Effectiveness of group cognitive-behavioral therapy in reducing self-stigma in Japanese psychiatric patients.

OBJECTIVE: There is evidence that the stigma surrounding mental illness may be greater in Japan than elsewhere. However, few Japanese studies have focused on self-stigma (the internalization of social stigma), and few interventions to reduce self-stigma exist. To remedy this deficiency, we evaluated the efficacy of group cognitive-behavioral therapy (CBT) in reducing self-stigma and examined the relationship between cognitive restructuring and self-stigma. METHODS: We administered a 10-session group CBT program to 46 Japanese outpatients with anxiety and depressive symptoms (36 men, 10 women; mean age=38.57 years, SD=8.33; 20 diagnosed with mood disorders; 24 with neurotic, stress-related, or somatoform disorders; and 2 with other disorders). A pretest-posttest design was used to examine the relationship between cognitive restructuring and self-stigma. Outcomes were measured using the Japanese versions of the Devaluation-Discrimination Scale, Dysfunctional Attitude Scale, Beck Depression Inventory-II, State-Trait Anxiety Inventory State-Form, and Rosenberg's Self Esteem Scale. RESULTS: Participants exhibited significant improvements in depression, anxiety, and maladjusted cognitive bias and reductions in self-stigma. Cognitive bias was significantly correlated with self-stigma. CONCLUSIONS: Group CBT is effective in improving both emotional symptoms and self-stigma in outpatients with anxiety and depressive symptoms. Reduction in self-stigma plays a mediating role in alleviating emotional symptoms and improving cognition.

[Investigation into drinking problem of patients who visited a general hospital in central and northern Okinawa].

In Japan, many problems related to alcohol are pointed out from before. We believe that there is a unique drinking culture in Okinawa, such as a large amount of alcohol. Therefore, we estimate many people in Okinawa have a drinking problem. We conducted a survey of patients who visited general hospital (medical or surgical or orthopedic) in 2007. The purpose of this study is to collect basic data for introducing alcoholics to specialized treatment as early as possible, detecting the person who drink large amounts of alcohol, performing early intervention for people who drink large amount of alcohol, and advancing cooperation with specialized medical agencies of alcohol. As a result, Among the patients who visited general hospital in Okinawa, many problem drinkers are concentrated in the young age. and they have strong fears of health. The possibility of early intervention with intervention techniques, such as brief intervention, has been suggested.

Magnetic resonance imaging of sequelae of central pontine myelinolysis in chronic alcohol abusers.

Central pontine myelinolysis (CPM) is one of the serious neurological complications of alcoholism. This study evaluated magnetic resonance images of sequelae of CPM. Approximately 600 alcoholic patients were examined by a 1.0-T magnetic resonance imaging device, and 11 patients were retrospectively found to have a central pontine lesion, a presumed sequela of CPM. The lesions had various shapes and most were cavitary. In 3 of the 11 patients bilateral symmetrical oval lesions were faintly visible in the middle cerebellar peduncles. These middle cerebellar peduncular lesions were diagnosed as having Wallerian degeneration of the pontocerebellar tract secondary to CPM.

Comparison between patient characteristics and cranial MR findings in chronic thinner intoxication.

Chronic thinner intoxication is one of the most serious social problems among teenagers and young adults in Japan. The purpose of this study was to evaluate clinical characteristics of patients with thinner intoxication who had positive MR findings. During the past 4 years, cranial MR imaging of 85 patients (51 males and 34 females) with chronic thinner intoxication was done at a national psychiatric hospital. The MR imaging was performed on a 1.0-T scanner with use of standard pulse sequences including fluid-attenuated inversion recovery (FLAIR). The established characteristic MR findings of chronic thinner intoxication were observed in 8 of the 85 patients: 4 males and 4 females. The female patients tended toward emaciation and were approximately 5 years younger than the male patients. Six of the 8 patients had severe neurological symptoms such as cerebellar ataxia and decreased visual acuity. In contrast, only 3 of 77 (4%) patients with normal MR findings had mild neurological abnormalities such as tremor. If patients with chronic thinner intoxication have significant neurological symptoms, MR imaging should be performed for evaluation of brain abnormalities. Emaciated female patients may be particularly vulnerable to neurological damage caused by thinner intoxication.