The relationship among sleep, resilience, and stress response in Japanese female university students during the COVID-19 pandemic.

We examined the effect of sleep and resilience on stress responses in female Japanese university students during the COVID-19 pandemic. Sleep was measured using the Japanese version of the Pittsburgh Sleep Quality Index (PSQI-J), stress response was evaluated using the Stress Response Scale-18 (SRS-18), and resilience using the Resilience Scale for Students (RS-S). Multiple regression analysis showed that approximately 40% of the SRS-18 score could be explained by PSQI-J score and RS-S score. Subjective sleep quality, daytime dysfunction, and global score of PSQI-J had direct influences on SRS-18.

Work productivity loss and work-related factors during the first wave of the COVID-19 pandemic: A cross-sectional web-based survey.

BACKGROUND: The COVID-19 pandemic could have led to a technological revolution however it has caused work productivity loss, especially among people working from home. OBJECTIVE: This study examined the frequency and related factors of work productivity loss, focusing on work-related factors, during the first wave of the COVID-19 pandemic in Japan. METHODS: We conducted a cross-sectional, web-based survey of Japanese workers. Questionnaires were distributed using snowball sampling through e-mail and social networking sites. RESULTS: Of the respondents, 708 non-medical workers reported subjective work productivity loss during the first wave of the pandemic, compared with before. A multiple regression analysis showed that living with preschool-age children, having poor mental health, not using video conferencing solutions, and increased e-mail communication were related to work productivity loss. A subgroup analysis of those working from home showed similar variables associated with work productivity loss. CONCLUSIONS: More than 70% of workers in Japan experienced work productivity loss during the first wave of the pandemic. Moreover, factors such as time-consuming tasks or background distractions might lead to operational inefficacy.

Association between Physical Frailty and Sleep Disturbances among Patients on Hemodialysis: A Cross-Sectional Study.

INTRODUCTION: Among patients on hemodialysis (HD), physical frailty and sleep disturbances are not only common but also associated with adverse outcomes. The aim of this study was to evaluate the association between physical frailty and sleep disturbances in patients on HD. METHODS: This cross-sectional study was conducted from June 2017 to March 2021, with outpatients receiving HD 3 times a week at two dialysis facilities in Japan. Sleep disturbances were identified with the Athens Insomnia Scale (AIS). Physical frailty was defined using the Fried Frailty Phenotype. Patients were classified as "non-frailty (number of frailty components: 0-2)" or "frailty (3-5)." We examined the association of sleep disturbances with physical frailty and its components by performing a logistic regression analysis. RESULTS: We analyzed 360 patients (mean age 65.6 years; 62% men). Eighty-one patients (23%) were classified into the group with frailty, and the mean AIS score was 5.2 ± 4.2 points. After adjusting for clinical characteristics, increasing the AIS score per 1 point was associated with higher odds of physical frailty (odds ratio, 1.12; 95% confidence interval, 1.05-1.20; p < 0.01). As for the frailty components, exhaustion, low physical activity, and weak grip strength showed an association with sleep disturbances (all p < 0.05). CONCLUSIONS: Sleep disturbances were independently associated with physical frailty in patients on HD. Future studies are warranted to investigate the causality between physical frailty and sleep disturbances in this population.

Development of the Parenting Behavior Checklist to Promote Preschoolers' Sleep (PCPP).

OBJECTIVES: To develop the Parenting Behavior Checklist to Promote Preschoolers' sleep (PCPP), quantify sleep-promoting parenting behaviors for children, and examine the scale's reliability and validity. METHODS: The PCPP was developed based on the recommendations of the ABCs of SLEEPING for children's sleep, which is strongly supported by research evidence. Its validity and reliability were evaluated using data from 140 participants. Structural validity was estimated using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), and internal consistency was evaluated by Cronbach's α. Hypothesis testing was evaluated by analyzing the correlations between each factor of the Japanese Sleep Questionnaire for Preschoolers (JSQ-P) and the PCPP. RESULTS: Regarding structural validity, EFA was conducted because CFA showed a poor model fit. The PCPP comprised one factor and six items. The JSQ-P subfactors of insomnia or circadian rhythm sleep-wake disorders, undesirable morning symptoms and behaviors, and insufficient sleep were moderately negatively correlated with the PCPP; the subfactor of undesirable daytime behaviors related to sleep problems was weakly negatively correlated with the PCPP. Thus, the sleep-promoting parenting behaviors listed in the PCPP were associated with better sleep in children. CONCLUSIONS: The PCPP showed sufficient reliability and validity. Future studies should use the scale to examine more effective interventions regarding sleep-promoting parental behaviors for children.

Blunted diurnal interleukin-6 rhythm is associated with amygdala emotional hyporeactivity and depression: a modulating role of gene-stressor interactions.

Background: The immune system has major roles in the brain and related psychopathology. Disrupted interleukin-6 secretion and aberrant amygdala emotional reactivity are well-documented in stress-related mental disorders. The amygdala regulates psychosocial stress-related interleukin-6 affected by related genes. These led us to comprehensively examine the relationship between interleukin-6, amygdala activity, and stress-related mental symptoms under gene-stressor interactions. Methods: One hundred eight nonclinical participants with various levels of anxiety/depression underwent magnetic resonance imaging scans during an emotional face task for amygdala activity and saliva collection (at 10-time points across 2 days) for the total output and diurnal patterns of interleukin-6. Gene-stressor interactions between rs1800796 (C/G) and rs2228145 (C/A) and stressful life events for the biobehavioral measures were explored. Results: The blunting of interleukin-6 diurnal pattern was associated with hypoactivation of the basolateral amygdala in response to fearful (vs. neutral) faces (t = 3.67, FWE-corrected p = 0.003), and was predominantly observed in individuals with rs1800796 C-allele homozygotes and negative life changes in the past year (F = 19.71, p < 0.001). When considered in a comprehensive model, the diminished diurnal pattern predicted greater depressive symptoms (ß = -0.40), modulated by the amygdala hypoactivity (ß = 0.36) and rs1800796-stressor interactions (ß = -0.41; all p < 0.001). Conclusion: Here we show that the blunted interleukin-6 diurnal rhythm predicts depressive symptoms, modulated by amygdala emotional hyporeactivity and gene-stressor interactions. These findings indicate a potential mechanism underlying vulnerability to depressive disorders, suggesting their early detection, prevention, and treatment through the understanding of immune system dysregulation.

Symptoms and risk factors of depression and PTSD in the prolonged COVID-19 pandemic: a longitudinal survey conducted from 2020 to 2022 in Japan.

BACKGROUND: The present study aimed to explore changes in depression and posttraumatic stress disorder (PTSD) among the general population during the prolonged COVID-19 pandemic and to investigate risk factors and adaptive/nonadaptive strategies. METHODS: A web-based longitudinal survey was conducted across five timepoints from 2020 to 2022 in Japan. Depressive symptoms were measured using the Patient Health Questionnaire-9 (PHQ-9), PTSD was measured using Impact of Event Scale-Revised (IESR), and coping strategies were measured using Brief Coping Orientation to Problems Experienced (Brief COPE). Higher scores of PHQ-9 and IESR indicate more symptoms and Higher score of Brief COPE indicate that these means of coping are used very frequently. RESULTS: A total of 1,366 participants (mean age = 52.76, SD = 15.57) were analyzed. Regarding levels of depression, PHQ-9 scores in 2022 were lower than in 2020 and 2021 (all p < 0.01). Regarding levels of PTSD, IESR scores in 2022 were lower than in 2021 among females (p < 0.001). Being younger (ß = -0.08 and - 0.13, both p < 0.01) and engaging in self-blame (ß = 0.12 and 0.18, both p < 0.01) increased PHQ-9 scores regardless of sex. For males, not working (ß = 0.09, p = 0.004) and having suffered an economic impact (ß = 0.07, p = 0.003) were risk factors for depressive symptoms, and active coping (ß = -0.10, p = 0.005) was associated with decreased depressive symptoms. For females, substance use (ß = 0.07, p = 0.032) and behavioral disengagement (ß = 0.10, p = 0.006) increased depressive symptoms, and females did not show strategies that decreased the symptoms. CONCLUSIONS: Levels of depression might have increased in the early stages of the pandemic and decreased in January 2022. Although males need to improve their economic situation to decrease depressive symptoms, adaptive strategies might be difficult to identify due to the prolonged pandemic among both sexes. In addition, the pandemic might be a depressive event but not a traumatic event among the general population, at least in Japan.

Health care providers' perspectives on providing end-of-life psychiatric care in cardiology and oncology hospitals: a cross-sectional questionnaire survey.

BACKGROUND: Psychological distress is a major concern for patients with end-stage heart failure (HF). However, psychiatric care for patients with HF is not as organized as that for patients with cancer. Therefore, the aim of this study was to elucidate and compare the barriers faced by health care providers of cardiology and oncology hospitals in providing end-of-life psychiatric care to patients with HF and cancer, respectively. METHODS: We conducted a cross-sectional questionnaire survey among the health care providers of Japan. Questionnaires were mailed to physicians and nurses of 427 cardiology and 347 oncology hospitals in March 2018 to assess health care providers' perspectives. First, we compared the scores of the Palliative Care Difficulties Scale and the original scale of end-of-life psychiatric care difficulties between health care providers of cardiology and oncology hospitals. Second, we asked the health care providers to describe the barriers to providing end-of-life psychiatric care with an open-ended question and then compared the freely-provided descriptions using content analysis. RESULTS: A total of 213 cardiology and 224 oncology health care providers responded to the questionnaire. No significant differences were found between health care providers of cardiology and oncology hospitals in the frequency of experiencing barriers to providing end-of-life psychiatric care (59.8% and 62.2%, respectively). A content analysis identified the following eight barriers: "patients' personal problems," "family members' problems," "professionals' personal problems," "communication problems between professionals and patients," "problems specific to end-of-life care," "problems specific to psychiatric care," "problems of institution or system," and "problems specific to non-cancer patients." The "problems specific to noncancer patients" was described more frequently by health care providers in cardiology hospitals than that in oncology hospitals. However, there were no significant differences in other items between the two. CONCLUSION: Although health care providers of both cardiology and oncology hospitals faced barriers to providing end-of-life psychiatric care, those of cardiology hospitals particularly faced challenges pertaining to non-cancer patients, such as unpredictability of prognosis or insufficiency of guideline development. A system of psychiatric care, specifically for patients with HF, should be established.

Age-related differences in depressive symptoms and coping strategies during the COVID-19 pandemic in Japan: A longitudinal study.

OBJECTIVE: The coronavirus 2019 (COVID-19) pandemic has particularly influenced the mental health of younger adults; accordingly, this study investigated age-related factors related to mental health and provided suggestions related to mental health recovery. METHODS: A web-based longitudinal survey was conducted from 2020 to 2021 in Japan. The survey consisted of the Patient Health Questionnaire-9 (PHQ-9), used to measure depressive symptoms as a response variable, and an anger questionnaire and coping strategy scale to assess explanatory variables. RESULTS: A total of 1468 participants were analyzed (valid response rate = 54.2%); 368 were younger adults (age range = 20-39), 667 were middle-aged adults (age range = 40-64), and 433 were aged adults (age range = 65-79). The PHQ-9 scores in the younger adults worsened over the three survey timepoints. State anger was strongly related to PHQ-9 scores in all age groups (standardized beta = 0.39-0.47), and state anger in the younger group was highest at all survey times, In the younger group, only nonadaptive coping strategies were related to PHQ-9 scores. Emotional support, venting, and humor adaptive strategies used by middle-aged and aged adults were most commonly used by younger adults; however, there were no significant relationships of these strategies with PHQ-9 scores in the younger group. CONCLUSION: The level of depressive symptoms among the younger adults might be considerably worse than the middle-aged and aged adult. The younger adults might not make use of strategies, hence, they might need advice and skill training of strategies.

Association of childhood maltreatment history with salivary interleukin-6 diurnal patterns and C-reactive protein in healthy adults.

Childhood maltreatment has been associated with increased inflammation, as indicated by elevated levels of proinflammatory markers such as interleukin-6 (IL-6) and C-reactive protein (CRP). Studies in humans show that secretion of IL-6 follows a clear circadian rhythm, implying that its disturbed rhythm represents an important aspect of dysregulated inflammatory system. However, possible alterations in diurnal secretion patterns of IL-6 associated with childhood maltreatment have not been studied. Here we investigated this association in 116 healthy adults. Diurnal levels of IL-6 were examined using saliva samples collected at 5 times a day across 2 consecutive days. Salivary CRP levels were also determined by averaging measurements at 2 times a day for 2 days. Different types of childhood maltreatment were assessed with the Childhood Trauma Questionnaire (CTQ). CTQ total and emotional abuse scores were significantly correlated with smaller IL-6 diurnal variation as indexed by lower standard deviation across the measurement times (p = 0.024 and p = 0.008, respectively). Individuals with emotional abuse, as defined by a cut-off score of CTQ, showed flatter IL-6 rhythm than those without (p = 0.031). These results, both correlation and group comparison, remained significant after controlling for age, sex, and body mass index. Childhood maltreatment was not associated with total output of IL-6 or CRP. Our findings indicate that childhood trauma can have a long-term negative effect on the circadian rhythm of inflammatory system. The findings are consistent with those of previous studies on adulthood trauma, suggesting that the disrupted IL-6 rhythmicity may be associated with a broad range of trauma-related conditions.

Implicit and explicit emotional memory recall in anxiety and depression: Role of basolateral amygdala and cortisol-norepinephrine interaction.

Anxiety and depression are linked to both explicit and implicit memory biases, which are defined as the tendency to preferentially recall emotionally negative information at conscious and subconscious levels, respectively. Functional connectivity (FC) of the basolateral amygdala (BLA) and related stress hormones (i.e., cortisol and norepinephrine) are purportedly implicated in these biases. However, previous findings on memory biases in anxiety and depression have been inconsistent, likely due to their symptomatic complications. Therefore, the underlying neurobiological mechanism remains unclear. We thus investigated whether anxiety and depression as premorbid predispositions are related to the memory biases, and whether FC of BLA, cortisol, and 3-methoxy-4-hydroxyphenylglycol (MHPG: a major metabolite of norepinephrine) would affect the anxiety/depression-related biased memory recall in 100 participants without psychiatric symptomatology. Psycho-behavioral assessment, resting-state fMRI scans, and saliva collection at 10-points-in-time across two days were conducted. Correlations of memory biases with anxiety/depression and neurobiological markers were explored. As a result, neither anxiety nor depression were correlated with explicit memory bias to negative (vs. positive) information, although depression was associated with better recall of the negative stimuli only when they were perceived as self-relevant. In contrast, both anxiety and depression were correlated with implicit memory bias; however, the effects were solely explained by anxiety. Furthermore, FC of the BLA with subgenual anterior cingulate cortex (sgACC) and the synergetic effect of cortisol and MHPG uniquely affected the implicit memory bias. These findings suggest that anxiety facilitates an initial snapshot of negative information and can be accompanied by depression when the information creates negative semantic associations with the self. The BLA-sgACC neural connectivity and cortisol-norepinephrine interaction that are associated with the implicit memory bias might be one of the important neurobiological targets in the prevention and treatment for comorbid anxiety and depressive disorders.

Childhood trauma affects autobiographical memory deficits through basal cortisol and prefrontal-extrastriate functional connectivity.

BACKGROUND: Psychological trauma can damage the brain, especially in areas where glucocorticoid receptors are expressed, via perturbed secretion of cortisol. Childhood trauma is associated with blunted basal cortisol secretion, brain alterations, and autobiographical memory deficits referred to as overgeneral autobiographical memory (OGM). However, it remains unknown whether childhood trauma affects OGM through altered cortisol and brain alterations. METHODS: Using resting-state fMRI in 100 healthy humans, we examined whether childhood trauma affects OGM through its related basal cortisol and brain functional connectivity (FC). Trauma and OGM were assessed using the Childhood Trauma Questionnaire (CTQ) and Autobiographical Memory Test (AMT), respectively. Basal cortisol levels were measured by 10 points-in-time across two days. Multiple mediation analysis was employed. RESULTS: CTQ was associated with greater semantic-associate memory of OGM, a retrieval tendency toward semantic content with no specific contextual details of an experienced event, as well as blunted basal cortisol levels. While CTQ was correlated with decreased FC between the hippocampus and medial prefrontal cortex (PFC), it showed a more predominant correlation with increased FC between the lateral and anteromedial PFC and extrastriate cortex. Importantly, the increased prefrontal-extrastriate FC completely mediated the relationship between CTQ and semantic-associate memory, affected by hyposecretion of cortisol. CONCLUSION: Childhood trauma may lead to the lack of visuoperceptual contextual details in autobiographical memory by altering basal cortisol secretion and connectivity of the prefrontal-hippocampal-extrastriate regions. The intensified prefrontal-extrastriate connectivity may contribute to OGM formation by strengthening the semantic content in memory retrieval. Understanding the mechanisms underlying the trauma-cortisol-brain-memory link will provide important clinical implications for trauma-related mental disorders.

The influence of ageism on stereotypical attitudes among allied health students in Japan: a group comparison design.

BACKGROUND: Ageism is a serious problem in medical care. The importance of ageism-related education for students has been emphasized. To determine the most effective approach to ageism-related education for allied health students, this study examined ageism among this group of students, with the hypothesis that ageism was expressed not only toward elderly adults but also toward individuals other than elderly adults. METHODS: A questionnaire survey was conducted among 154 allied health students in Japan. The questionnaire involved tree drawings to evaluate the drawer's personality and a measurement of the participants' ageism. There were two display conditions for tree drawing. In the elderly display condition, participants were informed that the drawer was an elderly person, and in a control condition, participants were not informed of the drawer's age. Participants were randomly assigned to each condition and were required to evaluate the drawer's personality based on 5 personality traits. After the evaluation, all participants were required to complete the Japanese short version of the Fraboni Scale of Ageism (FSA-J). RESULTS: The participants were 123 allied health students, 61 of whom were in the elderly display condition and 62 of whom were in the control condition. Based on the mean score on the FSA-J (M = 29.80), we divided the participants into a low-FSA-J group (N = 64) and a high-FSA-J group (N = 59). There was no significant difference between the display conditions on the FSA-J score. In the high-FSA-J groups, the control condition evaluated the drawer's personality as more timid than did the elderly display condition (F = 4.26, df = 1, 119). For negligence, the high-FSA-J group evaluated the drawer's personality as more negligent than did the low-FSA-J group (F = 4.08). For broad interests, the main effects of condition and groups were significant (F = 4.23). CONCLUSIONS: The results suggested that ageism indicated a negative evaluation not only of elderly adults but also of individuals other than elderly adults, and students with negative ageism might evaluate the elderly drawer more positively. We have discussed the possibility that negative ageism among allied health students in Japan might underlie these positive stereotypes.

Depression, risk factors, and coping strategies in the context of social dislocations resulting from the second wave of COVID-19 in Japan.

BACKGROUND: Social dislocations resulting from coronavirus disease 2019 (COVID-19) pandemic have been prolonged, which has led to general population social suppression. The present study aimed to reveal risk factors associated with mental health problems and suggest concrete coping strategies in the context of COVID-19. METHODS: A web-based survey was conducted in July when Japan was experiencing a second wave of COVID-19. Demographics, Patient Health Questionnaire-9 (PHQ-9), state anger, anger control, and the Brief Coping Orientation to Problems Experienced were measured. Multivariate logistic regression analysis on PHQ-9 scores by set variables was conducted. RESULTS: The participants were 2708 individuals, and 18.35% of them were depressed. Logistic regression analysis showed that in the order of odds ratios (ORs), underlying disease (OR = 1.96, 95% confidence interval (CI) = 1.32-2.92), not working (OR = 1.85, CI = 1.22-2.80), negative economic impact (OR = 1.33, CI = 1.01-1.77), state anger (OR = 1.17, CI = 1.14-1.21), anger control (OR = 1.08, CI = 1.04-1.13), age (OR = 0.97, CI = 0.96-0.98), high income (OR = 0.45, CI = 0.25-0.80), and being married (OR = 0.53, CI = 0.38-0.74) were predictors of depressive symptoms. Regarding coping strategies, planning (OR = 0.84, CI = 0.74-0.94), use of instrumental support (OR = 0.85, CI = 0.76-0.95), denial (OR = 0.88, CI = 0.77-0.99), behavioural disengagement (OR = 1.28, CI = 1.13-1.44), and self-blame (OR = 1.47, CI = 1.31-1.65) were associated with probable depression. CONCLUSIONS: During prolonged psychological distress caused by COVID-19 pandemic, the prevalence of depressive symptoms in Japan was two to nine times as high as before the COVID-19 pandemic, even though Japan was not a lockdown country. Although some coping strategies were useful for maintaining mental health, such as developing ways, alone or with others, to address or avoid social dislocations, the influence of demographics was more powerful than these coping strategies, and medical treatments are needed for high-risk individuals.

Efficacy of stress management program for depressive patients with advanced head and neck cancer: A single-center pilot study / Eficacia de un programa de control del estrés para pacientes depresivos con cáncer avanzado de cabeza y cuello: estudio de un solo centro

BACKGROUND/OBJECTIVE: Patients with head and neck cancer (HNC) have some problems such as dysfunction of breathing, eating, and/or speaking. The aim of this study was to examine efficacy of the stress management program for HNC patients (SMAP-HNC) compared with usual care (UC). METHOD: We conducted a pilot study of SMAP-HNC for depressive HNC patients between January 2016 and March 2018. The program contains psychoeducation, stress coping training, and operant reinforcement. The outcome measure was the Hospital Anxiety and Depression Scale (HADS), Functional Assessment of Cancer Therapy (FACT), and Brief Coping Inventory (COPE). RESULTS: Twenty patients were randomly assigned to SMAP-HNC and UC group. Although a small sample sizes, there was no significant difference of depression score change between SMAP-HNC and UC group (Hedges’d g -0.83; 95% CI -1.80 to 0.13). CONCLUSIONS: It was the first study to conduct stress management program for HNC patients. Unfortunately, our trial designed as a randomized controlled trial is underpowered to make conclusion as to the efficacy of SMAP-HNC. However, there are some valuable suggestions to modify the stress management program in future

ANTECEDENTES/OBJETIVO: Los pacientes con cáncer de cabeza y cuello (CCC) tienen algunos problemas como trastornos de la respiración, la alimentación y/o el habla. El objetivo de este estudio fue examinar la eficacia de un programa de control del estrés para pacientes con CCC (SMAP-HNC) en comparación con la atención habitual (AH). MÉTODO: Llevamos a cabo un estudio piloto de SMAP-HNC para pacientes depresivos con CCC entre enero de 2016 y marzo de 2018. El programa contiene psicoeducación, entrenamiento para afrontar el estrés y refuerzo operante. Las medidas de los resultado fueron la Hospital Anxiety and Depression Scale (HADS), la Functional Assessment of Cancer Therapy (FACT) y el Brief Coping Inventory (COPE). RESULTADOS: Veinte pacientes fueron asignados aleatoriamente al grupo SMAP-HNC y AH. Aunque los tamaños de las muestras son pequeños, no hubo diferencias significativas en el cambio en el puntaje de depresión entre el grupo SMAP-HNC y el grupo AH (g de Heges's -0,83; IC del 95%: -1,80 a 0,13). CONCLUSIONES: Es el primer estudio en emplera un programa de control del estrés para pacientes con CCC. Desafortunadamente, nuestro ensayo diseñado como un ensayo controlado aleatorio tiene poco poder para llegar a una conclusión sobre la eficacia de SMAP-HNC. Sin embargo, hay algunas sugerencias valiosas para modificar el programa de control del estrés en el futuro

Efficacy of stress management program for depressive patients with advanced head and neck cancer: A single-center pilot study.

BACKGROUND/OBJECTIVE: Patients with head and neck cancer (HNC) have some problems such as dysfunction of breathing, eating, and/or speaking. The aim of this study was to examine efficacy of the stress management program for HNC patients (SMAP-HNC) compared with usual care (UC). METHOD: We conducted a pilot study of SMAP-HNC for depressive HNC patients between January 2016 and March 2018. The program contains psychoeducation, stress coping training, and operant reinforcement. The outcome measure was the Hospital Anxiety and Depression Scale (HADS), Functional Assessment of Cancer Therapy (FACT), and Brief Coping Inventory (COPE). RESULTS: Twenty patients were randomly assigned to SMAP-HNC and UC group. Although a small sample sizes, there was no significant difference of depression score change between SMAP-HNC and UC group (Hedges'd g -0.83; 95% CI -1.80 to 0.13). CONCLUSIONS: It was the first study to conduct stress management program for HNC patients. Unfortunately, our trial designed as a randomized controlled trial is underpowered to make conclusion as to the efficacy of SMAP-HNC. However, there are some valuable suggestions to modify the stress management program in future.

ANTECEDENTES/OBJETIVO: Los pacientes con cáncer de cabeza y cuello (CCC) tienen algunos problemas como trastornos de la respiración, la alimentación y/o el habla. El objetivo de este estudio fue examinar la eficacia de un programa de control del estrés para pacientes con CCC (SMAP-HNC) en comparación con la atención habitual (AH). MÉTODO: Llevamos a cabo un estudio piloto de SMAP-HNC para pacientes depresivos con CCC entre enero de 2016 y marzo de 2018. El programa contiene psicoeducación, entrenamiento para afrontar el estrés y refuerzo operante. Las medidas de los resultado fueron la Hospital Anxiety and Depression Scale (HADS), la Functional Assessment of Cancer Therapy (FACT) y el Brief Coping Inventory (COPE). RESULTADOS: Veinte pacientes fueron asignados aleatoriamente al grupo SMAP-HNC y AH. Aunque los tamaños de las muestras son pequeños, no hubo diferencias significativas en el cambio en el puntaje de depresión entre el grupo SMAP-HNC y el grupo AH (g de Heges's -0,83; IC del 95%: -1,80 a 0,13). CONCLUSIONES: Es el primer estudio en emplera un programa de control del estrés para pacientes con CCC. Desafortunadamente, nuestro ensayo diseñado como un ensayo controlado aleatorio tiene poco poder para llegar a una conclusión sobre la eficacia de SMAP-HNC. Sin embargo, hay algunas sugerencias valiosas para modificar el programa de control del estrés en el futuro.

Basolateral Amygdala Connectivity With Subgenual Anterior Cingulate Cortex Represents Enhanced Fear-Related Memory Encoding in Anxious Humans.

BACKGROUND: The amygdala can enhance emotional memory encoding as well as anxiogenesis via corticotropin-releasing factor neurons. However, the amygdala's explicit role in emotional encoding remains unclarified in humans. We examined how functional connectivity (FC) of amygdala subnuclei affects emotional encoding, considering its mechanism in which anxiety, attention, and cortisol conceivably participate. METHODS: A total of 65 healthy humans underwent resting-state functional magnetic resonance imaging scans and saliva collection at 10 points in time over 2 days. FC analysis was performed for basolateral amygdala subnucleus (BLA) and centromedial amygdala subnucleus. We assessed attentional control via an emotional Stroop task and assessed emotional encoding via a facial identification task that examines how strongly a neutral face is memorized when accompanied by an emotional face (fearful, sad, or happy). FC and task performance were compared between high-anxious and non-high-anxious groups classified by anxious personality scores. RESULTS: BLA connected with subgenual anterior cingulate cortex (sgACC) in proportion to the strength of fear-related encoding, whereas centromedial subnucleus connected with caudate nucleus for happy-related encoding. The high-anxious group showed more enhanced fear-related encoding but impaired happy-related encoding compared with the non-high-anxious group. BLA-sgACC FC was more intensified in the high-anxious group than in the non-high-anxious group; however, centromedial-caudate FC did not differ between them. Although emotional encoding was uncorrelated with either attentional control or cortisol, BLA-sgACC was positively correlated with cortisol increase after awakening. CONCLUSIONS: The study revealed that neural interactions of BLA, specifically with sgACC, might play a critical role in fear-related memory encoding, depending on the individual's level of anxiety. These findings aid in understanding the complicated mechanisms of emotional memory in anxiety disorders.

Evaluating depression in cognitively healthy elderly people by using Mini-Mental State Examination.

AIM: We examined a method for evaluating depression with the Mini-Mental State Examination in cognitively healthy elderly people and employed the projective perspective. METHODS: In MMSE three groups-normal, depressed tendency, and depressed-completed the Mini-Mental State Examination (MMSE) and a Japanese version of the 15-item Geriatric Depression Scale. The Mini-Mental State Examination evaluated individuals' writing based on a sentence, the number of written words, and sentence content; it also assessed their copying of drawn figures. RESULTS: In the depressed group, the proportion corresponding to the characteristics of (i) to (iii) was higher than in the other two groups: (i) the calculation score was 0 or 1; (ii) subjects scored above the median in sentence writing relative to similar subjects with the same language and clinical setting; and (iii) subjects expressed feelings in their writing. One point was given for each characteristic, and we calculated the sum. Depressed subjects had a score ≥2. CONCLUSIONS: This evaluation method can differentiate depressed subjects with high accuracy (sensitivity: 77.8%, specificity: 76.4%) without placing an extra burden on the subjects.

Cortisol-related hippocampal-extrastriate functional connectivity explains the adverse effect of cortisol on visuospatial retrieval.

Cortisol is known to affect visuospatial memory through its major binding site in the brain, the hippocampus. The synchronization of neural activity between the hippocampus, prefrontal cortex (PFC), and visual cortex is presumed to be essential for the formation of visuospatial memory because of their visuospatial learning-dependent neuroplasticity. However, it remains unclear how hippocampal connectivity with the PFC and visual cortex is involved in the relationship between cortisol and visuospatial memory in humans. We thus investigated whether functional connectivity (FC) of the hippocampus, specifically its rostral and caudal subdivisions, mediates the relationship between visuospatial memory and endogenous cortisol. One-hundred sixty-six healthy young adults underwent standard neuropsychological tests to assess visuospatial construction (a complex figure copying test) and retrieval (the corresponding recall test) and collected their saliva at 6-time points across 2 consecutive days for measurement of daily cortisol concentrations (dCOR). Ninety of them received resting-state fMRI scans. Greater dCOR was significantly associated with better figure copying performance, but contrastingly with poorer figure recall. In proportion to dCOR, the rostral hippocampus (rHC) showed significantly increased FC with the PFC (including its dorsolateral and medial parts) and the inferior lateral occipital cortex (iLOC), while the caudal hippocampus had increased FC with the anterior middle temporal cortex. Of the cortisol-related hippocampal connectivity, the rHC-iLOC FC was specifically correlated with figure recall and showed complete mediation for the negative relationship of dCOR with figure recall. These results suggest that cortisol might have enhancing effects on visuospatial encoding as well as impairing effects on visuospatial retrieval, possibly due to its occupancy patterns of corticosteroid receptors. Cortisol's adverse effects on visuospatial retrieval might be explained through cortisol-related rostral hippocampal connectivity with the iLOC, which is a part of the extrastriate cortex implicated in visuospatial perception. Thorough dissection of hippocampal-prefrontal-extrastriate connectivity might facilitate the understanding of neural mechanisms underlying cortisol's contrasting effects on encoding (or consolidation) and retrieval of visuospatial information.

Characteristics of dementia patients who described or did not describe the relationship between two people on the COGNISTAT speech sample.

Speech sample of Cognitive Status Examination (COGNISTAT) is a task in which examinees freely talk about what is happening in a presented picture. We investigated whether there are differences in the characteristics between patients who described or did not describe the relationship between two people in the speech sample based on age, gender, cognitive dysfunction, and type of dementia (Alzheimer's disease and dementia with Lewy bodies). The participants were 60-year-old or older patients diagnosed with Alzheimer's disease or dementia with Lewy bodies who undertook the Mini-Mental State Examination (MMSE) and COGNISTAT at a general hospital specialized in care for the elderly. MMSE and COGNISTAT were performed by a female clinical psychologist in all patients. In a stepwise logistic regression analysis using the two groups (description and no description groups) as a response variable, and the age, gender, diagnosis, MMSE score, and score of each COGNISTAT subtest as explanatory variables, the MMSE score (OR = 1.09; 95% CI [1.03, 1.15]) and gender (OR = 1.79; 95% CI [1.09, 2.93]) factors were extracted. These results indicated that patients with severer overall cognitive dysfunction and male patients were unlikely to describe the relationship between two people in a speech sample.