論文 - 内田　裕之

Magnitude of rater differences in assessment scales for schizophrenia

Suzuki T., Takeuchi H., Nakajima S., Nomura K., Uchida H., Yagi G., Watanabe K., Kashima H.

Journal of Clinical Psychopharmacology （Journal of Clinical Psychopharmacology）  30 （ 5 ） 607 - 611 2010年10月

ISSN  0271-0749

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The magnitude of rater differences, instead of interrater reliability, in the assessment scales of schizophrenia has rarely been investigated and was therefore addressed in this study.Thirty-six patients with schizophrenia were independently assessed by 4 expert physicians, using clinical rating scales including the Positive and Negative Syndrome Scale (PANSS). The scores obtained by the physician in charge (PIC), who had a long close contact with the patients, served as the referent answer for the purpose of this study. The scores rated by the other 3 non-PIC psychiatrists, who had a first formal examination with them, were evaluated for percentage deviance from the referent answer.The results showed that the PIC raters endorsed the numerically highest score in 20 (56%) of the 36 patients, whereas they rated the lowest in only 2 (6%) in the PANSS total score. The non-PIC assessors on the average underrated the PANSS total score by 10%, and such a tendency of underestimating the severity was noted across other clinical scales. Furthermore, the PANSS total score by one of the non-PIC physicians was deviant from the referent answer by at least 20% in 15 (42%) of 36 instances. Importantly, this magnitude of deviance was noted in the context of an intraclass correlation coefficient of 0.92.This unique investigation disclosed clinically pertinent differences among raters, even under an excellent interrater reliability. The magnitude of differences described herein seems to be an underestimation, and the baseline scores by the independent new raters might need to be corrected for those by the PICs. © 2010 Lippincott Williams & Wilkins.

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Oral nitrite ameliorates dextran sulfate sodium-induced acute experimental colitis in mice.

Ohtake K, Koga M, Uchida H, Sonoda K, Ito J, Uchida M, Natsume H, Kobayashi J

Nitric oxide : biology and chemistry 23 （ 1 ） 65 - 73 2010年08月

ISSN  1089-8603

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Analysis of antipsychotic dose reduction

Uchida Hiroyuki, Suzuki Takefumi, Takeuchi Hiroyoshi, Mamo David C.

American Journal of Psychiatry 167 （ 8 ） 994 2010年08月

ISSN  0002-953X

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Fasting-induced intestinal apoptosis is mediated by inducible nitric oxide synthase and interferon-{gamma} in rat.

Ito J, Uchida H, Yokote T, Ohtake K, Kobayashi J

American journal of physiology. Gastrointestinal and liver physiology 298 （ 6 ） G916 - 26 2010年06月

ISSN  0193-1857

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Depression severity and effect of antidepressant medications [4]

Suzuki Takefumi, Uchida Hiroyuki, Nakajima Shinichiro

JAMA - Journal of the American Medical Association 303 （ 16 ） 1597 - 1598 2010年04月

ISSN  0098-7484

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Depression severity and effect of antidepressant medications.

Suzuki T, Uchida H, Nakajima S

JAMA 303 （ 16 ） 1597 - 8; author reply 1599 2010年04月

ISSN  0098-7484

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In situ STM observation of morphological changes of the Pt(111) electrode surface during potential cycling in 10 mM HF solution.

Wakisaka M, Asizawa S, Uchida H, Watanabe M

Physical chemistry chemical physics : PCCP 12 （ 16 ） 4184 - 90 2010年04月

ISSN  1463-9076

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Durability of Pt/graphitized carbon catalysts for the oxygen reduction reaction prepared by the nanocapsule method.

Yano H, Akiyama T, Bele P, Uchida H, Watanabe M

Physical chemistry chemical physics : PCCP 12 （ 15 ） 3806 - 14 2010年04月

ISSN  1463-9076

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Are antipsychotic prescribing patterns different in older and younger adults?

Sproule Beth A., Lake Jennifer, Mamo David C., Uchida Hiroyuki, Mulsant Benoit H.

Canadian Journal of Psychiatry 55 （ 4 ） 248 - 254 2010年04月

ISSN  0706-7437

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<p>Objective: To compare antipsychotic prescribing patterns in younger (aged 59 years or younger) and older (aged 60 years or older) patients with psychotic or mood disorders. Method: Pharmacy records of all patients discharged from the Centre for Addiction and Mental Health over a 21-month period were reviewed. A total of 1357 patients who were prescribed an antipsychotic at the time of their discharge were included in the analysis (956 with a primary psychotic disorder and 401 with a primary mood disorder). World Health Organization-defined daily doses were used as the standardized dosing unit. Results: Both in patients with a primary psychotic disorder and in patients with a primary mood disorder, the prescribing patterns were similar in older and younger patients, with no statistical difference in the proportions receiving first-generation antipsychotics, second-generation antipsychotics (SGAs), multiple antipsychotics, or long-acting (depot) antipsychotics. Overall, the mean daily antipsychotic doses were lower only in the older group of patients with a primary mood disorder. However, the mean dose of SGAs was about 30% lower in older patients in both diagnostic groups. Regardless of age, patients with a mood disorder were prescribed lower doses of antipsychotics than those with a psychotic disorder. Conclusions: Our data suggest that older patients are prescribed lower antipsychotic dosages primarily when using SGAs. This finding emphasizes the need for dose-finding studies assessing both the efficacy and the safety of antipsychotics in older patients with a psychotic or mood disorder.</p>

Are antipsychotic prescribing patterns different in older and younger adults?: A survey of 1357 psychiatric inpatients in Toronto

Sproule B., Lake J., Mamo D., Uchida H., Mulsant B.

Canadian Journal of Psychiatry （Canadian Journal of Psychiatry）  55 （ 4 ） 248 - 254 2010年04月

ISSN  07067437

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Objective: To compare antipsychotic prescribing patterns in younger (aged 59 years or younger) and older (aged 60 years or older) patients with psychotic or mood disorders. Method: Pharmacy records of all patients discharged from the Centre for Addiction and Mental Health over a 21-month period were reviewed. A total of 1357 patients who were prescribed an antipsychotic at the time of their discharge were included in the analysis (956 with a primary psychotic disorder and 401 with a primary mood disorder). World Health Organization-defined daily doses were used as the standardized dosing unit. Results: Both in patients with a primary psychotic disorder and in patients with a primary mood disorder, the prescribing patterns were similar in older and younger patients, with no statistical difference in the proportions receiving first-generation antipsychotics, second-generation antipsychotics (SGAs), multiple antipsychotics, or long-acting (depot) antipsychotics. Overall, the mean daily antipsychotic doses were lower only in the older group of patients with a primary mood disorder. However, the mean dose of SGAs was about 30% lower in older patients in both diagnostic groups. Regardless of age, patients with a mood disorder were prescribed lower doses of antipsychotics than those with a psychotic disorder. Conclusions: Our data suggest that older patients are prescribed lower antipsychotic dosages primarily when using SGAs. This finding emphasizes the need for dose-finding studies assessing both the efficacy and the safety of antipsychotics in older patients with a psychotic or mood disorder.

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Potentials and current limitations of brain stimulation therapies to accelerate antidepressant response

Nakajima Shinichiro, Suzuki Takefumi, Watanabe Koichiro, Kashima Haruo, Uchida Hiroyuki

Progress in Neuro-Psychopharmacology and Biological Psychiatry 34 （ 2 ） 439 - 440 2010年03月

ISSN  0278-5846

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Accelerating response to antidepressant treatment in depression

Nakajima Shinichiro, Suzuki Takefumi, Watanabe Koichiro, Kashima Haruo, Uchida Hiroyuki

Progress in Neuro-Psychopharmacology and Biological Psychiatry 34 （ 2 ） 259 - 264 2010年03月

ISSN  0278-5846

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<p>Objective: The primary objective of this article is to review the literature regarding the speed of response to antidepressant drugs and potential strategies to accelerate the antidepressant response in new antidepressant-free patients with depression. Based on these data, we try to propose both an effective and safe antidepressant treatment strategy to alleviate depressive symptoms at the earliest opportunity. Data sources: Data were identified by searches of Medline (1966 to September 2009) and references from relevant articles and books. Search terms included depression, antidepressant, predictor, response, onset, acceleration, and augmentation. As our focus was on the acute phase treatment of depression, articles relevant to treatment-resistant depression were excluded. Only articles written in English or Japanese were consulted. Data selection: Studies, reviews, and books pertaining to the treatment of depression with a special regard to accelerating therapeutic effects were selected. Data synthesis: Most of the available treatment guidelines for major depressive disorders recommend the continuous use of antidepressants for 4 to 8. weeks based on the idea of a delayed onset of response to these drugs. Contrary to this conventional belief, the recent data indicate that antidepressants start to exert their effects within 2. weeks and early non-response could predict a subsequent unfavorable outcome. Conclusions: These findings suggest the need of revisiting the timing of an antidepressant switch for early non-responders, whereby switching could be commenced in as early as 2. weeks.</p>

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Adverse effects of anticholinergic activity on cognitive functions in Alzheimer's disease

Konishi K., Hori K., Uchida H., Watanabe K., Tominaga I., Kimura M., Hosoyamada M., Shibasaki T., Kataoka A., Hachisu M.

Psychogeriatrics （Psychogeriatrics）  10 （ 1 ） 34 - 38 2010年03月

ISSN  1346-3500

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Background: Elderly patients with Alzheimer's disease (AD) take more medicines, other than those for anti-dementia agents, than healthy people and are sensitive to anticholinergic medications. There are only a few reports, however, on the relationship between cognitive function and anticholinergic activity in AD patients, which is caused by taking prescribed medication. Methods: We measured serum anticholinergic activity (SAA) in 76 AD patients referred to a Psychogeriatric Unit and separated them into SAA positive group (n = 26, SAA (+) group) and SAA negative group (n = 50, SAA (-) group). The difference in demographic data and cognitive functions were compared between the two groups. Results and Conclusions: The total scores of the Mini-Mental State Examination (MMSE), the score of MMSE domain of registration and recall were significantly lower (P < 0.05) and the Functional Assessment Staging (FAST) score, the number of different kinds of prescribed psychotropic medications (the number of prescribed psychotropic medications) were significantly higher (P < 0.05) in the SAA (+) group than in the SAA (-). These results suggest that a higher number of psychotropic medications prescribed leads to a tendency for SAA to be positive and that anticholinergic activity accelerates Alzheimer's pathology and decreases cognitive function, especially memory in AD patients. We should more prudently prescribe psychotropic medications to AD patients, because the prescribed psychotropic medications are one of the important causes of decline in cognitive function of AD patients by way of anticholinergic activity. © 2010 The Authors Journal compilation © 2010 Japanese Psychogeriatric Society.

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Potential risks of adjunctive use of atypical antipsychotic drugs for the treatment of depression

Nakajima Shinichiro, Suzuki Takefumi, Watanabe Koichiro, Kashima Haruo, Uchida Hiroyuki

Progress in Neuro-Psychopharmacology and Biological Psychiatry 34 （ 2 ） 435 - 436 2010年03月

ISSN  0278-5846

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Control of particle size of pt and pt alloy electrocatalysts supported on carbon black by the nanocapsule method.

Okaya K, Yano H, Uchida H, Watanabe M

ACS applied materials & interfaces 2 （ 3 ） 888 - 95 2010年03月

ISSN  1944-8244

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Sensitivity to antipsychotic drugs in older adults

Leon C., Gerretsen P., Uchida H., Suzuki T., Rajji T., Mamo D.

Current Psychiatry Reports （Current Psychiatry Reports）  12 （ 1 ） 28 - 33 2010年02月

ISSN  1523-3812

　概要を見る

Antipsychotic medications are widely used to manage psychotic and behavioral disorders in older adults, including primary psychotic disorders such as schizophrenia, and psychosis and behavioral disturbances associated with dementia. These two broad diagnostic indications are associated with contrasting recommended treatment durations, with the former requiring indefinite treatment across the life span. Antipsychotic drug dosing for schizophrenia is based primarily on studies of younger patients and thus may not apply to older adults. It is critically important to address the effects of aging on antipsychotic dosing given the recent emergence of data that suggest a critical role for age-related sensitivity to these drugs. Antipsychotic drugs are not only associated with somatic and neurological adverse effects but also increased all-cause mortality and sudden cardiac death in this vulnerable population. This review focuses on the sensitivity of older adults to adverse effects from antipsychotic medications and the current pharmacokinetic and pharmacodynamic explanatory models of susceptibility. Implications of recent research findings for individualized pharmacotherapy are discussed. © 2010 Springer Science+Business Media, LLC.

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Changes in metabolic parameters following a switch to aripiprazole in Japanese patients with schizophrenia

Takeuchi Hiroyoshi, Uchida Hiroyuki, Suzuki Takefumi, Watanabe Koichiro, Kashima Haruo

Psychiatry and Clinical Neurosciences 64 （ 1 ） 104 - 106 2010年02月

ISSN  1323-1316

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<p>The purpose of the present study was to evaluate changes in metabolic parameters after switching to aripiprazole in Japanese population. In this 1-year observation study, following a switch to aripiprazole, 32 patients with schizophrenia were observed and assessment was done of bodyweight, total cholesterol, triglyceride, serum prolactin level, and corrected QT (QTc) interval. Significant reductions were observed in these parameters other than QTc interval. Given known detrimental metabolic and hormonal effects of some atypical antipsychotics, a switch to aripiprazole may warrant serious consideration also in Asian patients who suffer those side-effects.</p>

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Changes in metabolic parameters following a switch to aripiprazole in Japanese patients with schizophrenia: One-year follow-up study

Takeuchi H., Uchida H., Suzuki T., Watanabe K., Kashima H.

Psychiatry and Clinical Neurosciences （Psychiatry and Clinical Neurosciences）  64 （ 1 ） 104 - 106 2010年02月

ISSN  13231316

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The purpose of the present study was to evaluate changes in metabolic parameters after switching to aripiprazole in Japanese population. In this 1-year observation study, following a switch to aripiprazole, 32 patients with schizophrenia were observed and assessment was done of bodyweight, total cholesterol, triglyceride, serum prolactin level, and corrected QT (QTc) interval. Significant reductions were observed in these parameters other than QTc interval. Given known detrimental metabolic and hormonal effects of some atypical antipsychotics, a switch to aripiprazole may warrant serious consideration also in Asian patients who suffer those side-effects. © 2009 Japanese Society of Psychiatry and Neurology.

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Clozapine and global cognition in schizophrenia

Rajji T.K., Uchida H., Ismail Z., Ng W., Mamo D.C., Remington G., Pollock B.G., Mulsant B.H.

Journal of Clinical Psychopharmacology （Journal of Clinical Psychopharmacology）  30 （ 4 ） 431 - 436 2010年

ISSN  0271-0749

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Objective: Clozapine (CLZ) has been shown to have a beneficial effect on cognition in schizophrenia in some studies and a detrimental effect in others. The relative effect and exposure to CLZ and its major metabolite-N- desmethylclozapine (NDMC)-could explain these discrepancies. Methods: Using a validated measure of global cognition, we performed 2 binary logistic regression models to assess the relationship among cognition, age, sex, CLZ dose, CLZ and NDMC plasma levels, and their ratio (CLZ/NDMC) in individuals with schizophrenia spectrum disorders. Model 1 included age, sex, CLZ dose, and CLZ and NDMC levels. Model 2 included age, sex, CLZ dose, and CLZ/NDMC. Results: Among 73 subjects (mean [SD] age, 41.6 [12.0] years), 16 (21.9%) had high cognitive impairment, whereas the rest had low cognitive. In model 1, age and CLZ level were associated with high cognitive impairment (odds ratio [95% confidence interval] for age, 1.079 [1.011-1.152]; CLZ level, 1.010 [1.003-1.017]), whereas NDMC level was associated with its absence (NDMC level, 0.987 [0.977-0.997]). In model 2, age, male sex, and CLZ/NDMC were associated with cognitive impairment (age, 1.083 [1.015-1.154]; sex, 0.178 [0.032-0.994]; CLZ/NDMC, 7.302 [1.823-29.253]). Clozapine dose was not associated with cognition in either model. Conclusions: After controlling for age, sex, and dose, CLZ/NDMC was more strongly associated with cognition than CLZ or NDMC levels. N-desmethylclozapine agonist activity versus CLZ antagonist activity at the muscarinic receptors could explain the strength of the association of CLZ/NDMC with cognition. © 2010 Lippincott Williams & Wilkins.

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Proton-conductive aromatic ionomers containing highly sulfonated blocks for high-temperature-operable fuel cells.

Bae B, Yoda T, Miyatake K, Uchida H, Watanabe M

Angewandte Chemie (International ed. in English) 49 （ 2 ） 317 - 20 2010年

ISSN  1433-7851

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