niigata University Medical and Dental Hospital, Niigata, Japan, was 1.04%. The male : female ratio was 1:0.73, so male patients appeared to be more common in the sample. (ii) With regard to subtype, generalized type (73% of the patients) was more common than non-generalized type (27%). (iii) The mean age of onset was 18.6 +/- 7.8 years, and there was a trend towards onset of disease at a younger age in the generalized type compared to the non-generalized type. (iv) The most common chief complaint was anxiety and tension in front of others (40.4%). (v) Pharmacotherapy resulted in improvement in 63.5% of the patients. Treatment by fluvoxamine and alprazolam resulted in high response rates of more than 70%.

Dominant-negative hypoxia-inducible factor-1 alpha reduces tumorigenicity of pancreatic cancer cells through the suppression of glucose metabolism.

In the tumor cells exposed to hypoxia, hypoxia-inducible factor-1 (HIF-1)-mediated adaptation responses such as angiogenesis and anaerobic metabolism are induced for their survival. We have recently reported that the constitutive expression of HIF-1 alpha renders pancreatic cancer cells resistant to apoptosis induced by hypoxia and glucose deprivation. We then established dominant-negative HIF-1 alpha (dnHIF-1 alpha) transfectants and examined their susceptibility to apoptosis and growth inhibition induced by hypoxia and glucose deprivation in vitro and their tumorigenicity in SCID mice. We further examined the expressions of aldolase A and Glut-1 in vitro and Glut-1 expression and glucose uptake in the tumor tissues and microvessel counts in the tumor tissues. As a result, dnHIF-1 alpha rendered the pancreatic cancer cells sensitive to apoptosis and growth inhibition induced by hypoxia and glucose deprivation. Also it abrogated the enhanced expression of Glut-1 and aldolase A mRNAs under hypoxia and reduced the expression of Glut-1 and the glucose uptake in the tumor tissues and consequently in vivo tumorigenicity. We found no significant difference in the microvessel counts among the tumor tissues. From these results, we suggest that the disruption of the HIF-1 pathway might be effective in the treatment of pancreatic cancers.

Adrenomedullin antagonist suppresses in vivo growth of human pancreatic cancer cells in SCID mice by suppressing angiogenesis.

Since it is reported that adrenomedullin (AM) upregulated by hypoxia inhibits hypoxic cell death, we examined the effects of AM antagonist (AM C-terminal fragment; AM(22-52)) on the growth of pancreatic cancer cells. We, for the first time, demonstrated that AM antagonist significantly reduced the in vivo growth of the pancreatic cancer cell line. Immunohistochemical analysis demonstrated that the mean diameter of blood vessels was significantly smaller in the tumor tissues treated with AM antagonist than in those treated with AM N-terminal fragment (AM(1-25)), and that the PCNA-labeling index was lower in the former than in the latter. Then we demonstrated that AM antagonist showed no effect on the in vitro growth of the pancreatic cancer cell line. These results showed that AM played an important role in the growth of pancreatic cancer cells in vivo, suggesting that AM antagonist might be a useful tool for treating pancreatic cancers.