Details of a Researcher - Uchida, Hiroyuki

Papers - Uchida, Hiroyuki

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A Possible Role of Takotsubo Cardiomyopathy in Ventricular Fibrillation During Delirium Tremens

Ishida Takuto, Uchida Hiroyuki, Miyazaki Kazuki, Yukawa Takahiro, Sugiyama Kazuhiro, Hamabe Yuuichi, Mimura Masaru, Suzuki Takefumi

Psychosomatics 2018.01

ISSN 0033-3182

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[Gender Differences in Projected Life Expectancy in Japan (2023-2047) Determined by Bayesian Age-Period-Cohort Analysis].

Uchida H, Mito R, Heishi H, Saito M, Odagiri Y, Ohtake K, Yamaki T, Uchida M, Natsume H, Kobayashi J

Nihon eiseigaku zasshi. Japanese journal of hygiene 73 ( 3 ) 338 - 353 2018

ISSN 0021-5082

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Dietary Nitrite Attenuates Elastase-Induced Pulmonary Emphysema in a Mouse Model.

Sonoda K, Ohtake K, Tagiri M, Hirata M, Tamada H, Uchida H, Ito J, Kobayashi J

Biological & pharmaceutical bulletin 41 ( 12 ) 1818 - 1823 2018

ISSN 0918-6158

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血液透析患者のプレガバリン薬物動態解析による補充投与の必要性の検討を行った2症例

内田裕之, 竹内裕紀, 河野誠, 矢尾淳, 中村真理, 宇田晋, 菅谷弘之, 川口崇, 畝崎栄, 石井嘉之, 浅井茂夫

日本腎臓病薬物療法学会誌 (日本腎臓病薬物療法学会) 6 ( 3 ) 189 - 192 2017.12

ISSN 2187-0411

【目的】プレガバリン(PGN)の添付文書には、透析後の「血液透析後の補充用量」が記載されている。しかし、この補充投与量は透析開始6時間前に投与した場合のシミュレーションに基づいており、透析性のある薬剤は透析後に投与することが一般的である実臨床と条件が異なっている。著者らは血漿PGN濃度の高値が持続し、有害事象発生と関連を否定できない症例を経験しており、透析後の補充投与について十分検討する必要があると考え、PGNを継続投与中の血液透析患者における体内薬物動態を解析し、補充投与の必要性について検討した。【方法】維持血液透析患者でPGN投与中の2例を対象とした。PGN投与量は50mg/日であった。ダイアライザー前後の採血を含め透析日、非透析日の全7点で採血を行い、血漿PGN濃度を測定し、体内動態パラメータを解析した。【結果】2例の透析による補正後(真)の透析除去率、および透析クリアランスはそれぞれ55.6%、37.8%、および109.5mL/min、74.6mL/minであった。2例の透析クリアランスの平均値を用いて、1週間当たりの正常腎機能に対する透析の薬物除去寄与率を算出するとそれぞれ9.6%、4.9%であった。非透析日のPGN半減期はそれぞれ35時間、89時間であった。非透析日の推定AUC(eAUC)に対する透析日のeAUCの割合は、それぞれ85.3%、85.7%であった。【考察】本検討は症例報告であるが、透析日と非透析日のeAUCの差は15%程度であること、非透析時の半減期は延長しているた次回透析まで十分な血中濃度が維持できること、透析の薬物除去寄与率は僅かであることなどから、PGNを透析患者に投与する場合は、Ccr<15mL/minの投与量を透析後に投与すれば、「血液透析後の補充用量」の追加は必ずしも必要ではない可能性が示唆された。(著者抄録)

Placebo effects in the treatment of Noncognitive symptoms of Alzheimer’s disease

Ozawa Chisa, Roberts Rachel, Yoshida Kazunari, Suzuki Takefumi, Lebowitz Barry, Reeves Suzanne, Howard Robert, Abe Takayuki, Mimura Masaru, Uchida Hiroyuki

Journal of Clinical Psychiatry 78 ( 9 ) e1204 - e1210 2017.11

ISSN 0160-6689

Objective: To compare symptom trajectories between placebo and active drug responders and to examine whether early placebo improvement would be associated with subsequent placebo response in the treatment of patients with behavioral and psychological symptoms of dementia. Methods: A post hoc analysis of data from 371 patients with DSM-IV Alzheimer’s disease in Phase 1 of the Clinical Antipsychotic Trials of Intervention Effectiveness for Alzheimer’s disease (CATIE-AD) (April 2001 to November 2004) was conducted. Patients were randomly assigned to double-blind treatment with olanzapine, quetiapine, risperidone, or placebo. Trajectories of change in Brief Psychiatric Rating Scale (BPRS) total scores were compared between placebo and active drug responders. The predictive power of improvement at week 2 for response at week 8 was investigated, and sensitivity and specificity of incremental 5% cutoff points between 5% and 25% reduction in BPRS total score at week 2 were calculated. Results: There were no significant differences in symptom trajectories between placebo and active drug responders. BPRS score reduction at week 2 was significantly associated with placebo response at week 8 (odds ratio = 1.13; P< .001). Use of a cutoff of 10% showed the highest accuracy of 0.67 (sensitivity, 0.63; specificity, 0.70). Conclusions: Symptom trajectories of improvement of behavioral and psychological symptoms of dementia follow the same pattern irrespective of treatment. A 10% improvement at week 2 was the most appropriate predictor of subsequent placebo response at week 8, which may indicate utility for the placebo lead-in phase to minimize future trial failures of treatment for noncognitive symptoms of Alzheimer’s disease.

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Dopamine D₂ receptor blockade needed for the treatment of schizophrenia

Uchida Hiroyuki

Japanese Journal of Neuropsychopharmacology 37 ( 5-6 ) 127 - 131 2017.11

ISSN 1340-2544

For most antipsychotics, positron emission tomography studies have demonstrated that a therapeutic window of striatal D₂ receptor occupancy (65-80%) is associated with clinical response in young adults with schizophrenia. On the other hand, the dopamine D₂ receptor occupancy required for the maintenance of remission may be lower than that for acute phase treatment. A series of our modeling work has shown that the dose needed to achieve a target dopamine D_2/3 receptor occupancy at peak and trough can be estimated for each individual. First, striatal dopamine D₂ receptor occupancy levels with antipsychotics such as risperidone and olanzapine can be predicted from plasma antipsychotic concentrations. Second, doses that result in any given target plasma levels at any point in time can be estimated, using plasma levels of those drugs with two sparsely collected plasma samples with population pharmacokinetic techniques. Furthermore, we demonstrated that by combining these two models, doses that correspond to any given dopamine D_2/3 receptor occupancy with risperidone and olanzapine can be reliably estimated for each individual. Thus, in practice, the dose needed to achieve a target D₂ receptor blockade at peak and trough can be estimated for each individual and therefore could be used as a target dose.

Effects of chair yoga therapy on physical fitness in patients with psychiatric disorders

Ikai Saeko, Uchida Hiroyuki, Mizuno Yuya, Tani Hideaki, Nagaoka Maki, Tsunoda Kenichi, Mimura Masaru, Suzuki Takefumi

Journal of Psychiatric Research 94 194 - 201 2017.11

ISSN 0022-3956

Introduction Since falls may lead to fractures and have serious, potentially fatal outcomes, prevention of falls is an urgent public health issue. We examined the effects of chair yoga therapy on physical fitness among psychiatric patients in order to reduce the risk of falls, which has not been previously reported in the literature. Methods In this 12-week single-blind randomized controlled trial with a 6-week follow-up, inpatients with mixed psychiatric diagnoses were randomly assigned to either chair yoga therapy in addition to ongoing treatment, or treatment-as-usual. Chair yoga therapy was conducted as twice-weekly 20-min sessions over 12 weeks. Assessments included anteflexion in sitting, degree of muscle strength, and Modified Falls Efficacy Scale (MFES) as well as QOL, psychopathology and functioning. Results Fifty-six inpatients participated in this study (36 men; mean ± SD age, 55.3 ± 13.7 years; schizophrenia 87.5%). In the chair yoga group, significant improvements were observed in flexibility, hand-grip, lower limb muscle endurance, and MFES at week 12 (mean ± SD: 55.1 ± 16.6 to 67.2 ± 14.0 cm, 23.6 ± 10.6 to 26.8 ± 9.7 kg, 4.9 ± 4.0 to 7.0 ± 3.9 kg, and 114.9 ± 29.2 to 134.1 ± 11.6, respectively). Additionally, these improvements were observable six weeks after the intervention was over. The QOL-VAS improved in the intervention group while no differences were noted in psychopathology and functioning between the groups. The intervention appeared to be highly tolerable without any notable adverse effects. Conclusions The results indicated sustainable effects of 20-min, 12-week, 24-session chair yoga therapy on physical fitness. Chair yoga therapy may contribute to reduce the risk of falls and their unwanted consequences in psychiatric patients.

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Patients' Knowledge about Prescribed Antipsychotics and Medication Adherence in Schizophrenia: A Cross-Sectional Survey

Nagai N., Tani H., Suzuki T., Ikai S., Gerretsen P., Mimura M., Uchida H.

Pharmacopsychiatry (Pharmacopsychiatry) 50 ( 6 ) 264 - 269 2017.11

ISSN 01763679

© Georg Thieme Verlag KG Stuttgart - New York. Introduction Data on the knowledge about antipsychotic medications prescribed in patients with schizophrenia are very limited. Moreover, it remains unclear how patients' knowledge about prescribed antipsychotics affects medication adherence. Methods ighty-one Japanese outpatients with schizophrenia according to the International Classification of Diseases, 10th edition, were included. Patients' knowledge of the primary antipsychotics prescribed to them in terms of therapeutic effects, type, and implicated neurotransmitters was assessed with a multiple-choice questionnaire developed for this study. Medication possession ratios (MPRs) were compared between patients who answered correctly and those who did not in each category. Results The percentages of subjects who answered correctly regarding antipsychotic effects, type, and implicated neurotransmitters were low at 30.9%, 30.9%, and 7.4%, respectively. No differences were found in MPRs between subjects who answered correctly and those who did not. Discussion Our preliminary results indicate that patients lack knowledge about their antipsychotic medications. More concerning, they suggest that knowledge about prescribed antipsychotics may not directly translate into actual medication adherence in patients with schizophrenia.

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Dopamine D<inf>2</inf> receptor blockade needed for the treatment of schizophrenia

Uchida H.

Japanese Journal of Neuropsychopharmacology (Japanese Journal of Neuropsychopharmacology) 37 ( 5-6 ) 127 - 131 2017.11

ISSN 13402544

© 2017 Japanese Society of Neuropsychopharmacology. All rights reserved. For most antipsychotics, positron emission tomography studies have demonstrated that a therapeutic window of striatal D2 receptor occupancy (65-80%) is associated with clinical response in young adults with schizophrenia. On the other hand, the dopamine D2 receptor occupancy required for the maintenance of remission may be lower than that for acute phase treatment. A series of our modeling work has shown that the dose needed to achieve a target dopamine D2/3 receptor occupancy at peak and trough can be estimated for each individual. First, striatal dopamine D2 receptor occupancy levels with antipsychotics such as risperidone and olanzapine can be predicted from plasma antipsychotic concentrations. Second, doses that result in any given target plasma levels at any point in time can be estimated, using plasma levels of those drugs with two sparsely collected plasma samples with population pharmacokinetic techniques. Furthermore, we demonstrated that by combining these two models, doses that correspond to any given dopamine D2/3 receptor occupancy with risperidone and olanzapine can be reliably estimated for each individual. Thus, in practice, the dose needed to achieve a target D2 receptor blockade at peak and trough can be estimated for each individual and therefore could be used as a target dose.

Effects of chair yoga therapy on physical fitness in patients with psychiatric disorders: A 12-week single-blind randomized controlled trial

Ikai S., Uchida H., Mizuno Y., Tani H., Nagaoka M., Tsunoda K., Mimura M., Suzuki T.

Journal of Psychiatric Research (Journal of Psychiatric Research) 94 194 - 201 2017.11

ISSN 00223956

© 2017 Elsevier Ltd Introduction Since falls may lead to fractures and have serious, potentially fatal outcomes, prevention of falls is an urgent public health issue. We examined the effects of chair yoga therapy on physical fitness among psychiatric patients in order to reduce the risk of falls, which has not been previously reported in the literature. Methods In this 12-week single-blind randomized controlled trial with a 6-week follow-up, inpatients with mixed psychiatric diagnoses were randomly assigned to either chair yoga therapy in addition to ongoing treatment, or treatment-as-usual. Chair yoga therapy was conducted as twice-weekly 20-min sessions over 12 weeks. Assessments included anteflexion in sitting, degree of muscle strength, and Modified Falls Efficacy Scale (MFES) as well as QOL, psychopathology and functioning. Results Fifty-six inpatients participated in this study (36 men; mean ± SD age, 55.3 ± 13.7 years; schizophrenia 87.5%). In the chair yoga group, significant improvements were observed in flexibility, hand-grip, lower limb muscle endurance, and MFES at week 12 (mean ± SD: 55.1 ± 16.6 to 67.2 ± 14.0 cm, 23.6 ± 10.6 to 26.8 ± 9.7 kg, 4.9 ± 4.0 to 7.0 ± 3.9 kg, and 114.9 ± 29.2 to 134.1 ± 11.6, respectively). Additionally, these improvements were observable six weeks after the intervention was over. The QOL-VAS improved in the intervention group while no differences were noted in psychopathology and functioning between the groups. The intervention appeared to be highly tolerable without any notable adverse effects. Conclusions The results indicated sustainable effects of 20-min, 12-week, 24-session chair yoga therapy on physical fitness. Chair yoga therapy may contribute to reduce the risk of falls and their unwanted consequences in psychiatric patients.

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Placebo effects in the treatment of Noncognitive symptoms of Alzheimer’s disease: Analysis of the CATIE-AD data

Ozawa C., Roberts R., Yoshida K., Suzuki T., Lebowitz B., Reeves S., Howard R., Abe T., Mimura M., Uchida H.

Journal of Clinical Psychiatry (Journal of Clinical Psychiatry) 78 ( 9 ) e1204 - e1210 2017.11

ISSN 01606689

© Copyright 2017 Physicians Postgraduate Press, Inc. Objective: To compare symptom trajectories between placebo and active drug responders and to examine whether early placebo improvement would be associated with subsequent placebo response in the treatment of patients with behavioral and psychological symptoms of dementia. Methods: A post hoc analysis of data from 371 patients with DSM-IV Alzheimer’s disease in Phase 1 of the Clinical Antipsychotic Trials of Intervention Effectiveness for Alzheimer’s disease (CATIE-AD) (April 2001 to November 2004) was conducted. Patients were randomly assigned to double-blind treatment with olanzapine, quetiapine, risperidone, or placebo. Trajectories of change in Brief Psychiatric Rating Scale (BPRS) total scores were compared between placebo and active drug responders. The predictive power of improvement at week 2 for response at week 8 was investigated, and sensitivity and specificity of incremental 5% cutoff points between 5% and 25% reduction in BPRS total score at week 2 were calculated. Results: There were no significant differences in symptom trajectories between placebo and active drug responders. BPRS score reduction at week 2 was significantly associated with placebo response at week 8 (odds ratio = 1.13; P< .001). Use of a cutoff of 10% showed the highest accuracy of 0.67 (sensitivity, 0.63; specificity, 0.70). Conclusions: Symptom trajectories of improvement of behavioral and psychological symptoms of dementia follow the same pattern irrespective of treatment. A 10% improvement at week 2 was the most appropriate predictor of subsequent placebo response at week 8, which may indicate utility for the placebo lead-in phase to minimize future trial failures of treatment for noncognitive symptoms of Alzheimer’s disease.

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Self-rated cognitive functions following chemotherapy in patients with breast cancer

Kitahata Ryosuke, Nakajima Shinichiro, Uchida Hiroyuki, Hayashida Tetsu, Takahashi Maiko, Nio Shintaro, Hirano Jinichi, Nagaoka Maki, Suzuki Takefumi, Jinno Hiromitsu, Kitagawa Yuko, Mimura Masaru

Neuropsychiatric Disease and Treatment 13 2489 - 2496 2017.10

ISSN 1176-6328

Purpose: The purpose of the study was to evaluate subjective (self-rated), family-rated, and objective (researcher-rated) cognitive functions in patients with breast cancer after chemotherapy. Method: We conducted a prospective study to trace self-rated cognitive functions in 30 patients with breast cancer at the completion of chemotherapy (T0) and 6 months later (T1). Subjective cognitive functions were assessed with Cognitive Failures Questionnaire (CFQ), Dysexecutive Questionnaire (DEX-S), and Everyday Memory Checklist (EMC-S) for attention, executive function, and episodic memory, respectively. Their family members also completed DEX-I and EMC-I for executive function and episodic memory, respectively. We also examined objective cognitive functions. Self-rated cognitive functions were compared with the normative data. They were compared between T0 and T1. We calculated correlation coefficients between self-rated and other cognitive functions. Results: At T0, 6 (20.0%) and 2 (6.7%) participants showed higher DEX-S and EMC-S scores than the normative data, respectively, while no participant had abnormal CFQ scores. At T1, DEX-S and EMC-S scores were normalized in 3 (50.0%) and 2 (100.0%) participants, respectively. No participant showed increases in CFQ scores. No changes were found in objective cognitive functions from T0 to T1. DEX-S and DEX-I or EMC-S and EMC-I scores were correlated at both T0 and T1, which did not survive multiple corrections. There was no association between subjective and objective cognitive functions. Conclusion: Impairments in subjective cognition may be transient after chemotherapy in patients with breast cancer. Furthermore, patients and their families appear to share similar prospects on their cognitive functions.

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Self-rated cognitive functions following chemotherapy in patients with breast cancer: A 6-month prospective study

Kitahata R., Nakajima S., Uchida H., Hayashida T., Takahashi M., Nio S., Hirano J., Nagaoka M., Suzuki T., Jinno H., Kitagawa Y., Mimura M.

Neuropsychiatric Disease and Treatment (Neuropsychiatric Disease and Treatment) 13 2489 - 2496 2017.10

ISSN 11766328

© 2017 Kitahata et al. Purpose: The purpose of the study was to evaluate subjective (self-rated), family-rated, and objective (researcher-rated) cognitive functions in patients with breast cancer after chemotherapy. Method: We conducted a prospective study to trace self-rated cognitive functions in 30 patients with breast cancer at the completion of chemotherapy (T0) and 6 months later (T1). Subjective cognitive functions were assessed with Cognitive Failures Questionnaire (CFQ), Dysexecutive Questionnaire (DEX-S), and Everyday Memory Checklist (EMC-S) for attention, executive function, and episodic memory, respectively. Their family members also completed DEX-I and EMC-I for executive function and episodic memory, respectively. We also examined objective cognitive functions. Self-rated cognitive functions were compared with the normative data. They were compared between T0 and T1. We calculated correlation coefficients between self-rated and other cognitive functions. Results: At T0, 6 (20.0%) and 2 (6.7%) participants showed higher DEX-S and EMC-S scores than the normative data, respectively, while no participant had abnormal CFQ scores. At T1, DEX-S and EMC-S scores were normalized in 3 (50.0%) and 2 (100.0%) participants, respectively. No participant showed increases in CFQ scores. No changes were found in objective cognitive functions from T0 to T1. DEX-S and DEX-I or EMC-S and EMC-I scores were correlated at both T0 and T1, which did not survive multiple corrections. There was no association between subjective and objective cognitive functions. Conclusion: Impairments in subjective cognition may be transient after chemotherapy in patients with breast cancer. Furthermore, patients and their families appear to share similar prospects on their cognitive functions.

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Quality of life in schizophrenia and bipolar disorder

Hofer A., Mizuno Y., Wartelsteiner F., Wolfgang Fleischhacker W., Frajo-Apor B., Kemmler G., Mimura M., Pardeller S., Sondermann C., Suzuki T., Welte A., Uchida H.

European Psychiatry 46 42 - 47 2017.10

ISSN 0924-9338

Background Health-related quality of life (HRQOL) is significantly affected in individuals with schizophrenia or bipolar I disorder (BD-I). The current study investigated whether symptomatic remission and resilience might differently impact HRQOL in these patients. Methods Fifty-two patients with schizophrenia and 60 patients suffering from BD-I from outpatient mental health services as well as 77 healthy control subjects from the general community were included into a cross-sectional study. HRQOL and resilience were assessed using the WHOQOL-BREF and the Resilience Scale. In patients, psychopathology was quantified by the Positive and Negative Syndrome Scale or the Montgomery Asberg Depression Rating Scale and the Young Mania Rating Scale, respectively. Results Notably, both patient groups showed lower HRQOL and resilience compared to control subjects, non-remitted patients indicated lower HRQOL than remitted ones. The effect of remission on HRQOL was significantly larger in patients with BD-I than in those with schizophrenia but did not explain the difference in HRQOL between groups. Resilience predicted HRQOL in all three groups. When accounting for the effect of resilience among remitted patients, only the difference in HRQOL between schizophrenia patients and control subjects was significant. Conclusion These findings demonstrate the impact of symptomatic remission and resilience on HRQOL of both patients suffering from schizophrenia and BD-I and indicate that these factors are especially relevant for HRQOL of patients with BD-I.

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Psychotic Symptoms Associated with Varenicline in a Patient with Alcohol and Nicotine Dependence

Ueno Fumihiko, Uchida Hiroyuki, Suzuki Takefumi, Yokoyama Akira, Matsushita Sachio, Mimura Masaru, Higuchi Susumu

Journal of Clinical Psychopharmacology 37 ( 5 ) 627 - 628 2017.10

ISSN 0271-0749

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Quality of life in schizophrenia and bipolar disorder: The impact of symptomatic remission and resilience

Hofer A., Mizuno Y., Wartelsteiner F., Wolfgang Fleischhacker W., Frajo-Apor B., Kemmler G., Mimura M., Pardeller S., Sondermann C., Suzuki T., Welte A., Uchida H.

European Psychiatry (European Psychiatry) 46 42 - 47 2017.10

ISSN 09249338

© 2017 Elsevier Masson SAS Background Health-related quality of life (HRQOL) is significantly affected in individuals with schizophrenia or bipolar I disorder (BD-I). The current study investigated whether symptomatic remission and resilience might differently impact HRQOL in these patients. Methods Fifty-two patients with schizophrenia and 60 patients suffering from BD-I from outpatient mental health services as well as 77 healthy control subjects from the general community were included into a cross-sectional study. HRQOL and resilience were assessed using the WHOQOL-BREF and the Resilience Scale. In patients, psychopathology was quantified by the Positive and Negative Syndrome Scale or the Montgomery Asberg Depression Rating Scale and the Young Mania Rating Scale, respectively. Results Notably, both patient groups showed lower HRQOL and resilience compared to control subjects, non-remitted patients indicated lower HRQOL than remitted ones. The effect of remission on HRQOL was significantly larger in patients with BD-I than in those with schizophrenia but did not explain the difference in HRQOL between groups. Resilience predicted HRQOL in all three groups. When accounting for the effect of resilience among remitted patients, only the difference in HRQOL between schizophrenia patients and control subjects was significant. Conclusion These findings demonstrate the impact of symptomatic remission and resilience on HRQOL of both patients suffering from schizophrenia and BD-I and indicate that these factors are especially relevant for HRQOL of patients with BD-I.

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Protective effects of oral glutathione on fasting-induced intestinal atrophy through oxidative stress.

Uchida H, Nakajima Y, Ohtake K, Ito J, Morita M, Kamimura A, Kobayashi J

World journal of gastroenterology 23 ( 36 ) 6650 - 6664 2017.09

ISSN 1007-9327

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Analysis of the Surface Oxidation Process on Pt Nanoparticles on a Glassy Carbon Electrode by Angle-Resolved, Grazing-Incidence X-ray Photoelectron Spectroscopy.

Miyashita S, Wakisaka M, Iiyama A, Uchida H

Langmuir : the ACS journal of surfaces and colloids 33 ( 36 ) 8877 - 8882 2017.09

ISSN 0743-7463

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The long-term effects of antipsychotic medication on clinical course in schizophrenia

Goff Donald C., Falkai Peter, Fleischhacker W. Wolfgang, Girgis Ragy R., Kahn Rene M., Uchida Hiroyuki, Zhao Jingping, Lieberman Jeffrey A.

American Journal of Psychiatry (American Journal of Psychiatry) 174 ( 9 ) 840 - 849 2017.09

ISSN 0002-953X

Concerns have been raised that treatment with antipsychotic medication might adversely affect long-term outcomes for people with schizophrenia. The evidence cited for these concerns includes the association of antipsychotic treatment with brain volume reduction and with dopamine receptor sensitization, which might make patients vulnerable to relapse and illness progression. An international group of experts was convened to examine findings from clinical and basic research relevant to these concerns. Little evidence was found to support a negative long-term effect of initial or maintenance antipsychotic treatment on outcomes, compared with withholding treatment. Randomized controlled trials strongly support the efficacy of antipsychotics for the acute treatment of psychosis and prevention of relapse; correlational evidence suggests that early intervention and reduced duration of untreated psychosis might improve longer-term outcomes. Strategies for treatment discontinuation or alternative non-pharmacologic treatment approaches maybenefit a subgroup of patients but may be associated with incremental risk of relapse and require further study, including the development of biomarkers that will enable a precision medicine approach to individualized treatment.

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Resilience and spirituality in patients with depression and their family members

Ozawa Chisa, Suzuki Takefumi, Mizuno Yuya, Tarumi Ryosuke, Yoshida Kazunari, Fujii Kazuhito, Hirano Jinichi, Tani Hideaki, Rubinstein Ellen B., Mimura Masaru, Uchida Hiroyuki

Comprehensive Psychiatry 77 53 - 59 2017.08

ISSN 0010-440X

Objective The degree and quality of resilience in patients with depression have never been investigated in the context of remission status, spirituality/religiosity, and family members' resilience levels, which was addressed in this study. Methods This cross-sectional study recruited Japanese outpatients with depressive disorder according to ICD-10 and cohabitant family members who were free from psychiatric diagnoses. Resilience was assessed using the 25-item Resilience Scale (RS). Other assessments included the Montgomery-Asberg Depression Rating Scale (MADRS); the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT) and Kasen et al.'s (2012) scale for spirituality/religiosity; and the Rosenberg Self-Esteem Scale (RSES). Results One hundred outpatients with depression (mean ± SD age, 50.8 ± 14.5 years; 44 men; MADRS total score 9.8 ± 9.0) and 36 healthy family members (mean ± SD age, 56.5 ± 15.0 years; 18 men) were included. Symptom severity, attendance at religious/spiritual services, and self-esteem were significantly associated with RS scores in the patient group. RS total scores were significantly higher in remitted patients compared to non-remitted patients (mean ± SD, 112.3 ± 17.1 vs. 84.8 ± 27.7, p < 0.001). No correlation was found in RS total scores between patients and their family members (p = 0.265), regardless of patients' remission status. Conclusions Resilience may be influenced by individual characteristics rather than familial environment; furthermore, self-esteem or spirituality/religiosity may represent reinforcing elements. While caution is necessary in extrapolating these findings to other patient populations, our results suggest that resilience may be considered a state marker in depression.

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