A composite measure of sleep health is associated with symptoms of depression among Japanese female hospital nurses.

BACKGROUND: Individual dimensions of sleep health, including satisfaction, sleepiness/alertness, timing, efficiency, and duration, are associated with depression. We investigated whether a composite sleep health score is associated with symptoms of depression among Japanese female hospital nurses. METHODS: Participants were nurses (n = 2482, all women, age 31.2 ± 8.9 years) working at three general hospitals in Tokyo, Japan. A cross-sectional survey, conducted in 2015, assessed self-reported sleep and symptoms of depression. Sleep health was categorized as "good" or "poor" across five dimensions: satisfaction, daytime sleepiness, mid-sleep time, efficiency, and duration. A composite sleep health score was calculated by summing the number of "poor" dimensions. Depression was defined by depressed mood, loss of interest, or at least one of those symptoms ("depression symptoms"). Associations between sleep health and symptoms of depression were evaluated with multivariate logistic regression analyses, adjusting for sociodemographic factors and hypnotic medication use. RESULTS: In multivariate logistic regression analyses, sleep health symptoms of poor satisfaction, efficiency, and duration were significantly associated with depressed mood; daytime sleepiness and poor efficiency were significantly associated with loss of interest; and poor satisfaction, daytime sleepiness, mid-sleep time, and efficiency were significantly associated with having at least one depressive symptom. The composite sleep health score was associated in a graded fashion with greater odds of depression symptoms. CONCLUSION: Individual and composite sleep health scores were associated with symptoms of depression. Assessing composite measures of multidimensional sleep health may help to better understand the well-known associations between poor sleep and depression and lead to improved intervention strategies.

Factors Associated with the Development of Childhood Asthma in Japan: A Nationwide Longitudinal Study.

INTRODUCTION: Many environmental factors are related to the development of asthma. However, the key factors of childhood asthma onset have not been sufficiently elucidated. Further, low-weight births have increased in Japan. The aim of this study was to examine the risk factors for the incidence of childhood asthma and to evaluate whether these risk factors differ according to birth weight in Japan. METHODS: We used the National Longitudinal Survey from 2001 to 2010. Multiple logistic regression analyses were conducted to determine the effects of gender, birth weight, single vs. multiple births, birth order, nutrition, keeping pets in the home, place of residence, annual household income, and parent ages, smoking behaviors, and educational backgrounds on asthma-related hospital visits. RESULTS: Overall, 45,060 children were analyzed. The rate of cumulative hospital visits until age 10 was 18.9%. Birth weight < 2500 g (adjusted odds ratio [AOR] = 1.14, 95% confidence interval [CI] 1.03-1.26), being a boy (AOR = 1.27, 95% CI 1.21-1.33), having older siblings (AOR = 1.07, 95% CI 1.02-1.14), parental smoking behavior, mother`s age, and low household income (AOR = 1.17, 95% CI 1.10-1.24) were associated with asthma-related hospital visits. DISCUSSION: Parental smoking behavior is a key risk factor for the development of asthma. Among low birth weight infants, being a boy, having older siblings, and father`s smoking behavior were predictive factors for the development of asthma. However, low birth weight was not associated with the development of asthma after 6 years of age.

The association between alcohol use and problematic internet use: A large-scale nationwide cross-sectional study of adolescents in Japan.

BACKGROUND: This study aimed to clarify the associations between the frequency and amount of alcohol consumption and problematic Internet use, such as Internet addiction and excessive Internet use. METHODS: A self-administered questionnaire survey was administered to students enrolled in randomly selected junior and senior high schools throughout Japan, and responses from 100,050 students (51,587 males and 48,463 females) were obtained. Multiple logistic regression analyses were performed in order to examine the associations between alcohol use and problematic Internet, use such as Internet addiction (Young Diagnostic Questionnaire for Internet Addiction ≥5) and excessive Internet use (≥5 h/day). RESULTS: The results of multiple logistic regression analyses indicated that the adjusted odds ratios for Internet addiction (YDQ ≥5) and excessive Internet use (≥5 h/day) became higher as the number of days in which alcohol had been consumed during the previous 30 days increased. In addition, the adjusted odds ratio for excessive Internet use (≥5 h/day) indicated a dose-dependent association with the amount of alcohol consumed per session. CONCLUSIONS: This study revealed that adolescents showing problematic Internet use consumed alcohol more frequently and consumed a greater amount of alcohol than those without problematic Internet use. These findings suggest a close association between drinking and problematic Internet use among Japanese adolescents.

The Association Between Alcohol-Flavoured Non-Alcoholic Beverages and Alcohol Use in Japanese Adolescents.

AIMS: There are no legal regulations in Japan governing minors' consumption of alcohol-flavoured non-alcoholic beverages (AFNAB); therefore, we examined if their consumption could lead to increased alcohol use among adolescents in Japan. METHODS: This cross-sectional study used a nonclinical, nationally representative sample of 38,494 junior (19,662 boys) and 61,556 senior (31,925 boys) high school students recruited in 2012. We measured AFNAB consumption rates and the order that adolescents first consumed AFNAB and alcohol. RESULTS: The AFNAB consumption was strongly associated with alcohol use in high school students. Among all age groups, alcohol was more commonly consumed before AFNAB for both males and females. CONCLUSIONS: Consumption of AFNAB is more prevalent among minors than alcohol consumption and it has a strong association with alcohol consumption. However, concerns that AFNAB use would lead to increased alcohol use were not supported because AFNAB consumption usually started after adolescents began consuming alcohol. SHORT SUMMARY: Consumption of AFNAB is more prevalent among high school students than alcohol consumption and it has a strong association with alcohol consumption. However, concerns that AFNAB use would lead to increased alcohol use were not supported because AFNAB consumption usually started after adolescents began consuming alcohol.

Irritable bowel syndrome among Japanese adolescents: A nationally representative survey.

BACKGROUND AND AIM: No nationally representative survey of irritable bowel syndrome (IBS) among adolescents has ever been performed in Japan. In the present study, we aimed to clarify the prevalence of IBS among Japanese adolescents and the factors associated with it. METHODS: The items related to the diagnostic criteria for IBS based on the Rome III Diagnostic Criteria for Functional Gastrointestinal Disorders were included in a cross-sectional nationwide survey of "alcohol consumption and smoking habits among junior and senior high school students." The participating schools were sampled from among all junior and senior high schools in Japan using the cluster-sampling method, and self-administered questionnaires were sent to the selected schools by mail. Among 99 416 questionnaires that were collected, data from 98 411 valid responses were analyzed. RESULTS: The results showed that the prevalence of IBS was 18.6%. Although no sex difference was observed in the overall prevalence of IBS, the prevalence of diarrhea-predominant IBS was higher among boys than among girls, and the prevalence of constipation-predominant IBS was higher among girls than among boys. The prevalence of IBS increased with progression of the school grade, and there were the significant relationships between IBS and sleep-phase delay and insomnia symptoms. IBS was also significantly associated with poor mental health status. CONCLUSION: These results indicate that IBS is common among junior and senior high school students, and associated with lifestyle and mental health.

Mental health status among Japanese medical students: a cross-sectional survey of 20 universities.

The purposes of this study were to evaluate the mental health status of Japanese medical students and to examine differences based on gender, as well as on university type and location, using the results of a nationwide survey. Between December 2006 and March 2007, we conducted a questionnaire survey among fourth-year medical students at 20 randomly selected medical schools in Japan. The data from 1,619 students (response rate: 90.6%; male: 1,074; female: 545) were analyzed. We used the Japanese version of the 12-item General Health Questionnaire (GHQ-12) to measure mental health status. Poor mental health status (GHQ-12 score of 4 points or higher) was observed in 36.6% and 48.8% of the male and female medical students, respectively. The ratio of the age-adjusted prevalence of poor mental health status in female versus male medical students was 1.33 (95% confidence interval: 1.10-1.62). The universities were categorized into two groups based on the university type (national/public: 15 vs. private: 5) or location (in a large city: 7 vs. in a local city: 13 cities). The prevalence of poor mental health status in both men and women differed between these groups, although not significantly. The GHQ-12 scores in men significantly differed between the categorized groups of universities. These results suggest that adequate attention must be paid to the mental health of medical students, especially females, and that a system for providing mental health care for medical students must be established in the context of actual conditions at each university.

Longitudinal study of parental smoking habits and development of asthma in early childhood.

OBJECTIVE: This study examined the association between parental smoking habits and the development of asthma in early childhood by using representative samples. METHODS: The survey subjects included all of the 53,575 babies born in Japan during the periods January 10-17 and July 10-17, 2001. The families of the subjects were asked to complete questionnaires that were delivered by post at 6 months, 1 year 6 months, 2 years 6 months, 3 years 6 months, and 4 years 6 months postpartum. The first survey contained questions regarding the smoking habits of the parents. The second to fifth surveys asked if the child had needed medical attention for the treatment of asthma. RESULTS: Data from 36,888 subjects (collection rate: 68.9%) were analyzed. The 4-year cumulative incidence of asthma was 12.0%. Maternal indoor smoking significantly increased the risk of asthma development in children, 4-year risk 14.4% vs. 11.7%, risk ratio=1.24, 95% CI: 1.11 to 1.38. No statistically significant association was found between paternal smoking and asthma development in children. CONCLUSIONS: In order to prevent the development of asthma in early childhood, it is necessary to formulate measures to stop or discourage maternal smoking.

Preferable forms of relaxation for health promotion, and the association between recreational activities and self-perceived health.

Little research has been done on the association between relaxation and health. In the present study, by conducting a nationwide cross-sectional survey, we aimed to obtain scientific data on the preferable forms of relaxation for health promotion, and to clarify the associations between specific recreational activities and self-perceived mental and physical health. We selected 4,000 households by stratified random sampling from across Japan in November 2009 and used the interview method to collect data (number of subjects: 2,206). The questionnaire contained items on sleep, recreation status, recreational activities, and self-perceived mental and physical health status. We obtained responses from 1,224 adults (response rate: 55.5%). Insufficient rest from sleep, short sleep duration (<6 h/day), ineffective use of free time, and less free time used for activities other than rest showed independent positive associations with poor mental and physical health. The results of the logistic regression analyses showed significantly low adjusted odds ratios with regard to the status of poor mental and physical health for outings/walking among men (0.33 [95% confidence interval; 0.16-0.68] and 0.49 [0.26-0.90], respectively), and for community activities among women (0.19 [0.04-0.79] and 0.27 [0.09-0.77], respectively). Relaxation for the promotion of health should include both passive relaxation (rest) and active relaxation (recreation). In addition, ensuring sufficient sleep duration is important for passive relaxation, and engaging in outings/walking for men and community activities for women are important for active relaxation.

[Epidemiological studies of sleep disturbance in Japan].

Sleep has been a great interest in modern developed countries, epidemiological studies have been carried out extensively. In 2006, average sleep duration of the Japanese men, has been reported 7 hours 49 minutes (9 minutes shorter than 20 years ago) and women has been reported 7 hours 35 minutes (7 minutes shorter than 20 years ago). Sleep habits is affected by gender, age and also social factors and lifestyle. Thus, sleep-related problems have become an important public health issue in the society in developed countries. It is important to progress the preventive health promotion activities and results that are based on the development of future epidemiological studies of sleep.

Clarification of the factor structure of the 12-item General Health Questionnaire among Japanese adolescents and associated sleep status.

If the factors affecting the mental health status of adolescents and their association with sleep status could be clarified, this information would be helpful for formulating lifestyle and healthcare guidance for the promotion of healthy growth and the prevention of mental problems in these individuals. The purpose of this study was to clarify (1) the factor structure of the 12-item General Health Questionnaire (GHQ-12), and (2) the associations between the factors extracted from this questionnaire and lifestyle, in particular sleep status, by using a representative sample population of Japanese adolescents. One hundred three thousand sixty hundred fifty self-administered questionnaires were collected from students enrolled in junior high and high schools in Japan. Of these questionnaires, 99,668 were analyzed. Sleep duration, subjective sleep assessment, bedtime, and insomnia symptoms of these students over the past month were studied to investigate sleep status. The factor analyses yielded two factors: depression/anxiety and loss of positive emotion. Sleep duration of less than 7h was found to be associated with both depression/anxiety and loss of positive emotion, whereas sleep duration of 8h or more was associated only with loss of positive emotion. Subjective sleep assessment and insomnia symptoms were associated with both depression/anxiety and loss of positive emotion. It was demonstrated that two underlying factors of mental health status were associated with differences in sleep status. In order to improve the mental health status of adolescents, it is important to provide guidance about sleep and lifestyle habits according to the mental health status of the individual.

Age verification cards fail to fully prevent minors from accessing tobacco products.

BACKGROUND: Proper age verification can prevent minors from accessing tobacco products. For this reason, electronic locking devices based on a proof-of age system utilising cards were installed in almost every tobacco vending machine across Japan and Germany to restrict sales to minors. OBJECTIVE: We aimed to clarify the associations between amount smoked by high school students and the usage of age verification cards by conducting a nationwide cross-sectional survey of students in Japan. METHODS: This survey was conducted in 2008. We asked high school students, aged 13-18 years, in Japan about their smoking behaviour, where they purchase cigarettes, if or if not they have used age verification cards, and if yes, how they obtained this card. RESULTS: As the amount smoked increased, the prevalence of purchasing cigarettes from vending machines also rose for both males and females. The percentage of those with experience of using an age verification card was also higher among those who smoked more. Somebody outside of family was the top source of obtaining cards. Surprisingly, around 5% of males and females belonging to the group with highest smoking levels applied for cards themselves. CONCLUSIONS: Age verification cards cannot fully prevent minors from accessing tobacco products. These findings suggest that a total ban of tobacco vending machines, not an age verification system, is needed to prevent sales to minors.

Association between depression and insomnia subtypes: a longitudinal study on the elderly in Japan.

STUDY OBJECTIVE: To examine the association between depression and three subtypes of insomnia, namely, difficulty initiating sleep (DIS), early morning awakening (EMA), and difficulty maintaining sleep (DMS). DESIGN: Cross-sectional and longitudinal study. SETTING: Community dwellers in Japan. PARTICIPANTS: Nationally representative samples of adults aged 65 and over (total N=4,997) were selected by a multistage stratified random sampling method in 1999 and were interviewed face-to-face in 1999, 2001, 2003, and 2006. Those who responded to the 3rd survey conducted in 2003 and the 4th survey conducted in 2006 were used in this study. MEASUREMENT AND RESULTS: Depression was evaluated according to the 11-item short form of the CES-D scale at 2 points in time. Insomnia subtypes were assessed by self-reported measures. A logistic regression was employed to examine the association between insomnia subtypes and the presence of depression, controlling for relevant factors. A cross-sectional analysis based on the 2003 data demonstrated statistically significant odds ratios (ORs) for DIS and EMA. In the longitudinal study, DIS at the time of the 3rd survey was found to be significantly related to the presence of depression at the time of the 4th survey, with an odds ratio (95%CI) of 1.592 (1.012 to 2.504). EMA (OR 1.070; 95% CI, 0.664 to 1.723) and DMS (OR 1.215; 95% CI, 0.860 to 1.716), however, were not found to be significantly related to the presence of depression. CONCLUSION: The longitudinal study revealed a statistically significant relationship, controlling for other relevant factors, between DIS and the presence of depression three years later, but not between EMA or DMS and depression. Based on our findings, we recommend that the association between insomnia subtypes and depression be studied longitudinally in clinical settings.

Epidemiological study of smoking among Japanese physicians.

OBJECTIVE: In this study, we attempted to clarify recent changes in the prevalence of smoking among Japanese physicians and factors related to smoking among physicians. METHOD: We conducted three self-administered questionnaire surveys on members of the Japan Medical Association in 2000, 2004, and 2008. In each survey, 3000 male and 1500 female physicians were randomly selected. RESULTS: The total number of effective responses was 3771 in 2000, 3633 in 2004, and 3486 in 2008. The prevalence of smoking among male physicians decreased significantly from 27.1% in 2000 to 21.5% in 2004, and then to 15.0% in 2008 (p<0.01). The prevalence of smoking among female physicians was 6.8%, 5.4%, and 4.6%, in 2000, 2004, and 2008, respectively (p=0.07). With regard to factors associated with being a current smoker, the odds ratios were significantly high for "male gender," "greater number of days on call/night shift," and "habit of daily alcohol consumption." CONCLUSIONS: The prevalence of smoking among Japanese male physicians has shown a declining trend. When planning antismoking measures for physicians, the number of days on call/night shift as well as the habit of daily alcohol consumption must be taken into consideration.

Prevalence of and factors associated with smoking among Japanese medical students.

BACKGROUND: The aim of the present study was to determine the prevalence of and factors associated with smoking among Japanese medical students, to help promote effective antismoking measures in this population. METHODS: From the 80 university medical schools in Japan, 20 were randomly selected and invited to participate in our survey. The survey focused on medical students and employed an anonymous self-administered questionnaire. Information on each university's antismoking measures was obtained using a separate questionnaire administered to teaching staff. The survey was conducted from December 2006 through March 2007. Factors associated with smoking were identified by using the chi-square test and multiple logistic regression analysis. RESULTS: A total of 1619 valid surveys were returned. The overall prevalence of smoking was 13.7% (18.1% among men and 5.1% among women). Factors associated with smoking among medical students were male sex, enrollment at a private medical university, smoking by siblings, alcohol consumption, coffee consumption, insomnia, and less than 6 hours of sleep per night. CONCLUSIONS: Antismoking education must be further promoted to Japanese medical students, with consideration given to the factors associated with smoking behavior found in the present study.

Relationship between late-life depression and life stressors: large-scale cross-sectional study of a representative sample of the Japanese general population.

AIM: The purpose of the present study was to clarify the relationship between late-life depression and daily life stress in a representative sample of 10 969 Japanese subjects. METHODS: Data on 10 969 adults aged > or =50 who participated in the Active Survey of Health and Welfare in 2000, were analyzed. The self-administered questionnaire included items on 21 reasons for life stressors and the magnitude of stress, as well as the Japanese version of the Center for Epidemiologic Studies Depression Scale (CES-D). The relationship between the incidence of life stressors and mild-moderate (D(16)) and severe (D(26)) depressive symptoms was examined using logistic regression analysis. RESULTS: A total of 21.9% of subjects had D(16) symptoms, and 9.3% had D(26) symptoms. Further, increased age and being female were associated with more severe depressive state. Logistic regression analysis indicated that the strongest relationship between both the incidence of D(16) and D(26) symptoms and life stressors stemmed from 'having no one to talk to' (odds ratio = 3.3 and 5.0, respectively). Late-life depression was also associated with 'loss of purpose in life', 'separation/divorce', 'having nothing to do', 'health/illness/care of self', and 'debt'. CONCLUSION: There is a relationship between late-life depression and diminished social relationships, experiences involving loss of purpose in life or human relationships, and health problems in the Japanese general population.

Association between reduced serum BDNF levels and insomnia with short sleep duration among female hospital nurses.

OBJECTIVE: Previous studies have suggested that brain-derived neurotrophic factor (BDNF) is associated with sleep regulation in humans. However, its relationship with self-reported sleep problems has not been clarified. The aim of the present study was to examine the association between serum BDNF levels and sleep problems among hospital nurses. METHODS: Participants were enrolled from among nurses working at a general hospital in Tokyo, Japan. Data from 577 women (age: 35.45 ± 10.90 years) were analyzed. This cross-sectional survey was conducted from November to December 2015. Serum BDNF concentrations were evaluated. Participants completed a self-reported questionnaire on sleep including the presence or absence of insomnia symptoms (ie, difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), and early morning awakening [EMA]), and sleep duration. Insomnia with short sleep duration (ISS) was defined as: DIS, or DMS, or EMA; and <6 h sleep duration. RESULTS: Among 577 participants, 21.3% reported insomnia, 41.4% slept less than 6 h, and finally 12.5% suffered from ISS. Serum BDNF levels were significantly lower in subjects with ISS than in those without ISS. The serum BDNF levels in insomniacs were significantly lower than in non-insomniacs for short sleep duration (<6 h), while serum BDNF levels did not differ between insomniacs and non-insomniacs for normal sleep duration (≥6 h). CONCLUSION: This is the first documented study to indicate that ISS is associated with reduced serum BDNF levels. These results may lead to clarification of the underlying pathophysiological relationship between BDNF and poor sleep.

Decrease in the prevalence of adolescent alcohol use and its possible causes in Japan: periodical nationwide cross-sectional surveys.

BACKGROUND: Trends in alcohol drinking prevalence were assessed among Japanese adolescents, and possible reasons for a decrease in drinking prevalence observed in 2004. METHODS: Cross-sectional nationwide surveys were conducted periodically. High schools were randomly sampled from throughout Japan in 1996, 2000, and 2004. All enrolled students in sampled schools were subjects of the surveys. Self-reporting anonymous questionnaires were collected from 115,814 students in 1996, 106,297 in 2000, and 102,451 in 2004. Questions about drinking prevalence of students and family members, proportion of students who have no friends, and sources of alcohol were included. Students who drunk at least one day of the 30 days preceding the survey were defined as the current drinkers. RESULTS: The drinking prevalence in 2004 was decreased in comparison to that in 1996 and 2000 in both sexes and in all school grades. The current drinking rate (monthly drinker) among junior high school boys was 29.4% in 1996, 29.0% in 2000, and 20.5% in 2004, while that among senior high school boys was 49.7%, 48.7%, and 36.2%, respectively. The respective prevalence among junior and senior girls was 24.0%, 25.5%, and 20.0% and 40.8%, 42.1%, and 34.1%. The prevalent sources of alcohol beverages were searching in home, stores (convenience store, supermarket, or gas-stand), liquor shops, and bars. An analysis of the reasons for this decrease identified a decrease in drinking prevalence in students' families, especially by fathers and older brothers, and an increase in the proportion of students who had no friends. CONCLUSIONS: A decrease in drinking prevalence of male family members and a limitation of sources of alcoholic beverages may contribute to the decrease in adolescent drinking prevalence.

Coping strategies and their correlates with depression in the Japanese general population.

This study's aim was to examine the relation between depression and stress-coping strategy among the general population. The survey was conducted in June 2000, using a large sample representative of the Japanese general population. A total of 24,551 responses from individuals aged 20 years or older were analyzed. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to assess the prevalence of depression with two different cut-off points; 16 and 26. Stress-coping strategies were asked based on given examples of actual behaviors covering problem-focused, emotion-focused, and avoidant ones. There was no marked gender difference in the prevalence of a problem-solving strategy, while various types of gender differences were found with respect to the prevalence of emotion-focused and avoidant strategies. In relation to depression, multivariate logistic regression analyses revealed the significantly highest odds ratios (OR) for avoidant coping strategies and the lowest OR for problem-focused ones in both genders. The fact that depression was associated positively with avoidant strategies but negatively with problem-solving strategies indicates that individual stress-coping strategies have their own significance with respect to depression, and may be utilized in establishing an evidence-based cognitive behavioral approach to depressive patients.

Usage of the .9 codes of the ICD-10 for Japanese mortality statistics.

The structural deficits and problems associated with application of the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) were investigated. For this purpose, mortality statistics in Japan were examined for bias in the proportions of death causes classified using the ICD-10 four-character subcategory system, particularly the large distribution of cases classified under the .9 (unspecified) codes. The results showed that most deaths due to the 3 major causes were coded into the .9 subcategories. For example, 97.6% of the 607,065 deaths between 1995 and 2007 classified as I21 (acute myocardial infarction) were coded as I21.9 (acute myocardial infarction, unspecified). This suggests that the quality of the data recorded on many death certificates is poor. Thus, to ensure that the fourth-digit-level subcategories of the ICD-10 code system are effectively used to represent mortality data and actual causes of death in Japan, future studies should address the following objectives:(1) to minimize the discrepancy between the ICD classification terms and the names of diseases actually used in clinical practice, and (2) to actively raise awareness among physicians about the need to accurately record death causes on death certificates, since these records form the basis for determining mortality statistics in Japan.

Attitudes of Japanese medical students towards disclosure of a diagnosis of life-threatening illness.

In this study we investigated the attitudes of Japanese medical students toward being informed of a diagnosis of life-threatening illness. Fourth-year medical students from 20 randomly sampled universities were administered questionnaires that examined their opinion about whether they would welcome disclosure of medical information if they were diagnosed as having an ultimately fatal disease. Data from 1,619 students (male 1,074, female 545, effective collection rate 90.6%) were analyzed. With regard to attitudes about disclosure of a diagnosis of life-threatening illness, 87.7% of the students stated that they would wish to be informed even if there was little chance of recovery, and 11.6% expressed a wish to be informed of their condition only if there was a chance of recovery. Students who did not wish to be informed even if there was a chance of recovery accounted for 0.7% of those surveyed. Our study reveals that medical students are more positive than are members of the general population with regard to being informed of the truth. The proportion of those who wished to be informed even if there was little chance of recovery was higher among students from national and public universities than among those from private universities, and the inter-group difference was statistically significant. Among male students, answers to the survey were significantly correlated with 12-item General Health Questionnaire scores and mental health status, suggesting that mental health status may have affected how this study population viewed being informed of their diagnosis.