研究者詳細 - 三村　将

論文 - 三村　将

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Feasibility study of mindfulness-based cognitive therapy for anxiety disorders in a Japanese setting Retrospectively registered at the University Hospital Medical Information Network on 1st August 2013 (ID UMIN000011347)

Sado M., Park S., Ninomiya A., Sato Y., Fujisawa D., Shirahase J., Mimura M.

BMC Research Notes （BMC Research Notes） 11 （ 1 ） 2018年09月

© 2018 The Author(s). Objective: Mindfulness-based cognitive therapy (MBCT) could be a treatment option for anxiety disorders. Although its effectiveness under conditions of low pharmacotherapy rates has been demonstrated, its effectiveness under condition of high pharmacotherapy rate is still unknown. The aim of the study was to evaluate effectiveness of MBCT under the context of high pharmacotherapy rates. Results: A single arm with pre-post comparison design was adopted. Those who had any diagnosis of anxiety disorders, between the ages of 20 and 74, were included. Participants attended 8 weekly 2-hour-long sessions followed by 2 monthly boosters. Evaluation was conducted at baseline, in the middle, at end of the intervention, and at follow-up. The State-Trait Anxiety Inventory (STAI)-state was set as the primary outcome. Pre-post analyses with mixed-effect models repeated measures were conducted. Fourteen patients were involved. The mean age was 45.0, and 71.4% were female. The mean change in the STAI-state at every point showed statistically significant improvement. The STAI-trait also showed improvement at a high significance level from the very early stages. The participants showed significant improvement at least one point in some other secondary outcomes. Trial registration Retrospectively registered at the University Hospital Medical Information Network on 1st August 2013 (ID: UMIN000011347)

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5-HT<inf>3</inf> antagonists decrease discounting rate without affecting sensitivity to reward magnitude in the delay discounting task in mice

Mori M., Tsutsui-Kimura I., Mimura M., Tanaka K.

Psychopharmacology （Psychopharmacology） 235 （ 9 ） 2619 - 2629 2018年09月

ISSN 00333158

© 2018, Springer-Verlag GmbH Germany, part of Springer Nature. Rationale: Impulsive choice has often been evaluated in rodents according to the proportion of choices for the delayed large magnitude reinforcer (%large choice) in a delay-discounting task (DDT). However, because %large choice is influenced by both sensitivity to reinforcer magnitude and sensitivity to delayed reinforcement (i.e., discounting rate), distinctively evaluating such discounting parameters represents a critical issue demanding methods to determine each parameter in rats. The serotonin (5-HT) system is well known to be involved in impulsive choice; nevertheless, only a few studies have distinguished discounting parameters and investigated how 5-HT modulators affect discounting rate. Objective: Here, we performed a discounting parameter analysis in mice and examined the effects of various 5-HT modulators on discounting rate. Methods: We set up DDTs with different delay schedules to determine which schedule could address delay-discounting rates in mice. We examined the effect of the following drugs on impulsive choice: a 5-HT reuptake inhibitor (paroxetine), a 5-HT1A receptor agonist (8-OH-DPAT), and two 5-HT3 receptor antagonists (granisetron and ondansetron). Results: Mice showed typical delay discounting at the shorter delay schedules (up to 4 s delay). The %large choice under shorter, but not longer, schedules followed an exponential function and allowed us to derive discounting rates. We selected a DDT with a 4-s delay schedule for further experiments. Granisetron and ondansetron, but not paroxetine or 8-OH-DPAT, decreased discounting rates without affecting sensitivity to reinforcer magnitude. Conclusion: We found that a method to calculate discounting rates in rats is also applicable to mouse models. We also provided evidence that 5-HT3 antagonism controls impulsive choice in mice.

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Web-based cognitive behavioral therapy blended with face-to-face sessions for major depression: Randomized controlled trial

Nakao S., Nakagawa A., Oguchi Y., Mitsuda D., Kato N., Nakagawa Y., Tamura N., Kudo Y., Abe T., Hiyama M., Iwashita S., Ono Y., Mimura M.

Journal of Medical Internet Research （Journal of Medical Internet Research） 20 （ 9 ） 2018年09月

© Shigetsugu Nakao, Atsuo Nakagawa, Yoshiyo Oguchi, Dai Mitsuda, Noriko Kato, Yuko Nakagawa, Noriko Tamura, Yuka Kudo, Takayuki Abe, Mitsunori Hiyama, Satoru Iwashita, Yutaka Ono, Masaru Mimura. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 21.09.2018. This is an open-access article distributed under the terms of the Creative Commons Attribution License. Background: Meta-analyses of several randomized controlled trials have shown that cognitive behavioral therapy (CBT) has comparable efficacy to antidepressant medication, but therapist availability and cost-effectiveness is a problem. Objective: This study aimed to evaluate the effectiveness of Web-based CBT blended with face-to-face sessions that reduce therapist time in patients with major depression who were unresponsive to antidepressant medications. Methods: A 12-week, assessor-masked, parallel-group, waiting- list controlled, randomized trial was conducted at 3 medical institutions in Tokyo. Outpatients aged 20-65 years with a primary diagnosis of major depression who were taking ≥1 antidepressant medications at an adequate dose for ≥6 weeks and had a 17-item GRID-Hamilton Depression Rating Scale (HAMD) score of ≥14 were randomly assigned (1:1) to blended CBT or waiting-list groups using a computer allocation system, stratified by the study site with the minimization method, to balance age and baseline GRID-HAMD score. The CBT intervention was given in a combined format, comprising a Web-based program and 12 45-minute face-to-face sessions. Thus, across 12 weeks, a participant could receive up to 540 minutes of contact with a therapist, which is approximately two-thirds of the therapist contact time provided in the conventional CBT protocol, which typically provides 16 50-minute sessions. The primary outcome was the alleviation of depressive symptoms, as measured by a change in the total GRID-HAMD score from baseline (at randomization) to posttreatment (at 12 weeks). Moreover, in an exploratory analysis, we investigated whether the expected positive effects of the intervention were sustained during follow-up, 3 months after the posttreatment assessment. Analyses were performed on an intention-to-treat basis, and the primary outcome was analyzed using a mixed-effects model for repeated measures. Results: We randomized 40 participants to either blended CBT (n=20) or waiting-list (n=20) groups. All patients completed the 12-week treatment protocol and were included in the intention-to-treat analyses. Participants in the blended CBT group had significantly alleviated depressive symptoms at week 12, as shown by greater least squares mean changes in the GRID-HAMD score, than those in the waiting list group (−8.9 points vs −3.0 points; mean between-group difference=−5.95; 95% CI −9.53 to −2.37; P<.001). The follow-up effects within the blended CBT group, as measured by the GRID-HAMD score, were sustained at the 3-month follow-up (week 24) and posttreatment (week 12): posttreatment, 9.4 (SD 5.2), versus follow-up, 7.2 (SD 5.7); P=.009. Conclusions: Although our findings warrant confirmation in larger and longer term studies with active controls, these suggest that a combined form of CBT is effective in reducing depressive symptoms in patients with major depression who are unresponsive to antidepressant medications.

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Optogenetic astrocyte activation evokes BOLD fMRI response with oxygen consumption without neuronal activity modulation

Takata N., Sugiura Y., Yoshida K., Koizumi M., Hiroshi N., Honda K., Yano R., Komaki Y., Matsui K., Suematsu M., Mimura M., Okano H., Tanaka K.F.

GLIA （GLIA） 66 （ 9 ） 2013 - 2023 2018年09月

ISSN 08941491

© 2018 Wiley Periodicals, Inc. Functional magnetic resonance imaging (fMRI) based on the blood oxygenation level-dependent (BOLD) signal has been used to infer sites of neuronal activation in the brain. A recent study demonstrated, however, unexpected BOLD signal generation without neuronal excitation, which led us to hypothesize the presence of another cellular source for BOLD signal generation. Collective assessment of optogenetic activation of astrocytes or neurons, fMRI in awake mice, electrophysiological measurements, and histochemical detection of neuronal activation, coherently suggested astrocytes as another cellular source. Unexpectedly, astrocyte-evoked BOLD signal accompanied oxygen consumption without modulation of neuronal activity. Imaging mass spectrometry of brain sections identified synthesis of acetyl-carnitine via oxidative glucose metabolism at the site of astrocyte-, but not neuron-evoked BOLD signal. Our data provide causal evidence that astrocytic activation alone is able to evoke BOLD signal response, which may lead to reconsideration of current interpretation of BOLD signal as a marker of neuronal activation.

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Neurometabolite levels in antipsychotic-naïve/free patients with schizophrenia: A systematic review and meta-analysis of <sup>1</sup> H-MRS studies

Iwata Y., Nakajima S., Plitman E., Mihashi Y., Caravaggio F., Chung J., Kim J., Gerretsen P., Mimura M., Remington G., Graff-Guerrero A.

Progress in Neuro-Psychopharmacology and Biological Psychiatry （Progress in Neuro-Psychopharmacology and Biological Psychiatry） 86 340 - 352 2018年08月

ISSN 02785846

© 2018 Elsevier Inc. Background: Studies using proton magnetic resonance spectroscopy ( 1 H-MRS) have reported altered neurometabolite levels in patients with schizophrenia. However, results are possibly confounded by the influence of antipsychotic (AP). Thus, this meta-analysis aimed to examine neurometabolite levels in AP-naïve/free patients with schizophrenia. Methods: A literature search was conducted using Embase, Medline, and PsycINFO to identify studies that compared neurometabolite levels in AP-naïve/free patients with schizophrenia to healthy controls (HCs). Eight neurometabolites (glutamate, glutamine, glutamate + glutamine, N-acetylaspartate [NAA], choline, creatine, myo-inositol, and γ-Aminobutyric acid [GABA]) and seven regions of interest (ROI; medial prefrontal cortex, dorsolateral prefrontal cortex, frontal white matter, occipital lobe, basal ganglia, hippocampus/medial temporal lobe, and thalamus) were examined. Results: Twenty-one studies (N = 1281) were included in the analysis. The results showed lower thalamic NAA levels (3 studies, n = 174, effect size = −0.56, P = 0.0005) in the patient group. No group differences were identified for other neurometabolites. Conclusions: Our findings suggest that impaired neuronal integrity in the thalamus may be a potential trait maker in the early stages of schizophrenia.

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Decision-making based on social conventional rules by elderly people

Komeda H., Eguchi Y., Kusumi T., Kato Y., Narumoto J., Mimura M.

Frontiers in Psychology （Frontiers in Psychology） 9 （ AUG ） 2018年08月

© 2018 Komeda, Eguchi, Kusumi, Kato, Narumoto and Mimura. Information used by older adults engaging in a social decision making task of judging a protagonist as a good or a bad person was investigated. Older (n = 100, 50 women, mean age = 63.6 years) and younger (n = 100, 50 women, mean age = 25.7 years) adults participated in a web-based survey. In Experiment 1, we assessed participants' rapid decision-making processes when making good or bad judgments after reading consecutive sentences without reviewing previously read sentences. The percentages of good judgments were analyzed. In Experiment 2, two protagonists engaging in a deliberate decision-making process were presented, and participants were asked to judge better and worse protagonists. The percentages of behavior-based judgments were analyzed. Results of Experiment 1 indicated that older adults judged protagonists as "good" more often than younger adults. Especially, older adults judged protagonists with good behavior as being "good." In Experiment 2, older adults made behavior-based judgments more than younger people. Additionally, older and younger adults used information on personalities of protagonists for making judgments in situations with bad outcomes, or incongruent. Moreover, multiple regression analysis suggested that people with more general trust engaged more, whereas people with more caution engaged less in making behavior-based judgments.

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Predictive factors associated with psychological distress of caregivers of people with dementia in Japan: A cross-sectional study

Shikimoto R., Sado M., Ninomiya A., Yoshimura K., Ikeda B., Baba T., Mimura M.

International Psychogeriatrics （International Psychogeriatrics） 30 （ 8 ） 1089 - 1098 2018年08月

ISSN 10416102

© 2017 International Psychogeriatric Association. Background: Caregivers of people with dementia are likely to have psychological distress that sometimes results in mental health problems, such as depression. The objective of this study was to examine some predictive factors that are thought to be associated with psychological distress of caregivers of people with dementia in Japan. Methods: Design: A cross-sectional study. Sample: As part of a study to estimate the cost of dementia in Japan, 1,437 people with dementia-caregiver dyads were enrolled in the current informal care time study. The measurements in the study included were the basic characteristics of the caregivers and the people with dementia, and the informal care time during a week.Analysis: Factors that predict caregivers' psychological distress, which was measured by Kessler's Psychological Distress scale (K6) score, were evaluated using univariate and multivariate regression analyses. Results: Approximately 69% of the caregivers recorded a K6 score higher than 4, while 18% scored higher than 12. According to the results of the logistic regression analysis (cut-off 4/5), the K6 score was associated with mental and comorbid diseases of people with dementia, informal care time, its lower number of caregivers, and the level of nursing care. According to the results of logistic regression analysis (cut-off 12/13), the K6 score was associated with mental symptoms and comorbid disease of people with dementia, sex of caregivers, informal care time, and its lower number of caregivers. Conclusion: Our findings indicated that the psychological distress of the caregivers is quite high and that informal care time and behavioral and psychological symptoms of dementia are associated with it. These results corroborate with previous findings.

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The effect of fecal microbiota transplantation on psychiatric symptoms among patients with irritable bowel syndrome, functional diarrhea and functional constipation: An open-label observational study

Kurokawa S., Kishimoto T., Mizuno S., Masaoka T., Naganuma M., Liang K., Kitazawa M., Nakashima M., Shindo C., Suda W., Hattori M., Kanai T., Mimura M.

Journal of Affective Disorders （Journal of Affective Disorders） 235 506 - 512 2018年08月

ISSN 01650327

© 2018 Elsevier B.V. Backgrounds: The intestinal microbiota is considered as a potential common underpinning pathophysiology of Functional Gastrointestinal Disorders (FGIDs) and psychiatric disorders such as depression and anxiety. Fecal Microbiota Transplantation (FMT) has been reported to have therapeutic effects on diseases related to dysbiosis, but few studies have evaluated its effect on psychiatric symptoms. Methods: We followed 17 patients with either Irritable Bowel Syndrome (IBS), Functional Diarrhea (FDr) or Functional Constipation (FC) who underwent FMT for the treatment of gastrointestinal symptoms and observation of psychiatric symptoms. Changes in Hamilton Rating Scale for Depression (HAM-D) and subscale of sleep-related items, Hamilton Rating Scale for Anxiety (HAM-A) and Quick Inventory for Depressive Symptoms (QIDS) between baseline and 4 weeks after FMT, and relationship with the intestinal microbiota were measured. Results: At baseline, 12 out of 17 patients were rated with HAM-D ≥ 8. Significant improvement in HAM-D total and sleep subscale score, HAM-A and QIDS were observed (p = 0.007, p = 0.007, p = 0.01, p = 0.007, respectively). Baseline Shannon index indicated that microbiota showed lower diversity in patients with HAM-D ≥ 8 compared to those of healthy donors and patients with HAM-D < 8. There was a significant correlation between baseline Shannon index and HAM-D score, and a correlation between Shannon index change and HAM-D improvement after FMT. Limitations: The small sample size with no control group. Conclusions: Our results suggest that depression and anxiety symptoms may be improved by FMT regardless of gastrointestinal symptom change in patients with IBS, FDr and FC, and the increase of microbiota diversity may help to improve patient's mood.

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Associations between problematic Internet use and psychiatric symptoms among university students in Japan

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

Psychiatry and Clinical Neurosciences （Psychiatry and Clinical Neurosciences） 72 （ 7 ） 531 - 539 2018年07月

ISSN 13231316

© 2018 The Author. Psychiatry and Clinical Neurosciences © 2018 Japanese Society of Psychiatry and Neurology Aim: Research on the adverse effects of Internet use has gained importance recently. However, there is currently insufficient data on Japanese young adults’ Internet use, so we conducted a survey targeting Japanese university students to research problematic Internet use (PIU). We also investigated the relationship between PIU and multiple psychiatric symptoms. Methods: A paper-based survey was conducted at five universities in Japan. Respondents were asked to fill out self-report scales regarding their Internet dependency using the Internet Addiction Test (IAT). Sleep quality, attention-deficit hyperactivity disorder (ADHD) tendency, depression, and anxiety symptom data were also collected based on respective self-reports. Results: There were 1336 responses and 1258 were included in the analysis. The mean IAT score (± SD) was 37.87 ± 12.59; and 38.2% of participants were classified as PIU, and 61.8% as non-PIU. The trend level for young women showed that they were more likely to be classified as PIU than young men (40.6% and 35.2% respectively, P = 0.05). Compared to the non-PIU group, the PIU group used the Internet longer (P < 0.001), had significantly lower sleep quality (P < 0.001), had stronger ADHD tendencies (P < 0.001), had higher Depression scores (P < 0.001), and had higher Trait-Anxiety scores (P < 0.001). Based on multiple logistic regression analyses, the factors that contributed to an increased risk of PIU were: being female (odds ratio [OR] = 1.52), being older (OR = 1.17), having poor sleep quality (OR = 1.52), having ADHD tendencies (OR = 2.70), having depression (OR = 2.24), and having anxiety tendencies (OR = 1.43). Conclusion: We found a high PIU prevalence among Japanese young adults. The factors that predicted PIU were: female sex, older age, poor sleep quality, ADHD tendencies, depression, and anxiety.

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Kynurenine pathway in depression: A systematic review and meta-analysis

Ogyu K., Kubo K., Noda Y., Iwata Y., Tsugawa S., Omura Y., Wada M., Tarumi R., Plitman E., Moriguchi S., Miyazaki T., Uchida H., Graff-Guerrero A., Mimura M., Nakajima S.

Neuroscience and Biobehavioral Reviews （Neuroscience and Biobehavioral Reviews） 90 16 - 25 2018年07月

ISSN 01497634

© 2018 Elsevier Ltd Abnormalities of the kynurenine (KYN) pathway may be implicated in the pathophysiology of depression. However, the relationships between depression and each metabolite of the KYN pathway remain uncertain. Therefore, we conducted a meta-analysis about the levels of the metabolites of KYN pathway between patients with depression and controls. Out of 899 initial records, we identified 22 articles to form the empirical basis. Seventeen, 10, and 18 studies examined levels of kynurenic acid (KYNA), quinolinic acid (QUIN), and KYN, respectively. KYNA and KYN levels were lower in patients with depression in comparison to controls, while QUIN levels did not differ between the two groups. Antidepressant-free patients showed decreased KYNA levels and increased QUIN levels compared with controls. Male ratios of the samples were negatively associated with study SMDs for KYNA. In conclusion, this meta-analysis revealed that patients with depression had decreased level of KYNA and KYN, whereas antidepressant-free patients showed increased level of QUIN. Nevertheless, given the heterogeneity among their sample characteristics, further research is clearly needed.

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Striatonigral direct pathway activation is sufficient to induce repetitive behaviors

Bouchekioua Y., Tsutsui-Kimura I., Sano H., Koizumi M., Tanaka K., Yoshida K., Kosaki Y., Watanabe S., Mimura M.

Neuroscience Research （Neuroscience Research） 132 53 - 57 2018年07月

ISSN 01680102

© 2017 Pharmacological intervention in the substantia nigra is known to induce repetitive behaviors in rodents, but a direct causal relationship between a specific neural circuit and repetitive behavior has not yet been established. Here we demonstrate that optogenetic activation of dopamine D1 receptor-expressing MSNs terminals in the substantia nigra pars reticulata resulted in sustained and chronic repetitive behaviors. These data show for the first time that activation of the striatonigral direct pathway is sufficient to generate motor stereotypies.

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Relationships between socio-clinico-demographic factors and global cognitive function in the oldest old living in the Tokyo Metropolitan area: Reanalysis of the Tokyo Oldest Old Survey on Total Health (TOOTH)

Eguchi Y., Tasato K., Nakajima S., Noda Y., Tsugawa S., Shinagawa S., Niimura H., Hirose N., Arai Y., Mimura M.

International Journal of Geriatric Psychiatry （International Journal of Geriatric Psychiatry） 33 （ 7 ） 926 - 933 2018年07月

ISSN 08856230

Copyright © 2018 John Wiley & Sons, Ltd. Background: Despite a steady increase in life expectancy, a few studies have investigated cross-sectional correlates and longitudinal predictors of cognitive function, a core domain of the successful aging, among socio-clinico-demographic factors in the oldest-old exclusively. Objectives: The aims of this study were to examine socio-clinico-demographic characteristics associated with global cognition and its changes in the oldest-old. Methods: We reanalyzed a dataset of cognitively preserved community-dwelling subjects aged 85 years and older in the Tokyo Oldest Old Survey on Total Health, a 6-year longitudinal observational study. This study consisted of (1) baseline cross-sectional analyses examining correlates of global cognition (n = 248) among socio-clinico-demographic factors and (2) longitudinal analyses examining baseline predictors for changes of global cognition in 3-year follow-up (n = 195). The Mini-Mental State Examination was used as a screening test to assess global cognition. Results: At baseline, higher weights were related to higher cognitive function in the oldest-old. The baseline predictors of global cognitive decline in 3-year follow-up were higher global cognition, shorter education period, and lower sociocultural activities and lower instrumental activity of daily living, in this order. Conclusions: The present study suggests that it is crucial to attain higher education during early life and avoid leanness or obesity, participate in sociocultural cognitive activities during late life, and maintain instrumental activity of daily living to preserve optimal cognitive function in the oldest-old, which will facilitate developing prevention strategies for cognitive decline and promoting successful aging in this increasing population.

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A practical BCG measuring system with bed sensors and algorithm for heartbeat detection

Nagura M., Mitsukura Y., Kishimoto T., Mimura M.

Proceedings - 2018 IEEE 15th International Workshop on Advanced Motion Control, AMC 2018 （Proceedings - 2018 IEEE 15th International Workshop on Advanced Motion Control, AMC 2018） 317 - 321 2018年06月

ISSN 9781538619469

© 2018 IEEE. Ballistocardiogram (BCG) is useful and informative signal result from the cardiac activity. In this paper, we present a practical BCG measurement system with bed sensors. Moreover, the simple algorithm to detect all individual heartbeats and estimate beat-to-beat interval lengths is presented. These are effective for all night continuous monitoring of cardiovascular system and enable us to detect sleep stage. Heart beats is detected by cross-correlation method. This method has three steps, preprocessing, typical wave form creation and cross-correlation calculation. Output of this process were validated with 10 subjects. As the results, the average 71.5% of the beat-to-beat intervals were detected. Moreover this study revealed that the individual difference is significant factor to detect heart beats precisely.

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Catatonic Stupor in Schizophrenic Disorders and Subsequent Medical Complications and Mortality

Funayama M., Takata T., Koreki A., Ogino S., Mimura M.

Psychosomatic Medicine （Psychosomatic Medicine） 80 （ 4 ） 370 - 376 2018年05月

ISSN 00333174

© 2018 The Author(s). Objective Although catatonia can occur secondary to a general medical condition, catatonia itself has been known to lead to various medical compolications. Although case reports on the association of catatonia with subsequent medical complications have been documented, no comprehensive large-scale study has been performed. To investigate specific medical complications after catatonia, we conducted a retrospective cohort study of specific medical complications of schizophrenia patients with catatonia. Methods The 1719 schizophrenia inpatients in our study were categorized into two groups: the catatonia group, i.e., those who exhibited catatonic stupor while they were hospitalized, and the noncatatonia group, i.e., those who never exhibited catatonic stupor. Differences between the two groups in the occurrence of subsequent medical complications were examined using linear and logistic regression analyses, and models were adjusted for potentially confounding factors. Results The catatonia group had an increased risk for mortality (odds ratio = 4.8, 95% confidence interval = 2.0-10.6, p <.01) and certain specific medical complications, i.e., pneumonia, urinary tract infection, sepsis, disseminated intravascular coagulation, rhabdomyolysis, dehydration, deep venous thrombosis, pulmonary embolism, urinary retention, decubitus, arrhythmia, renal failure, neuroleptic malignant syndrome, hypernatremia, and liver dysfunction (all p values <.01, except for deep venous thrombosis, p =.04 in the multiple linear regression analysis). Conclusions Catatonic stupor in schizophrenia substantially raises the risk for specific medical complications and mortality. Hyperactivity of the sympathetic nervous system, dehydration, and immobility, which are frequently involved in catatonia, might contribute to these specific medical complications. In catatonia, meticulous care for both mental and medical conditions should be taken to reduce the risk of adverse medical consequences.

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Prediction Model of Serum Lithium Concentrations

Yoshida K., Uchida H., Suzuki T., Watanabe M., Yoshino N., Houchi H., Mimura M., Fukuoka N.

Pharmacopsychiatry （Pharmacopsychiatry） 51 （ 3 ） 82 - 88 2018年05月

ISSN 01763679

© Georg Thieme Verlag KG Stuttgart.New York. Introduction Therapeutic drug monitoring is necessary for lithium, but clinical application of several prediction strategies is still limited because of insufficient predictive accuracy. We herein proposed a suitable model, using creatinine clearance (CLcr)-based lithium clearance (Li-CL). Methods Patients receiving lithium provided the following information: serum lithium and creatinine concentrations, time of blood draw, dosing regimen, concomitant medications, and demographics. Li-CL was calculated as a daily dose per trough concentration for each subject, and the mean of Li-CL/CLcr was used to estimate Li-CL for another 30 subjects. Serum lithium concentrations at the time of sampling were estimated by 1-compartment model with Li-CL, fixed distribution volume (0.79 L/kg), and absorption rate (1.5/hour) in the 30 subjects. Results One hundred thirty-one samples from 82 subjects (44 men; mean±standard deviation age: 51.4±16.0 years; body weight: 64.6±13.8 kg; serum creatinine: 0.78±0.20 mg/dL; dose of lithium: 680.2±289.1 mg/day) were used to develop the pharmacokinetic model. The mean±standard deviation (95% confidence interval) of absolute error was 0.13±0.09 (0.10-0.16) mEq/L. Discussion Serum concentrations of lithium can be predicted from oral dosage with high precision, using our prediction model.

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The psychological impact of disclosing amyloid status to Japanese elderly: A preliminary study on asymptomatic patients with subjective cognitive decline

Wake T., Tabuchi H., Funaki K., Ito D., Yamagata B., Yoshizaki T., Kameyama M., Nakahara T., Murakami K., Jinzaki M., Mimura M.

International Psychogeriatrics （International Psychogeriatrics） 30 （ 5 ） 635 - 639 2018年05月

ISSN 10416102

© 2018 International Psychogeriatric Association. In Japan, 4.6 million people are living with dementia and the number is expected to rise to 7 million by 2025. Amyloid-β (Aβ) positron emission tomography (PET) is used for cognitively normal Japanese people with or without subjective cognitive decline (SCD) for the purpose of clinical trials or diagnosis. Nevertheless, no empirical studies have been conducted on the safety of disclosing amyloid status to such populations. We conducted amyloid PET imaging on 42 participants (Aβ positive (n = 10) and negative (n = 32)). State anxiety and depression were measured at pre- and post-disclosure, and test-related distress at post-disclosure. Mean state anxiety and depression scores were below the cut-off through pre- and post-disclosure in the Aβ positive and negative groups. State anxiety and depression did not change over time and were not different between groups. Mean test-related distress scores were within normal limits at post-disclosure in both groups. No significant difference was found between groups. Disclosing Aβ positive results did not cause greater mood disturbance than negative results in a short period of time. The short-term psychological safety of disclosing Aβ PET results to asymptomatic Japanese adults with SCD was indicated.

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A Possible Role of Takotsubo Cardiomyopathy in Ventricular Fibrillation During Delirium Tremens: A Case Report and Literature Review

Ishida T., Uchida H., Miyazaki K., Yukawa T., Sugiyama K., Hamabe Y., Mimura M., Suzuki T.

Psychosomatics （Psychosomatics） 59 （ 3 ） 293 - 297 2018年05月

ISSN 00333182

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An estimation of heart rate variability from ballistocardiogram measured with bed leg sensors

Nagura M., Mitsukura Y., Kishimoto T., Mimura M.

Proceedings of the IEEE International Conference on Industrial Technology （Proceedings of the IEEE International Conference on Industrial Technology） 2018-February 2005 - 2009 2018年04月

ISSN 9781509059492

© 2018 IEEE. Ballistocardiogram (BCG) is the repetitive body movements related to cardiac cycle. All night continuous measuring of BCG by using bed sensors enable us to detect sleep stage. However conventional methods are seemed to have unreliability caused by position of lying down. In this paper, we propose a reliable method of all night continuous measuring of BCG. Heart rate variability (HRV) is estimated from BCG measured with new bed sensors by template-matching approach. This approach has three steps, pre-processing, template-creation and template matching. Output of this process were validated with 4 subjects. The mean beat-to-beat interval error was 9.8[ms] and on an average 87.1% of the beat-to-beat intervals were detected.

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Religiosity and psychological resilience in patients with schizophrenia and bipolar disorder: an international cross-sectional study

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

Acta Psychiatrica Scandinavica （Acta Psychiatrica Scandinavica） 137 （ 4 ） 316 - 327 2018年04月

ISSN 0001690X

© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd Objective: The impact of religious/spiritual activities on clinical outcomes in patients with serious mental illnesses remains controversial, which was addressed in this international cross-sectional study. Method: Three-hundred sixty-nine subjects were recruited from Austria (n = 189) and Japan (n = 180), consisting of 112 outpatients with paranoid schizophrenia, 120 with bipolar I disorder (DSM-IV), and 137 healthy controls. Religiosity was assessed in terms of attendance and importance of religious/spiritual activities, while resilience was assessed using the 25-item Resilience Scale. General linear models were used to test whether higher religiosity will be associated with higher resilience, higher social functioning, and lower psychopathology. The association between levels of spiritual well-being and resilience was also examined. Results: Attendance of religious services (F [4,365] = 0.827, P = 0.509) and importance of religion/spirituality (F [3,365] = 1.513, P = 0.211) did not show significant associations with resilience. Regarding clinical measures, a modest association between higher importance of religion/spirituality and residual manic symptoms was observed in bipolar patients (F [3,118] = 3.120, P = 0.029). In contrast to the findings regarding religiosity, spiritual well-being showed a strong positive correlation with resilience (r = 0.584, P < 0.001). Conclusion: The protective effect of religiosity in terms of resilience, social functioning, and psychopathology was not evident in our sample. Spiritual well-being appears more relevant to resilience than religiosity.

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Is it possible to implement community care based on mental health in Japan? A comparison between decade ago and present on Duration of Untreated Psychosis (DUP)

Suzuki K., Niimura H., Yamazawa R., Nemoto T., Murakami M., Mimura M., Mizuno M.

Asian Journal of Psychiatry （Asian Journal of Psychiatry） 33 88 - 92 2018年03月

ISSN 18762018

© 2018 Elsevier B.V. Introduction: In recent years, the early detection and treatment of the first episode of schizophrenia (FES) has attracted worldwide attention. In Japan, psychiatric care has changed to an open and accessible framework over the past decade. Therefore, the duration of untreated psychosis (DUP) is thought to have been shortened. The purposes of this study were to investigate whether recent DUP periods are shorter than they were 10 years ago and whether the DUP at present differs among psychiatric facilities. We investigated the recent DUP at a psychiatric hospital and its satellite clinic. Material and methods: We examined the differences in DUP, age, sex, referral pathway, living companions, social participation, and schooling history among 3 groups of FES patients: (i) a psychiatric hospital during 1999–2001 and (ii) during 2009–2011, and (iii) a psychiatric clinic during 2009–2011. Results: The average DUP was 14.3 (SD = 17.5) months for the psychiatric hospital during 1999–2001, 16.0 (SD = 18.7) months for the psychiatric hospital during 2009–2011, and 24.4 (SD = 30.0) months for the psychiatric clinic during 2009–2011. No significant differences were found in the DUP for each facility and during this decade. Also, the differences in the DUP could not be attributed to factors such as living companions or social participation. Discussion: Increases in the numbers of patients and psychiatric clinics have not led to the early detection of FES. To shorten the DUP in the future, closer cooperation among the medical field, the educational field, and the health and welfare will be needed.

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