研究者詳細 - 岸本　泰士郎

論文 - 岸本　泰士郎

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発話特徴を用いた自閉スペクトラム症の重症度推測システム

﨑下雅仁, 小川ちひろ, 土屋賢治, 岩渕俊樹, 岸本泰士郎, 狩野芳伸.

人工知能学会論文誌 35 （ 3 ） 2020年

研究論文（学術雑誌）, 査読有り

Changes in Telepsychiatry Regulations during the COVID-19 Pandemic: 17 Countries and Regions' Approaches to an Evolving Healthcare Landscape

Kinoshita S., Cortright K., Crawford A., Mizuno Y., Yoshida K., Hilty D., Guinart D., Torous J., Correll C.U., Castle D.J., Rocha D., Yang Y., Xiang Y.T., Kølbæk P., Dines D., Elshami M., Jain P., Kallivayalil R., Solmi M., Favaro A., Veronese N., Seedat S., Shin S., De Pablo G.S., Chang C.H., Su K.P., Karas H., Kane J.M., Yellowlees P., Kishimoto T.

Psychological Medicine （Psychological Medicine） 52 （ 13 ） 1 - 8 2020年

ISSN 00332917

© 2020 American Medical Association. All rights reserved. Background: During the COVID-19 pandemic, the use of telemedicine as a way to reduce COVID-19 infections was noted and consequently deregulated. However, the degree of telemedicine regulation varies from country to country, which may alter the widespread use of telemediine. This study aimed to clarify the telepsychiatry regulations for each collaborating country/region before and during the COVID-19 pandemic. Methods: We used snowball sampling within a global network of international telepsychiatry experts. Thirty collaborators from 17 different countries/regions responded to a questionnaire on barriers to the use and implementation of telepsychiatric care, including policy factors such as regulations and reimbursement at the end of 2019 and as of May 2020. Results: Thirteen of 17 regions reported a relaxation of regulations due to the pandemic; consequently, all regions surveyed stated that telepsychiatry was now possible within their public healthcare systems. In some regions, restrictions on prescription medications allowed via telepsychiatry were eased, but in 11 of the 17 regions, there were still restrictions on prescribing medications via telepsychiatry. Lower insurance reimbursement amounts for telepsychiatry consultations versus in-person consultations were reevaluated in 4 regions, and consequently, in 15 regions telepsychiatry services were reimbursed at the same rate (or higher) than in-person consultations during the COVID-19 pandemic. Conclusions: Our results confirm that, due to COVID-19, the majority of countries surveyed are altering telemedicine regulations that had previously restricted the spread of telemedicine. These findings provide information that could guide future policy and regulatory decisions, that facilitate greater scale and spread of telepsychiatry globally.

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機械学習を用いた自殺予防の可能性とその問題点

木下翔太郎, 岸本泰士郎

日本生物学的精神医学会誌（日本生物学的精神医学会） 31 （ 3 ） 141 - 146 2020年

ISSN 2186-6619

自殺者の90%以上は精神疾患を有しているとされており，精神科医にとって自殺の予防は最重要課題の一つである。しかし，精神神経科領域は，診断や重症度評価の客観的指標となるバイオマーカーに乏しく，複合的な要因によって引き起こされる自殺もまた正確な予測が困難とされてきた。近年，自殺予防において，機械学習（machine learning）を用いた研究が数多く行われるようになってきており，画像データや，自然言語処理（natural language processing）を用いた個人の日記やSNSへの投稿に関する研究など，従来にはない試みも出てきている。本稿では，機械学習を用いた自殺予防に関する新しい知見について紹介しつつ，社会への実装に際し検討すべき倫理的・法的・社会的な課題（ethical legal and social implications：ELSI）についても触れる。

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Electroconvulsive Therapy for Parkinson's Disease: A Systematic Review and Meta-Analysis

Takamiya A., Seki M., Kudo S., Yoshizaki T., Nakahara J., Mimura M., Kishimoto T.

Movement Disorders （Movement Disorders） 36 （ 1 ） 50 - 58 2020年

ISSN 08853185

© 2020 International Parkinson and Movement Disorder Society Background: Electroconvulsive therapy (ECT) is a well-established treatment for psychiatric disorders, including depression and psychosis. ECT has been reported to be effective in treating such psychiatric symptoms in patients with Parkinson's disease (PD) and has been also reported to be effective in treating motor symptoms. The aim of the study is to summarize previous clinical studies investigating the efficacy of ECT for symptoms in patients with PD. Methods: A systematic review and meta-analysis of any study designs assessing motor and/or non-motor symptoms in patients with PD before and after ECT. Co-primary outcomes were set as motor manifestations assessed using the Unified Parkinson's Disease Rating Scale or other rating scales, and non-motor symptoms included depression and psychosis. Secondary outcomes were wearing-off phenomenon and cognitive function. The impact of ECT on those symptoms was examined by comparing the severity of the symptoms before and after ECT using a random effect model and was expressed in standardized mean difference. Results: Of 1219 identified citations, 14 studies (n = 129; 1 randomized controlled study, 9 prospective observational studies, and 4 retrospective studies) were analyzed. The findings were as follows: ECT significantly improved motor manifestations in patients with PD, and the improvement was significant in the subpopulation without psychiatric symptoms; ECT significantly improved depression and psychosis; and ECT significantly relieved wearing-off phenomenon and did not worsen cognitive functioning. Conclusion: The current meta-analysis suggests the potential benefit of ECT on motor and non-motor symptoms in presumably complicated and difficult-to-treat subgroups. © 2020 International Parkinson and Movement Disorder Society.

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デスクワーク労働者のパフォーマンスに関連する要因の検討

志賀希子, 泉啓介, 湊和修, 吉村道孝, 北沢桃子, 三村將, 岸本泰士郎

日本心理学会大会発表論文集（公益社団法人日本心理学会） 84 （ 0 ） PQ - 020-PQ-020 2020年

【目的】本研究は「現場の負担を抑えたセンシングでストレスや幸福度を定量し健康経営オフィスを実現するシステムの開発」（日本医療研究開発機構）の中から，質問紙データを用い，労働者の日々のパフォーマンス（被験者が感じる自身の仕事の能率）と職場環境，生活習慣，ストレス，うつ，well-beingの関連を検討した。 【方法】国内11社の労働者を対象に，業務時間中に4週間調査を実施した。パフォーマンスは3件法（1：悪，2：普通，3：良）で自己申告にて毎日回答を得た。解析はパフォーマンス平均値を従属変数とした重回帰分析を行い，独立変数は性別，PC使用時間，学歴，喫煙歴，平日／休日の睡眠時間，睡眠負債，睡眠の質，気分／体調，ストレス，うつ，well-being得点とした。 【結果】被験者192名（男性103名，年齢38.9±8.4歳），パフォーマンスは2.04±0.31だった。パフォーマンスに対して気分／体調，PC使用時間，女性は正の影響，ストレスは負の影響が示された（p＜.05）。 【考案】本研究より毎日の気分や体調，PC使用時間，ストレス，性別が労働者のパフォーマンスに関連している可能性が示唆された。パフォーマンスを促進するにはこれらの要素を考慮する必要がある。

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Volume Increase of the Dentate Gyrus Induced by Electroconvulsive Therapy: Shedding Light on the Clinical Relevance of Plasticity in the Hippocampus

Takamiya A., Nuninga J., Mandl R., Sommer I., Mimura M., Kishimoto T.

The journal of ECT （The journal of ECT） 35 （ 4 ） e57 - e58 2019年12月

ISSN 1095-0680

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Volume Increase of the Dentate Gyrus Induced by Electroconvulsive Therapy Shedding Light on the Clinical Relevance of Plasticity in the Hippocampus

Takamiya Akihiro, Nuninga Jasper O., Mandl Rene C. W., Sommer Iris E. C., Mimura Masaru, Kishimoto Taishiro

JOURNAL OF ECT 35 （ 4 ） E57 - E58 2019年12月

ISSN 1095-0680

A Validation Study of the Remotely Administered Montreal Cognitive Assessment Tool in the Elderly Japanese Population

Iiboshi Kiyoko, Yoshida Kazunari, Yamaoka Yoshitaka, Eguchi Yoko, Sato Daisuke, Kishimoto Megumi, Funaki Kei, Mimura Masaru, Kishimoto Taishiro

TELEMEDICINE AND E-HEALTH （Telemedicine and e-Health） 26 （ 7 ） 1 - 9 2019年11月

ISSN 1530-5627

© MARY ANN LIEBERT, INC. Background: In an aging society, neuropsychological testing using video teleconferencing (VTC) is increasingly important. Despite the potential benefit of a VTC-administered Montreal Cognitive Assessment Tool (MoCA) to detect cognitive decline, only a limited number of studies have investigated this tool's reliability. Therefore, we aimed to evaluate the reliability of VTC-administered MoCA compared with face-to-face (FTF)-administered MoCA among elderly Japanese participants. Moreover, we examined participants' satisfaction with VTC-administered MoCA. Methods: Participants ‡60 years of age with and without cognitive impairment (i.e., those with mild cognitive impairment [MCI], those with dementia, and healthy controls [HC]) were assessed with VTC- and FTF-administered MoCA at an interval of >2 weeks and <3 months. The order effect (VTC first vs. FTF first) and time effect (first vs. second testing session), as well as several covariates such as age and years of education were controlled. Intraclass correlation coefficients (ICCs) were calculated using a mixed-effects model to assess the agreement between the two (VTC- vs. FTF-administered) groups. Participants' satisfaction with VTC-administered MoCA was examined using a Likert scale asking seven questions. Results: We included 73 participants in the study (36 men; age, 76.3 - 7.5 years). The ICC for the MoCA total score was high in the entire sample (0.85), whereas ICCs were moderate to high for the subgroups (MCI: 0.82, dementia: 0.82, and HC: 0.53). Furthermore, we found good overall participant satisfaction with VTC-administered MoCA. Discussion: VTC-administered MoCA appears viable as an alternative to FTF-administered MoCA, although further replication studies with larger sample sizes are needed.

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Survey of the effects of internet usage on the happiness of Japanese university students

Kitazawa M., Yoshimura M., Hitokoto H., Sato-Fujimoto Y., Murata M., Negishi K., Mimura M., Tsubota K., Kishimoto T.

Health and quality of life outcomes （Health and quality of life outcomes） 17 （ 1 ） 151 2019年10月

BACKGROUND: Besides research on psychiatric diseases related to problematic Internet use (PIU), a growing number of studies focus on the impact of Internet on subjective well-being (SWB). However, in previous studies on the relationship between PIU and SWB, there is little data for Japanese people specifically, and there is a lack of consideration for differences in perception of happiness due to cultural differences. Therefore, we aimed to clarify how happiness is interdependent on PIU measures, with a focus on how the concept of happiness is interpreted among Japanese people, and specifically among Japanese university students. METHODS: A paper-based survey was conducted with 1258 Japanese university students. Respondents were asked to fill out self-report scales regarding their happiness using the Interdependent Happiness Scale (IHS). The relationship between IHS and Internet use (Japanese version of the Internet addiction test, JIAT), use of social networking services, as well as social function and sleep quality (Pittsburgh Sleep Quality Index, PSQI) were sought using multiple regression analyses. RESULTS: Based on multiple regression analyses, the following factors related positively to IHS: female gender and the number of Twitter followers. Conversely, the following factors related negatively to IHS: poor sleep, high- PIU, and the number of times the subject skipped a whole day of school. CONCLUSIONS: It was shown that there was a significant negative correlation between Japanese youths' happiness and PIU. Since epidemiological research on happiness that reflects the cultural background is still scarce, we believe future studies shall accumulate similar evidence in this regard.

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Thalamic volume, resting-state activity, and their association with the efficacy of electroconvulsive therapy

Takamiya A., Kishimoto T., Liang K., Terasawa Y., Nishikata S., Tarumi R., Sawada K., Kurokawa S., Hirano J., Yamagata B., Mimura M.

Journal of Psychiatric Research （Journal of Psychiatric Research） 117 135 - 141 2019年10月

ISSN 00223956

© 2019 Electroconvulsive therapy (ECT) is the most effective antidepressant treatment. Biological predictors of clinical outcome to ECT are valuable. We aimed to examine multimodal magnetic resonance imaging (MRI) data that correlates to the efficacy of ECT. Structural and resting-state functional MRI data were acquired from 46 individuals (25 depressed individuals who received ECT, and 21 healthy controls). Whole-brain grey matter volume (GMV) and fractional amplitude of low frequency fluctuations (fALFF) were investigated to identify brain regions associated with post-ECT Hamilton Depression Rating Scale (HAM-D) total scores. GMV and fALFF values were compared with those in healthy controls using analysis of covariance (ANCOVA). Remission was defined by HAM-D ≤7. A multiple regression analysis revealed that pretreatment smaller GMV in the left thalamus was associated with worse response to ECT (i.e. higher post-ECT HAM-D). Pretreatment higher fALFF in the right anterior insula, and lower fALFF in the left thalamus and the cerebellum were associated with worse outcomes. The left thalamus was identified in both GMV and fALFF analyses. Nonremitters showed significantly smaller thalamic GMV compared to remitters and controls. We found that pretreatment thalamic volume and resting-state activity were associated with the efficacy of ECT. Our results highlight the importance of the thalamus as a possible biological predictor and its role in the underlying mechanisms of ECT action.

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Effectiveness and safety of long-term benzodiazepine use in anxiety disorders: a systematic review and meta-analysis

Shinfuku M., Kishimoto T., Uchida H., Suzuki T., Mimura M., Kikuchi T.

International clinical psychopharmacology （International clinical psychopharmacology） 34 （ 5 ） 211 - 221 2019年09月

Long-term benzodiazepines (BZDs) use is not endorsed in the treatment guidelines for anxiety disorders, but is prevalent in the real-world clinical settings. A systematic literature review was performed by using PubMed (last search: May 2019) to identify randomized controlled trials (RCTs) or maintenance studies following RCT that examined the effectiveness of BZDs in patients with anxiety disorders for a duration of 13 weeks or more. Meta-analyses were then conducted regarding changes in the Hamilton Anxiety Rating Scale (HAM-A) scores from baseline through endpoint, all-cause discontinuation, side effects, and the numbers of panic attacks at endpoint. Eight studies were identified (N = 1228). There were no significant differences in all outcomes between BZDs and antidepressants after the initial 8-week treatment. While no significant difference was noted in the HAM-A score changes between BZDs and placebo, BZDs resulted in a lower discontinuation rate and more frequent constipation and dry mouth than placebo. Our study indicates that for those who respond to an initial 8-week treatment, continuing BZDs is equivalent to antidepressants in efficacy and safety. However, the limited number of studies warranted further investigations of the long-term effectiveness and safety of BZDs.

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Long-Acting Injectables Versus Oral Antipsychotics: A Retrospective Bidirectional Mirror-Image Study

Miura G., Misawa F., Kawade Y., Fujii Y., Mimura M., Kishimoto T.

Journal of Clinical Psychopharmacology （Journal of Clinical Psychopharmacology） 39 （ 5 ） 441 - 445 2019年09月

ISSN 02710749

© Wolters Kluwer Health, Inc. All rights reserved. Purpose Mirror-image studies, which compare equal periods of time before and after a new treatment is introduced, may reflect the real-world impact of that treatment. However, most mirror-image studies that have investigated the impact of long-acting injectable antipsychotics (LAIs) were unidirectional in design, for patients switching from oral antipsychotics (OAPs) to LAIs. Therefore, we conducted a bidirectional mirror-image study comparing LAIs and OAPs. Methods We included 126 schizophrenia or schizoaffective disorder patients' LAI treatment data from 3 psychiatric hospitals. Patients took OAPs for 6 months or more before initiating LAIs, or the reverse. We obtained data on the number of hospitalizations as a primary outcome, plus the total duration and mean duration of hospitalization as secondary outcomes during the 6 months of the patients' first treatment, and the 6 months after the patients started their second type of treatment. Results The results indicated that there was no significant difference in any outcomes between LAI and OAP treatment when going from LAIs to OAPs (n = 59). However, when patients started with OAPs and switched to LAIs (n = 67), they were hospitalized a significantly fewer number of times, and the duration of their stays was shorter in the LAI phase than in the OAP phase. When combined with bidirectional data, LAI superiority was still observed. Conclusions The findings endorse the relative effectiveness of LAIs over OAPs in the real world, although the inherent flaws of mirror-image studies such as expectation bias and having no parallel comparator should be considered.

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Prolonged Post-Electroconvulsive Therapy Delirium Controlled With Donepezil

Takamiya A, Sawada K, Hirano J, Mimura M, Kishimoto T.

Journal of ECT 35 （ 3 ） E29 - E33 2019年09月

査読有り, ISSN 10950680

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Facial Landmark Activity Features for Depression Screening

Sumali B., Mitsukura Y., Tazawa Y., Kishimoto T.

2019 58th Annual Conference of the Society of Instrument and Control Engineers of Japan, SICE 2019 （2019 58th Annual Conference of the Society of Instrument and Control Engineers of Japan, SICE 2019） 1376 - 1381 2019年09月

© 2019 The Society of Instrument and Control Engineers - SICE. Depression is the most common mood disorder in the world which is also the leading cause of suicide. Depression might be diagnosed using varying modalities, as it affects many aspects of the patient, not only the patient will appear melancholic, but the patient's sleep quality and life quality might also be disrupted. In this study, we aim to extract facial landmark features unique to depression patients and build a machine learning model to classify the depression severity. The facial landmark activities considered in this study include: speed statistics of the landmarks, the standard deviation of eye pupils, and statistical features of mouth area. We found several facial landmark activity features with significant differences between healthy volunteers and depressed patients. We also successfully built machine learning models for automatic depression severity prediction.

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Psychiatrists' perceptions of medication adherence among patients with schizophrenia: An international survey.

59. Kurokawa S, Kishimoto T, Su KP, Chang JP, Chang HC, Yu X, Rodrigues-Silva N,Nielsen J, Unadkat A, Castle D, Haddad PM, Rocha D, Gadelha A, Kaliora S,Petrides G, Agid O, Tazawa Y, Takamiya A, Horigome T, Kane JM.

Schizophr Res 211 105 - 107 2019年09月

研究論文（学術雑誌）, 共著, 査読有り

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Effectiveness and safety of long term benzodiazepine use in anxiety disorders: a systematic review and meta-analysis.

Int Clin Psychopharmacol 34 （ 5 ） 211 - 221 2019年09月

研究論文（学術雑誌）, 査読有り

日本の大学生におけるインターネット使用と精神症状との関連, 精神神経学雑誌

9. 北沢桃子, 吉村道孝, 村田まゆ, 藤本友香, 一言英文, 三村　將, 坪田一男, 岸本泰士郎

精神神経学雑誌 121 （ 8 ） 593 - 601 2019年08月

研究論文（学術雑誌）, 共著, 査読有り

Corpus Analysis of Psychiatric Disorders Utilizing Natural Language Processing and Neurolinguistics

Kudo K., Kishimoto T.

Brain and nerve = Shinkei kenkyu no shinpo （Brain and nerve = Shinkei kenkyu no shinpo） 71 （ 7 ） 765 - 770 2019年07月

ISSN 18816096

Natural language processing (NLP) is a technology in which a computer processes human "natural language" directly. Along with the development of technologies such as automatic morphological analysis and transition words or sentences to vectors, more research that targets psychiatric disorders utilizing NLP is being conducted. In this manuscript, we will review some of these studies. Such approaches may resolve many problems regarding the assessment of psychiatric illnesses, and are expected to contribute to neurolinguistics.

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Switching to antipsychotic monotherapy vs. staying on antipsychotic polypharmacy in schizophrenia: A systematic review and meta-analysis

Matsui K., Tokumasu T., Takekita Y., Inada K., Kanazawa T., Kishimoto T., Takasu S., Tani H., Tarutani S., Hashimoto N., Yamada H., Yamanouchi Y., Takeuchi H.

Schizophrenia Research （Schizophrenia Research） 209 50 - 57 2019年07月

ISSN 09209964

© 2019 Elsevier B.V. Background: While recent meta-analyses have reported the superiority of antipsychotic polypharmacy (APP) over antipsychotic monotherapy (APM) in schizophrenia, switching to APM can be beneficial in terms of side effects. To determine whether patients receiving APP should switch to APM or stay on APP, we conducted a systematic review and meta-analysis. Methods: Randomized controlled trials (RCTs) examining a switch from APP to APM vs. staying on APP were systematically selected from a previous meta-analysis comparing APP with APM in patients with schizophrenia. In addition, we conducted an updated systematic literature search using MEDLINE, Embase, and Cochrane Central Register of Controlled Trials. Data on study discontinuation, relapse, psychopathology, neurocognition, extrapyramidal symptoms, and body weight/body mass index (BMI) were extracted and synthesized. Results: A total of 6 RCTs involving 341 patients were included. All studies examined a switch from 2 antipsychotic agents to a single agent. Clozapine-treated patients were included in 3 studies. There was a significant difference in study discontinuation due to all causes in favor of staying on APP (N = 6, n = 341, RR = 2.28, 95% CI = 1.50–3.46, P < 0.001). There were no significant differences in relapse, any psychopathology, neurocognition, extrapyramidal symptoms, or body weight/BMI between the 2 groups. The quality of evidence was low to very low. Conclusions: The findings suggest that clinicians should closely monitor patient condition when switching to APM after receiving 2 antipsychotics. Given the low to very low overall quality of the evidence, the findings should be considered preliminary and inconclusive.

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Actigraphy for evaluation of mood disorders: A systematic review and meta-analysis

Tazawa Y., Wada M., Mitsukura Y., Takamiya A., Kitazawa M., Yoshimura M., Mimura M., Kishimoto T.

Journal of Affective Disorders （Journal of Affective Disorders） 253 257 - 269 2019年06月

ISSN 01650327

© 2019 Background: Actigraphy has enabled consecutive observation of individual health conditions such as sleep or daily activity. This study aimed to examine the usefulness of actigraphy in evaluating depressive and/or bipolar disorder symptoms. Method: A systematic review and meta-analysis was conducted. We selected studies that used actigraphy to compare either patients vs. healthy controls, or pre- vs. post-treatment data from the same patient group. Common actigraphy measurements, namely daily activity and sleep-related data, were extracted and synthesized. Results: Thirty-eight studies (n = 3,758) were included in the analysis. Compared with healthy controls, depressive patients were less active (standardized mean difference; SMD=1.27, 95%CI=[0.97, 1.57], P<0.001) and had longer wake after sleep onset (SMD= − 0.729, 95%CI=[− 1.20, − 0.25], p = 0.003). Total sleep time (SMD= − 0.33, 95%CI=[− 0.55, − 0.11], P = 0.004), sleep latency (SMD= − 0.22, 95%CI=[− 0.42, − 0.02], P = 0.032), and wake after sleep onset (SMD= − 0.22, 95%CI=[− 0.39, − 0.04], P = 0.015) were longer in euthymic/remitted patients compared to healthy controls. In pre- and post-treatment comparisons, sleep latency (SMD=− 0.85, 95%CI=[− 1.53, − 0.17], P = 0.015), wake after sleep onset (SMD= − 0.65, 95%CI=[− 1.20, − 0.10], P = 0.022), and sleep efficiency (SMD=0.77, 95%CI=[0.29, 1.24], P = 0.002) showed significant improvement. Limitation: The sample sizes for each outcome were small. The type of actigraphy devices and patients’ illness severity differed across studies. It is possible that hospitalizations and medication influenced the outcomes. Conclusion: We found significant differences between healthy controls and mood disorders patients for some actigraphy-measured modalities. Specific measurement patterns characterizing each mood disorder/status were also found. Additional actigraphy data linked to severity and/or treatment could enhance the clinical utility of actigraphy.

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論文 - 岸本　泰士郎