Prevalence of sleep problems in Japanese preschoolers in a medium-sized city: Community-based survey using the Children's Sleep Habits Questionnaire.

Although the mean score of the Children's Sleep Habits Questionnaire (CSHQ) differs between countries, there are no normative data for the CSHQ of Japanese preschoolers based on a community sample. The aims of this study were therefore to present normative data for the CSHQ and determine the prevalence and characteristics of sleep problems in Japanese preschoolers. Parents or the primary caregiver of 482 preschoolers aged 4-5 years completed the CSHQ and the Strength and Difficulties Questionnaire. Approximately 80% of preschoolers scored above the cut-off for sleep disturbance on the CSHQ. In addition, co-sleeping was prevalent in Japanese preschoolers but the habit of co-sleeping contributed little to behavioral and emotional problems. Sleep problems appear to be prevalent in Japanese preschoolers based on the CSHQ, and could be associated with the Japanese sleep habit of co-sleeping.

Serum x03C9;-3 and x03C9;-6 Fatty Acids Are Not Associated with Personality Traits in Healthy Japanese Young People.

BACKGROUND: Recent studies have reported that polyunsaturated fatty acids (PUFAs) are associated with mood and behaviors including depression and suicide risk. The aim of this study was to examine the relationship between PUFAs and personality traits in healthy subjects. METHODS: A total of 279 subjects completed the Temperament and Character Inventory and Beck Depression Inventory. Serum levels of the PUFAs eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), the x03C9;-6 fatty acid arachidonic acid (AA), and dihomo-x03B3;-linolenic acid were measured. RESULTS: Pearson's correlation analysis showed a positive correlation between DHA and cooperativeness scores. In the multiple regression analysis, harm avoidance scores were positively associated with AA, and a negative association was found between the EPA/AA ratio and reward dependence scores. However, these associations were nonsignificant after a Bonferroni correction. CONCLUSION: The results of the present study suggest that the blood levels of PUFAs are not likely to be associated with personality traits.

An attempt to construct a 7-item short version of the temperament and character inventory to predict the treatment response of patients with depression; a validation study.

BACKGROUND: The Temperament and Character Inventory (TCI) is a psychological test that is frequently used to assess personality traits. Many studies have shown the potential of the inventory to predict the treatment response of patients with major depressive disorder (MDD). Previously, we showed the association between 10 items of the TCI and the treatment response. In the present study, we reanalyzed the 10 items and aimed to provide cut-off values. METHODS: This work is a secondary analysis of previously published work. Seventy-three patients were enrolled in the previously done study. Participants were treated with 10-40 mg/day of paroxetine for six weeks, and then the participants completed the TCI. The Montgomery-Asberg Depression Rating Scale (MADRS) was used to evaluate depression. The participants were divided into two groups (responders and non-responders). Using chi-squared tests, we reanalyzed the 10 items that had the strongest association with the treatment response in the previous study. We rated the answers to each item associated with the treatment response as a "1", and the answers associated with a non-response were rated as a "0". We calculated predictive scores using 10 models. Each model consisted of 1-10 scores of the best 1-10 items. We defined cut-off values for predicting treatment responses using a receiver operating characteristic (ROC) curve analysis. RESULTS: Ranked by the strength of the association with the treatment response, items 174, 137, 70, 237, 106, 191, 34, 232, 161, and 215 of the TCI significantly predicted treatment responses. All predictive scores from models 1 to 10 significantly predicted treatment responses. The predictive score threshold of model 7 was 3/4, with an area under the curve of 0.825, and this model showed the highest odds and likelihood ratios (19.3 and 8.86, respectively). CONCLUSIONS: We might predict the treatment response of patients with MDD using TCI predictive scoring, including items 174, 137, 70, 237, 106, 191, and 34 and a cut-off value of 3/4.

Changes in the Temperament and Character Inventory dimensions after paroxetine treatment in patients with major depressive disorder.

Previous studies have reported changes in the dimensions of the Temperament and Character Inventory (TCI) after patients with major depressive disorder are treated. We aimed to investigate the changes in the TCI dimensions after paroxetine treatment in patients with major depressive disorder. Forty-eight patients were enrolled in this study and were treated with 10-40 mg/day of paroxetine for 6 weeks. The TCI was completed twice, at weeks 0 and 6. We used the Montgomery-Asberg Depression Rating Scale (MADRS) to evaluate patients. The participants were divided into three groups (responders, non-responders, and early responders) based on treatment response. The scores of each dimension of the TCI were compared before and after treatment using repeated-measures two-way analyses of variance. In the responders group (n = 24), no TCI dimension scores changed significantly during treatment, but the interaction between sex and MADRS score change was significantly associated with the results. In the non-responders group (n = 15), the self-directedness score increased significantly during the treatment period (p = 0.000), and the change in MADRS score significantly affected the results. In the early responders group (n = 9), no TCI dimension scores changed significantly during treatment. The results of the present study may reveal a possible correlation between paroxetine treatment and changes in personality traits.

Therapeutic reference range for plasma concentrations of paroxetine in patients with major depressive disorders.

BACKGROUND: We investigated the relationship between plasma concentrations of paroxetine and the therapeutic effect of the drug, and we evaluated the therapeutic reference range for plasma concentration of paroxetine in patients with major depressive disorders (MDD). METHODS: In this study, 120 patients with MDD were treated with 10-40 mg/d of paroxetine for 6 weeks, and 89 patients completed the protocol. The Montgomery-Asberg Depression Rating Scale (MADRS) was used to evaluate the patients at 0, 1, 2, 4, and 6 weeks. At the 6-week treatment time point, the patients were divided into 7 groups according to their paroxetine plasma concentrations in increments of 20 ng/mL. We used an analysis of variance and a χ test to define the therapeutic reference range for plasma paroxetine concentrations. RESULTS: We used 50% as the cutoff values for the percentage of MADRS improvement to determine the responder rates, and we defined remitters as patients with MADRS scores <10 at the 6-week treatment time point. We analyzed the responder and remitter rates of the patients according to their plasma paroxetine concentrations: 20 ng/mL, 40 ng/mL, and 60 ng/mL using the χ test. According to the results of the χ test in the responder rates, the 20-60 ng/mL plasma paroxetine group showed the highest effect size. CONCLUSIONS: The results of this study suggested that a range of 20-60 ng/mL is the therapeutic reference range for concentrations of paroxetine in plasma in patients with MDD.

Relationships between vascular endothelial growth factor levels and temperament and character inventory traits in healthy Japanese subjects.

BACKGROUND AND AIM: Personality traits and vascular endothelial growth factor (VEGF) levels are both independently correlated with major depressive disorder and depressive mood. However, no studies have reported associations between personality traits and VEGF levels. Thus, we hypothesized that there is a correlation between the results of the Temperament and Character Inventory (TCI) and VEGF levels. METHODS: We investigated 179 healthy participants who completed the TCI. We collected a serum sample from each subject and measured each participant's VEGF level by an enzyme-linked immunosorbent assay (ELISA). Simple and multiple regression analyses were performed to examine the correlations between the scores on the seven TCI dimensions and several other factors, including gender, age and VEGF level. RESULTS: A total of 150 subjects completed the examination. Among the dimensions of the TCI, the harm avoidance (HA) scores were negatively correlated with VEGF levels, but there were no significant correlations between the scores for any other dimensions and VEGF levels. The HA score was significantly correlated with sex, age and VEGF level, and single and multiple regression analyses yielded the same results. CONCLUSION: VEGF may be associated with certain personality factors. This study is the first to demonstrate a direct association between VEGF levels and a dimension of the TCI in healthy subjects.

Sex-specific effects of subjective memory complaints with respect to cognitive impairment or depressive symptoms.

AIM: The aim of this study was to investigate the association between subjective memory complaints (SMC) and sex. METHODS: We researched the prevalence of SMC in a sample of 394 participants who were at least 60 years of age (138 male and 256 female). We also administered the Mini-Mental State Examination (MMSE) and the Center for Epidemiologic Studies for Depression (CES-D) scale. A multiple logistic regression analysis, which included SMC in association with the MMSE or CES-D scores and other confounding factors, was performed to determine the influence of sex on SMC. A P-value < 0.05 was considered statistically significant. RESULTS: The durations of education of male participants were significantly higher than those of female participants. MMSE scores for female participants were significantly higher than those for male participants. There was no significant difference in CES-D scores between male and female participants. Twenty-four male participants and 72 female participants showed evidence of SMC. The incidence of SMC was more frequent in female participants than in male participants. In all participants, sex difference and CES-D score were significantly associated with SMC. In male participants, MMSE score was independently and significantly associated with SMC. Both in female participants and all participants, CES-D score was independently and significantly associated with SMC. CONCLUSION: SMC varied by sex and were associated with the degree of cognitive impairment in male participants, while they were associated with depressive symptoms in female participants.

The CLOCK C3111T polymorphism is associated with reward dependence in healthy Japanese subjects.

BACKGROUND: The Circadian Locomotor Output Cycles Kaput (CLOCK) T3111C polymorphism has been associated with several psychiatric disorders, including mood disorders and schizophrenia, which are linked to specific personality traits. We investigated the relationship between the personality traits measured by the Temperament and Character Inventory (TCI) and the C3111T polymorphism of the CLOCK gene in healthy Japanese subjects. METHODS: The sample population contained 1,092 healthy subjects (age = 27.4 ± 8.7 years) who completed the TCI. Genomic DNA was isolated from whole blood and genotyped using the TaqMan allele-specific assay method. The associations between the gene polymorphisms and TCI scores were evaluated by one-way analysis of variance and multiple regression analysis. We also compared the TCI scores between the C allele carrier (C/T and C/C genotypes) and non-carrier (T/T genotype) groups using Student's t test. Males and females were analyzed separately. RESULTS: There was no significant association between the C3111T genotype and any TCI score, but multiple regression analyses revealed significant but opposite associations between reward dependence and the C3111T polymorphism in males and females (p = 0.032, ß = 0.087 and p = 0.05, ß = -0.087, respectively). Similarly, when we compared the TCI scores of CLOCK C3111T C carrier and non-carrier subjects, we found that male C allele carriers had significantly higher reward dependence scores than non-carriers (p = 0.02). CONCLUSION: Our findings suggest that the CLOCK C3111T polymorphism may affect personality traits in healthy Japanese subjects.

No association between a polymorphism in the serotonin receptor 2B (HTR2B) gene and personality traits in healthy Japanese subjects.

AIM: The brain neurotransmitter serotonin affects many aspects of human behavior, including personality traits. Because the serotonin receptor 2B (HTR2B) gene has recently been associated with impulsivity, we investigated the potential association between the rs10194776 and Q20* polymorphism in the HTR2B gene and personality traits in healthy subjects. METHODS: A total of 1,171 healthy Japanese subjects were enrolled in this study. Their personality traits were evaluated using the Temperament and Character Inventory (TCI), and the rs10194776 and Q20* genotype was determined using real-time polymerase chain reaction. RESULTS: There was a significant main effect of the rs10194776 polymorphism on harm avoidance and self-directedness in females (p = 0.037 and p = 0.043, respectively). However, these differences were insignificant after a Bonferroni correction. Subjects carrying the minor allele of the Q20* polymorphism were nonexistent. CONCLUSION: The results of the present study suggest that the HTR2B polymorphism is not likely to be associated with personality traits, including novelty seeking and impulsivity.

Synthesis, structures, and solid-state photoresponsive color change behavior of boronium complexes bearing a pyridine-imine, diimine, or pyridine-ketone bidentate ligand.

9-Borabicyclo[3.3.1]nonane-based boronium triflates bearing a N-substituted 2-pyridylmethanimine, N,N'-dialkylethane-1,2-diimine, or 2-arylcarbonylpyridine ligand were synthesized. Their tetracoordinate boron structures were determined using 11B NMR spectra and X-ray crystallography. The pyridine-imine complexes exhibited solid-state photoresponsive color changes upon UV irradiation, which indicated that boronium complexes without a bipyridine moiety also have photoresponsive capabilities. Combination of TD-DFT calculations and measurements of UV-vis absorption and fluorescence properties, diffuse reflectance spectra, and ESR spectra provided suggestions on the determining factor of the photoresponsive color change capabilities and structures of the photoproducts.

Factor structure of the Liebowitz Social Anxiety Scale in community-dwelling subjects in Japan.

This study examined the internal consistency and structural/construct validity of the Liebowitz Social Anxiety Scale (LSAS) for community-dwelling subjects in Japan. A cross-sectional study that included 929 participants was conducted. Structural/construct validity was assessed on confirmatory factor analysis. The internal consistency reliability was good for the overall LSAS scale (α = 0.97) and for its original four factors (α = 0.92-0.89). The original four-factor model fit the observed data relatively better than alternative models. These findings indicate that the LSAS is a valid and reliable measure of anxiety symptoms for this community-dwelling population in Japan.

No association between dietary patterns and depressive symptoms among a community-dwelling population in Japan.

BACKGROUND: Studies of the associations between diet and depression have primarily focused on single nutrients or foods. Recently, dietary patterns representing a combination of foods have attracted more interest than individual nutrient. The objective of this study was to examine the association between dietary patterns and depressive symptoms among a community-dwelling population in Japan. METHODS: We examined the association between dietary patterns and the risk of depression among 791 Japanese community-dwelling individuals. Diet was assessed with a validated brief-type self-administered diet history questionnaire (BDHQ). Dietary patterns from 52 predefined food groups [energy-adjusted food (g/d)] were extracted by principal component analysis. The Center for Epidemiologic Studies Depression Scale (CES-D) with a cut-off point of 16 was used to assess the prevalence of depression. RESULTS: A total of 97 subjects (12.3%) were classified as having depression. Four dietary patterns were identified: "Healthy", "Western", "Bread and confectionery", and "Alcohol and accompanying" dietary patterns. After adjusting for potential confounders, the dietary patterns were not related to the risk of depression. CONCLUSIONS: The present study failed to find associations between dietary patterns and the risk of depression. However, the interpretation of our results was hampered by the lack of certain data, including employment physical activity and longitudinal observations. Potential associations between dietary patterns and depressive symptoms were not completely ruled out. Future research exploring dietary patterns and depressive symptoms is warranted.

Ankle brachial pressure index as a marker of apathy in a community-dwelling population.

BACKGROUND: Apathy is defined as a lack of interest or emotion. Several studies have shown the relationship between apathy and atherosclerotic change in poststroke patients. Although apathy is confused with depression, it might be a specific neuropsychiatric syndrome separate from depression. OBJECTIVE: To clarify the relationship between atherosclerotic change and apathy in a community-dwelling population, which does not include the psychologic factors associated with stroke events. METHODS: The ankle brachial pressure index (ABI) was measured using a volume-plethymographic apparatus in 860 volunteers (315 males and 545 females) who participated in the Iwaki Health Promotion Project 2008. Starkstein's apathy score and the Center for Epidemiologic Studies Depression Scale (CES-D) were used to assess the psychologic status. The association between the ABI and apathy was assessed by a multiple linear regression analysis. RESULTS: Gender and low-density lipoprotein (LDL)-cholesterol were independently and significantly associated with the CES-D score. We did not find any association between CES-D score and the ABI. In addition, the extent of education and the ABI were independently and significantly associated with the apathy scale (AS). CONCLUSION: In a community-dwelling population, a lower ABI score was an independent risk factor for a higher AS score, but not for a higher CES-D score. Apathy and depression may have different etiologies in vascular factors.

Inverse correlation between clinical response to paroxetine and plasma drug concentration in patients with major depressive disorders.

OBJECTIVE: There are few data concerning a clear relationship between the clinical effect of paroxetine and plasma drug concentrations, although therapeutic ranges have been established for some tricyclic antidepressants. METHODS: In this study, 120 patients with major depressive disorders were treated with 10-40 mg/day of paroxetine for 6 weeks, and a total of 89 patients completed the protocol. A clinical evaluation using the Montgomery-Asberg Depression Rating Scale (MADRS) was performed at 0, 1, 2, 4 and 6 weeks. RESULTS: Significant correlations were found between the plasma concentrations of paroxetine and the percentage improvement in the total MADRS scores (r = -0.282, p < 0.01) and the final MADRS scores at 6 weeks (r = 0.268, p < 0.05). The conventional receiver-operating-characteristic curve showed the fraction of true positive results and false negative results for various cut-off levels of paroxetine concentration for response and remission. The thresholds for both response and remission that gave the maximal sensitivity and specificity for paroxetine concentrations were 64.2 ng/ml. CONCLUSIONS: These results suggest that plasma paroxetine concentrations are negatively associated with improvement and that response occurs at the upper threshold of 64.2 ng/ml of paroxetine. These findings should be replicated with a larger patient sample.

Comparing the influences of age and disease on distortion in the clock drawing test in Japanese patients with schizophrenia.

OBJECTIVE: The Clock Drawing Test (CDT) is commonly used for cognitive screening, but there are few studies that compare performance on the CDT among schizophrenic patients of different ages. The objective of this study was to investigate the influence of schizophrenia and aging on performance in the CDT. METHOD: Schizophrenic patients (N = 244) and a comparison group (N = 875) were recruited as subjects. Freedman's CDT was completed by all subjects, and the influences of disease and aging on performance in the CDT were examined. Multiple comparisons of the CDT scores between patients and the comparison group and within three age subgroups (young: less than 40 years, middle aged: 40-59 years, elderly: more than 60 years) were performed. RESULTS: There was a significant interaction of diagnosis and age, and the education significantly influenced the total score for all CDT conditions. For almost all age subgroups of patients, individuals with schizophrenia had significantly lower scores on all the CDT conditions than did the comparison group subjects. For patients and the comparison group, the elderly subgroup performed significantly worse than the young and middle-aged subgroups on almost all conditions of the CDT. Qualitative analysis of the clocks drawn revealed that the number of CDT categories in which schizophrenic patients scored significantly lower than the comparison group tended to increase with aging across both groups. CONCLUSIONS: This study suggests that performance on the CDT was impaired not only by disease but also by aging. The study confirms that the CDT is sensitive enough to screen for cognitive impairments in schizophrenia.

Comparison of ankle-brachial pressure index and pulse wave velocity as markers of cognitive function in a community-dwelling population.

BACKGROUND: Vascular factors have been implicated in the development of cognitive decline and dementia. The purpose of this study is to determine the association of the Ankle Brachial pressure Index (ABI) and brachial-ankle Pulse Wave Velocity (ba-PWV) to cognitive impairment in a community-dwelling population. METHODS: The ABI and ba-PWV were measured using the volume-plethymographic apparatus in 388 subjects aged 60 years old and over. The Mini-Mental State Examination was also employed to measure global cognitive status. The effectiveness of the ABI and ba-PWV as putative markers of cognitive impairment were determined by using a multiple logistic regression analysis after adjusting for confounding factors. RESULTS: Subjects with poor cognition were significantly older and less well educated than those with normal cognition. According to the multiple logistic regression analysis, the lowest ABI tertile was found to be a significant independent risk factor (OR = 3.19, 95% CI = 1.30 to 7.82) of the cognitive impairment, whereas the highest brachial-ankle PWV tertile was not. CONCLUSIONS: A low ABI was an independent risk factor for cognitive impairment in community-dwelling older populations, whereas a high ba-PWV may not be. Further research will be required to analyze ABI and PWV with greater accuracy.

Characteristics of the tree-drawing test in chronic schizophrenia.

AIMS: A tree-drawing test acts as both a projective psychological examination as well as a supplementary psychodiagnostic tool. There is little information relating the characteristics of schizophrenia and the tree-drawing test. The present study compared the structural and morphological differences in the results of the tree-drawing test between schizophrenic patients and healthy individuals, as well as between schizophrenic patients who responded well to treatment and those who responded poorly. METHODS: The subjects included 202 chronic schizophrenic patients and 113 healthy individuals. The schizophrenic patients were categorized as 'good responders' or 'poor responders' based on their response to medical treatments. The tree-drawing test was performed on all subjects. The tree drawn by each subject was analyzed structurally and morphologically. RESULTS: There were significant differences between the trunk and branches drawn by schizophrenic patients and those drawn by healthy controls. There were no significant differences between the good responders and the poor responders in any aspect of the tree drawings. Multiple regression models showed that the ratio of the tree area to the total area of the drawing paper, the width of the trunk, the trunk base opening, and the size of the branch ends were significantly associated with schizophrenia. CONCLUSION: The present study suggests that the trees drawn by schizophrenic patients are significantly different from those drawn by healthy individuals, but among schizophrenic patients, it is difficult to distinguish between good responders and poor responders using the tree-drawing test.

No association between polymorphism in tyrosine hydroxylase and personality traits in healthy Japanese subjects.

The aim of the present study was to investigate whether there is an association between the (TCAT)(n) repeat polymorphism in the tyrosine hydroxylase (TH) gene and personality. The (TCAT)(n) repeat polymorphism in the TH gene was genotyped in 898 healthy Japanese subjects. Personality traits were evaluated using the Temperament and Character Inventory (TCI). There was no significant difference in the TCI scores of subjects with and without the T9 allele. Furthermore, no significant association was found between each genotype and the TCI scores, even when the TCI scores were compared with the homozygous genotype. These findings suggest that the (TCAT)(n) repeat polymorphism in the TH gene does not contribute to the personality traits evaluated on the TCI in healthy Japanese subjects.

Clock drawing performance in a community-dwelling population: Normative data for Japanese subjects.

OBJECTIVES: The Clock Drawing Test (CDT) is commonly used for cognitive screening. The purpose of this study is to develop normative data for the CDT for the Japanese community-dwelling population, using the method of Freedman. This study also investigates the effect of demographic factors on the performance of the subjects in this task. METHODS: We administered the CDT and the Mini-Mental State Examination (MMSE) to 873 volunteers. Using a multiple linear regression analysis, we found a gender difference in the free-drawn condition. RESULTS: A detrimental effect of age was observed in the free-drawn and pre-drawn conditions. The years of education affected the CDT in the examiner 2 condition. Correlations of the MMSE with each of the five conditions of the CDT were significant, further validating this test. CONCLUSIONS: Our study provides preliminary normative data for the Japanese population stratified by the age and level of education. However, interpretation of our results was hampered by the large variability in the performance of the subjects and the possibility of a selection bias. Thus, additional studies will be necessary to further characterise the CDT scores for the Japanese community.