Effect of the medication management module evaluated using the role play test.

Training in social skills has been shown to have a strong, positive impact, according to behavioral measures, on social skills, self-rated assertiveness, and the hospital discharge rate. It is important to establish a system of assessing social skills because it is necessary for the effects of social skills training to be assessed in Japan. In Project 1, we devised a Japanese version of the role play test to quantify social skills using a standard method. We tested 30 patients attending the day hospital who were considered to need intensive rehabilitation. We found the role play test had high inter-rater and test-retest reliability, and had construct validity and criterion related validity. Thus, the role play test was thought to be a useful tool for assessing social skills. For Project 2, eight inpatients who were ready for discharge but who needed to improve their skills in self-managed medication participated in this study. The social skills of self-managed medication assessed using the role play test were significantly improved after the subjects participated in the Medication Management Module of the UCLA social and independent living skills program. Knowledge of self-managed medication also tended to improve after training. This study is preliminary and it should be confirmed that improved skills influenced by the medication management module decreases the relapse rates.

[Assessment of social disability of patients suffering from chronic mental illness with the role play test].

UNLABELLED: Among the chronic mentally ill patients, disabilities invade most parts of their social functioning, and influences their long term course profoundly. It is important clinical issue to improve disability. Social skills training is assumed to be effective method to improve disability, and it has been disseminated over Japan recently. The assessment system to evaluate disabilities objectively at the viewpoint of social skills must be required to verify effects of social skills training, and to develop further effective therapeutic method. A role play test is the assessment tool for social skills through role plays under specific social conditions. It was reported to be useful as the method of functional assessment before treatment, and as the tool to evaluate effects of treatment to improve disability. PURPOSE: We created the Role Play Test (RPT) which was adapted to Japanese cultural background, and we tried to verify feasibility, reliability, and validity of the RPT. SUBJECTS: Thirty out-patients attending in the Day Hospital attached to Tokyo University Hospital. Twenty-six were schizophrenia, and 4 were other diagnoses. METHOD: Subjects were assessed with the RPT, BPRS, SANS, four rating scales for social functioning, and self-efficacy rating scale. The RPT was designed to assess components of social skills--social perception, role play behavior, and self-efficacy. Role play behaviors were recorded with video tapes for analysis of interrater reliability. The RPT is consisted of 12 scenes to evaluate social skills which are required in daily life. Statistical analyses were done with SAS (Statistical Analysis System). RESULTS: (1) The RPT was presumed to be feasible clinically, because the RPT could be practiced easily and responsibilities of both subjects and testers were not so much. (2) Interrater reliabilities assessed with ANOVA-ICC on 12 items was sufficiently high except one item. (3) Construct validity was certified through factor analysis, and criterion-related validity was certified through correlation analysis with other rating scales of social functioning. (4) Individual profile of the RPT should be useful instrument for functional analysis before social skills training. We also discussed on some hypotheses on the causal relationship between positive and negative symptoms and social skills. The RPT could be used as a tool to research causes of disabilities, and to evaluate improvement of social functioning after psycho-social intervention including social skills training, because the RPT can assess social skills quantitatively according to the cognitive-behavioral model.

Effects of TJ-960 on Sternberg's paradigm results in epileptic patients.

OBJECTIVES: This study is aimed at investigating the effects of TJ-960 on cognitive function in epileptic patients. Sternberg's paradigm was used to examine the change in cognitive function, especially short-term memory, resulting from administration of TJ-960, along with the effects of the drug on seizures. SUBJECTS: The subjects of this investigation were 26 epileptic outpatients (14 males and 12 females; average age: 35 +/- 11 years old) of the Saitama Medical School Hospital, the Tokyo Medical and Dental University Hospital and the Tokyo University Hospital. The controls were 17 other epileptic outpatients (12 males and 5 females; average age: 40 +/- 12 years old) of the same hospitals. METHODS: The subjects were administered 7.5 g of TJ-960 per day for 8 weeks in addition to their previous medications. Immediately before the beginning of drug administration, and again after 8 weeks of administration, they were examined, using Sternberg's paradigm. The controls were examined at intervals of 8 weeks in the same manner as the subjects (i.e., no change in regimen). RESULTS: After 8 weeks of treatment with TJ-960, 8 of the subjects exhibited a greater than 25% decrease in the number of seizures. Seventeen cases showed no change, and one case showed exacerbation. The correct reaction times for Sternberg's paradigm in the group administered TJ-960 were 955 +/- 307 ms at the time of the first examination and 881 +/- 277 ms at the time of the second, and those of the control group were 845 +/- 288 ms for the first examination and 829 +/- 269 ms for the second. As these figures show, the correct reaction time was significantly shortened between the first and second examinations in the TJ-960 group. No change was exhibited in the sample reaction time between the first and second examination in either group. The difference in alpha wave power of the occipital region before and after the TJ-960 administration was significantly greater in the patients who showed improvement in Sternberg's paradigm as compared to the patients who remained unchanged in Sternberg's paradigm. In addition, the results for the theta wave power were opposite to those of alpha waves. As mentioned above, TJ-960 was presumed to have the effect of improving the cognitive function in epileptic patients.