Preventive effect of aripiprazole once monthly on rehospitalization for bipolar disorder: A multicenter 1-year retrospective mirror image study.

AIM: We conducted a 1-year retrospective mirror-image study to investigate the effect of aripiprazole once monthly (AOM) on rehospitalization for bipolar disorder. METHODS: Participants were recruited from psychiatric emergency and acute care hospitals in western Japan. We included 39 participants with bipolar disorder who had been administered AOM for at least 1 year with no missing medical records during the observational period. The primary outcomes were rehospitalization rate, number of rehospitalizations, total hospitalization days, and time to rehospitalization in the context of overall psychiatric readmissions. The significance level was set at p < 0.05. RESULTS: AOM significantly reduced the rehospitalization rate from 23/39 (59%) to 7/39 (18%) (p = 0.001). The number of rehospitalizations decreased significantly from a mean of 0.85 per person-year to 0.41 per person-year (p = 0.048). The total hospitalization days significantly decreased from a mean of 34.9 days to 14.4 days (p = 0.008). AOM significantly prolonged the time to rehospitalization (p < 0.001). CONCLUSION: This study found that AOM reduces overall psychiatric rehospitalization for bipolar disorder based on data from 1 year before and after AOM administration in the real-world setting. Future studies should examine the robustness and persistence of the rehospitalization preventive effect of AOM with larger sample sizes and longer observation periods beyond 1 year.

Effectiveness of etanercept vs cyclophosphamide as treatment for patients with amyloid A amyloidosis secondary to rheumatoid arthritis.

OBJECTIVES: To compare the effectiveness of an alkylating agent with that of a biologic agent in the treatment of patients with amyloid A (AA) amyloidosis secondary to RA and to assess the association of the serum AA (SAA) 1.3 allele with treatment. METHODS: CYC and etanercept (ETN) were administered to 62 and 24 RA patients, respectively, who were confirmed with biopsy as having AA amyloidosis. We evaluated whether the SAA1.3 allele, a factor indicating genetic risk and poor prognosis of Japanese RA patients with AA amyloidosis, influenced treatments and retrospectively analysed the effectiveness of both agents via statistical methods. RESULTS: Two treatment groups were similar, except for the SAA1.3 genotype (P = 0.015) and duration of AA amyloidosis since diagnosis (P < 0.001). Also, patients given ETN had somewhat worse renal function, i.e. 24-h proteinuria (P = 0.02), at the initiation of treatment. ETN demonstrated greater effectiveness than CYC, as shown by significantly improved levels of serum CRP and serum albumin (both P < 0.01) and estimated glomerular filtration rate (eGFR; P = 0.032). ETN improved survival (P = 0.025), and the hazard ratios for the risk of death endpoint with eGFR and 24-h proteinuria were significant by P = 0.024 and P = 0.025, respectively. The SAA1.3 allele did not affect the response to medications in AA amyloidosis secondary to RA. CONCLUSION: ETN treatment was more effective than CYC treatment, and CRP, albumin and eGFR may be valuable biomarkers for analysis. The SAA1.3 allele was not a factor affecting treatment in Japanese patients with AA amyloidosis secondary to RA.

Effects of child abuse history on borderline personality traits, negative life events, and depression: a study among a university student population in Japan.

To simultaneously examine the impact of childhood abuse history on borderline personality traits, negative life events, and depression, undergraduate students (N=243) were studied by questionnaire surveys with one week intervals. Neglect and emotional abuse as well as sexual maltreatment predicted borderline personality traits and baseline depression. Baseline depression as well as the impact of negative life events occurring the week prior predicted depression a week later. However, after considering the baseline depression level, child abuse history failed to predict the follow-up depression level. Borderline personality traits did not moderate these findings. Childhood emotional and sexual abuse history may influence depression and borderline personality traits.

Psychological well-being, depression, and anxiety in Japanese university students.

BACKGROUND: In order to further investigate the relationship of psychological well-being with depression and anxiety. METHOD: Students from five universities were solicited to participate in this study and 545 students with a mean age of 20.1 (SD = 2.2) years were finally accessed to analysis. RESULT: All six dimensions-autonomy (AU), environment mastery (EM), personal growth (PG), positive relationships with others (PR), purpose in life (PL), and self-acceptance (SA)-of the Scales of Psychological Well-being Inventory (SPWB) were moderately negatively correlated with depression and anxiety as measured by the Hospital Anxiety and Depression Scale (HADS). Furthermore, due to a good fit with the present data, the model of SPWB on depression and anxiety was consistent with the theory of psychological well-being and indicated that HADS depression was predicted by EM, PR, and SA, while HADS anxiety was predicted by AU, EM, PG, PR, and SA. CONCLUSION: SPWB is a reliable measure of well-being for Japanese young adults, and the negative affectivity such as depression and anxiety is to some extent determined by the lack of psychological well-being.

The Inventory of Personality Organisation: its psychometric properties among student and clinical populations in Japan.

BACKGROUND: The Inventory of Personality Organisation (IPO) is a self-report measure that reflects personality traits, as theorized by Kernberg. METHODS: In study 1, the Japanese version of the IPO was distributed to a population of Japanese university students (N = 701). The students were randomly divided into two groups. The factor structure derived from an exploratory factor analysis among one subsample was tested using a confirmatory factor structure among another subsample. In study 2, the factor-driven subscales of the IPO were correlated with other variables that would function as external criteria to validate the scale in a combined population of the students used in study 1 and psychiatric outpatients (N = 177). RESULTS: In study 1 the five-factor structure presented by the original authors was replicated in exploratory factor analyses in one subgroup of students. However, this was through reduction of the number of items (the number of the primary items was reduced from 57 to 24 whereas the number of the additional items was reduced from 26 to 13) due to low endorsement frequencies as well as low factor loadings on a designated factor. The new factor structure was endorsed by a confirmatory factor analysis in the other student subgroup. In study 2 the new five subscales of the Japanese IPO were likely to be correlated with younger age, more personality psychopathology (borderline and narcissistic), more dysphoric mood, less psychological well-being, more insecure adult attachment style, lower self-efficacy, and more frequent history of childhood adversity. The IPO scores were found to predict the increase in suicidal ideation in a week's time in a longitudinal follow-up. CONCLUSION: Although losing more than 40% of the original items, the Japanese IPO may be a reliable and valid measure of Kernberg's personality organisation for Japanese populations.

Effects of coping styles and stressful life events on depression and anxiety in Japanese nursing students: a longitudinal study.

Nursing students face stressful situations during a clinical training. This two-wave (between June and December 2004) study explored the relationship between the coping styles and stressful life events in terms of the occurrence of depression and anxiety among 97 Japanese female nursing students before (Time 1) and after (Time 2) a clinical training. In a structural equation modelling, Time 2 depression was significantly predicted by Time 1 depression and stressful life events whereas Time 2 anxiety was predicted by Time 1 anxiety, stressful life events and emotion-oriented coping. Moreover, Time 1 depression predicted the impact of stressful life events and Time 1 anxiety predicted emotion-oriented coping.

The effects of adult attachment and life stress on daily depression: a sample of Japanese university students.

To investigate the relationship among adult attachment style, life stress, and daily depression, a sample of 437 undergraduate students was prospectively studied. Insecure adult attachment and perceived life stress were related to their daily depressive mood. Further analyses using both multiple hierarchical regression and structural equation models (SEM) demonstrated that adult attachment style and perceived life stress independently predicted depression and had no interactive effects on daily depression. The impact of adult attachment on depression was not contingent upon the presence of life stress and securely attached participants were less impacted by depression than insecurely attached ones. These results suggest that adult attachment can play an important role in mental health intervention and may be helpful when it comes to preventing and treating depression.

Prospective study on suicidal ideation among Japanese undergraduate students: correlation with stressful life events, depression, and depressogenic cognitive patterns.

The present study examines the effects of stressful life events, depression, and depressogenic cognitive patterns on suicidal ideation in 500 Japanese undergraduate students. The above factors were assessed at baseline (T1) and two weeks later (T3). At T1, structural equation modeling confirmed that (1) cognitive patterns and depression, but not stressful life events, influence suicidal ideation, and (2) cognitive patterns also influence suicidal ideation through depression. These findings were confirmed in a longitudinal analysis. The results suggest that the effects of stressful life events on suicidal ideation are indirect and are mediated by depressogenic cognitive styles and depressed mood.

Case illustrations of negative sexual experiences among university women in Japan: victimization disclosure and reactions of the confidant.

A retrospective study of negative sexual experiences (NSEs) was conducted among 532 Japanese university women. More than one third of the respondents reported having experienced at least one NSE, and two thirds were victimized by strangers. When the woman knew the perpetrator well, the NSE was more likely to be repeated. One sixth of victims did not disclose the incident. Older children disclosed incidents more frequently than did younger children. Women in the total disclosure group disclosed the incidents more quickly than did those in the partial disclosure group. Women victimized by strangers were more likely to disclose the incident completely. Less than 10% of women were disappointed with the reaction of the first-disclosure receiver. Unlike results obtained in previous studies, the victims did not necessarily regard it negatively when the incident was viewed less seriously or they were criticized by first-disclosure receivers. On the other hand, instrumental support was not always supportive.

Hand arm vibration syndrome among quarry workers in Vietnam.

Few studies have focused on the health effects of vibrating tools on workers in the tropical area. Work conditions and health effects related to rock drill operation were studied in 102 quarry workers, including 73 rock drill operators in Vietnam. We aimed to clarify (1) risk of vibration exposure, (2) occurrence of vibration-induced white finger (VWF), and (3) characteristics of hand-arm vibration syndrome (HAVS). Total weighted r.m.s. acceleration of the Chinese -or Russian-made rock drills, was 45-55 m/s(2). According to work observation studies, daily exposure time to vibration was 160-210 min. ISO5349 predicted that this exposure level would be associated with a high risk of HAVS in workers. We found no clear evidence of VWF. There may be several reasons why no worker exhibited VWF: (1) warmer work conditions, (2) younger and less experienced workers, (3) seasonal changes in work operations, and (4) healthy worker effect. On the other hand, 5-10% of rock drill operators might be suffering from moderate HAVS which was sensori-neural type dominant. There may be some characteristic features of HAVS among quarry workers in the tropical area.

Long-term follow-up study of health status in population living in methylmercury-polluted area.

At present, it is important to follow-up on the health condition of inhabitants living in a methylmercury-polluted area surrounding Minamata City, paying attention to subclinical disorders not only of the central nervous system, which have been concentrically studied for more than 40 years, but also to other health issues as well. We have performed annual follow-up multiple health examinations on about 1,500 persons of ages more than 40 years old in Tsunagi Town near Minamata City each summer from 1984 to 2004. Case-control studies were designed to estimate the role of risk factors for various health issues using geographical differences to compare the verified patients. The results of the study are summarized as follows: (1) There were no significant differences in the prevalence of diseases associated with Minamata disease (MD) (e.g., liver diseases, renal diseases). (2) Subjective complaints, which were related not only to neurological but also to general complaints were consistently much more common in the polluted area than in the control area. (3) Five percent of the inhabitants who were not certified as MD patients had a high predicting index of MD. They could be affected by methylmercury poisoning. It is important to make a differential diagnosis. (4) No significant differences with respect to ADL by residential area were observed. However, MD patients who stayed in their homes showed some impairments of instrumental ADL. (5) It is important to take into consideration mental distress not only from the physical effects but also from the secondary social damage experienced through MD in these area.

[Factors relating to the conditions and characteristics of mental health among the inhabitants in a methylmercury polluted area].

OBJECTIVES: Little attention has been paid to mental health of inhabitants of methylmercury-polluted areas. The objective of this study was to examine the factors relating to the conditions and characteristics of mental health of inhabitants residing in a methylmercury-polluted area. METHODS: The eligible subjects of the study were inhabitants over the age of 40 years (n=301) living in two fishing village districts that were polluted by high concentrations of methylmercury. The study was conducted in two phases. In the first phase, a structured questionnaire was used to gather information on the current health condition and experience with Minamata disease of each subject through interviews. In the second phase, the General Health Questionnaire (GHQ)-30 was distributed to measure the psychological distress of the respondents. RESULTS: There were 133 (44.2%) study subjects. Factor analysis of the data collected using the GHQ was carried out and five factors that accounted for 57.9% of the total variance were selected. The first factor was labeled "depression and anxiety". Depression and anxiety were significantly associated with self-rated health status, the number of subjective symptoms, monthly outpatient visits and the receipt of compensation. Covariance structure analysis using the Amos 4.0 program demonstrated that depression and anxiety were significantly associated with the subjects' health condition, which in turn was influenced by experience with Minamata disease. CONCLUSION: Depression and anxiety of the inhabitants may be directly caused by the health condition. Further investigations with more precise and detailed measurements are needed to corroborate the causal relationship.

Efficacy of cyclophosphamide combined with prednisolone in patients with AA amyloidosis secondary to rheumatoid arthritis.

Secondary amyloid A (AA) amyloidosis is an uncommon yet important complication of rheumatoid arthritis (RA). It is one of the most relentless of the extra-articular features of RA, and suitable treatments have not yet been found. We studied the efficacy of cyclophosphamide (CYC) combined with prednisolone (PSL) in amyloidotic patients who had serum amyloid A (SAA) 1.3 genotype, which is a risk factor for secondary amyloidosis in Japanese RA patients. Fifteen RA patients who were SAA1.3 homo- and heterozygotes with biopsy-confirmed AA amyloidosis were treated with a combination of CYC and PSL. Laboratory variables of C-reactive protein (CRP), rheumatoid factor (RF), erythrocyte sedimentation rate (ESR), serum albumin (Alb), serum creatinine (Cre) and Lansbury's index were carried out by statistical analysis of changes between before and during the medication. According to the Mann-Whitney rank test, CRP, RF, ESR, Alb and Cre levels improved significantly with the combination treatment (p<0.05). Also, paired t-tests showed significance in Lansbury's index between before and during the medication (p=0.007). CYC combined with PSL ameliorated not only laboratory markers but also clinical rheumatoid activity in patients with amyloidosis secondary to RA, whose genotypes were SAA1.3 homo- and heterozygous. CRP, ESR, RF, Alb and Cre will be surrogate markers of therapeutic efficacy. The combination of CYC and PSL appears to be beneficial for Japanese RA patients who are SAA1.3 homo- and heterozygous carriers, associated with secondary AA amyloidosis.

Relationship between health status and psychological distress among the inhabitants in a methylmercury-polluted area in Japan.

This study examined the relationship between health parameters and psychological distress among inhabitants of methylmercury-polluted areas in Japan. The subjects were 133 inhabitants over the age of 40 yr living in two methylmercury-polluted villages. Information on demographic factors, health status, and mental health was obtained using questionnaires, including the General Health Questionnaire (GHQ). The proportional odds model was used to estimate the adjusted odds ratios of factors associated with a higher GHQ score after adjustment for age, gender, and district. Very poor self-rated health status, a high number (5+) of subjective symptoms, having monthly outpatient visits and medical house calls, and receiving compensation for methylmercury poisoning were significantly associated with psychological distress. Poor physical condition may lead to the development of psychological distress.

Social factors associated with psychological distress among inhabitants in a methyl-mercury polluted area in rural Japan.

Little attention has been paid to the mental health of inhabitants of methylmercury-polluted areas in Japan. This study examined the relationship between one's experience with Minamata disease (MD) (such as compensation issues) and psychological distress. The subjects were 133 (44.2%) of the 301 inhabitants over the age of 40 years living in two fishing village districts along the coast of the Yatsushiro Sea which had been contaminated with methylmercury. Data on the inhabitants' experience with MD, social network factor, health condition and mental health were obtained using questionnaires including the General Health Questionnaire (GHQ)-30. The proportional odds model was used to estimate the adjusted odds ratios of factors associated with a higher GHQ score after adjustment for age, sex and village. MD status based on MD compensation, level of participation in MD patients' groups, and presence of certified MD patients in the family were significantly associated with psychological distress. Although these associations decreased after further adjustments were made taking health condition into consideration, MD status, participation in several sit-ins and the presence of certified MD patients in the family maintained marginally positive association with psychological distress. Further investigations with more precise and detailed measurements are needed to corroborate the relationship between inhabitants' experience with MD and mental health.

Etanercept can induce resolution of renal deterioration in patients with amyloid A amyloidosis secondary to rheumatoid arthritis.

The benefit of biological therapies in rheumatoid arthritis (RA) treatment is well known, but their role in amyloid A (AA) amyloidosis secondary to RA is unclear. The aim of this study was to clarify the clinical benefit of etanercept in RA patients with AA amyloidosis. We treated 14 RA patients who had serum amyloid A protein (SAA) 1.3 allele, with biopsy-confirmed AA amyloidosis with etanercept and investigated the efficacy of etanercept treatment, focusing on renal function retrospectively. The AA amyloidosis improved and stabilized after 89.1 ± 27.2 weeks. Proteinuria decreased from 2.24 ± 0.81 to 0.57 ± 0.41 g/day (P < 0.01) and SAA fell from 250 ± 129 to 26 ± 15 µg/ml (P < 0.01), respectively. Diarrhea secondary to gastrointestinal AA amyloidosis was less. Overall, the serum creatinine levels did not benefit with treatment, but in those with a creatinine values <2.0 mg/dl the creatinine level continued to fall (P = 0.021). Serum albumin increased following 96 weeks of etanercept treatment (P = 0.003). Etanercept treatment led to clinical improvement in proteinuria and serum albumin levels accompanied by a fall in SAA levels.

Rape Myth Scale: factor structure and relationship with gender egalitarianism among Japanese professionals.

Services provided to rape victims by human service professionals are usually helpful but are occasionally very harmful in that the victim ends up feeling 're-victimized'. This may be caused by the attitudes of the professionals towards the victims based on beliefs regarding rape and gender roles. Japanese human service professionals were solicited for responses to the Rape Myth Scale (RMS) and the short form of the Scale of Egalitarian Sex Role Attitudes (SESRA-S). One interpretable factor was extracted according to an exploratory factor analysis. Impact of the participants' age, sex, residential area, and type of profession on rape myth acceptance were examined by four-way layout ANOVA. Nurses had significantly higher rape myth acceptance than any other professional group. Furthermore, a structural equation model showing the contribution of sex role egalitarian attitude to rape myth acceptance was established.

Factorial structure of the parental bonding instrument (PBI) in Japan: a study of cultural, developmental, and gender influences.

This study explored the factorial structure of the Parental Bonding Instrument (PBI) in the Japanese population. Several differences between the structure model in the current study and Parker et al.'s original model were identified. We also examined the adaptability of the inventory to children currently being raised by parents. We also developed a structural equation model that takes into account the impacts of the respondents' generation and gender and the caregivers' gender. The cultural, developmental, generational, and gender influences on the factorial structure of the PBI as well as the implications for clinical settings were discussed.

Egalitarian sex role attitudes among Japanese human service professionals: confirmatory factor analytic study.

The psychometric properties of the short form of the Scale of Egalitarian Sex Role Attitudes (SESRA-S) were studied among human service professionals. An exploratory factor analysis yielded two factors interpreted as reflecting women's rights (e.g. women at home and men at work [a reverse item]) and women's independence (e.g. working outside is equally important for women [a non-reverse item]), respectively. Confirmatory factor analysis showed a good fit. Impact of participant age, sex, residential area, and type of profession on sex role egalitarianism were examined by four-way layout anova. Men in rural areas had the lowest score in the women's rights subscale and psychiatrists in rural areas had the lowest score in the women's independence subscale.

Correlation between forearm bone mineral density and body composition in Japanese females aged 18-40 years.

OBJECTIVE: The purpose of this study was to clarify the relationship between forearm bone mineral density (BMD), body mass index (BMI), and body composition focusing on body fat percentage (BF%) in Japanese females 18 to 40 years old. METHODS: Subjects were 2,280 females 18-40 years old. Anthropometric measurements were taken, and a medical history was obtained by questionnaire, including age at the time of the study and age at menarche. BF% was measured by bioelectrical impedance analysis. Forearm BMD was measured using dual-energy X-ray absorptiometry (DXA). The correlations of BMD with BMI and BF% were analyzed using a structural equation model. RESULTS: The standardized regression coefficients for the path from BMI to BMD and the path from BF% to BMD were 0.538 and -0.184 respectively. The squared multiple correlation of BMD was 0.146. In addition, the standardized regression coefficient for the path from BMI to BF% was 0.896. CONCLUSION: The results showed a positive correlation between BMD and BMI and an inverse correlation between BMD and BF%. At the same time, it was noted that BF% increased with BMI. This indicated that BMD is dependant on BF% in subjects who have a similar BMI. Therefore, this study concluded that it is necessary to take body composition measurements into account when examining the relationship between BMI and BMD, especially in young females.