Peer Support Formation and the Promotion of Recovery Among People Using Psychiatric Day Care in Japan.

The present study aimed to clarify the process of peer support formation and the promotion of recovery in people using psychiatric day care. From January to March 2014, semi-structured interviews were conducted with 18 participants with mental illness living in the community in Japan. The qualitative data were analyzed using a modified grounded theory approach. The results described a two-stage process: (1) awareness of peers with similar disability and distress and (2) formation and utilization of peer support. These results suggest that adjusting the environment and engaging in activities assisting others are useful for facilitating peer support and promoting the recovery of users in psychiatric day care.

Modulation of alpha activity in the parieto-occipital area by distractors during a visuospatial working memory task: a magnetoencephalographic study.

Oscillatory brain activity is known to play an essential role in information processing in working memory. Recent studies have indicated that alpha activity (8-13 Hz) in the parieto-occipital area is strongly modulated in working memory tasks. However, the function of alpha activity in working memory is open to several interpretations, such that alpha activity may be a direct neural correlate of information processing in working memory or may reflect disengagement from information processing in other brain areas. To examine the functional contribution of alpha activity to visuospatial working memory, we introduced visuospatial distractors during a delay period and examined neural activity from the whole brain using magnetoencephalography. The strength of event-related alpha activity was estimated using the temporal spectral evolution (TSE) method. The results were as follows: (1) an increase of alpha activity during the delay period as indicated by elevated TSE curves was observed in parieto-occipital sensors in both the working memory task and a control task that did not require working memory; and (2) an increase of alpha activity during the delay period was not observed when distractors were presented, although TSE curves were constructed only from correct trials. These results indicate that the increase of alpha activity is not directly related to information processing in working memory but rather reflects the disengagement of attention from the visuospatial input.

Exploratory` study on driving ability of people with schizophrenia: Relationships among cognitive function, symptoms, and brain activity.

BACKGROUND: This study aimed to examine the relationships among cognitive function, symptoms, prefrontal activation, basic driving skills, and collision risk factors using a hazard prediction task in simulated driving. METHODS: Participants included 42 people with schizophrenia aged 20-50 years who had actual experience of driving. The Trail making test (TMT) A and TMTB, Wechsler Memory Test-Revised (WMS-R), and Zoo Map test (ZMT) were used to evaluate cognitive function. Positive and negative syndrome scale was used to assess symptoms, and brain activity was assessed by evaluating cerebral blood flow during a visual working memory task using functional near-infrared spectroscopy. Driving tasks that tested basic skills, such as brake reaction, steering wheel skills, and standard deviation of lateral position, were analyzed using multiple regression analysis. Three hazard prediction tasks were performed using discriminant analysis. RESULTS: Brake reaction associated with cerebral blood flow and TMT-A. Steering wheel skills associated with WMS-R, driving experience and depression. Significant differences were found between the collision and noncollision groups in the hazard prediction task, as shown by the ZMT, driving experience, and brake reaction. CONCLUSIONS: Brain activity in the frontal lobe during a desk task may be useful data for driving assessment. Assessment of processing speed and learning ability may be particularly important in the evaluation of basic skills for safe driving. In addition, for people with schizophrenia, foresight, as represented by proactive planning, experience, and quick braking may be an essential characteristic to anticipate danger and react quickly enough to avoid collisions.

Development of the Self-Assessment Self-Disclosure Questionnaire to Examine the Association between Self-Disclosure and Frailty among Community-Dwelling Older Adults in Japan.

Self-disclosure is the attitude of communicating one's experiences and condition to others and is an indicator of mental health and an open personality. Frailty, characterized by reduced physical and psychological resistance, predicts the incidence of dependency and mortality. Although low self-disclosure may be associated with frailty, there is no scale to measure older adults' self-disclosure. This cross-sectional study assessed the validity of a self-assessment self-disclosure questionnaire and examined the association between the content of self-disclosures to friends and acquaintances and frailty among community-dwelling older adults. A total of 237 adults aged ≥65 in Japan were surveyed using a mailed self-administered questionnaire in 2021. The self-disclosure scale consisted of 10 items and showed adequate validity. Participants were classified into a robust group (n = 117, women 57.3%) and a frailty group (n = 120, women 73.3%) using the Kihon Checklist. After adjusting for covariates, multivariate-adjusted logistic regression models revealed frailty was associated with lower self-disclosure of recent positive events, motivation and strengths (indicating strong points) in life, relationships with family and relatives, experiences of work and social activities, and financial status. The proposed questionnaire must still be further tested in other populations, but our initial results may contribute to preventing frailty and improving mental health among community-dwelling older adults.

Prefrontal activation during simulated driving in people with schizophrenia: A functional near-infrared spectroscopy study.

People with schizophrenia (PWS) could be at risk when driving, yet this remains to be confirmed. In this study, we used functional near-infrared spectroscopy (fNIRS) and a driving simulator to assess potential driving skill difficulties as reflected by brain activity in PWS and compared them with those of healthy controls (HCs). Twenty PWS and 20 HCs were evaluated. Four tasks were performed: 50-kph and 100-kph sudden braking and 50-kph left and right curve tasks. The hemodynamic activity and driving performance of the two groups were compared. No significant differences were found in the performance of the four tasks. However, significant differences in hemodynamic activity were observed in the left and right dorsolateral prefrontal cortex (DLPFC) during the 100-kph sudden braking task. In addition, a significant negative correlation was found between brake reaction time and brain activity in the left DLPFC during the 100-kph sudden braking task in both groups. The brain mechanisms involved in processing the mental load associated with driving a car are possibly similar in PWS and HCs. Our results suggest that PWS may be able to drive their vehicles safely in the community.

Influence of self-efficacy on the interpersonal behavior of schizophrenia patients undergoing rehabilitation in psychiatric day-care services.

AIM: The present study examined whether the self-efficacy of interpersonal behavior influenced the interpersonal behavior of schizophrenia patients using psychiatric day-care services. METHODS: Thirty-nine patients with schizophrenia were examined with the Interpersonal Relations subscale of the Life Assessment Scale for Mentally Ill, the Self-efficacy Scale of Interpersonal Behavior, the Brief Assessment of Cognition in Schizophrenia-Japanese version, and the Positive and Negative Syndrome Scale. RESULTS: The Life Assessment Scale for Mentally Ill score was significantly correlated with the self-efficacy of interpersonal behavior, and was also significantly correlated with neurocognitive functions and negative symptoms. However, the Self-efficacy Scale of Interpersonal Behavior score was not correlated with neurocognitive functions and negative symptoms. To examine the causal correlations between the above social, psychological and clinical factors, multiple regression analysis was performed with the self-efficacy of interpersonal behavior, neurocognitive functions, and negative symptoms as the independent variables and interpersonal behavior as the dependent variable. The self-efficacy of interpersonal behavior was found to contribute to interpersonal behavior as well as neurocognitive functions. CONCLUSION: The self-efficacy of interpersonal behavior contributed to the interpersonal behavior as well as the neurocognitive functions in the case of schizophrenia patients in the community. This suggested that interventions targeting the self-efficacy of interpersonal behavior, as well as those targeting neurocognitive functions, were important to improve the interpersonal behavior of schizophrenia patients undergoing psychiatric rehabilitation in the community.

Influences of COVID-19 pandemic and the states of emergency on occupational therapy for physical disorders: A questionnaire survey in Hokkaido, Japan.

Objective: This study aimed to explore the influence of coronavirus disease-2019 (COVID-19) on occupational therapy (OT) for physical disorders, including changes in the assessment, treatment, other restrictions, and measures of OT. Methods: A questionnaire survey was conducted among occupational therapists working in Hokkaido, Japan, and 123 out of the 334 (36.8%) were from OT facilities that target physical disorders. The responses were classified the categories and codes by [ ] and < >, respectively. Results: The number of patients decreased in 47.1% of the OT facilities after the pandemic declaration. Only one facility reported . Therefore, [thoroughness of standard precautions] including , , and [changes in treatment structure] including were implemented. Additionally, there were not only [restrictions on participation of patients] and [restrictions on outpatient services], but also [restrictions on operations of OT], such as and so on. Furthermore, [changes in treatment structure] and [setting criteria for discontinuation of participation] were utilized in some facilities to prevent and to reduce the risk of infection. Conclusions: By revisiting the assessment and treatment guidelines on infection control, it is possible to provide continuous OT services and to tackle the challenges posed by the pandemic.

Association between Productive Roles and Frailty Factors among Community-Dwelling Older Adults: A Cross-Sectional Analysis.

The employment rate of older people in Japan is expected to increase in the future owing to the increase in the retirement age. Preventing frailty is imperative to maintaining productive roles of older adults. Therefore, this study aimed to examine the association between productive roles and frailty factors among community-dwelling older adults. A total of 135 older adults, enrolled in 2017, participated in the study. Productive roles and domains related to frailty were measured. We measured usual gait speed and grip strength for the physical domain; Mini-Mental State Examination (MMSE) and Geriatric Depression Scale (GDS-15) scores for the cognitive and mental domains; and social role and group activity for the social domain. Multivariate-adjusted logistic regression models revealed that having productive roles was associated with faster usual gait speed (odds ratios [OR] = 1.05; 95% confidence interval [CI], 1.01-1.08; p = 0.005) and lower GDS-15 score (OR = 0.79; 95% CI, 0.64-0.97; p = 0.023). These results suggest that health promotion to maintain gait speed and prevent depressive symptoms may contribute to maintaining productivity in community-dwelling older adults.

Relationship between self-disclosure to first acquaintances and subjective well-being in people with schizophrenia spectrum disorders living in the community.

OBJECTIVE: Focusing on people with schizophrenia spectrum disorders living in the community, the present study aims to examine the characteristics of and gender differences in self-disclosure to first acquaintances, and to clarify the relationship between self-disclosure and subjective well-being. METHODS: Participants (32 men and 30 women with schizophrenia spectrum disorders) were examined using the subjective well-being inventory, an original self-disclosure scale for people with mental illness, as well as the Rosenberg self-esteem scale, the Link devaluation-discrimination scale, and the affiliation scale. RESULTS: The self-disclosure content domains in descending order were as follows: "living conditions," "own strengths," "experiences of distress," and "mental illness and psychiatric disability." There were no significant gender differences in self-disclosure in the total and domain scores. Multiple regression analyses by gender revealed that: (1) in men, decreasing feelings of ill-being were significantly predicted by self-disclosure about "living conditions," self-esteem, and perceived stigma; (2) in women, increasing feelings of well-being were significantly predicted by self-disclosure about "own strengths," self-esteem, and sensitivity to rejection. CONCLUSIONS: Self-disclosure to first acquaintances was related to subjective well-being in people with schizophrenia spectrum disorders living in the community. This result supports the recovery model and the strengths model. It suggests the importance of interventions targeting self-disclosure to first acquaintances about experiences as human beings, such as "living conditions" and "own strengths," as it relates to subjective well-being in community-based mental health rehabilitation.

Neuropsychological Assessment of a New Computerized Cognitive Task that Was Developed to Train Several Cognitive Functions Simultaneously.

Recent studies have indicated that computerized cognitive training is effective as therapy for reducing the cognitive decline with aging and the dysfunction associated with neuropsychiatric illness. Although cognitive trainings that targets a specific function and multi-domain cognitive training have both been shown to have significant effects, we need one simple behavioral training paradigm to improve multiple domains of cognitive functions easily and simultaneously. We had developed a new computerized task that seeks to engage the cognitive functions of planning, mental calculation, and divergent thinking based on a working memory task in a single task. The purpose of this study was to assess the cognitive features of our new task by comparing the scores of seven known neuropsychological batteries in healthy elderly subjects. The relationships between performance in our task and the scores obtained by the neuropsychological batteries were examined. The percentage of correct performance on our task was correlated with the scores on the category fluency test, the digit span backward task, and the Trail making test B. Stepwise multiple regression analyses revealed that the scores on the category fluency test and the Trail making test B showed significant positive correlations with the percentage of correct performance on our task. Although the present study did not show high correlations between the percentage of correct performance on our task and working memory functions as a primary target, we observed mid-level correlations between the percentage of correct performance on our task and functions for divided attention and word fluency. Our new task requires not only working memory, but also attention and divergent thinking. Thus, this task might be a useful tool for training multiple cognitive functions simultaneously.

[Difference between alcohol dependence and nicotine dependence in cognitive dysfunction].

The extent of cognitive dysfunction in the nicotine and/or alcohol dependent subjects has been evaluated with Digit Span, Number Connection Test and Wisconsin Card-Sorting Test. Samples were divided into 4 groups, 8 subjects with alcohol and nicotine dependence, 9 subjects with alcohol dependence, 10 subjects with nicotine dependence and 31 subjects without the dependences who met ICD-10 criteria for dependence syndrome. The performance times of Number Connection Test were prolonged in the alcohol dependence and the presence of the nicotine dependence did not influence the performance times of Number Connection Test. The performances on the Wisconsin Card-Sorting Test were impaired by the alcohol dependence and the presence of the nicotine dependence did not influence the performances on the Wisconsin Card-Sorting Test.

Falls among community-dwelling elderly people of Hokkaido, Japan.

BACKGROUND: Although the circumstances surrounding falls among community-dwelling elderly people have been described by numerous studies, there are few that have reported falls in the northern regions of Japan, such as Hokkaido, that experience a severe winter with heavy snow. As a preliminary study, we surveyed the circumstances of falls among community-dwelling elderly people in Hokkaido with a self-administered questionnaire. METHODS: Residents living in private homes throughout Hokkaido were randomly contacted by telephone and those aged over 65 years were recruited for this study. In all, 1000 subjects participated in the survey. A questionnaire was used to obtain the histories of falls, including the number of falls, the season and place of occurrence, and the cause of the falls in the year prior to the survey. RESULTS: Of the 1000 subjects, 849 (436 men and 413 women; mean age, 73.0 years) completed the questionnaire. Among the 849 subjects, 277 (32.6%) fell at least once during the year of the survey. Of these 277 subjects, 155 subjects (56.0%) experienced two or more falls in the year. Approximately 60% of the falls occurred during the winter. The most common location where falls occurred was on roads or sidewalks, and slipping was the most prevalent cause. CONCLUSION: Our findings revealed several aspects regarding the circumstances surrounding falls among community-dwelling elderly people in Hokkaido.