bluuebunny/crossref_metadata_2025 huggingface dataset:
Recent trends in suicidal behavior in Japan
Authors: TAKAHASHI YOSHITOMO
Published: March 2008

Abstract This paper reviews the present situation of suicidal behavior in Japan. Although the suicide rate among the younger generation has been decreasing steadily, that among elderly Japanese has been high. In addition, it is expected that the elderly population in Japan will increase more rapidly than in other countries in the 21st century. This paper highlights the problems of suicidal elderly in Japan, by focusing on characteristics of their psychopathology, and it proposes an integrated model for suicide prevention. Accurate knowledge about suicide crisis in the elderly and appropriate countermeasures should be acquired by every individual in the community, and efficient social support networks should be established. The long‐term objective should be to create an environment in which senior citizens can contribute to the community to the best of their ability, and every effort should be made to decrease the social stigma against old age and suicide.
Ethical orientations and dignified death
Authors: OHI GEN
Published: March 2008

Abstract Dignified death is regarded commonly as a recent social phenomenon as a consequence of technological development in medical sciences; the phenomenon emerging in developed countries. Two cases were provided to demonstrate that dignified deaths have been occurring in Nepal as well as in traditional destitute Japan. A difference between the presented cases of dignified death in the developing countries and the cases in the developed countries hinges upon the relationship the dying perceive vis‐a‐vis the group they belong to; in the former the core of dignity is none other than their altruistic self‐sacrifice for the continuation of their group, whereas in the latter no such valued group seems to exist. Two types of ethical orientations were postulated to account for the difference, and the coping behavior of Japanese‐American patients with cancer is shown by the denial of the existence of cancer.
Death with dignity in the Japanese culture
Authors: MD YONEZO NAKAGAWA
Published: March 2008

Abstract In Japanese culture, the concept of death with dignity focuses on enhancing the relationship with significant others (especially with family members) and is expected to continue even after death, unlike the autonomous decision making in Western cultures. Deaths in such relationships are self‐worthy, majestic and wished for. The author depicts these traits by describing the worship of sudden death aspiration in a special temple, the death ceremonies repeated even after death which involve even distantly related people, a suicide allusively asking for something, and a joint suicide.
A Japanese perspective on crisis intervention
Authors: ISHIKAWA YOSHIHIRO
Published: March 2008

Abstract This paper describes the author's therapeutic team's general rules for crisis intervention that have been built up by gaining experience in therapy and crisis intervention for ‘difficult cases to treat’. It discusses how the author's therapeutic team actually intervenes in the crisis, building a relationship as quickly as possible with the patient and/or family, and providing follow‐up treatment with the family and others involved in the crisis. The paper then outlines recent trends in Japanese crisis intervention in comparison with the Western system of psychiatric emergency services. Finally, the paper concludes the necessity of establishing comprehensive and on‐going community‐care in order for a psychiatric emergency system to become successful in Japan.
Suicide in adolescence and crisis intervention in Japan
Authors: INAMURA HIROSHI
Published: March 2008

Abstract This study will report first suicide in adolescence in Japan and then highlight the findings of the suicide cases experienced.
Prevention of late life suicide: When, where, why and how
Authors: MD YEATES CONWELL , Duberstein PAUL R.
Published: March 2008

Abstract Suicide in late life is discussed from the perspective of four guidelines derived from preventive medicine; preventive efforts (1) are beneficial in proportion both to the prevalence and severity of a disease, (2) must consider how the outcome might affect individuals and society as a whole, (3) should take into account biological, psychological and social dimensions, (4) can only be effective if important and ‘alterable’ risk factors are identified. Possible risk factors for late life suicide which may be altered include social isolation, stressful circumstances, and affective disorder. Primary prevention may involve outreach programs to decrease social isolation, secondary prevention may include education of primary care physicians, and tertiary prevention may, in patients with severe affective disorder, include hospitalization and aggressive somatic therapies.
Suicide and mental disorders
Authors: ASUKAI NOZOMU
Published: March 2008

Abstract In Japan, there has not yet been a complete psychological autopsy study. The author conducted a retrospective study of failed suicides (quasi‐completed suicides) admitted to an emergency critical care center. According to the lethality of suicide methods, 133 out of 265 subjects over 6 years (1986–1991) were classified as the absolutely dangerous (AD; the failed suicides) group. As a principal diagnosis, psychoses, endogenous depression, substance abuse were present in 75% of the AD group. The diagnostic distribution largely differed with depressive disorders being mainly in the older group (50+ years), and psychoses predominating in the younger group (<30 years). This study suggested that the majority of suicide victims in Japan also had mental disorders, and suicide prevention should be confronted with this clinical fact.
Effect of the medication management module evaluated using the role play test
Authors: IKEBUCHI EMI , ANZAI NOBUO
Published: March 2008

Abstract Training in social skills has been shown to have a strong, positive impact, according to behavioral measures, on social skills, self‐rated assertiveness, and the hospital discharge rate. It is important to establish a system of assessing social skills because it is necessary for the effects of social skills training to be assessed in Japan. In Project 1, we devised a Japanese version of the role play test to quantify social skills using a standard method. We tested 30 patients attending the day hospital who were considered to need intensive rehabilitation. We found the role play test had high inter‐rater and test‐retest reliability, and had construct validity and criterion related validity. Thus, the role play test was thought to be a useful tool for assessing social skills. For Project 2, eight inpatients who were ready for discharge but who needed to improve their skills in self‐managed medication participated in this study. The social skills of self‐managed medication assessed using the role play test were significantly improved after the subjects participated in the Medication Management Module of the UCLA social and independent living skills program. Knowledge of self‐managed medication also tended to improve after training. This study is preliminary and it should be confirmed that improved skills influenced by the medication management module decreases the relapse rates.
Reliability of the Japanese version of the Inventory to Diagnose Depression
Authors: UEHARA TORU , SATO TETSUYA , SAKADO KAORU , SATO SATOSHI
Published: March 2008

Abstract The reliability of the Japanese version of the Inventory to Diagnose Depression (IDD) which is a self‐report to diagnose major depressive disorders (MDD) of DSM‐III‐R, was investigated in 30 cases with MDD and 30 control subjects. On test‐retest reliability, the agreement of diagnostic performance was substantial (K= 0.64, P < 0.001) for 60 subjects, and scores of total and individual items correlated significantly (P < 0.001) between test and retest except for decreased energy, decreased interest, and decreased concentration. The average score of the total IDD severity at test (38.4) was significantly higher than that at retest (28.0; P < 0.01). However, excluding the recovered 10 cases, there was no significant difference seen on the average total score between test and retest (38.8, 30.1, respectively). Internal consistency (Cronbach's a= 0.80) and split‐half reliability (0.79) were sufficient, and item‐total correlations of the IDD were significant (P < 0.01) except for weight gain. The IDD might be useful as a screening tool and for clinical evaluation of subjects in Japan; however, it is necessary to examine the validity of this instrument.
Functional psychosis mimicking acute confusional state: Longitudinal neuropsychological assessment of an acute and transient psychotic patient
Authors: MURAI TOSHIYA , TOICHI MOTOMI , SENGOK.U AKIRA
Published: March 2008

Abstract One patient with acute and transient functional psychosis was assessed repeatedly using a brief neuropsychological assessment during his recovery from the psychotic episode. The psychotic features of the patient were characterized by perplexed behavior, attentional disturbance and emotional turmoil. Characteristic findings, including impairment of attention tests, dysgraphia and constructional disturbances, were seen. Findings improved in accordance with recovery on a behavioral level. We discussed the similarity of neuropsychological and behavioral abnormalities of this patient and those of patients in an acute confusional state.
The influence of physical restraint or fasting on plaque‐forming cell response in mice
Authors: KOMORI TERUHISA , FUJIWARA RYOICHI , SHIZUYA KOJI , MIYAHARA SATORU , NOMURA JUNICHI
Published: March 2008

Abstract This study was designed to investigate the effects of 1‐ and 3‐day (16 h/day) physically restrained or fasting on immunological and endocrine responses in CBF1 mice. The influence of stressors on these responses was evaluated using anti‐sheep red blood cell plaque‐forming assay, and by examining T cell subsets, thymus weight and endocrine hormone levels. The results revealed that a significant elevation of the plaque‐forming cells (PFC) was found in spleen cells in 1‐day restrained mice, that the PFC were conversely suppressed following 3‐day physically restrained stress, and that the PFC were not affected by 1‐ or 3‐day fasting stress. Serum levels of norepinephrine were found to be significantly increased only in 1‐day physically restrained mice. No change of T cell subsets and thymus weight was found in 1‐day physically restrained mice. A significant increase in serum corticosterone levels was elicited in both 1‐ and 3‐day physically restrained mice, and 3‐day fasting mice, while increased Lyt2‐positive T cells and thymic atrophy were found only in 3‐day physically restrained mice. These findings suggest that immune function was differentially affected by the duration and types of stressors.
Age‐dependent induction and maintenance of sensitization to methamphetamine‐induced hyperactivity in mice
Authors: KURIBARA HISASHI , YASUDA HIDEKO , UCHIHASHI YOSHITAKA
Published: March 2008

Abstract Repeated administrations of methamphetamine (2 mg/kg, s.c), 10 times at 3‐day intervals, induced ambulatory sensitization in all groups of mice that were 13‐, 15‐, 19‐, 23‐ and 36‐weeks‐old at the start of methamphetamine administration. The most prominent sensitization was observed in the 19‐week‐old mice. Among five groups of mice, even though the mice of 36 weeks old showed the highest sensitivity to methamphetamine at the first administration, they exhibited the lowest sensitization during the latter stage of repeated methamphetamine administration. Methamphetamine sensitization once established was well reproduced by the post‐sensitization period of 8 weeks. Furthermore, the group of mice given methamphetamine with post‐sensitization interval of 8 weeks (19‐week‐old mice) exhibited further enhancement of the sensitization. In contrast, the groups of mice given methamphetamine with post‐sensitization intervals of 12 and 25 weeks (the 23‐ and 36‐week‐old, respectively) showed a significant reduced sensitization, and the latter group failed to reach the level of sensitization previously established. These results suggest that the induction of and maintenance of methamphetamine sensitization are dependent on the age of the mice, and that methamphetamine sensitization once established completely persists for up to 8 weeks.
Depression among cancer patients
Authors: HOSAKA TAKASHI , AOKI TAKAYUKI
Published: March 2008

Abstract This study was done to investigate the frequency of co‐morbidity and to demonstrate the best method for assessing depression among cancer patients. The subjects were 50 (25 male and 25 female) cancer patients and 50 (25 male and 25 female) medically ill patients. All subjects were interviewed by psychiatrists and were administered psychological tests such as SAS (self‐rating anxiety scale), SDS (self‐rating depression scale), POMS (Profile of Mood States), HADS (Hospital Anxiety and Depression Scale) and DRP (Depression‐related personality traits). The psychiatric interview revealed that 44% of cancer patients and 38% of the medical patients had mental disorders according to DSM‐IV. The most frequently observed disorder was depression, which was seen in 28% of the cancer patients and 30% of the medical patients. The cancer patients with depression scored significantly higher on the DRP and the Anger mood state of POMS than did the medically ill patients with depression. In addition, most psychological tests employed had no discrimination between depressed and normal subjects among the cancer and the medical patients. However, it was found that the Depression scale in HADS (HADS‐D) split depressed patients from normal subjects since the HADS‐D was composed of items that were not concerned with physically ill conditions.
A case of Sheehan's syndrome with delirium
Authors: UMEKAWA TSUNEKAZU , YOSHIDA TOSHIHIDE , SAKANE NAOKI , KONDO MOTOHARU
Published: March 2008

Abstract A 53 year old woman was brought to a psychiatric clinic because of delirium. Upon immediate examination, severe hyponatremia (105 mEq/L) was detected. She was suspected of having internal diseases and referred to our university hospital. When she reached our hospital she was delirious and showed excitement and agitation. Her electroencephalogram showed low voltage θ waves (20 μV) in all leads. She was hospitalized and diagnosed with acute tonsillar abscess and panhypopituitarism based on various endocrine tests. Her past history suggested that Sheehan's syndrome had developed after child‐bearing at age 31, resulting in panhypopituitarism. After administration of antibiotics, the fever and tonsillar abscess gradually recovered, and the correction of electrolytes improved the level of consciousness, suggesting that the hyponatremia had been closely related to the clouding of consciousness. As the subsequent administration of Cortisol kept the patient's serum sodium levels within the normal range, a decrease in plasma Cortisol seemed to be the major cause of the hyponatremia. Psychological symptoms of panhypopituitarism often included abulia, apathy and occasionally coma. However, it is rare for a patient with panhypopituitarism to be misdiagnosed as having a psychiatric disease with delirium. This rare case is presented.
No association between c‐fos gene polymorphisms and sporadic Alzheimer's disease
Authors: DAI XIAO Y. , HATTORI MINEKO , YOSHIZAWA JUN , MATSUDA HIROSHI , ARAI HEII , AKIZUKI SEIICHI , NANKO SHINICHIRO
Published: March 2008

Abstract Although ApoE ε4 is a major risk factor for sporadic Alzheimer's disease (AD), 20–30% of sporadic AD patients do not have this allele. This indicates that other risk factors are involved in the pathogenesis of sporadic AD. Studies of the genetic association between AD and polymorphisms in the c‐fos gene, a candidate gene for AD, were conducted. The polymorphisms of Dsal in exon 2 and Sau3Al in intron 2 were examined in 89 patients diagnosed as sporadic cases of probable AD clinically and radiologically according to the NINCDS‐ADRDA criteria. This was also undertaken in 96 controls. There was no significant difference between the groups in allele frequencies or genotype counts. Although c‐fos gene as a locus conferring susceptibility to sporadic AD cannot be ruled out, these data could not support the hypothesis that a c‐fos allele should be another risk factor for sporadic AD.
Effectiveness of Shakuyaku‐kanzo‐to in neuroleptio induced hyperprolactinemia: A preliminary report
Authors: YAMADA KAZUO , KANBA SHIGENOBU , MURATA TAKAAKI , FUKUZAWA MOTOKO , TERASHI BOKUSOU , YAGI GOHEI , ASAI MASAHIRO
Published: March 2008

Abstract We investigated the efficacy of Shakuyaku‐kanzo‐to (TJ‐68) in neuroleptic‐induced hyperprolactinemia in 11 treated schizophrenic patients. The mean plasma prolactin level decreased significantly from 28.9 ± 14.5 ng/mL at baseline to 22.0 ± 15.2 ng/mL at 4 weeks. Potassium levels did not change significantly. Neither the exacerbation of psychosis nor other adverse effects occurred.
An anecdote in the dawn of Japanese psychiatry: The tragedy of Dr. Noboru Ishida
Authors: AKIMOTO HARUO
Published: March 2008

Abstract This is a historical review of the tragic life of a psychiatrist in the dawn of Japanese psychiatry, who was sentenced to life imprisonment for first‐degree murder by an American court and imprisoned in America. The purpose of this article is firstly to clarify the strange circumstances under which he was sentenced guilty in spite of his psychosis. In the author's opinion there appeared to be an incorrectness and injustice of the judicial decision in the American court from consideration of the documents of his trial. Secondly, the author would like to acknowledge Dr. Ishida's pioneering contributions to the Japanese psychiatry which, because of the circumstances, have been long buried in the history of Japanese psychiatry.
The concept of ‘atypical psychoses’: Special reference to its development in Japan
Authors: HATOTANI NOBORU
Published: March 2008

Abstract Reviewing the development of concepts of ‘atypical’ psychoses in European countries and in the United States shows that there are various terminologies which are given to a group of psychoses unclassifiable within Kraepelinian dichotomy. Bouffee delirante (French school), cycloid psychoses (Leonhard, Perris), reactive psychoses (Scandinavian school) and acute schizoaffective psychoses (Kasanin) are the most common terms. These are consistent in terms of acute onset, polymorphic symptomatology and good prognosis, and are considered to be distinct from major psychoses, especially from typical schizophrenia. The concept atypical psychoses in Japan was developed under the influence of Mitsuda's clinico‐genetic studies. According to Mitsuda, atypical psychoses are not mere phenotypical variants of typical schizophrenia and manic‐depressive psychosis (MDP) but belong to a genetically different category and are probably heterogeneous. The characteristic features in the Japanese concept of atypical psychoses emphasizes the alteration of consciousness in symptomatology and pays attention to the nosological relationship with epilepsy, as well as with schizophrenia and MDP. Thus, in Japan it is generally considered that atypical psychoses are independent of ‘typical’ major psychoses and are located nosologically in the border area between typical schizophrenia, MDP and epilepsy.
A spectrum for obsession and personality disorders
Authors: NAKAZAWA TSUNEYUKI
Published: March 2008

Abstract Obsession was introduced by Kraepelin in 1915 and has been studied extensively since. When a person with obsession becomes psysically exhausted with chronic rumination accompanied by suspicion, he or she is driven to impulsive acts, and develops a personality disorder that displays persistent abnormal activities. Obsession is related closely to depression and schizophrenia. Obsession is induced when uncertainty and instability dominates intelligence and creativity. The current social hierarchy of a strongly controlled society rejects diversity of humanity and often triggers personality disorders. This article reviews obsession and a myth as primitive mentality, normal and abnormal obsession, obsession vs possession, society and obsession/ impulsion/degeneration, obsession and slowness/autism, a recent biological approach to obsession and a spectrum for obsession.
Relationship between solvent inhalation and antisocial behavior: Special emphasis on two types of violence seen in solvent abusers
Authors: MORITA NOBUAKI , SATOH SHINJI , ODA SUSUMU , TOMITA HIROSHI , SHOJI MASAMI , SENO EIICHI , ABE KEIICHIRO , KONISHI TAKAKO , OKADA TAKAYUKI
Published: March 2008

Abstract Organic solvent inhalation is a serious problem among youths in Japan. It induces physical and mental disorders, and is related closely to crime and delinquency. The relationship between solvent inhalation and antisocial behavior was investigated in 75 youths. The subjects were divided into three groups according to the level of violent behavior and the time of appearance: a non‐violent group, a late‐onset group (violence occurred after the start of inhalation) and an early‐onset group (violence had occurred before the start of inhalation). Various parameters were compared among the groups. The late‐onset group showed the following characteristics: (i) the frequency of inhalation was high, and many subjects experienced hallucinations and mood changes caused by inhalation; (ii) the family environment was characterized by conflict; and (iii) the subjects had strong psychological conflicts and showed dissociative coping with frustration. The violence, psychological conflict and dissociation in this group were found to be related to the inhalation, with familial conflict as a background. The violence in the early‐onset group was considered to be the manifestation of a violent personality as the frequency of inhalation and the incidence of mental symptoms were both low. The subjects in this group showed weak psychological conflict and tended to be demanding of others when attempting to cope with frustration. Two types of violent behaviors in the teenagers who inhaled solvents were identified. The violence of solvent inhalers should be managed according to the type.
Somatization in adolescence with reference to dysmorphophobia
Authors: OHYA DAI , MATSUMOTO ISSHO , SAITO MASAMI
Published: March 2008

Abstract An adolescent male obtained a position in a large business with assistance from others. Initially he had tension headaches due to maladjustment. He then showed signs of dysmorphophobic symptoms, expressed as a dissatisfaction with his nose. Subsequently, he had cosmetic rhinoplasty twice for esthetic reasons. After a few years, he presented with a psychosis. During treatment his symptoms developed into headache and fever that disappeared upon recovery. He was therefore able to seek employment independently. This transition of symptoms assumes an aspect of adolescent mentality and presents a trial and error approach to establishing a social identity. In general, somatization is assumed to be an immature defense mechanism of individual psychopathology. However, somatization may be a sign of an improvement in one's health. Somatization in adolescence may also be a sign of the beginning of a reintegration into society and have a bridging functional aspect that induces socialization in adulthood.
Obsessive‐compulsive disorder comorbid with borderline personality disorder: A long‐term case study
Authors: HAYASHI NAOKI
Published: March 2008

Abstract Three case reports of patients with borderline personality disorder (BPD) and obsessive‐compulsive disorder (OCD) for more than 10 years are used to illustrate the relationship between OCD and borderline pathology. The recognizable features of the obsessive‐compulsive symptoms in these reports are: (i) pervasiveness, the symptomatic overlap of obsessive‐compulsive symptoms; (ii) poor insight and resistance; and (iii) obsessive control evident in personal relationships. These features are manifestations of OCD psychopathology as well as of a personality disorder. The symptoms with these features are located hypothetically towards the severe end of the symptomatic spectrum of OCD. The comorbidity is not a simple relationship, and the symptomatology of the comorbid patient is derived from OCD pathology linked with the personality disorder rather than from independent BPD pathology.
Treatment for inpatients with anorexia nervosa: Comparison of liquid formula with regular meals for improvement from emaciation
Authors: ARII ICHIRO , YAMASHITA TATSUHISA , KINOSHITA MIZUKO , SHIMIZU HIROSHI , NAKAMURA MICHIHIKO , NAKAJIMA TERUO
Published: March 2008

Abstract A new refeeding program using only liquid formula was given to six anorexic inpatients (LF group) at the initial stage of hospitalization. These patients were compared with six other inpatients who regular meals (RM group). The LF group did not develop a phobia of gaining weight, while the RM group showed a vicious cycle of gastrointestinal discomforts leading to fat phobia and stagnation in weight gain. By comparison, the LF group had fewer gastrointestinal symptoms, which resulted in the disruption of this cycle and seemed to help motivate these patients to obtain a steady gain in bodyweight.
Computerized electroencephalogram in untreated schizophrenics: A comparison between disorganized and paranoid types
Authors: MIYAUCHI TOSHIRO , ENDO SEIJI , KAJIWARA SATOSHI , ISHII MIYUKI , OKAJIMA JIRO
Published: March 2008

Abstract Computerized electroencephalogram (CEEG) data were obtained from 30 patients with the disorganized type and 20 patients with the paranoid type of acute untreated schizophrenia and compared with data from age‐ and sex‐matched controls. All patients with acute untreated schizophrenia exhibited more pronounced delta, theta, alpha1 and beta1 activity and less prominent alpha2 activity than the control subjects. These findings support previous studies, and indicate the coexistence of cerebral hypofunction and excitability in acute schizophrenic patients. Compared with the controls, patients with disorganized type schizophrenia had significant increases in theta and beta1 and decreases in alpha2 activities; but a significant increase in delta and alpha1 activities in the posterior regions and beta2 activity in the frontal regions of the brain. Patients with paranoid type schizophrenia showed significantly increased delta activity in the posterior regions, increased alpha1 activity in the anterior regions and decreased alpha2 activity in both these regions. In the paranoid type, however, there was no significant finding for the theta, beta1 and beta2 activities. Disorganized type schizophrenics exhibited more increased theta and decreased alpha2 activity than patients with paranoid type schizophrenia. The CEEG differences between the disorganized and the paranoid types appear to reflect different clinical entities and may help to differentiate both schizophrenias.
Psychological stress in middle‐aged and aged executives
Authors: MORIOKA CHIKAKO , KINUMAKI JYUNKO , SODA JYUNJI , NAMETA KEN , KOMATSU YOICHI , TSUJIO TAKEHIKO
Published: March 2008

Abstract Neurotic symptoms were considered to be present in 21.9% of the 210 employees of a company following data analysis from a General Health Questionnaire (GHQ, 60 question items). The results in middle‐aged and aged executives were compared. The total GHQ score was ≪ 17 in 18/55 executives aged 40 years or above, but in only 9/60 non‐executives controls was a significant difference observed (P > 0.05) between executives and non‐executives. The scores for three subordinate scales, namely somatic symptoms, anxiety and insomnia, and social dysfunction, were higher in the executives than in the non‐executives and showed a significant difference (P > 0.05) in the anxiety and insomnia scale. These results suggest that middle‐aged and aged executives are more likely to have neurotic symptoms and more frequently to have anxiety and insomnia than their controls. We would like to apply this method to aid in the prevention, early detection and early management of stress.
Alcohol dementia and alcohol delirium in aged alcoholics
Authors: KASAHARA HIROO , KARASAWA AKIHIDE , ARIYASU TAKAYOSHI , THUKAHARA TATSUYA , SATOU JOUJI , USHIJIMA SADANOBU
Published: March 2008

Abstract In the present study, 126 alcoholics aged 60 years or older were compared with 104 alcoholics aged 35–45 years. No dementia was found in the younger group, whereas 62.7% of the aged patients had dementia; the dementia being irreversible in 32.9% of such patients. Cases of so‐called alcohol dementia excluding organic brain diseases accounted for 42.1%. The percentage of aged alcoholics having dementia increased with age, being far beyond the frequency of senile dementia in the general aged. Among various physical complications, hepatic injury and myocardiopathy were more frequent in the aged alcoholics than in general aged people, suggesting that hypertension, myocardiopathy and hepatic injury underlie the manifestation of dementia. There was no case of dementia attributable to the direct effect of alcohol distinctly exceeding the effects of various physical factors. Problem behaviors characteristic of the aged group included ‘being soaked in drink’ and being inebriated, showing no correlation with the presence or absence of dementia. There was no significant difference in frequency of delirium between the aged group and the younger group. However, in aged alcoholics delirium tended to continue for a longer period during abstinence and was more likely to occur even during non‐abstinence. A similar trend was found in aged alcoholics with dementia compared with those without dementia.
Effective electroconvulsive therapy for stupor in the high risk patient: A report of two cases
Authors: MASHIMO KIYOSHI , SATO YUUICHI , YAMAUCHI TOSHIO
Published: March 2008

Abstract We report two cases of stupor in which the patients were safely treated by electroconvulsive therapy (ECT) despite high risk conditions. Case 1 was a 72 year old schizophrenic woman who had developed catatonic stupor and had joint contractures as a complication of rheumatoid arthritis. Case 2 was a 52 year old woman who developed a stuporous state which was complicated by severe dehydration with hypernatremia. In both cases, psychotic symptoms were improved by ECT without event. Careful application of ECT seemed to be effective and safe even for stupor in high risk patients.
Immunohistochemical examination of phosphorylated tau in granulovacuolar degeneration granules
Authors: IKEGAMI KEN , KIMURA TAKEMI , KATSURAGI SHOICHI , ONO TSUNEHIKO , YAMAMOTO HIDEYUKI , MIYAMOTO EISHICHI , MIYAKAWA TAIHEI
Published: March 2008

Abstract Granulovacuolar degeneration (GVD) and neurofibrillary tangles (NFT) are neuropathological features in Alzheimer's disease (AD). The molecular mechanism of GVD formation remains unknown. Recent immunohistochemical investigations suggested a potential link of NFT to GVD formation. Enzyme histochemical studies and electronmicroscopic findings suggested that GVD is formed through lysosomal autophagy of intraneuronal substances. We recently demonstrated that in non‐demented cases NFT was phosphorylated at serines 199, 202 and 422 in paired helical filament (PHF)‐tau more than in serine 396, while NFT in AD cases was similarly phosphorylated at these four sites in tau. In this study, we demonstrated immunohistochemically a similar phosphorylation state of tau in GVD granules to that in NFT in both non‐demented cases and AD patients by using a mouse monoclonal anti‐tau antibody and three phosphorylation site‐specific antibodies for PHF‐tau, indicating that GVD granules and NFT are composed of similar phosphorylated‐tau. However, we could not detect PHF structures within any GVD using electronmicros‐copy, indicating that PHF itself is not phagocytized by lysosomes during GVD formation. Therefore, the source of GVD granules might be phosphorylated pre‐PHF‐tau.
Effect of chronic ipsapirone treatment on the density of 5‐HT1A receptors and 5‐HT1A receptor mRNA in discrete regions of the rat brain
Authors: SHIRO YOSHIHIKO , FUJIWARA YUTAKA , HIKIJI MITSURU , HAMAMURA TAKASHI , SHOMORI TOSHIKIYO , KURODA SHIGETOSHI
Published: March 2008

Abstract There is increasing evidence that the 5‐hydroxytryptamine (HT)1A partial agonist ipsapirone is an effective anxiolytic/antidepressant agent, although its mechanism of action is not clear. In this study, we investigated the effects of chronic ipsapirone treatment (5 or 10 mg/kg; twice daily, 3 weeks) on 5‐HT1A receptor density 8‐hydroxy‐2‐(di‐n‐propyl amino) tetralin (80H‐DPAT) binding and the level of its mRNA (in situ hybridization) in various regions of the rat (male Wistar 250 g) brain. Receptor density was reduced in the frontal cortex, but did not change significantly in the hippocampus and dorsal raphe nucleus. The level of receptor mRNA was unchanged in each of these brain regions. The present results suggest that the clinical anxiolytic effects of ipsapirone may be mediated partly by postsynaptic action on serotonergic transmission in the frontal cortex, but not in the hippocampus or dorsal raphe nuclei.
Transient elevation of nerve growth factor content in the rat hippocampus and frontal cortex by chronic ethanol treatment
Authors: NAKANO TOSHIHIKO , FUJIMOTO TOSHIRO , SHIMOOKI SUSUMU , FUKUDOME TERUMI , UCHIDA TSUNEHISA , TSUJI TAKAYUKI , MITSUYAMA YOSHIO , AKIMOTO HARUO , FURUKAWA SHOEI
Published: March 2008

Abstract The nerve growth factor (NGF) content in the hippocampus and frontal cortex of chronic ethanol‐treated rats was measured and compared with that of control rats, using a two‐site enzyme immunoassay (EIA) system. The different time periods of chronic ethanol treatment caused transient elevation of the NGF content in both the hippocampus and frontal cortex. The NGF content in the hippocampus was significantly elevated in rats undergoing ethanol treatment of 2 weeks and 1 month. Nerve growth factor content of the 1 month treatment was higher than that of the 2 week treatment. However, a 3 month administration of ethanol reduced the NGF content to the control level. The NGF content in the frontal cortex increased significantly in the 2 week administration, but decreased to the control level in the 1 month administration. The increase of NGF may be caused by the proliferation of glial cells or the enhancement of neuronal production of NGF.
Increased striatal glutamate transporter by repeated intermittent administration of methamphetamine
Authors: SHIRAI YUTAKA , SHIRAKAWA OSAMU , NISHINO NAOKI , SAITO NAOAKI , NAKAI HISAO
Published: March 2008

Abstract We have examined the immunoreactivities of a glutamate (Glu) transporter, GLT‐1, in rat brains treated with a single or repeated intermittent administration of methamphetamine (MAP). In the stratum of behaviorally sensitized rate induced by repeated intermittent MAP treatment, GLT‐1 immunoreactivities were increased by 51%. There was no difference in the GLT‐1 immunoreactivities in all regions examined between rate treated with a single administration of MAP and the control rats. These results suggest that hyperglutamatergic activity in the striatum is involved in the induction of behavioral sensitization caused by MAP.
Clinical studies of pervasive developmental disorders in Japan
Authors: KURITA HIROSHI
Published: March 2008

Abstract Articles on pervasive developmental disorders (PDD) published mainly by Japanese child psychiatrists in international journals for the last 20 years were reviewed for the purpose of clarifying the accomplishment and aims of Japanese PDD research. Although Japanese child psychiatrists investigated PDD in various specialties, their contributions to international archives were much fewer than those of Japanese professionals in other branches of medical sciences. This may be accounted for by the absence of an authorized education system of child psychiatrists and strong clinical orientation together with some reluctance of Japanese child psychiatrists to perform research. However, the epidemiology of PDD subtypes, the speech loss in PDD and the psychopathology of persons with high‐functioning PDD seem to be providing promising research areas for Japanese child psychiatrists based on their clinical experiences.
The clinical features of Tourette's disorder with obsessive‐compulsive symptoms
Authors: IIDA JUNZO , SAKIYAMA SHINOBU , IWASAKA HIDEMI , HIRAO FUMIO , HASHINO KENICHI , KAWABATA YOKO , IKAWA GENRO
Published: March 2008

Twenty‐three patients with Tourette's disorder (13 with obsessive‐compulsive symptoms [OCS] and 10 without) were comparatively investigated. In contrast to OCS‐free Tourette's disorder patients, those with OCS were found to be characterized by (i) a higher incidence of volatile temper, (ii) a higher incidence of compulsive tics, (iii) a higher incidence of perinatal disorders and brain wave abnormalities, (iv) a higher severity as rated using the Seventy Scale, and (v) a higher prevalence of complications, especially of developmental disorders. Of the subjects with OCS‐accompanied Tourette's disorder, approximately half had developed OCS by the onset of tics. These findings suggest the likelihood that OCS‐accompanied Tourette's disorder is more strongly associated with organic cerebral disorders, independently of sites of tic disorders, than is OCS‐free Tourette's disorder.
Erythrocyte deformability in schizophrenic patients
Authors: NAKASHIMA HISASHI , UEDA KEISHI , YASUGAWA SETSUKO , KATSURAGI SYHOICHI , KIMURA TAKEMI , MIYAKAWA TAIHEI
Published: March 2008

Erythrocyte deformability as a clinical indicator of microcirculatory disturbance was determined in the erythrocyte of 25 schizophrenic patients and of 18 normal controls. Schizophrenic patients had significantly lower erythrocyte deformability than did the normal controls (P < 0.001). This result suggests that microcirculation in schizophrenic patients is disturbed, and that this disturbance might be involved in the pathophysiological genesis of schizophrenia.
A multicenter study of sleep‐wake rhythm disorders: Clinical features of sleep‐wake rhythm disorders
Authors: YAMADERA HIROSHl , TAKAHASHI KIYOHISA , OKAWA MASAKO
Published: March 2008

A multicenter study of sleep‐wake rhythm disorders (i.e. non‐24 hour sleep‐wake syndrome; non‐24), delayed sleep phase syndrome (DSPS), irregular sleep‐wake pattern (irregular sleepers), and long sleepers, was conducted with the co‐operation of 25 institutions. One hundred and twenty‐one primary sleep‐wake rhythm disorders were diagnosed and were classified as 13 non‐24, 90 DSPS, 12 irregular and six long sleepers. The mean onset age was about 20 years old and psycho‐social factors associating the onset of the disorder were identified in 36% of these patients. The major factors of sleep‐wake disorders were personal relationships, advancing to a higher level education, gaining employment, and changes in environment. Most patients were ‘night active’ prior to appearance of their symptoms. Increase in night activities of modern society seem to result in the occurrence of such sleep‐wake rhythm disorders.
Effects of entorhinal cortex lesion on learning behavior and on hippocampus in the rat
Authors: MIWA CHITOKU , UEKI AKINORI
Published: March 2008

The initial stage of Alzheimer's disease is characterized by a neuropathological change in the entorhinal cortex. In a previous study it was shown that rats with excitotoxic lesion of entorhinal cortex showed an impaired acquisition of passive and active avoidance responses. In this study a rat with excitotoxic lesion of the entorhinal cortex was tested for ‘more operant’ behavioral learning (i.e., positive reinforcement operant learning). The hippocampus was also examined histologically as acetylcholinesterase‐stained sections, and as synaptophysin immunostained sections and examined biochemically by liquid chromatography. Eight weeks after operation, the bilateral entorhinal cortex lesioned rats showed an impaired acquisition of positive reinforcement operant learning. The lesioned side of unilateral entorhinal cortex lesioned rats showed a decrease of acecylcholinesterase‐positive fibers in the CA3, the dentate gyrus, and of synaptophysin‐positive substances in the CA3. Biochemical study showed a decreased level of acetylcholine in the CA3, and in the dentate gyrus. The histological and biochemical findings are interpreted as indicating that the entorhinal cortex of the rat provides the major extrinsic synaptic input to the hippocampal formation via the circuit which serves as a relay passage through the dentate gyrus and via direct projections into the hippocampus. Behavioral findings confirmed the importance of the entorhinal cortex in memory acquisition and indicated that rats with a partial neuronal loss in the entorhinal cortex may be a useful model for the memory disturbance of Alzheimer's disease.
Non‐existence of a positive correlation between urinary levels of α1 ‐microglobulin and ulinastatin in patients with Parkinson's disease
Authors: INAGAKI TAKUJI , SHIKIMI TADAHIRO , MATSUBARA KAZUO , KOBAYASHI SHOUTAI , ISHINO HIROSHI , OKUNISHI HIDEKI , TAKAORI SHUJI
Published: March 2008

Urinary levels of a,‐microglobulin (αlM) and of ulinastatin (UT) and the αlM/UT ratio did not differ significantly between age‐matched controls and patients with Parkinson's disease, and among subdivided groups based on Yahr's stages in Parkinson's disease. Furthermore, these indexes did not correlate with Yahr's stages. Although αlM and UT levels did not correlate in patients with Parkinson's disease, a positive correlation was observed in the control group. The non‐existence of a positive correlation between αlM and UT levels distinguishes Parkinson's disease from other neuropsychiatric diseases such as dementia (Alzheimer‐type and vascular dementia), schizophrenia and mood disorder.
Liaison psychiatry and HIV infection (II): Application of relaxation in HIV positive patients
Authors: FUKUNISHI ISAO , HOSAKA TAKASHI , MATSUMOTO TOMOKO , HAYASHI MOTOKO , NEGISHI MASAYOSHI , MORIYA HIROFUMI
Published: March 2008

Abstract We examined the efficacy of relaxation techniques in a sample of HIV patients without AIDS in the early stages after infection, by comparing the three groups: relaxation group (progressive muscle relaxation and modified autogenic training); ordinary supportive psychotherapy group, and finally no psychiatric treatment group. Scores for anxiety, fatigue, depression and confusion, as measured by the profile of mood states (POMS), were significantly lower after relaxation than before. There were no significant differences in the POMS scores (except for anger) among the three groups. These two results suggest that a combination of progressive muscle relaxation and modified autogenic training is a useful method, which can be easily employed in HIV patients without AIDS.
Dreamy states and psychoses in temporal lobe epilepsy: Mediating role of affect
Authors: SENGOKU AKIRA , TOICHI MOTOMI , MURAI TOSHIYA
Published: March 2008

Abstract Among 104 patients with temporal lobe epilepsy treated in our clinic between 1992–1995, thirteen patients with repeated dreamy states were evaluated for affective manifestations of dreamy states and their relationship with psychotic states. The types of dreamy states were classified as déjà vu, jamais vu and reminiscence. The affective experiences during dreamy states were evaluated as positive, negative or neutral. As a result, seven patients had déjà vu and/or reminiscence: seizure manifestations in four of these patients were affectively evaluated as positive (familiar and/or pleasurable), and three as neutral. Six cases had experience of jamais vu: five of them were affectively evaluated as negative (mostly fear), and one as neutral.

Psychiatrically, only four patients with jamais vu accompanied by feelings of fear had mental disorders: a chronic paranoid‐hallucinatory state in two cases, a chronic paranoid state in one case, and obsessive‐compulsive symptoms in one case. Other patients who had positive or neutral affect did not demonstrate psychiatric disturbances. Thus, most patients with jamais vu were accompanied by negative affect of fear, and those patients with jamais vu tended to show more psychotic symptoms than those with reminiscence or déjà vu, which were associated with positive or neutral affects. Based on these results, we discuss the possibility that repeated negative feelings associated with jamais vu are one of the causes for developing epileptic psychoses.
Daily melatonin intake resets circadian rhythms of a sighted man with non‐24‐hour sleep‐wake syndrome who lacks the nocturnal melatonin rise
Authors: NAKAMURA KOUJI , HASHIMOTO SATOKO , HONMA SATO , HONMA KEN‐ICHI
Published: March 2008

Abstract Effects of daily melatonin intake on the circadian rhythms of sleep and wakefulness, rectal temperature and plasma cortisol were examined in a sighted man who had suffered from the non‐24‐hour sleep‐wake syndrome. The subject lacked the nocturnal melatonin rise in plasma, but showed robust circadian rhythms in rectal temperature and plasma cortisol. The sleep‐wake rhythm free‐ran with a period longer than 24 hours. Daily melatonin intake at 21:00 h concentrated sleep episodes in the nocturnal period (24:00–8:00 h), and increased the length of the episodes. A single oral dose (3 mg) of melatonin increased plasma melatonin levels to about 1300 pg/mL within one hour and remained at pharmacological levels for approximately 6 hours. The trough of rectal temperature and the circadian rise of plasma cortisol were fixed to the early morning. A higher dose of melatonin (6 mg) did not improve the general feature. After the cessation of melatonin intake, the sleep‐wake rhythm began to free‐run together with the circadian rhythms in rectal temperature and plasma cortisol. It is concluded that daily intake of melatonin at early night time resets the circadian rhythms in a sighted man who lacked the nocturnal melatonin rise and showed free‐running circadian rhythms in routine life.
Influence of reference electrodes, stimulation characteristics and task paradigms on auditory P50
Authors: CHEN CHUNG‐HO , NINOMIYA HIDEAKI , ONITSUKA TOSHIAKI
Published: March 2008

Abstract To clarify the nature of auditory P50, middle latency auditory evoked potentials were recorded by using different conditions of reference electrodes (linked earlobes, LE; balanced non‐cephalic, BN), stimulation characteristics (tone burst, human voice) and tasks (counting, simple reaction) in 10 right‐handed males (aged 21–36 years). EEG was recorded from Fz, Cz, Pz, C3, C4, T3 and T4 according to the 10–20 system. Two groups of electrode sites were made for the statistical analysis: a midline group, Fz, Cz and Pz; and a lateral group, T3, C3, Cz, C4 and T4. The results were that the P50 amplitudes with BN electrodes were significantly higher than those with LE in both groups (midline, P < 0.01; lateral, P < 0.01); the P50 amplitudes by voice stimulation were significantly higher than those by tone stimulation in the lateral group (P < 0.05), and the P50 latencies under a simple reaction paradigm were significantly shorter than those under a counting task in both groups (midline, P < 0.05; lateral, P < 0.05). These results suggest that various factors including motor response affect the P50 amplitudes and latencies.