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1.
J Affect Disord ; 260: 432-439, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-31539677

RESUMO

BACKGROUND: The present study examined the data from the Fukushima Health Management Survey conducted after the Great East Japan Earthquake to identify disaster-related factors affecting the mental health status of adolescents following the disaster and obtained basic data necessary in providing mental healthcare. METHODS: The study included 2808 adolescents aged 15-19 years (male: 1327; female: 1481) who completed the 2011 edition of the registered questionnaire. The Kessler Psychological Distress Scale scores, age, sex, health status, sleep satisfaction level, Great East Japan Earthquake experience, experience of losing a loved one, change in employment status, change in residence, and awareness of the impact of radiation on health were examined. RESULTS: Psychological distress was significantly correlated with sex, health status, sleep satisfaction of, experience of losing a loved one, change in employment status, extreme anxiety regarding the acute health impact of radiation, and extreme anxiety regarding the impact of radiation on health in adolescents and the next generation. LIMITATIONS: The present study is limited because of its cross-sectional design, due to which, the causal relationship between each factor and psychological distress could not be clarified. CONCLUSIONS: The results of the present study suggest that appropriate mental healthcare should be administered immediately following an earthquake to adolescents who have lost a loved one and experienced anxiety regarding the health impact of radiation following a nuclear accident.

2.
Infect Genet Evol ; 74: 103923, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31207401

RESUMO

Japan reportedly has high incidence rate of nontuberculous mycobacterial lung disease (14.7 cases per 100,000 person in 2014). In Japan, the most common etiology is Mycobacterium avium subsp. hominissuis (MAH). MAH is a typical inhabitant of the environment, especially bathrooms, which are considered as a potential source of infection. To corroborate this hypothesis, we determined the detection rate of MAH in bathrooms of healthy volunteers by an ordinary culture method and we analyzed the genetic relatedness of these isolates with those from patients and other sources. We collected swabs of bathtub inlets, showerheads, bathroom drains, and shower water from 180 residences throughout Japan. The overall MAH detection rate was 16.1%, but the rate varied among regions: it was high in Kanto (9/34, 26.5%) and Kinki (9/33, 27.3%), but low in Kyushu (0/11, 0%), Tohoku (1/23, 4.3%), and Hokkaido (2/23, 8.7%). MAH was detected primarily in bathtub inlet samples (25 out of 170 residences). Variable numbers of tandem repeats (VNTR) analysis was used to examine the genetic relatedness of 57 MAH isolates from bathrooms of the healthy volunteers with human clinical isolates. A minimum spanning tree generated on the basis of the VNTR data indicated that isolates from the bathrooms of the healthy volunteers had a high degree of genetic relatedness with those from Japanese patients, bathrooms of patients, and river water, but not with those from Russian patients and Japanese pigs. These results showed that bathtub inlets in Japan provide an environmental niche for MAH and suggest that bathrooms are one of the important infection sources of MAH in Japan. Understanding country-specific lifestyle habits, such as bathing in Japan, as well as the genetic diversity of MAH, will help in elucidating the sources of this pathogen.

3.
Artigo em Inglês | MEDLINE | ID: mdl-30373233

RESUMO

The 2011 Fukushima nuclear accident resulted in the exposure to radiation and evacuation, which has created psychological distress among the Fukushima residents. With the provision of multi-faceted support and the progress of the reconstruction, their mental health has appeared to show signs of recovery. However, there have been few studies investigating their recovery. To clarify the related factors associated with mental health recovery, a cross-sectional questionnaire survey was conducted. Subjects whose answers were associated with Resilience, Recovery, and Remitting patterns of mental health status were categorized in the Recovery group, while those associated with Delayed/Chronic dysfunction were placed in the Non-recovered group. In a multivariable logistic regression analysis, disaster-related unemployment (odds ratio (OR): 0.80, 95% CI (confidence interval): 0.65⁻0.99) and economic hardship (OR: 0.80, 95% CI: 0.65⁻0.98) were associated with the hindrance of recovery. In contrast, overall good health (OR: 1.47, 95% CI: 1.20⁻1.80), regular physical activity (OR: 1.23, 95% CI: 1.01⁻1.50), social interaction with friends (OR: 1.25, 95% CI: 1.00⁻1.55), and established social roles (OR: 1.44, 95% CI: 1.14⁻1.82) were associated with the promotion of recovery. In conclusion, our study showed a positive association between mental health recovery and a desirable lifestyle and social network, particularly with social roles. Thus, the provision of active social roles can promote recovery related to a disaster as with multi-faceted support.


Assuntos
Acidente Nuclear de Fukushima , Estilo de Vida , Recuperação da Saúde Mental , Rede Social , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Desastres , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Apoio Social , Inquéritos e Questionários , Adulto Jovem
4.
Artigo em Inglês | MEDLINE | ID: mdl-30012739

RESUMO

Although grief is a natural response to loss among human beings, some people have a severe and prolonged course of grief. In the 1990s, unusual grief persisting with a high level of acute symptoms became known as 'complicated grief (CG)'. Many studies have shown that people who suffer from CG are at risk of long-term mental and physical health impairments and suicidal behaviours; it is considered a pathological state, which requires clinical intervention and treatment. DSM-5 (2013 Diagnostic and statistical manual of mental disorders, 5th edn) proposed 'persistent complex bereavement disorder' as a psychiatric disorder; it is similar to CG in that it is a trauma- and stress-related disorder. In recent years, there has been considerable research on the treatment of CG. Randomized controlled trials have suggested the efficacy of cognitive behavioural therapy including an exposure component that is targeted for CG. However, experts disagree about the terminology and diagnostic criteria for CG. The ICD-11 (International classification of diseases, 11th revision) beta draft proposed prolonged grief disorder as a condition that differs from persistent complex bereavement disorder with respect to terminology and the duration of symptoms. This divergence has arisen from insufficient evidence for a set of core symptoms and the biological basis of CG. Future studies including biological studies are needed to reach consensus about the diagnostic criteria for CG.This article is part of the theme issue 'Evolutionary thanatology: impacts of the dead on the living in humans and other animals'.


Assuntos
Pesar , Trauma Psicológico/diagnóstico , Trauma Psicológico/terapia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Humanos , Guias de Prática Clínica como Assunto
5.
Artigo em Inglês | MEDLINE | ID: mdl-29890768

RESUMO

After the Fukushima nuclear power plant accident, numerous evacuees reported poor mental health status and high-risk perceptions of the health effects of radiation. However, the temporal associations between these variables have not yet been examined. Using data from the Fukushima Health Survey, we examined changes in risk perception of the health effects of radiation over time and assessed the effects of mental health on such changes using logistic regression analysis. Risk perception for delayed effect pertains a brief on health effect in later life (delayed effect), whereas that of genetic effect pertains a brief on health effect of future children and grandchildren (genetic effect). We found that many participants showed consistently high or low-risk perceptions over all three study years (2011⁻2013) (for delayed effect: 59% and 41% of participants were in the low and high-risk perception groups, respectively; for genetic effect: 47% and 53%, respectively). Stronger traumatic reactions (≥50 on the PTSD Checklist⁻Specific) significantly affected the odds of being in the high-risk perception group for the delayed and genetic effects, with the associations being strongest soon after the disaster: The adjusted ORs (95%CIs) were 2.05 (1.82⁻2.31), 1.86 (1.61⁻2.15), and 1.88 (1.62⁻2.17) for the delayed effect in 2011, 2012, and 2013, respectively, and 2.18 (1.92⁻2.48), 2.05 (1.75⁻2.40), and 1.82 (1.55⁻2.15) for the genetic effect. As initial mental health status had the strongest impact on later risk perceptions of radiation, it should be considered in early response and communication efforts.


Assuntos
Acidente Nuclear de Fukushima , Nível de Saúde , Inquéritos Epidemiológicos , Saúde Mental/estatística & dados numéricos , Exposição à Radiação/efeitos adversos , Adolescente , Adulto , Família , Feminino , Humanos , Japão , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Exposição à Radiação/estatística & dados numéricos , Medição de Risco , Fatores de Tempo , Adulto Jovem
6.
Mol Brain ; 9: 2, 2016 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-26745987

RESUMO

BACKGROUND: The conditions under which memory generalization occurs are not well understood. Although it is believed that fear memory generalization is gradually established after learning, it is not clear whether experiences soon after learning affect generalization. RESULTS: Using a contextual fear conditioning paradigm in mice, we found that fear memory generalization occurred when mice were exposed to a familiar, unconditioned context soon after fear learning. CONCLUSIONS: Our results suggest that the familiarity of contexts and the timing of their exposure influences memory generalization, which increases our understanding of the mechanisms of generalization.


Assuntos
Medo/fisiologia , Generalização da Resposta/fisiologia , Memória/fisiologia , Animais , Camundongos Endogâmicos C57BL
7.
Disaster Med Public Health Prep ; 9(4): 359-66, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25905559

RESUMO

OBJECTIVE: We intended to build consensus on appropriate disaster mental health services among professionals working in the area affected by the Great East Japan Earthquake. METHODS: We focused on the first 3 months after the disaster, divided into 3 phases: immediate aftermath, acute phase, and midphase. We adopted the Delphi process and asked our survey participants (n=115) to rate the appropriateness of specific mental health services in each phase and comment on them. We repeated this process 3 times, giving participants feedback on the results of the previous round. Through this process, we determined the criterion for positive consensus for each item as having the agreement of more than 80% of the participants. RESULTS: We found that the importance of acute psychiatric care and prescribing regular medication for psychiatric patients gained positive consensus in the immediate aftermath and acute phase. Counseling and psychoeducation after traumatic events or provision of information gained consensus in the acute phase and midphase, and screening of mental distress gained consensus in the midphase. CONCLUSIONS: Higher priority was given to continuous psychiatric services in the immediate aftermath and mental health activities in later phases.


Assuntos
Consenso , Desastres/estatística & dados numéricos , Terremotos/estatística & dados numéricos , Serviços de Saúde Mental/estatística & dados numéricos , Estresse Psicológico/complicações , Ondas de Maré/estatística & dados numéricos , Adulto , Idoso , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Estresse Psicológico/terapia , Inquéritos e Questionários
8.
PLoS Curr ; 72015 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-25685634

RESUMO

OBJECTIVES: In this survey, we aimed to build consensus and gather opinions on 'Kokoro-no care' or mental health services and psychosocial support (MHSPSS) after a disaster, among mental health professionals who engaged in care after the Great East Japan Earthquake. METHODS: We recruited mental health professionals who engaged in support activities after the Great East Japan Earthquake, which included local health professionals in the affected areas and members of mental health care teams dispatched from outside (n = 131). Adopting the Delphi process, we proposed a definition of 'Kokoro-no care', and asked the participants to rate the appropriateness on a 5-point Likert scale. We also solicited free comments based on the participants' experiences during the disaster. After Round 1, we presented the summary statistics and comments, and asked the participants to re-rate the definition that had been modified based on their comments. This process was repeated twice, until the consensus criterion of ≥ 80% of the participants scoring ≥ 4 on the statement was fulfilled. RESULTS: In Round 1, 68.7% of the respondents rated the proposed definition ≥ 4 for its appropriateness, and 88.4% did so in Round 2. The comments were grouped into categories (and subcategories) based on those related to the definition in general (Appropriate, Continuum of MHSPSS, Cautions in operation, Alternative categorisation of care components, Whether the care component should be categorised according to the professional involved, Ambiguous use of psychology, and Others), to mental health services (Appropriate, More specification within mental health services, More explicit remarks on mental health services, and Others), and to psychosocial support (Whether the care component should be categorised according to the professional involved, Raising concerns about the terms, and Others), and others. CONCLUSION: We achieved a consensus on the definition of 'Kokoro-no care', and systematically obtained suggestions on the concept, and practical advice on operation, based on the participants' experiences from the Great East Japan Earthquake. This collective knowledge will serve as reference to prepare and respond to future disasters.

9.
Hepatology ; 61(2): 437-46, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25203900

RESUMO

UNLABELLED: The human liver reacts to hepatitis C virus (HCV) with a balanced response consisting of host anti- and proviral activities. To explore these subtle host responses, we used oligonucleotide microarrays to investigate the differential gene expression between two groups of liver samples with high and low HCV loads (>100-fold difference). We identified and validated 26 genes that were up-regulated in livers with high HCV loads, including transmembrane protease serine 2 (TMPRSS2). Trypsin inhibitors inhibited the infection of Huh7-25-CD81 cells with cell-culture-derived HCV (HCVcc) of Japanese fulminant hepatitis 1 isolate at the postbinding and entry step, and trypsin enhanced HCVcc infection at an early stage of infection. Several major transmembrane serine proteases, in particular, furin and hepsin, were detected in Huh7-25-CD81 cells, but TMPRSS2 was not. Huh7-25-CD81 cell clones stably expressing TMPRSS2- WT (wild type) and inactive TMPRSS2-mutant genes showed positive and negative enhancement of their susceptibility to HCVcc infection, respectively. The enhanced susceptibility of TMPRSS2-WT Huh7-25-CD81 cells was confirmed by knockdown of TMPRSS2 using small interfering RNA. The cell-surface protease activity of TMPRSS2-WT cells was markedly active in the cleavage of QAR and QGR, corresponding to amino acid residues at P3 to P1. CONCLUSION: The cell-surface activity of a trypsin-like serine protease, such as TMPRSS2, activates HCV infection at the postbinding and entry stage. Host transmembrane serine proteases may be involved in the sensitivity, persistence, and pathogenesis of HCV infection and be possible targets for antiviral therapy.


Assuntos
Hepatite C Crônica/metabolismo , Interações Hospedeiro-Patógeno , Serina Endopeptidases/metabolismo , Idoso , Linhagem Celular , Feminino , Perfilação da Expressão Gênica , Hepatite C Crônica/virologia , Humanos , Fígado/metabolismo , Fígado/virologia , Masculino , Pessoa de Meia-Idade
10.
J Palliat Med ; 17(9): 1025-31, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25050607

RESUMO

BACKGROUND: Little is known about the association between quality of end-of-life care of a patient and complicated grief among bereaved family members. OBJECTIVE: This study aims to examine the impact of quality of end-of-life care on complicated grief among bereaved family members in a Japanese general population sample. METHODS: A mail-based cross-sectional questionnaire survey was used. A total of 641 individuals aged 40 to 79 years in the general population who lost their loved one within the period between 6 months and 10 years were enrolled. Complicated grief was assessed using the Brief Grief Questionnaire, and the bereaved family members' perceptions on quality of end-of-life care were assessed using the Care Evaluation Scale and the Good Death Inventory. Logistic regression analysis was used to identify the variables that associated with possible complicated grief. RESULTS: Possible complicated grief was observed in 24.5% of the participants. Three components of quality of end-of-life care, namely, dissatisfaction with the explanation to the family about the patient's expected outcome, unreasonable cost of care, and family's perception that the deceased person had not achieved a sense of completion about his or her life, were significantly associated with possible complicated grief. Spousal relationship, primary caregiver, and high psychological distress also had significant association. CONCLUSIONS: Perceptions on quality of end-of-life care were significantly associated with complicated grief. Providing sufficient information to patients' family about expected outcome and enhancing patients' sense of completion about their life may prevent bereaved family members from developing complicated grief.


Assuntos
Luto , Família/psicologia , Qualidade da Assistência à Saúde , Assistência Terminal/normas , Adulto , Idoso , Estudos Transversais , Humanos , Japão , Pessoa de Meia-Idade , Inquéritos e Questionários
11.
J Trauma Stress ; 26(2): 201-8, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23512593

RESUMO

We recently developed new disaster mental health guidelines in Japan through the Delphi process, a method for building consensus among experts, using as a reference the guidelines developed by The European Network for Traumatic Stress (TENTS) in Europe. We included in our survey 30 items used in the TENTS survey, 20 of which achieved positive consensus in that survey. Here we report on the extent of agreement of 95 Japanese experts on each of these 30 items and examine the reasons for disagreements with the TENTS survey results based on the comments obtained from the participants of our survey. Of the 20 items, 12 also gained consensus in our survey and 1 additional item achieved consensus that did not achieve it in the TENTS survey. Items that did not gain consensus in our survey, but did in the TENTS survey, were recommendations for close collaboration with the media, screening volunteers for their suitability, and withholding formal screening of the affected population. The need for specialist care for specific populations was endorsed in our survey, but not in the TENTS survey. Overall, the opinion of Japanese experts was congruent with that of Western experts, but some guideline amendments would be beneficial.


Assuntos
Consenso , Planejamento em Desastres/organização & administração , Serviços de Saúde Mental/organização & administração , Adulto , Coleta de Dados , Técnica Delfos , Planejamento em Desastres/métodos , Planejamento em Desastres/normas , Europa (Continente) , Humanos , Japão
12.
J Affect Disord ; 149(1-3): 202-8, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23489406

RESUMO

INTRODUCTION: The current study investigated whether the influence of alexithymia on psychological distress (PD) differed according to the seriousness of complicated grief (CG) and the time since bereavement in the Japanese general population. METHODS: 1162 participants between 40 and 79 years of age (effective response rate: 58.8%) completed a cross-sectional anonymous questionnaire regarding the following factors: alexithymia (DD: Difficulty describing feeling, DI: Difficulty identifying feeling, EO: Externally oriented thinking), PD, and CG. To compare the non-bereaved (group 1) with four other groups, which were organized by CG score (high/low) and the time since bereavement (within half/two years postloss); the half year_low/high CG (group 2 and 3) and the two years_low/high CG (group 4 and 5), a simultaneous analysis of the five groups with standard maximum likelihood estimations was performed and hypothesized models were verified. RESULTS: The model (RMSEA=0.000, AIC=57.686) showed that the models' constructions for group 1 and 4 were significantly similar. In the other groups, the degree of correlation between alexithymia (especially EO) and psychological distress was significantly different. LIMITATIONS: The study is a cross-sectional design and not with a clinical population. CONCLUSIONS: Our findings showed that the relationship between alexithymia and psychological distress was significantly same for group 1 and 4. In group 2, EO was less correlated with the other subscales of alexithymia, which suggests that EO is utilized as a coping style for bereavement that, in turn, influences convalescence during the half year following bereavement.


Assuntos
Sintomas Afetivos/psicologia , Pesar , Estresse Psicológico/psicologia , Adaptação Psicológica , Adulto , Idoso , Luto , Estudos Transversais , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Modelos Psicológicos , Inquéritos e Questionários , Fatores de Tempo
13.
Psychosomatics ; 54(3): 263-71, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23194933

RESUMO

BACKGROUND: Incidence proportion of post-traumatic stress disorder (PTSD) after motor vehicle accidents (MVA) vary considerably across countries, and whether heart rate (HR) and respiratory rate (RR) immediately after MVA predict subsequent PTSD remains controversial. This study examined the incidence proportion of PTSD at 6 months after MVA in Japan, and the predictors of PTSD in MVA survivors. METHOD: Patients with MVA-related injuries consecutively admitted to the intensive care unit of a teaching hospital in Tokyo were recruited. Six months after MVA, PTSD was diagnosed using the Clinician Administered Post-traumatic Stress Disorder Scale (CAPS). RESULTS: Of the 300 participants, 106 completed the assessments at 6 months after MVA and PTSD was diagnosed in 7.5% of the patients. Eight of the 300 participants (2.7%) were regarded as having PTSD after imputing their CAPS score at follow-up assessment for participants who dropped out. In multivariate regression analysis, no variables were shown to be independent predictors for PTSD. HR and RR did not predict PTSD in the analysis. DISCUSSION: The results suggested that the incidence proportion of PTSD following MVA in Japan was lower than that in most developed countries, and HR and RR might not be accurate screening tools despite their importance in a fear-conditioning model of the genesis of PTSD.


Assuntos
Acidentes de Trânsito/psicologia , Frequência Cardíaca/fisiologia , Taxa Respiratória/fisiologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Adolescente , Adulto , Idoso , Estudos de Coortes , Feminino , Humanos , Incidência , Testes de Inteligência , Entrevista Psicológica , Japão/epidemiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Escalas de Graduação Psiquiátrica , Distribuição por Sexo , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Adulto Jovem
14.
Int J Ment Health Syst ; 6(1): 7, 2012 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-22747882

RESUMO

BACKGROUND: The mental health community in Japan had started reviewing the country's disaster mental health guidelines before the Great East Japan Earthquake, aiming to revise them based on evidence and experience accumulated in the last decade. Given the wealth of experience and knowledge acquired in the field by many Japanese mental health professionals, we decided to develop the guidelines through systematic consensus building and selected the Delphi method. METHODS: After a thorough literature review and focus group interviews, 96 items regarding disaster mental health were included in Delphi Round 1. Of 100 mental health professionals experienced in disaster response who were invited to participate, 97 agreed. The appropriateness of each statement was assessed by the participants using a Likert scale (1: extremely inappropriate, 9: very appropriate) and providing free comments in three rounds. Consensus by experts was defined as an average score of ≥7 for which ≥70% of participants assigned this score, and items reaching consensus were included in the final guidelines. RESULTS: Overall, of the 96 items (89 initially asked and 7 added items), 77 items were agreed on (46 items in Round 1, and 19 positive and 12 negative agreed on items in Round 2). In Round 2, three statements with which participants agreed most strongly were: 1) A protocol for emergency work structure and information flow should be prepared in normal times; 2) The mental health team should attend regular meetings on health and medicine to exchange information; and 3) Generally, it is recommended not to ask disaster survivors about psychological problems at the initial response but ask about their present worries and physical condition. Three statements with which the participants disagreed most strongly in this round were: 1) Individuals should be encouraged to provide detailed accounts of their experiences; 2) Individuals should be provided with education if they are interested in receiving it; and 3) Bad news should be withheld from distressed individuals for fear of causing more upset. CONCLUSIONS: Most items which achieved agreement in Round 1 were statements described in previous guidelines or publications, or statements regarding the basic attitude of human service providers. The revised guidelines were thus developed based on the collective wisdom drawn from Japanese practitioners' experience while also considering the similarities and differences from the international standards.

15.
Dialogues Clin Neurosci ; 14(2): 210-4, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22754294

RESUMO

Violent death, such as homicide, accident, and suicide, is sudden, unexpected, and caused by intentional power, The prevalence of complicated grief among those bereaved by violent death is 12.5% to 78.0%. The factors affecting this prevalence rate are considered to be comorbid mental disorders, lack of readiness for the death, difficulty in making sense of the death, high level of negative appraisal about the self and others, and various social stressors. Post-traumatic stress disorder is, in particular, considered to contribute to the development of complicated grief by suppressing function of the medial prefrontal cortex and the anterior cingulate cortex, which works at facilitating the normal mourning process. An understanding of the mechanism and biological basis of complicated grief by violent death will be helpful in developing effective preventive intervention and treatment.


Assuntos
Transtornos de Adaptação/psicologia , Luto , Transtornos de Estresse Pós-Traumáticos/psicologia , Violência/psicologia , Adaptação Psicológica , Transtornos de Adaptação/epidemiologia , Pesar , Humanos , Prevalência , Transtornos de Estresse Pós-Traumáticos/epidemiologia
16.
PLoS One ; 7(2): e31209, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22348057

RESUMO

BACKGROUND: Complicated grief, which is often under-recognized and under-treated, can lead to substantial impairment in functioning. The Brief Grief Questionnaire (BGQ) is a 5-item self-report or interview instrument for screening complicated grief. Although investigations with help-seeking samples suggest that the BGQ is valid and reliable, it has not been validated in a broader population. METHODOLOGY/PRINCIPAL FINDINGS: A questionnaire was mailed to a randomly selected sample (n = 5000) residing in one of 4 areas of Japan. The BCQ was examined for responders who were bereaved more than 6 months and less than 10 years (n = 915). Non-specific psychological distress was assessed with the K6 screening scale. Multiple group confirmatory factor analysis supported a uni-dimensional factor structure and the invariance of parameters across gender and age. Cronbach's alpha was sufficiently high (alpha = .75) to confirm internal consistency. Average Variance Extracted (0.39) was higher than the shared covariance (0.14) between BGQ and K6, suggesting discriminant validity. CONCLUSIONS: The results of this study support the reliability and validity of the BGQ in the Japanese population. Future studies should examine predictive validity by using structured interviews or more detailed scales for complicated grief.


Assuntos
Pesar , Estresse Psicológico/diagnóstico , Inquéritos e Questionários/normas , Humanos , Japão/epidemiologia , Programas de Rastreamento/métodos , Reprodutibilidade dos Testes
17.
J Affect Disord ; 135(1-3): 122-7, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21802742

RESUMO

BACKGROUND: The present research investigated whether the relationship between alexithymia and complicated grief was different from the relationship between alexithymia and general depressive symptom according to the seriousness of complicated grief in the Japanese general population. METHODS: In the Japanese general population sample, 948 participants between 40 and 79 years old (effective response rate, 48.0%) completed a cross-sectional anonymous questionnaire about alexithymia, depression, and complicated grief. To compare the high risk (n=243) and low risk (n=705) of complicated grief groups, simultaneous analysis of two groups with standard maximum likelihood estimation was performed and six hypothesized models were verified. RESULTS: The model (RMSEA=0.047, AIC=71.520) that showed that the path coefficients of the latent variable of alexithymia to the observed variables were equal and that the path coefficient of alexithymia to psychological distress was equal was adopted. The contribution ratios from alexithymia to complicated grief were apparently smaller (2-4%) than those to depression (37-38%). CONCLUSIONS: Our findings showed that alexithymia scarcely contributed to complicated grief compared to depression and that the contribution ratio in the high risk group was lower than that in the low risk group. The contribution of the latent variable of psychological distress to complicated grief and depression was lower in the high risk group than in the low risk group. The lack of a correlation between alexithymia and complicated grief might indicate that there are different mechanisms underlying the symptoms of alexithymia and complicated grief.


Assuntos
Sintomas Afetivos/psicologia , Depressão/psicologia , Pesar , Adulto , Sintomas Afetivos/diagnóstico , Sintomas Afetivos/epidemiologia , Idoso , Estudos Transversais , Depressão/diagnóstico , Depressão/epidemiologia , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/psicologia , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Modelos Psicológicos , Inquéritos e Questionários
18.
Psychiatry Clin Neurosci ; 65(2): 121-9, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21414087

RESUMO

Cognitive therapy/cognitive behavior therapy was introduced into the field of psychiatry in the late 1980s in Japan, and the Japanese Association for Cognitive Therapy (JACT), founded in 2004, now has more than 1500 members. Along with such progress, awareness of the effectiveness of cognitive therapy/cognitive behavioral therapy has spread, not only among professionals and academics but also to the public. The Study Group of the Procedures and Effectiveness of Psychotherapy, funded by the Ministry of Health, Labor and Welfare, has conducted a series of studies on the effectiveness of cognitive therapy/cognitive behavior therapy since 2006 and shown that it is feasible for Japanese patients. As a result, in April 2010 cognitive therapy/cognitive behavior therapy for mood disorders was added to the national health insurance scheme in Japan. This marked a milestone in Japan's psychiatric care, where pharmacotherapy has historically been more common. In this article the authors review research on cognitive therapy/cognitive behavior therapy in Japan.


Assuntos
Terapia Cognitivo-Comportamental/tendências , Transtornos Mentais/terapia , Ensaios Clínicos como Assunto , Humanos , Japão
19.
Depress Anxiety ; 28(2): 103-17, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21284063

RESUMO

Bereavement is a severe stressor that typically incites painful and debilitating symptoms of acute grief that commonly progresses to restoration of a satisfactory, if changed, life. Normally, grief does not need clinical intervention. However, sometimes acute grief can gain a foothold and become a chronic debilitating condition called complicated grief. Moreover, the stress caused by bereavement, like other stressors, can increase the likelihood of onset or worsening of other physical or mental disorders. Hence, some bereaved people need to be diagnosed and treated. A clinician evaluating a bereaved person is at risk for both over-and under-diagnosis, either pathologizing a normal condition or neglecting to treat an impairing disorder. The authors of DSM IV focused primarily on the problem of over-diagnosis, and omitted complicated grief because of insufficient evidence. We revisit bereavement considerations in light of new research findings. This article focuses primarily on a discussion of possible inclusion of a new diagnosis and dimensional assessment of complicated grief. We also discuss modifications in the bereavement V code and refinement of bereavement exclusions in major depression and other disorders.


Assuntos
Transtornos de Adaptação/diagnóstico , Luto , Manual Diagnóstico e Estatístico de Transtornos Mentais , Pesar , Transtornos de Adaptação/psicologia , Doença Crônica , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/psicologia , Diagnóstico Diferencial , Humanos , Fatores de Risco
20.
J Affect Disord ; 127(1-3): 352-8, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20580096

RESUMO

BACKGROUND: Few epidemiological studies have examined complicated grief in the general population, especially in Asian countries. Therefore, this study aimed to explore the prevalence and predictors of complicated grief among community dwelling individuals in Japan. METHODS: A questionnaire survey regarding grief and related issues was conducted on community dwelling individuals aged 40-79 who were randomly sampled from census tracts. Complicated grief was assessed using the Brief Grief Questionnaire. Stepwise logistic regression analysis was conducted in order to identify predictors of complicated grief. RESULTS: Data from 969 responses (response rate, 39.9%) were subjected to analysis. The analysis revealed 22 (2.4%) respondents with complicated grief and 272 (22.7%) with subthreshold complicated grief. Respondents who were found to be at a higher risk for developing complicated grief had lost their spouse, lost a loved one unexpectedly, lost a loved one due to stroke or cardiac disease, lost a loved one at a hospice, care facility or at home, or spent time with the deceased everyday in the last week of life. LIMITATIONS: Limitations of this study include the small sample size, the use of self-administered questionnaire, and the fact that the diagnoses of complicated grief were not based on robust diagnostic criteria. CONCLUSIONS: The point prevalence of complicated grief within 10years of bereavement was 2.4%. Complicated grief was maintained without significant decrease up to 10years after bereavement. When subthreshold complicated grief is included, the prevalence of complicated grief boosts up to a quarter of the sample, therefore, routine screening for complicated grief among the bereaved is desired. Clinicians should pay particular attention to the bereaved families with abovementioned risk factors in order to identify people at risk for future development of complicated grief.


Assuntos
Transtornos de Adaptação/epidemiologia , Transtornos de Adaptação/psicologia , Pesar , Adaptação Psicológica , Transtornos de Adaptação/diagnóstico , Adulto , Idoso , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Inquéritos e Questionários
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