[Early intervention practice in Toyama Prefecture: efforts to improve the clinical service].

We report our activity in the Consultation and Support Service in Toyama (CAST), a clinical service provided by the collaboration of Toyama Prefectural Mental Health Center and University Hospital of Toyama(UHT). About 23% of users diagnosed with at-risk mental state (ARMS), during October 2006 until March 2012, transitioned to overt schizophrenia. More than half of the subjects who continued to visit the specialized clinic in UHT were treated with antipsychotic drugs. We encountered a case of schizophrenia in which early treatment with an atypical psychotic drug was effective in normalizing cognitive function and achieving a good social consequence. The ability of mismatch negativity, an event-related potential, to predict progression to psychosis in subjects with ARMS is discussed. Further efforts should be directed towards improving long-term outcomes, such as social function, for users of the CAST.

Associations between lifestyle factors, working environment, depressive symptoms and suicidal ideation: a large-scale study in Japan.

To improve the management of depression and the prevention of suicide, we investigated associations between lifestyle, working environment, depressive symptoms and suicidal ideation. Variables measured included job stressors, working hours, overtime work, smoking status, alcohol consumption, sleep, exercise, meals, and family factors. Original items were used to measure working on holidays, number of confidants, use of stress reduction techniques, and suicidal ideation. A total of 4,118 employees (2,834 men, 1,284 women) in eleven cities and districts across Japan were analyzed. On stepwise multivariate logistic regression analysis, variables associated with depressive symptoms were exposure to high job stress, problem drinking, a feeling of insufficient sleep, absence of confidants, and no use of stress reduction techniques in both sexes. Further, problem drinking and absence of confidants were associated with suicidal ideation in both sexes. The prevalence of workers who had no confidants and who did not use stress reduction techniques was unexpectedly high. Given their clear association with depressive symptoms, greater attention to these factors should improve measures aimed at the prevention of suicide.