研究者詳細 - 岸本　泰士郎

論文 - 岸本　泰士郎

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Reliability of Telepsychiatry Assessments Using the Attention-Deficit/Hyperactivity Disorder Rating Scale-IV for Children With Neurodevelopmental Disorders and Their Caregivers: Randomized Feasibility Study

Kurokawa S., Nomura K., Hosogane N., Nagasawa T., Kawade Y., Matsumoto Y., Morinaga S., Kaise Y., Higuchi A., Goto A., Inada N., Kodaira M., Kishimoto T.

Journal of Medical Internet Research 26 （ 1 ） e51749 2024年

ISSN 1438-8871

Background: Given the global shortage of child psychiatrists and barriers to specialized care, remote assessment is a promising alternative for diagnosing and managing attention-deficit/hyperactivity disorder (ADHD). However, only a few studies have validated the accuracy and acceptability of these remote methods. Objective: This study aimed to test the agreement between remote and face-to-face assessments. Methods: Patients aged between 6 and 17 years with confirmed Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnoses of ADHD or autism spectrum disorder (ASD) were recruited from multiple institutions. In a randomized order, participants underwent 2 evaluations, face-to-face and remotely, with distinct evaluators administering the ADHD Rating Scale-IV (ADHD-RS-IV). Intraclass correlation coefficient (ICC) was used to assess the reliability of face-to-face and remote assessments. Results: The participants included 74 Japanese children aged between 6 and 16 years who were primarily diagnosed with ADHD (43/74, 58%) or ASD (31/74, 42%). A total of 22 (30%) children were diagnosed with both conditions. The ADHD-RS-IV ICCs between face-to-face and remote assessments showed “substantial” agreement in the total ADHD-RS-IV score (ICC=0.769, 95% CI 0.654-0.849; P<.001) according to the Landis and Koch criteria. The ICC in patients with ADHD showed “almost perfect” agreement (ICC=0.816, 95% CI 0.683-0.897; P<.001), whereas in patients with ASD, it showed “substantial” agreement (ICC=0.674, 95% CI 0.420-0.831; P<.001), indicating the high reliability of both methods across both conditions. Conclusions: Our study validated the feasibility and reliability of remote ADHD testing, which has potential benefits such as reduced hospital visits and time-saving effects. Our results highlight the potential of telemedicine in resource-limited areas, clinical trials, and treatment evaluations, necessitating further studies to explore its broader application.

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Home-Based Cognitive Intervention for Healthy Older Adults Through Asking Robots Questions: Randomized Controlled Trial

Tokunaga S., Sekiguchi T., Miura K.W., Sugimoto H., Abe M.S., Tamura K., Kishimoto T., Kudo T., Otake-Matsuura M.

JMIR Aging 7 e47229 2024年

Background: Asking questions is common in conversations, and while asking questions, we need to listen carefully to what others say and consider the perspective our questions adopt. However, difficulties persist in verifying the effect of asking questions on older adults’ cognitive function due to the lack of a standardized system for conducting experiments at participants’ homes. Objective: This study examined the intervention effect of cognitive training moderated by robots on healthy older adults. A focus on the feasibility of the intervention at participants’ homes was also maintained. Feasibility was evaluated by considering both the dropout rate during the intervention and the number of questions posed to each participant during the experiment. Methods: We conducted a randomized controlled trial with 81 adults older than 65 years. Participants were recruited through postal invitations and then randomized into 2 groups. The intervention group (n=40) received sessions where participants listened to photo-integrated stories and posed questions to the robots. The control group (n=41) received sessions where participants listened to photo-integrated stories and only thanked the robots for confirming participation. The participants participated in 12 dialogue sessions for 2-3 weeks. Scores of global cognitive functioning tests, recall tests, and verbal fluency tasks measured before and after the intervention were compared between the 2 groups. Results: There was no significant intervention effect on the Telephone Interview for Cognitive Status-Japanese scores, recall tests, and verbal fluency tasks. Additionally, our study successfully concluded with no participant dropouts at follow-up, confirming the feasibility of our approach. Conclusions: There was no statistically significant evidence indicating intervention benefits for cognitive functioning. Although the feasibility of home-based interventions was demonstrated, we identified areas for improvement in the future, such as setting up more efficient session themes. Further research is required to identify the effectiveness of an improved cognitive intervention involving the act of asking questions.

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Financial inclusion and financial gerontology in Japan's aging society

Kinoshita S., Komamura K., Kishimoto T.

BioScience Trends （特定非営利活動法人バイオ＆ソーシャル・サイエンス推進国際研究交流会） 18 （ 5 ） 492 - 494 2024年

ISSN 18817815

Japan, the world's most rapidly aging society, faces increasing financial strains related to personalized dementia care. The government has shifted its focus from prevention to coexistence with dementia, as outlined in the 2023 Basic Act on Dementia. Emphasis on financial inclusion aligns with the G20's 2019 “Fukuoka Policy Priorities on Aging and Financial Inclusion", which addresses financial exclusion due to cognitive decline and poor financial literacy. While economic activity among older adults is already hampered by legal challenges and risks associated with dementia, outcomes are expected to worsen as the assets of older adults with dementia are projected to reach 215 trillion JPY ($1.4 trillion USD) by 2030. Government measures and research in financial gerontology advocate for protecting older adults and promoting flexible financial practices. Enhanced efforts and shared research outcomes are crucial for Japan to be a leader as an advanced aging society.

Associations between glycemic variability, sleep quality, and daily steps in subjects without diabetes using wearable devices.

Inaishi J, Kashiwagi K, Kinoshita S, Wada Y, Hanashiro S, Shiga K, Kitazawa M, Tsutsumi S, Yamakawa H, Kishimoto T

Metabolism open 20 100263 2023年12月

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The relationship between sleep, gut microbiota, and metabolome in patients with depression and anxiety: A secondary analysis of the observational study

Tanaka A., Sanada K., Miyaho K., Tachibana T., Kurokawa S., Ishii C., Noda Y., Nakajima S., Fukuda S., Mimura M., Kishimoto T., Iwanami A.

PLoS ONE （PLoS ONE） 18 （ 12 December ） e0296047 2023年12月

ISSN 1932-6203

Background Growing attention is paid to the association between alterations in the gut microbiota and their metabolites in patients with psychiatric disorders. Our study aimed to determine how gut microbiota and metabolomes are related to the sleep quality among patients with depression and anxiety disorders by analyzing the datasets of our previous study. Methods Samples were collected from 40 patients (depression: 32 patients [80.0%]); anxiety disorders: 8 patients [20.0%]) in this study. Gut microbiomes were analyzed using 16S rRNA gene sequencing and gut metabolomes were analyzed by a mass spectrometry approach. Based on the Pittsburgh Sleep Quality Index (PSQI), patients were categorized into two groups: the insomnia group (PSQI score ≥ 9, n = 20) and the non-insomnia group (PSQI score < 9, n = 20). Results The insomnia group showed a lower alpha diversity in the Chao1 and Shannon indices than the non-insomnia group after the false discovery rate (FDR) correction. The relative abundance of genus Bacteroides showed a positive correlation with PSQI scores in the non-insomnia group. The concentrations of glucosamine and N-methylglutamate were significantly higher in the insomnia group than in the non-insomnia group. Conclusions Our findings suggest that specific taxa could affect the sleep quality among patients with depression and anxiety disorders. Further studies are needed to elucidate the impact of sleep on specific gut microbiota and metabolomes in depression and anxiety disorders.

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Introduction to Evidence-Based Digital Interventions and Informatics Approaches to Service Delivery for Behavioral Health Populations

Hilty D.M., Ahuja S., Felker B.L., Kishimoto T., Krupinski E.A.

Journal of Technology in Behavioral Science （Journal of Technology in Behavioral Science） 8 （ 4 ） 333 - 335 2023年12月

Technology use is ubiquitous in the digital age, and to ensure quality care, patients, more research, and evaluation are needed of digital interventions and informatics approaches for behavioral health disorders—particularly those that have population-level impact. Clinicians, teams, organizations, and countries have to prioritize and implement systems to organize clinical care and set the stage for evidence-based interventions. Much of this is through electronic health records (EHRs), patient portals, artificial intelligence (AI), and data analytic approaches for workflow (e.g., clinical decision support). The Special Edition is geared to help clinicians/faculty, trainees, and healthcare leaders improve clinical care, by showcasing new systems, technologies, research, and evidence- and consensus-based best practices. One overarching goal is to apply the most recent health technology and evidence to promote behavioral health and to predict, assess, triage, and treat behavioral health disorders. Another goal is to describe how to shift from in-person/video care visits to longitudinal, in time care with patient and clinician decision support facilitated by artificial intelligence and other technologies. The issue focuses on effectiveness and implementation science approaches for patients across populations and settings. Evaluation of intended and unintended consequences of new technologies could facilitate or impede workflow and outcomes.

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Electroconvulsive therapy-induced volumetric brain changes converge on a common causal circuit in depression

Argyelan, M; Deng, ZD; Ousdal, OT; Oltedal, L; Angulo, B; Baradits, M; Spitzberg, AJ; Kessler, U; Sartorius, A; Dols, A; Narr, KL; Espinoza, R; van Waarde, JA; Tendolkar, I; van Eijndhoven, P; van Wingen, GA; Takamiya, A; Kishimoto, T; Jorgensen, MB; Jorgensen, A; Paulson, OB; Yrondi, A; Péran, P; Soriano-Mas, C; Cardoner, N; Cano, M; van Diermen, L; Schrijvers, D; Belge, JB; Emsell, L; Bouckaert, F; Vandenbulcke, M; Kiebs, M; Hurlemann, R; Mulders, PCR; Redlich, R; Dannlowski, U; Erhan, K; Kritzer, MD; Ellard, KK; Camprodon, JA; Petrides, G; Malhotra, AK; Abbott, CC

MOLECULAR PSYCHIATRY 2023年11月

ISSN 1359-4184

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Electroconvulsive therapy-induced volumetric brain changes converge on a common causal circuit in depression.

Argyelan M, Deng ZD, Ousdal OT, Oltedal L, Angulo B, Baradits M, Spitzberg AJ, Kessler U, Sartorius A, Dols A, Narr KL, Espinoza R, van Waarde JA, Tendolkar I, van Eijndhoven P, van Wingen GA, Takamiya A, Kishimoto T, Jorgensen MB, Jorgensen A, Paulson OB, Yrondi A, Péran P, Soriano-Mas C, Cardoner N, Cano M, van Diermen L, Schrijvers D, Belge JB, Emsell L, Bouckaert F, Vandenbulcke M, Kiebs M, Hurlemann R, Mulders PC, Redlich R, Dannlowski U, Kavakbasi E, Kritzer MD, Ellard KK, Camprodon JA, Petrides G, Malhotra AK, Abbott CC

Molecular psychiatry 2023年11月

ISSN 1359-4184

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Efficacy and Acceptability of Remote Cognitive Behavioral Therapy for Patients With Major Depressive Disorder in Japanese Clinical Settings: A Case Series

Nogami W., Nakagawa A., Kato N., Sasaki Y., Kishimoto T., Horikoshi M., Mimura M.

Cognitive and Behavioral Practice （Cognitive and Behavioral Practice） 30 （ 4 ） 635 - 645 2023年11月

ISSN 10777229

Remote cognitive and behavioral therapy (CBT) via videoconference has been garnering attention as a means of improving access to CBT for depression, in particular during the coronavirus disease 2019 pandemic. However, there is a lack of evidence supporting its implementation in Japanese clinical settings. This case series aimed to establish preliminary evidence of whether remote CBT can be an effective therapy for major depression in Japanese clinical settings. Five patients who met the diagnostic criteria for major depressive disorder were enrolled and underwent remote CBT via videoconference and face-to-face assessment interviews. The results showed that remote CBT via videoconference improved depressive symptoms, enabling a relatively high level of patient satisfaction and working alliance. Moreover, detailed feedback from our patients showed that continuous monitoring was preferable for increasing treatment engagement. Further research is warranted to test the efficacy and acceptability of remote CBT via videoconference for treating major depression.

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精神科で本当に必要な薬は何か?　精神科領域の安定確保医薬品に関する意識調査

稲垣中, 橋本亮太, 稲田健, 坪井貴嗣, 三島和夫, 小路純央, 齊尾武郎, 安田由華, 横井優磨, 小田陽彦, 加藤正樹, 岸田郁子, 岸本泰士郎, 齊藤卓弥, 冨田哲, 古郡規雄, 松尾幸治, 渡邊衡一郎, 木下利彦, 三木和平, 三野進, 三村將

精神神経学雑誌（(公社)日本精神神経学会） 125 （ 11 ） 932 - 943 2023年11月

ISSN 0033-2658

近年,医薬品の安定供給に疑念を抱かせるような事例が多発するようになったため,2020年に厚生労働省は10種類の向精神薬を含めた506種類の安定確保医薬品を指定した.しかしながら,このときには時間的な制約から精神科のステークホルダー全体のコンセンサスに基づいて10種類の向精神薬を選定できず,少数のエキスパートたちのコンセンサスに基づいて決定せざるをえなかった.今回われわれは精神科医,薬剤師,当事者・家族を対象としたweb媒体のアンケート調査を実施したうえで,第118回日本精神神経学会学術総会の際に開催されたシンポジウムにおいてデルファイ法に準じた方法により精神科のステークホルダー全体を反映したコンセンサスの形成を試みた.アンケート調査の結果,精神科医,薬剤師,当事者・家族の大半が10種類の向精神薬を安定確保医薬品に指定することを容認していることが示された.また,デルファイ法に準じた方法による意見集約の結果,リスペリドン,アリピプラゾール,オランザピン,クエチアピン,ミルタザピン,エスシタロプラム,バルプロ酸ナトリウム,炭酸リチウム,ロラゼパム,レンボレキサントの10種類の向精神薬がより妥当な安定確保医薬品として選択された.(著者抄録)

The now and future of ChatGPT and GPT in psychiatry

Cheng S.W., Chang C.W., Chang W.J., Wang H.W., Liang C.S., Kishimoto T., Chang J.P.C., Kuo J.S., Su K.P.

Psychiatry and Clinical Neurosciences （Psychiatry and Clinical Neurosciences） 77 （ 11 ） 592 - 596 2023年11月

ISSN 13231316

ChatGPT has sparked extensive discussions within the healthcare community since its November 2022 release. However, potential applications in the field of psychiatry have received limited attention. Deep learning has proven beneficial to psychiatry, and GPT is a powerful deep learning-based language model with immense potential for this field. Despite the convenience of ChatGPT, this advanced chatbot currently has limited practical applications in psychiatry. It may be used to support psychiatrists in routine tasks such as completing medical records, facilitating communications between clinicians and with patients, polishing academic writings and presentations, and programming and performing analyses for research. The current training and application of ChatGPT require using appropriate prompts to maximize appropriate outputs and minimize deleterious inaccuracies and phantom errors. Moreover, future GPT advances that incorporate empathy, emotion recognition, personality assessment, and detection of mental health warning signs are essential for its effective integration into psychiatric care. In the near future, developing a fully-automated psychotherapy system trained for expert communication (such as psychotherapy verbatim) is conceivable by building on foundational GPT technology. This dream system should integrate practical ‘real world’ inputs and friendly AI user and patient interfaces via clinically validated algorithms, voice comprehension/generation modules, and emotion discrimination algorithms based on facial expressions and physiological inputs from wearable devices. In addition to the technology challenges, we believe it is critical to establish generally accepted ethical standards for applying ChatGPT-related tools in all mental healthcare environments, including telemedicine and academic/training settings.

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特集遠隔医療,オンライン診療の現在と未来精神科領域のオンライン診療とAI利用

木下翔太郎, 岸本泰士郎

医学のあゆみ（医歯薬出版） 287 （ 2 ） 130 - 134 2023年10月

ISSN 00392359

Assessment of glycemic variability and lifestyle behaviors in healthy nondiabetic individuals according to the categories of body mass index

Kashiwagi K., Inaishi J., Kinoshita S., Wada Y., Hanashiro S., Shiga K., Kitazawa M., Tsutsumi S., Yamakawa H., Irie J., Kishimoto T.

PLoS ONE （PLoS ONE） 18 （ 10 October ） e0291923 2023年10月

ISSN 1932-6203

Background There are limited data about the association between body mass index (BMI), glycemic variability (GV), and life-related factors in healthy nondiabetic adults. Methods This cross-sectional study was carried out within our ethics committee-approved study called “Exploring the impact of nutrition advice on blood sugar and psychological status using continuous glucose monitoring (CGM) and wearable devices”. Prediabetes was defined by the HbA1c level of 5.7–6.4% and /or fasting glucose level of 100–125 mg/dL. Glucose levels and daily steps were measured for 40 participants using Free Style Libre and Fitbit Inspire 2 under normal conditions for 14 days. Dietary intakes and eating behaviors were assessed using a brief-type self-administered dietary history questionnaire and a modified questionnaire from the Obesity Guidelines. Results All indices of GV were higher in the prediabetes group than in the healthy group, but a significant difference was observed only in mean amplitude of glycemic excursions (MAGE). In the multivariate analysis, only the presence of prediabetes showed a significant association with the risk of higher than median MAGE (Odds, 6.786; 95% CI, 1.596–28.858; P = 0.010). Additionally, the underweight (BMI < 18.5) group had significantly higher value in standard deviation (23.7 ± 3.5 vs 19.8 ± 3.7 mg/dL, P = 0.038) and coefficient variability (22.6 ± 4.6 vs 18.4 ± 3.2%, P = 0.015), compared to the normal group. This GV can be partially attributed to irregularity of eating habits. On the contrary, the overweight (BMI > 25) group had the longest time above the 140 or 180 mg/dL range, which may be due to eating style and taking fewer steps (6394 ± 2337 vs 9749 ± 2408 steps, P = 0.013). Conclusions Concurrent CGM with diet and activity monitoring could reduce postprandial hyperglycemia through assessment of diet and daily activity, especially in non- normal weight individuals.

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Effect of education regarding treatment guidelines for schizophrenia and depression on the treatment behavior of psychiatrists: A multicenter study

Hasegawa N., Yasuda Y., Yasui-Furukori N., Yamada H., Hori H., Ichihashi K., Takaesu Y., Iida H., Muraoka H., Kodaka F., Iga J.i., Hashimoto N., Ogasawara K., Ohi K., Fukumoto K., Numata S., Tsuboi T., Usami M., Hishimoto A., Furihata R., Kishimoto T., Nakamura T., Katsumoto E., Ochi S., Nagasawa T., Atake K., Kubota C., Komatsu H., Yamagata H., Ide K., Takeshima M., Kido M., Kikuchi S., Okada T., Matsumoto J., Miura K., Shimazu T., Inada K., Watanabe K., Hashimoto R.

Psychiatry and Clinical Neurosciences （Psychiatry and Clinical Neurosciences） 77 （ 10 ） 559 - 568 2023年10月

ISSN 13231316

Aim: This study aims to examine the real-world effectiveness of education regarding clinical guidelines for psychiatric disorders using ‘the Effectiveness of guidelines for dissemination and education in psychiatric treatment (EGUIDE)’ project. Methods: The EGUIDE project is a nationwide prospective implementation study of two clinical practice guidelines, i.e., the Guideline for Pharmacological Therapy of Schizophrenia and the Treatment Guidelines for Major Depressive Disorders, in Japan. Between 2016 and 2019, 782 psychiatrists belonging to 176 hospitals with psychiatric wards participated in the project and attended lectures on clinical practice guidelines. The proportions of guideline-recommended treatments in 7405 patients with schizophrenia and 3794 patients with major depressive disorder at participating hospitals were compared between patients under the care of psychiatrists participating in the project and those not participating in the project. Clinical and prescribing data on the patients discharged from April to September each year from participating hospitals of the project were also analyzed. Results: The proportions of three quality indicators (antipsychotic monotherapy regardless of whether other psychotropics medication, antipsychotic monotherapy without other psychotropics and no prescription of anxiolytics or hypnotics) for schizophrenia were higher among participating psychiatrists than among nonparticipating psychiatrists. As similar results were obtained in major depressive disorder, the effectiveness of the project for the dissemination of guideline-recommended treatment has been replicated. Conclusion: This strategy of providing education regarding the clinical guidelines for psychiatric disorders was effective in improving the treatment-related behavior of psychiatrists. The use of this education-based strategy might contribute to resolving the mental health treatment gap.

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Telepsychiatry versus face-to-face treatment: Systematic review and meta-analysis of randomised controlled trials

Hagi K., Kurokawa S., Takamiya A., Fujikawa M., Kinoshita S., Iizuka M., Furukawa S., Eguchi Y., Kishimoto T.

British Journal of Psychiatry （British Journal of Psychiatry） 223 （ 3 ） 407 - 414 2023年09月

ISSN 00071250

Background The COVID-19 pandemic has transformed healthcare significantly and telepsychiatry is now the primary means of treatment in some countries. Aims To compare the efficacy of telepsychiatry and face-to-face treatment. Method A comprehensive meta-analysis comparing telepsychiatry with face-to-face treatment for psychiatric disorders. The primary outcome was the mean change in the standard symptom scale scores used for each psychiatric disorder. Secondary outcomes included all meta-analysable outcomes, such as all-cause discontinuation and safety/tolerability. Results We identified 32 studies (n = 3592 participants) across 11 mental illnesses. Disease-specific analyses showed that telepsychiatry was superior to face-to-face treatment regarding symptom improvement for depressive disorders (k = 6 studies, n = 561; standardised mean difference s.m.d. = -0.325, 95% CI -0.640 to -0.011, P = 0.043), whereas face-to-face treatment was superior to telepsychiatry for eating disorder (k = 1, n = 128; s.m.d. = 0.368, 95% CI 0.018-0.717, P = 0.039). No significant difference was seen between telepsychiatry and face-to-face treatment when all the studies/diagnoses were combined (k = 26, n = 2290; P = 0.248). Telepsychiatry had significantly fewer all-cause discontinuations than face-to-face treatment for mild cognitive impairment (k = 1, n = 61; risk ratio RR = 0.552, 95% CI 0.312-0.975, P = 0.040), whereas the opposite was seen for substance misuse (k = 1, n = 85; RR = 37.41, 95% CI 2.356-594.1, P = 0.010). No significant difference regarding all-cause discontinuation was seen between telepsychiatry and face-to-face treatment when all the studies/diagnoses were combined (k = 27, n = 3341; P = 0.564). Conclusions Telepsychiatry achieved a symptom improvement effect for various psychiatric disorders similar to that of face-to-face treatment. However, some superiorities/inferiorities were seen across a few specific psychiatric disorders, suggesting that its efficacy may vary according to disease type.

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Development and acceptability testing of a decision aid for considering whether to reduce antipsychotics in individuals with stable schizophrenia

Aoki Y., Takaesu Y., Matsui K., Tokumasu T., Tani H., Takekita Y., Kanazawa T., Kishimoto T., Tarutani S., Hashimoto N., Takeuchi H., Mishima K., Inada K.

Neuropsychopharmacology Reports （Neuropsychopharmacology Reports） 43 （ 3 ） 391 - 402 2023年09月

Aim: Continued antipsychotic treatment is the key to preventing relapse. Maintenance antipsychotic monotherapy and optimal dose use are recommended for individuals with stable schizophrenia because of their undesirable effects. Decision aids (DAs) are clinical conversation tools that facilitate shared decision-making (SDM) between patients and health-care providers. This study aimed to describe the development process and results of acceptability testing of a DA for individuals with stable schizophrenia, considering (i) whether to continue high-dose antipsychotics or reduce to the standard dose and (ii) whether to continue two antipsychotics or shift to monotherapy. Methods: A DA was developed according to the guidelines for the appropriate use of psychotropic medications and International Patient Decision Aid Standards (IPDAS). First, a DA prototype was developed based on a previous systematic review and meta-analysis conducted for identifying the effects of continuing or reducing antipsychotic treatment. Second, mixed-method survey was performed among individuals with schizophrenia and health-care providers to modify and finalize the DA. Results: The DA consisted of an explanation of schizophrenia, options to continue high-dose antipsychotics or reduce to the standard dose, options to continue two antipsychotics or shift to monotherapy, pros and cons of each option, and a value-clarification worksheet for each option. The patients (n = 20) reported acceptable language use (75%), adequate information (75%), and well-balanced presentation (79%). Health-care providers (n = 20) also provided favorable overall feedback. The final DA covered six IPDAS qualifying criteria. Conclusion: A DA was successfully developed for schizophrenia, considering whether to reduce antipsychotics, which can be used in the SDM process.

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Efficacy and safety/tolerability of antipsychotics in the treatment of adult patients with major depressive disorder: A systematic review and meta-analysis

Kishimoto T., Hagi K., Kurokawa S., Kane J.M., Correll C.U.

Psychological Medicine （Psychological Medicine） 53 （ 9 ） 4064 - 4082 2023年07月

ISSN 00332917

Background Antipsychotics are widely used in the treatment of major depressive disorder (MDD), but there has been no comprehensive meta-analytic assessment that examined their use as monotherapy and adjunctive therapy. Methods A systematic review and a meta-analysis were conducted on randomized placebo-controlled trials (RCTs) that reported on the efficacy and safety/tolerability of antipsychotics for the treatment of adults with MDD. Data of both monotherapy and adjunctive antipsychotic use were extracted, but analyzed separately using a random-effects model. Co-primary outcomes were study-defined-treatment response and intolerability-related discontinuation. We also illustrated the risk/benefit balance of antipsychotics for MDD, using two-dimensional graphs representing the primary efficacy and safety/tolerability outcome. Secondary outcomes included psychopathology, remission, all-cause-discontinuation, inefficacy-related discontinuation, and adverse events. Results Forty-five RCTs with 12 724 patients were included in the analysis. In monotherapy (studies = 13, n = 4375), amisulpride [1.99 (1.55-2.55)], sulpiride [1.50 (1.03-2.17)], and quetiapine [1.48 (1.23-1.78)] were significantly superior to placebo regarding treatment response. However, intolerability-related discontinuations were significantly higher compared to placebo with amisulpride and quetiapine. In adjunctive therapy (studies = 32, n = 8349), ziprasidone [1.80 (1.07-3.04)], risperidone [1.59 (1.19-2.14)], aripiprazole [1.54 (1.35-1.76)], brexpiprazole [1.41 (1.21-1.66)], cariprazine [1.27 (1.07-1.52)], and quetiapine [1.23 (1.08-1.41)] were significantly superior to placebo regarding treatment response. However, of these antipsychotics that were superior to placebo, only risperidone was equivalent to placebo regarding discontinuation due to intolerability, while the other antipsychotics were inferior. Conclusion Results suggest that there are significant differences regarding the risk/benefit ratio among antipsychotics for MDD, which should inform clinical care.

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Detecting Dementia from Face-Related Features with Automated Computational Methods

Zheng C., Bouazizi M., Ohtsuki T., Kitazawa M., Horigome T., Kishimoto T.

Bioengineering （Bioengineering） 10 （ 7 ） 2023年07月

ISSN 2306-5354

Alzheimer’s disease (AD) is a type of dementia that is more likely to occur as people age. It currently has no known cure. As the world’s population is aging quickly, early screening for AD has become increasingly important. Traditional screening methods such as brain scans or psychiatric tests are stressful and costly. The patients are likely to feel reluctant to such screenings and fail to receive timely intervention. While researchers have been exploring the use of language in dementia detection, less attention has been given to face-related features. The paper focuses on investigating how face-related features can aid in detecting dementia by exploring the PROMPT dataset that contains video data collected from patients with dementia during interviews. In this work, we extracted three types of features from the videos, including face mesh, Histogram of Oriented Gradients (HOG) features, and Action Units (AU). We trained traditional machine learning models and deep learning models on the extracted features and investigated their effectiveness in dementia detection. Our experiments show that the use of HOG features achieved the highest accuracy of 79% in dementia detection, followed by AU features with 71% accuracy, and face mesh features with 66% accuracy. Our results show that face-related features have the potential to be a crucial indicator in automated computational dementia detection.

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Electroconvulsive therapy-induced volumetric brain changes converge on a common causal circuit in depression.

Deng ZD, Ousdal OT, Oltedal L, Angulo B, Baradits M, Spitzberg A, Kessler U, Sartorius A, Dols A, Narr K, Espinoza R, Van Waarde J, Tendolkar I, van Eijndhoven P, van Wingen G, Takamiya A, Kishimoto T, Jorgensen M, Jorgensen A, Paulson O, Yrondi A, Peran P, Soriano-Mas C, Cardoner N, Cano M, van Diermen L, Schrijvers D, Belge JB, Emsell L, Bouckaert F, Vandenbulcke M, Kiebs M, Hurlemann R, Mulders P, Redlich R, Dannlowski U, Kavakbasi E, Kritzer M, Ellard K, Camprodon J, Petrides G, Maholtra A, Abbott C, Argyelan M

Research square 2023年06月

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Language patterns in Japanese patients with Alzheimer disease: A machine learning approach

Momota Y., Liang K.c., Horigome T., Kitazawa M., Eguchi Y., Takamiya A., Goto A., Mimura M., Kishimoto T.

Psychiatry and Clinical Neurosciences （Psychiatry and Clinical Neurosciences） 77 （ 5 ） 273 - 281 2023年05月

ISSN 13231316

Aim: The authors applied natural language processing and machine learning to explore the disease-related language patterns that warrant objective measures for assessing language ability in Japanese patients with Alzheimer disease (AD), while most previous studies have used large publicly available data sets in Euro-American languages. Methods: The authors obtained 276 speech samples from 42 patients with AD and 52 healthy controls, aged 50 years or older. A natural language processing library for Python was used, spaCy, with an add-on library, GiNZA, which is a Japanese parser based on Universal Dependencies designed to facilitate multilingual parser development. The authors used eXtreme Gradient Boosting for our classification algorithm. Each unit of part-of-speech and dependency was tagged and counted to create features such as tag-frequency and tag-to-tag transition-frequency. Each feature's importance was computed during the 100-fold repeated random subsampling validation and averaged. Results: The model resulted in an accuracy of 0.84 (SD = 0.06), and an area under the curve of 0.90 (SD = 0.03). Among the features that were important for such predictions, seven of the top 10 features were related to part-of-speech, while the remaining three were related to dependency. A box plot analysis demonstrated that the appearance rates of content words–related features were lower among the patients, whereas those with stagnation-related features were higher. Conclusion: The current study demonstrated a promising level of accuracy for predicting AD and found the language patterns corresponding to the type of lexical-semantic decline known as ‘empty speech’, which is regarded as a characteristic of AD.

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岸本 泰士郎

論文 - 岸本 泰士郎

岸本　泰士郎

論文 - 岸本　泰士郎