研究者詳細 - 岸本　泰士郎

論文 - 岸本　泰士郎

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A dissemination and education programme to improve the clinical behaviours of psychiatrists in accordance with treatment guidelines for schizophrenia and major depressive disorders: the Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment (EGUIDE) project

Yamada H., Motoyama M., Hasegawa N., Miura K., Matsumoto J., Ohi K., Yasui-Furukori N., Numata S., Takeshima M., Sugiyama N., Nagasawa T., Kubota C., Atake K., Tsuboi T., Ichihashi K., Hashimoto N., Inagaki T., Takaesu Y., Iga J.I., Hori H., Onitsuka T., Komatsu H., Hishimoto A., Fukumoto K., Fujimoto M., Nakamura T., Nemoto K., Furihata R., Yamamura S., Yamagata H., Ogasawara K., Katsumoto E., Murata A., Iida H., Ochi S., Makinodan M., Kido M., Kishimoto T., Yasuda Y., Usami M., Suwa T., Inada K., Watanabe K., Hashimoto R.

BJPsych Open （BJPsych Open） 8 （ 3 ） e83 2022年05月

ISSN 2056-4724

Background Clinical practice guidelines for schizophrenia and major depressive disorder have been published. However, these have not had sufficient penetration in clinical settings. We developed the Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment (EGUIDE) project as a dissemination and education programme for psychiatrists. Aims The aim of this study is to assess the effectiveness of the EGUIDE project on the subjective clinical behaviour of psychiatrists in accordance with clinical practice guidelines before and 1 and 2 years after participation in the programmes. Method A total of 607 psychiatrists participated in this study during October 2016 and March 2019. They attended both 1-day educational programmes based on the clinical practice guidelines for schizophrenia and major depressive disorder, and answered web questionnaires about their clinical behaviours before and 1 and 2 years after attending the programmes. We evaluated the changes in clinical behaviours in accordance with the clinical practice guidelines between before and 2 years after the programme. Results All of the scores for clinical behaviours in accordance with clinical practice guidelines were significantly improved after 1 and 2 years compared with before attending the programmes. There were no significant changes in any of the scores between 1 and 2 years after attending. Conclusions All clinical behaviours in accordance with clinical practice guidelines improved after attending the EGUIDE programme, and were maintained for at least 2 years. The EGUIDE project could contribute to improved guideline-based clinical behaviour among psychiatrists.

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Characteristics of single-channel electroencephalogram in depression during conversation with noise reduction technology

Mitsukura Y., Tazawa Y., Nakamura R., Sumali B., Nakagawa T., Hori S., Mimura M., Kishimoto T.

PLoS ONE （PLoS ONE） 17 （ 4 April ） e0266518 2022年04月

ISSN 1932-6203

Background Previous studies have attempted to characterize depression using electroencephalography (EEG), but results have been inconsistent. New noise reduction technology allows EEG acquisition during conversation. Methods We recorded EEG from 40 patients with depression as they engaged in conversation using a single-channel EEG device while conducting real-time noise reduction and compared them to those of 40 healthy subjects. Differences in EEG between patients and controls, as well as differences in patients’ depression severity, were examined using the ratio of the power spectrum at each frequency. In addition, the effects of medications were examined in a similar way. Results In comparing healthy controls and depression patients, significant power spectrum differences were observed at 3 Hz, 4 Hz, and 10 Hz and higher frequencies. In the patient group, differences in the power spectrum were observed between asymptomatic patients and healthy individuals, and between patients of each respective severity level and healthy individuals. In addition, significant differences were observed at multiple frequencies when comparing patients who did and did not take antidepressants, antipsychotics, and/or benzodiazepines. However, the power spectra still remained significantly different between non-medicated patients and healthy individuals. Limitations The small sample size may have caused Type II error. Patients’ demographic characteristics varied. Moreover, most patients were taking various medications, and cannot be compared to the non-medicated control group. Conclusion A study with a larger sample size should be conducted to gauge reproducibility, but the methods used in this study could be useful in clinical practice as a biomarker of depression.

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特集 AI時代の医師のクリニカル・スキル-君は生き延びることができるか? 【Ⅰ章】AIの特性と能力 ❸10年後のAIはどこまで「診断」できるようになるか?

古川渉太, 木下翔太郎, 岸本泰士郎

総合診療（株式会社医学書院） 32 （ 3 ） 303 - 307 2022年03月

ISSN 21888051

The characteristics of patients receiving psychotropic pro re nata medication at discharge for the treatment of schizophrenia and major depressive disorder: A nationwide survey from the EGUIDE project

Ichihashi K., Kyou Y., Hasegawa N., Yasui-Furukori N., Shimizu Y., Hori H., Hashimoto N., Ide K., Imamura Y., Yamada H., Ochi S., Iga J.i., Takaesu Y., Ohi K., Tsuboi T., Iida H., Yamagata H., Hishimoto A., Horai T., Usami M., Makinodan M., Nagasawa T., Komatsu H., Kido M., Muraoka H., Atake K., Takeshima M., Kubota C., Inagaki T., Tamai S., Kishimoto T., Furihata R., Matsumoto J., Miura K., Inada K., Watanabe K., Kasai K., Hashimoto R.

Asian Journal of Psychiatry （Asian Journal of Psychiatry） 69 103007 2022年03月

ISSN 18762018

Background: Although several guidelines indicate that daily pharmacotherapy is an important part of the treatment of schizophrenia and major depressive disorder, there are few reports regarding pro re nata (PRN) prescriptions. The purpose of this study is to clarify the characteristics of patients receiving psychotropic PRN prescription for the treatment of schizophrenia and major depressive disorder. Method: We used data from ‘the effectiveness of guideline for dissemination and education in psychiatric treatment’ (EGUIDE) project to evaluate the presence or absence of psychotropic PRN prescription at the time of discharge, the age and sex of patients receiving PRN prescription for each diagnosis, and the association between PRN prescription and regular daily psychotropics. Results: The psychotropic PRN prescription ratio was 29.9% among 2617 patients with schizophrenia and 31.1% among 1248 patients with major depressive disorder at discharge. In schizophrenia, the psychotropic PRN prescription ratio was 21.6% for patients aged 65 years or older, which was lower than that of all other age groups. In major depressive disorder, the psychotropic PRN prescription ratio was 34.2% for female patients, which was significantly higher than that for male patients (25.5%). In schizophrenia, there was an association between psychotropic PRN prescription and regular use of multiple psychotropic medications. Conclusions: Psychotropic PRN prescription was less common in elderly patients with schizophrenia and more common in female patients with major depressive disorder. In schizophrenia, psychotropic PRN prescription led to polypharmacy of psychotropics. Further studies are needed to accumulate evidence and to provide education on appropriate PRN prescriptions.

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Physical and mental health impact of COVID-19 on children, adolescents, and their families: The Collaborative Outcomes study on Health and Functioning during Infection Times - Children and Adolescents (COH-FIT-C&A)

Solmi M., Estradé A., Thompson T., Agorastos A., Radua J., Cortese S., Dragioti E., Leisch F., Vancampfort D., Thygesen L.C., Aschauer H., Schloegelhofer M., Akimova E., Schneeberger A., Huber C.G., Hasler G., Conus P., Cuénod K.Q.D., von Känel R., Arrondo G., Fusar-Poli P., Gorwood P., Llorca P.M., Krebs M.O., Scanferla E., Kishimoto T., Rabbani G., Skonieczna-Żydecka K., Brambilla P., Favaro A., Takamiya A., Zoccante L., Colizzi M., Bourgin J., Kamiński K., Moghadasin M., Seedat S., Matthews E., Wells J., Vassilopoulou E., Gadelha A., Su K.P., Kwon J.S., Kim M., Lee T.Y., Papsuev O., Manková D., Boscutti A., Gerunda C., Saccon D., Righi E., Monaco F., Croatto G., Cereda G., Demurtas J., Brondino N., Veronese N., Enrico P., Politi P., Ciappolino V., Pfennig A., Bechdolf A., Meyer-Lindenberg A., Kahl K.G., Domschke K., Bauer M., Koutsouleris N., Winter S., Borgwardt S., Bitter I., Balazs J., Czobor P., Unoka Z., Mavridis D., Tsamakis K., Bozikas V.P., Tunvirachaisakul C., Maes M., Rungnirundorn T., Supasitthumrong T., Haque A., Brunoni A.R., Costardi C.G., Schuch F.B., Polanczyk G., Luiz J.M., Fonseca L., Aparicio L.V., Valvassori S.S., Nordentoft M., Vendsborg P., Hoffmann S.H., Sehli J., Sartorius N., Heuss S., Guinart D., Hamilton J., Kane J., Rubio J., Sand M.

Journal of Affective Disorders （Journal of Affective Disorders） 299 367 - 376 2022年02月

ISSN 01650327

Background: The COVID-19 pandemic has altered daily routines and family functioning, led to closing schools, and dramatically limited social interactions worldwide. Measuring its impact on mental health of vulnerable children and adolescents is crucial. Methods: The Collaborative Outcomes study on Health and Functioning during Infection Times (COH-FIT – www.coh-fit.com) is an on-line anonymous survey, available in 30 languages, involving >230 investigators from 49 countries supported by national/international professional associations. COH-FIT has thee waves (until the pandemic is declared over by the WHO, and 6–18 months plus 24–36 months after its end). In addition to adults, COH-FIT also includes adolescents (age 14–17 years), and children (age 6–13 years), recruited via non-probability/snowball and representative sampling and assessed via self-rating and parental rating. Non-modifiable/modifiable risk factors/treatment targets to inform prevention/intervention programs to promote health and prevent mental and physical illness in children and adolescents will be generated by COH-FIT. Co-primary outcomes are changes in well-being (WHO-5) and a composite psychopathology P-Score. Multiple behavioral, family, coping strategy and service utilization factors are also assessed, including functioning and quality of life. Results: Up to June 2021, over 13,000 children and adolescents from 59 countries have participated in the COH-FIT project, with representative samples from eleven countries. Limitations: Cross-sectional and anonymous design. Conclusions: Evidence generated by COH-FIT will provide an international estimate of the COVID-19 effect on children's, adolescents’ and families’, mental and physical health, well-being, functioning and quality of life, informing the formulation of present and future evidence-based interventions and policies to minimize adverse effects of the present and future pandemics on youth.

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The collaborative outcomes study on health and functioning during infection times in adults (COH-FIT-Adults): Design and methods of an international online survey targeting physical and mental health effects of the COVID-19 pandemic

Journal of Affective Disorders （Journal of Affective Disorders） 299 393 - 407 2022年02月

ISSN 01650327

Background:. High-quality comprehensive data on short-/long-term physical/mental health effects of the COVID-19 pandemic are needed. Methods:. The Collaborative Outcomes study on Health and Functioning during Infection Times (COH-FIT) is an international, multi-language (n=30) project involving >230 investigators from 49 countries/territories/regions, endorsed by national/international professional associations. COH-FIT is a multi-wave, on-line anonymous, cross-sectional survey [wave 1: 04/2020 until the end of the pandemic, 12 months waves 2/3 starting 6/24 months threreafter] for adults, adolescents (14-17), and children (6-13), utilizing non-probability/snowball and representative sampling. COH-FIT aims to identify non-modifiable/modifiable risk factors/treatment targets to inform prevention/intervention programs to improve social/health outcomes in the general population/vulnerable subgrous during/after COVID-19. In adults, co-primary outcomes are change from pre-COVID-19 to intra-COVID-19 in well-being (WHO-5) and a composite psychopathology P-Score. Key secondary outcomes are a P-extended score, global mental and physical health. Secondary outcomes include health-service utilization/functioning, treatment adherence, functioning, symptoms/behaviors/emotions, substance use, violence, among others. Results:. Starting 04/26/2020, up to 14/07/2021 >151,000 people from 155 countries/territories/regions and six continents have participated. Representative samples of ≥1,000 adults have been collected in 15 countries. Overall, 43.0% had prior physical disorders, 16.3% had prior mental disorders, 26.5% were health care workers, 8.2% were aged ≥65 years, 19.3% were exposed to someone infected with COVID-19, 76.1% had been in quarantine, and 2.1% had been COVID 19-positive. Limitations:. Cross-sectional survey, preponderance of non-representative participants. Conclusions:. Results from COH-FIT will comprehensively quantify the impact of COVID-19, seeking to identify high-risk groups in need for acute and long-term intervention, and inform evidence-based health policies/strategies during this/future pandemics.

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特集精神科におけるオンライン診療特集にあたって

岸本泰士郎

精神医学（株式会社医学書院） 64 （ 2 ） 125 - 125 2022年02月

ISSN 04881281

特集精神科におけるオンライン診療遠隔医療に関連した諸外国の政策動向

木下翔太郎, 岸本泰士郎

精神医学（株式会社医学書院） 64 （ 2 ） 137 - 145 2022年02月

ISSN 04881281

特集精神科におけるオンライン診療精神科におけるオンライン診療のエビデンス

岸本泰士郎, 木下翔太郎

精神医学（株式会社医学書院） 64 （ 2 ） 147 - 155 2022年02月

ISSN 04881281

特集オンライン診療への取り組みと今後の展望日本におけるオンライン診療の展開

岸本泰士郎, 木下翔太郎

整形・災害外科（金原出版） 65 （ 1 ） 33 - 39 2022年01月

ISSN 03874095

特集オンライン診療への取り組みと今後の展望精神科領域におけるオンライン診療への取り組み

木下翔太郎, 岸本泰士郎

整形・災害外科（金原出版） 65 （ 1 ） 41 - 47 2022年01月

ISSN 03874095

オンライン診療の適正な普及に関するヒアリング調査　現状把握と課題分析

木下翔太郎, 成瀬浩史, 吉村健佑, 岸本泰士郎, 榎戸芙佐子, 押淵英弘, 兼子幸一, 瀬戸秀文, 辻本哲士, 長尾喜一郎, 三野進, 村田昌彦, 米田博, 稲垣中

精神神経学雑誌（(公社)日本精神神経学会） 124 （ 1 ） 16 - 27 2022年01月

ISSN 0033-2658

2020年から始まった新型コロナウイルス感染症の拡大のなかで,感染予防策の1つとして,遠隔医療が注目されることとなり,世界各国で規制緩和が行われ利用が促進された.わが国でも,種々の規制緩和により,従来利用が少なかった精神科領域でもオンライン診療が活用されることが増えた.日本精神神経学会オンライン精神科医療検討作業班では,オンライン診療の現状把握と課題分析を目的として,臨床現場でオンライン診療の実践に取り組む医療機関にヒアリング調査を行った.17の医療機関から調査の協力を得られた.回答した医療機関のうち6施設(35.3%)が2020年から新たにオンライン診療を導入しており,15施設(88.2%)で新型コロナウイルス感染症の拡大における時限的・特例的な措置に基づく診療を行っており,今般の規制緩和によって利用が拡大していることが示唆された.また,導入に際しての困難については,7施設(41.2%)が診療報酬の価格の低さや対象範囲の狭さを挙げており,精神科診療でオンライン診療を普及させるうえでの課題についての質問でも,診療報酬の価格を対面診療に近づけることと回答した医療機関が9施設(52.9%)であり,診療報酬が普及の障害となっていると考える医療機関が多かった.厚生労働省に対する要望についての質問でも,診療報酬の点数や施設基準の改善を求めるという回答が12施設(70.6%)と圧倒的に多かった.オンライン診療は患者のニーズに合わせた普及がなされるべきであり,普及の障害となっている規制で合理性に欠けるものについては,見直しがされていくことが望ましいといえる.一方で,オンライン診療の安易な多用は,医療の質の観点から問題となる場合もあると考えられるため,適切な規制のあり方についての議論も継続していくべきである.(著者抄録)

Association of work environment with stress and depression among Japanese workers

Shiga K., Izumi K., Minato K., Yoshimura M., Kitazawa M., Hanashiro S., Cortright K., Kurokawa S., Momota Y., Sado M., Maeno T., Takebayashi T., Mimura M., Kishimoto T.

Work （Work） 72 （ 4 ） 1321 - 1335 2022年

ISSN 10519815

BACKGROUND: There is a lack of studies that investigated the effect of a wide range of work environmental factors on stress and depression in Japan. OBJECTIVES: To examine the association of work environment factors with stress and depression among workers in Japan. METHODS: We conducted questionnaire surveys of workers that mainly engage in desk work in Japan. Stress was assessed through the Perceived Stress Scale (PSS), depression through the Patient Health Questionnaire-9 (PHQ-9), and work environment through physical and psychological workplace environment questionnaires. Workers were divided into low and high stress groups based on PSS score (median split), and divided into non-depressed and depressed groups based on their PHQ-9 score (< 5, and ≥5); these groups were then compared with their working environment. In addition, a multiple regression analysis was performed. RESULTS: Responses were obtained from 210 subjects. Multiple regression analysis showed that 'Ability to work at one's own pace' and 'Ability to apply personal viewpoint to work,' etc., had effect on stress, while 'Workplace harassment' and 'Support from colleagues,' etc., had effect on depression. CONCLUSIONS: The results suggest that stress and depression in Japanese workers are related to factors such as job demands, control of work, workplace harassment, and psychological safety.

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大規模ツイートデータを用いたメンタルヘルス不調者の推測

高須遼, 中村啓信, 岸本泰士郎, 狩野芳伸

人工知能学会全国大会論文集（一般社団法人人工知能学会） JSAI2022 （ 0 ） 1J4OS13a04 - 1J4OS13a04 2022年

<p>メンタルヘルスは社会的に重要な問題である。近年、メンタルヘルスの問題はインターネット上の活動と密接に関係している。そこで我々は、Twitterユーザーがメンタルヘルス問題を抱えているかどうかを分類するシステムを開発した。特定のパターンに合致するアカウントはメンタルヘルス問題を抱えている可能性が高いと仮定し、この仮定に基づいてポジティブな例とネガティブな例を100万件規模で収集した。また、キーワードに依存する先行研究とは異なり、メンタルヘルスに特化したキーワードを含まないユーザの発話を分類する可能性を検討するため、そのようなキーワードを含むツイートはデータセットから排除した。BERT、LSTM、SVMを学習させ、分類性能を比較した。BERTについては、大規模ツイートデータを用いた事前学習を行った。BERTが最も高い性能を示し、Accuracy 0.83, Recall 0.8, Precision 0.88,F1-score 0.84という実用レベルの高い分類性能を達成した。文脈情報の重要性とともに、一般的な発話からメンタルヘルス不調を推測しうることを示した。</p>

Current Status and Challenges of the Dissemination of Telemedicine in Japan After the Start of the COVID-19 Pandemic

Kinoshita Shotaro, Kishimoto Taishiro

TELEMEDICINE AND E-HEALTH （Telemedicine and e-Health） 28 （ 8 ） 1220 - 1224 2021年12月

ISSN 1530-5627

Background: The use of telemedicine is expanding worldwide in response to the COVID-19 pandemic, and deregulation is occurring even in countries with strict regulations, such as Japan. Methods: We conducted a narrative review of the activities and initiatives undertaken by the government and professional organizations to promote the use of telemedicine in Japan from January 2020, when the COVID-19 pandemic began, to September 2021. Results: In Japan, where before the pandemic the spread of telemedicine had been limited, various recommendations and deregulations have now been made, resulting in the expanded use of telemedicine. In particular, the government's overall policy direction has become a catalyst for deregulation. Conclusions: With the COVID-19 pandemic, telemedicine is now moving toward widespread use. However, further activities and initiatives, including policy changes such as reimbursement and the establishment of evidence to show the effectiveness of telemedicine in Japan, are needed to properly disseminate telemedicine.

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Japanese project for telepsychiatry evaluation during COVID-19: Treatment comparison trial (J-PROTECT): Rationale, design, and methodology

Kishimoto T., Kinoshita S., Bun S., Sato Y., Kitazawa M., Kikuchi T., Sado M., Takamiya A., Mimura M., Nakamae T., Abe Y., Kanazawa T., Kawabata Y., Tomita H., Abe K., Hishimoto A., Asami T., Suda A., Watanabe Y., Amagai T., Sakuma K., Kida H., Funayama M., Kimura H., Sato A., Fujiwara S., Nagao K., Sugiyama N., Takamiya M., Kodama H., Azekawa T.

Contemporary Clinical Trials （Contemporary Clinical Trials） 111 106596 2021年12月

ISSN 15517144

Introduction: The COVID-19 pandemic has had a profound impact on the mental health of people around the world. Anxiety related to infection, stress and stigma caused by the forced changes in daily life have reportedly increased the incidence and symptoms of depression, anxiety disorder and obsessive-compulsive disorder. Under such circumstances, telepsychiatry is gaining importance and attracting a great deal of attention. However, few large pragmatic clinical trials on the use of telepsychiatry targeting multiple psychiatric disorders have been conducted to date. Methods: The targeted study cohort will consist of adults (>18 years) who meet the DSM-5 diagnostic criteria for either (1) depressive disorders, (2) anxiety disorders, or (3) obsessive-compulsive and related disorders. Patients will be assigned in a 1:1 ratio to either a “telepsychiatry group” (at least 50% of treatments to be conducted using telemedicine, with at least one face-to-face treatment [FTF] within six months) or an “FTF group” (all treatments to be conducted FTF, with no telemedicine). Both groups will receive the usual treatment covered by public medical insurance. The study will utilize a master protocol design in that there will be primary and secondary outcomes for the entire group regardless of diagnosis, as well as the outcomes for each individual disorder group. Discussion: This study will be a non-inferiority trial to test that the treatment effect of telepsychiatry is not inferior to that of FTF alone. This study will provide useful insights into the effect of the COVID-19 pandemic on the practice of psychiatry. Trial Registration: jRCT1030210037, Japan Registry of Clinical Trials (jRCT).

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Response to Morina et al.'s criticisms of Horigome et al.'s recent report on the efficacy of virtual reality exposure therapy for social anxiety disorder.

Horigome T, Kurokawa S, Sawada K, Kudo S, Shiga K, Mimura M, Kishimoto T

Psychological medicine 1 - 2 2021年10月

ISSN 0033-2917

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Neural Substrates of Psychotic Depression: Findings From the Global ECT-MRI Research Collaboration.

Takamiya A, Dols A, Emsell L, Abbott C, Yrondi A, Soriano Mas C, Jorgensen MB, Nordanskog P, Rhebergen D, van Exel E, Oudega ML, Bouckaert F, Vandenbulcke M, Sienaert P, Péran P, Cano M, Cardoner N, Jorgensen A, Paulson OB, Hamilton P, Kampe R, Bruin W, Bartsch H, Ousdal OT, Kessler U, van Wingen G, Oltedal L, Kishimoto T

Schizophrenia bulletin （Schizophrenia Bulletin） 48 （ 2 ） 514 - 523 2021年10月

ISSN 0586-7614

Psychotic major depression (PMD) is hypothesized to be a distinct clinical entity from nonpsychotic major depression (NPMD). However, neurobiological evidence supporting this notion is scarce. The aim of this study is to identify gray matter volume (GMV) differences between PMD and NPMD and their longitudinal change following electroconvulsive therapy (ECT). Structural magnetic resonance imaging (MRI) data from 8 independent sites in the Global ECT-MRI Research Collaboration (GEMRIC) database (n = 108; 56 PMD and 52 NPMD; mean age 71.7 in PMD and 70.2 in NPMD) were analyzed. All participants underwent MRI before and after ECT. First, cross-sectional whole-brain voxel-wise GMV comparisons between PMD and NPMD were conducted at both time points. Second, in a flexible factorial model, a main effect of time and a group-by-time interaction were examined to identify longitudinal effects of ECT on GMV and longitudinal differential effects of ECT between PMD and NPMD, respectively. Compared with NPMD, PMD showed lower GMV in the prefrontal, temporal and parietal cortex before ECT; PMD showed lower GMV in the medial prefrontal cortex (MPFC) after ECT. Although there was a significant main effect of time on GMV in several brain regions in both PMD and NPMD, there was no significant group-by-time interaction. Lower GMV in the MPFC was consistently identified in PMD, suggesting this may be a trait-like neural substrate of PMD. Longitudinal effect of ECT on GMV may not explain superior ECT response in PMD, and further investigation is needed.

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特集オンライン診療・医療AI最前線オンライン診療・医療AIを取り巻く環境　海外における遠隔医療・医療AIの動静と現状

木下翔太郎, 飯塚真理, 岸本泰士郎

診断と治療（(株)診断と治療社） 109 （ 9 ） 1219 - 1224 2021年09月

ISSN 0370999X

Gastrointestinal symptoms and sensory abnormalities associated with behavioral problems in children with neurodevelopmental disorders

Kurokawa S., Nomura K., Miyaho K., Sanada K., Iwamoto C., Naraoka M., Yoneda S., Tomizawa Y., Sawae Y., Iwanaga R., Mimura M., Kishimoto T.

Autism Research （Autism Research） 14 （ 9 ） 1996 - 2001 2021年09月

ISSN 19393792

Behavioral problems directly affect the quality of life of caregivers and children with autism spectrum disorder (ASD) and/or attention-deficit/hyperactivity disorder (ADHD), and is known to be associated with clinical factors such as gastrointestinal (GI) symptoms, sensory abnormalities, intellectual abilities, and use of medication. However, previous studies have not considered these relationships comprehensively. We conducted a cross-sectional study of 6–12-year-old children with diagnoses of ASD and/or ADHD at two hospitals in Japan. Scores for the aberrant behavior checklist (ABC), autism-spectrum quotient (AQ), and Conners 3, as well as information on daily sleep and exercise, GI symptoms, and Short Sensory Profile, were collected. Each factor was subjected to a correlation analysis to investigate its effect on ABC scores. A stepwise multiple linear regression analysis for the factors with p < 0.05 was performed. Data were obtained from 60 patients with a mean age of 8.3 years; 21 had ASD alone, 18 had ADHD alone, and 21 had ASD + ADHD. The correlation analyses identified six factors associated with ABC severity: (a) methylphenidate use, (b) Conners hyperactivity score, (c) Conners inattention score, (d) AQ score, (e) SSP score, and (f) GI symptom score. The multiple regression showed that “GI symptoms” and “sensory abnormalities” were independently associated with ABC severity. Although further studies are needed to show a causal relationship, appropriate assessment of GI symptoms and sensory abnormalities may help alleviate some problematic behaviors and improve the quality of life of children with neurodevelopmental disorders and their families. Lay summary: Behavioral problems in children with neurodevelopmental disorders are known to be associated with many factors. This study aimed to comprehensively investigate the known factors. We have discovered that “gastrointestinal symptoms” and “sensory abnormalities” were independently associated with Behavioral problems. Our results suggest that it is important for clinicians and caregivers to pay more attention to children's GI symptoms and sensory abnormalities that may not present as obvious symptoms or complaints.

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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