Yoshida, Kazunari

写真a

Affiliation

School of Medicine, Clinical and Translational Research Center （Shinanomachi）

Position

Project Senior Assistant Professor (Non-tenured)/Project Assistant Professor (Non-tenured)/Project Lecturer (Non-tenured)
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Career 【 Display / hide 】

  • 2007.04
    -
    2009.03

    独立行政法人国立病院機構東京医療センター

  • 2009.04
    -
    2011.03

    應義塾大学病院精神神経科

  • 2011.04
    -
    2013.03

    医療法人財団厚生協会大泉病院

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Academic Background 【 Display / hide 】

  • 2001.04
    -
    2007.03

    徳島大学, 医学部

    University, Graduated

  • 2013.04
    -
    2017.03

    慶應義塾大学大学院, 医学研究科博士課程（精神・神経科学専攻）

    Graduate School, Graduated

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Licenses and Qualifications 【 Display / hide 】

  • 医師免許, 2007.04

  • 日本精神神経学会専門医, 2012.10

  • 精神保健指定医, 2012.12

  • コンサータ登録医師, 2015.01

  • クロザリル登録医師, 2015.05

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Research Areas 【 Display / hide 】

  • Life Science / Psychiatry

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Research Keywords 【 Display / hide 】

  • Pharamacogenomics

  • Schizophrenia

  • Clinical psychopharmacology

  • Pharmacogenetics

  • Telepsychiatry

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Research Themes 【 Display / hide 】

  • 抗精神病薬誘発性体重増加に関するゲノム薬理学, 

    2017.04
    -
    Present

  • 炭酸リチウムの薬物動態解析および血中濃度予測, 

    2013.04
    -
    Present

  • 離島と都市部における精神疾患の実態調査, 

    2013.04
    -
    Present

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Books 【 Display / hide 】

  • 新規抗うつ薬の特徴と使用法 -ミルタザピン-

    吉田和生, 渡邊衡一郎, 2014

  • SSRI, SNRIを中心とした新規抗うつ薬の選び方と上手な使い方

    YOSHIDA Kazunari, 2014

  • 睡眠薬の使われ方と中断方法 –オレキシン受容体拮抗薬について

    吉田 和生, 2014

  • 新規抗うつ薬の有効性と使い分けに関するエビデンス

    吉田和生, 渡邊衡一郎, 2013

  • 抗うつ薬の分類から考えるミルタザピンの位置づけ. ミルタザピンのすべて

    吉田和生, 渡邊衡一郎, 先端医学社, 2012

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Papers 【 Display / hide 】

  • Polygenic risk scores analyses of psychiatric and metabolic traits with antipsychotic-induced weight gain in schizophrenia: an exploratory study

    Yoshida K., Marshe V.S., Elsheikh S.S.M., Maciukiewicz M., Tiwari A.K., Brandl E.J., Lieberman J.A., Meltzer H.Y., Kennedy J.L., Müller D.J.

    Pharmacogenomics Journal （Pharmacogenomics Journal)  23 （ 5 ） 119 - 126 2023.09

    ISSN  1470269X

    　View Summary

    Given the polygenic nature of antipsychotic-induced weight gain (AIWG), we investigated whether polygenic risk scores (PRS) for various psychiatric and metabolic traits were associated with AIWG. We included individuals with schizophrenia (SCZ) of European ancestry from two cohorts (N = 151, age = 40.3 ± 11.8 and N = 138, age = 36.5 ± 10.8). We investigated associations of AIWG defined as binary and continuous variables with PRS calculated from genome-wide association studies of body mass index (BMI), coronary artery disease (CAD), fasting glucose, fasting insulin, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol (LDL-C), triglycerides, type 1 and 2 diabetes mellitus, and SCZ, using regression models. We observed nominal associations (uncorrected p < 0.05) between PRSs for BMI, CAD, and LDL-C, type 1 diabetes, and SCZ with AIWG. While results became non-significant after correction for multiple testing, these preliminary results suggest that PRS analyses might contribute to identifying risk factors of AIWG and might help to elucidate mechanisms at play in AIWG.

  • Glutamatergic Neurometabolite Levels in Bipolar Disorder: A Systematic Review and Meta-analysis of Proton Magnetic Resonance Spectroscopy Studies

    Ino H., Honda S., Yamada K., Horita N., Tsugawa S., Yoshida K., Noda Y., Meyer J.H., Mimura M., Nakajima S., Moriguchi S.

    Biological Psychiatry: Cognitive Neuroscience and Neuroimaging （Biological Psychiatry: Cognitive Neuroscience and Neuroimaging)  8 （ 2 ） 140 - 150 2023.02

    ISSN  24519022

    　View Summary

    Background: The glutamatergic system is thought to play an important role in the pathophysiology of bipolar disorder (BD). While there has been an increase in proton magnetic resonance spectroscopy studies examining this neurotransmission system, the results are inconsistent. Possible reasons for the inconsistency, including clinical features such as mood state and childhood versus adulthood age, were not addressed in previous meta-analyses. Methods: This systematic review and meta-analysis of proton magnetic resonance spectroscopy studies of BD included 40 studies, with 1135 patients with BD and 964 healthy control (HC) subjects. Results: Glutamate plus glutamine and glutamine levels in the anterior cingulate cortex of patients with BD were significantly elevated compared with those of HC subjects (standardized mean difference = 0.42, 0.48, respectively). Subgroup analyses showed that adult BD patients had significantly higher levels of glutamate plus glutamine than adult HC subjects, but this was not the case in pediatric patients. For mood states, anterior cingulate cortex glutamate plus glutamine levels were higher in patients with bipolar depression than those in HC subjects. Conclusions: Our results imply that glutamatergic dysfunction in the anterior cingulate cortex may be implicated in the pathophysiology of BD, which is most evident in adult BD patients and patients with bipolar depression.

  • Psychiatric manifestations of Kleefstra syndrome: a case report

    Yoshida K., Müller D.J., Desarkar P.

    Frontiers in Psychiatry （Frontiers in Psychiatry)  14 2023

    　View Summary

    Background: Kleefstra syndrome is a rare genetic condition, which affects at least 1 in 120,000 individuals who have a neurodevelopmental disorder, characterized by the core clinical phenotype of intellectual disability, hypotonia, severe speech delay, and distinct facial characteristics with additional clinical features including sleep disturbance, overweight, psychiatric disorders, and autism spectrum disorder. To date, a limited number of case reports of Kleefstra syndrome with psychiatric manifestations have been reported. Case presentation: We reported a case of a 35-year-old male diagnosed with Kleefstra syndrome, who also had diagnoses of autism spectrum disorder and moderate to severe intellectual disability. He exhibited various psychiatric manifestations, including temporarily manic-like symptoms, excessive eating/overweight, addictive/gambling behaviors, inappropriate and unsafe internet use, sleep disturbance, rigid routines, and behaviors that challenged in the form of meltdowns. These symptoms were eventually relatively successfully managed with a combination of non-pharmacological and pharmacological treatments. Conclusion: To our knowledge, there is only a limited number of case reports that detail patients with Kleefstra syndrome exhibiting various psychiatric manifestations. Our report adds further knowledge to the paucity of literature and highlights the effectiveness of a combination of non-pharmacological and pharmacological treatments for behavioral/psychiatric difficulties in Kleefstra syndrome.

  • 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 ） 2606 - 2613 2022.10

    ISSN  00332917

    　View Summary

    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 telemedicine. 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 v. in-person consultations were reevaluated in four 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, which facilitate greater scale and spread of telepsychiatry globally.

  • Dopaminergic dysfunction and excitatory/inhibitory imbalance in treatment-resistant schizophrenia and novel neuromodulatory treatment

    Wada M., Noda Y., Iwata Y., Tsugawa S., Yoshida K., Tani H., Hirano Y., Koike S., Sasabayashi D., Katayama H., Plitman E., Ohi K., Ueno F., Caravaggio F., Koizumi T., Gerretsen P., Suzuki T., Uchida H., Müller D.J., Mimura M., Remington G., Grace A.A., Graff-Guerrero A., Nakajima S.

    Molecular Psychiatry （Molecular Psychiatry)  27 （ 7 ） 2950 - 2967 2022.07

    ISSN  13594184

    　View Summary

    Antipsychotic drugs are the mainstay in the treatment of schizophrenia. However, one-third of patients do not show adequate improvement in positive symptoms with non-clozapine antipsychotics. Additionally, approximately half of them show poor response to clozapine, electroconvulsive therapy, or other augmentation strategies. However, the development of novel treatment for these conditions is difficult due to the complex and heterogenous pathophysiology of treatment-resistant schizophrenia (TRS). Therefore, this review provides key findings, potential treatments, and a roadmap for future research in this area. First, we review the neurobiological pathophysiology of TRS, particularly the dopaminergic, glutamatergic, and GABAergic pathways. Next, the limitations of existing and promising treatments are presented. Specifically, this article focuses on the therapeutic potential of neuromodulation, including electroconvulsive therapy, repetitive transcranial magnetic stimulation, transcranial direct current stimulation, and deep brain stimulation. Finally, we propose multivariate analyses that integrate various perspectives of the pathogenesis, such as dopaminergic dysfunction and excitatory/inhibitory imbalance, thereby elucidating the heterogeneity of TRS that could not be obtained by conventional statistics. These analyses can in turn lead to a precision medicine approach with closed-loop neuromodulation targeting the detected pathophysiology of TRS.

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Papers, etc., Registered in KOARA 【 Display / hide 】

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Reviews, Commentaries, etc. 【 Display / hide 】

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Presentations 【 Display / hide 】

  • 遠隔精神科医療のガイドライン暫定版の策定

    吉田 和生

    日本遠隔医療学会スプリングカンファレンス, 

    2017
    , 

    Oral presentation (general)

  • Improvement to antipsychotic treatment at week 2 predicts subsequent treatment response in behavioral and psychological symptoms with dementia: Analysis of the CATIE-AD data

    Yoshida K, Roberts R, Abe T, Suzuki T, Lebowitz B, Tsunoda K, Endo A, Ohtani A, Mimura M, Uchida H

    30th Collegium Internationale Neuro-Psychopharmacologium, 

    2016.07
    , 

    Poster presentation

  • Resilience in schizophrenia: a comparative study between a remote island and an urban area in Japan

    Yoshida K, Suzuki T, Imasaka Y, Kubo K, Mizuno Y, Saruta J, Tsukinoki K, Mimura M, Uchida H

    5th Schizophrenia International Research Society Conference, 

    2016.04
    , 

    Poster presentation

  • 血清リチウム濃度の予測モデル構築

    吉田和生，内田裕之，鈴木健文，渡邊政博，吉野成泰，芳地一，三村將，福岡憲泰

    第26回日本臨床精神神経薬理学会, 

    2016
    , 

    Oral presentation (general)

  • 都市部と島嶼部におけるレジリエンスの比較

    吉田 和生

    第32回日本ストレス学会学術総会,, 

    2016
    , 

    Oral presentation (general)

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Research Projects of Competitive Funds, etc. 【 Display / hide 】

  • Pharamacogenomics of Antipsychotic-Induced Weight Gain (AIWG)

    2017.04
    -
    Present

    臨床薬理研究振興財団, No Setting

  • 炭酸リチウムの薬物動態解析および血中濃度予測

    2014.04
    -
    2015.03

    井之頭病院研究基金, No Setting

  • 東京都大島における精神疾患の実態調査および都市部との比較

    2013.04
    -
    2014.03

    井之頭病院研究基金, No Setting

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Awards 【 Display / hide 】

  • JSNP Excellent Presentation Award for CINP

    2016

  • Collegium Internationale Neuro-Psychopharmacologium, Mentor/Mentee Award

    2016

  • American Society of Clinical Psychopharmacology Clinical Trials Workshop, Travel Fellowship Award

    2016

  • Collegium Internationale Neuro-Psychopharmacologium, Student Encouragement Award

    2016

  • World Psychiatric Association International Congress, Young Psychiatrist Award

    2015

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Memberships in Academic Societies 【 Display / hide 】

  • Japanese Society of Human Genetics, 

    2017.08
    -
    Present

  • Japanese Telemedicine and Telecare Association, 

    2015.11
    -
    Present

  • American Society of Clinical Psychopharmacology, 

    2015.05
    -
    Present

  • Japanese Society of Neuropsychopharmacology, 

    2015.05
    -
    Present

  • Japanese Society of Clinical Neuropsychopharmacology, 

    2012.12
    -
    Present

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