bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical features of childhood‐onset schizophrenia with obsessive‐compulsive symptoms during the prodromal phase
Authors: IIDA JUNZO , IWASAKA HIDEMI , HIRAO FUMIO , HASHINO KENICHI , MATSUMURA KAZUYA , TAHARA KOUICHI , AOYAMA FUKIKO , SAKIYAMA SHINOBU , TSUJIMOTO HIROKAZU , KAWABATA YOHKO , IKAWA GENRO
Published: March 2008

Abstract Thirty‐nine patients with schizophrenia, diagnosed according to DSM‐III‐R, who were under 15 years of age, were studied in two groups; 16 subjects with obsessive‐compulsive symptoms during the prodromal phase, and 23 with no obsessive‐compulsive disorders. The group with obsessive‐compulsive symptoms during the prodromal phase was characterized by a higher ratio of males, higher incidences of perinatal and brain computed tomography (CT) abnormalities, fewer hereditary factors, longer duration of the prodromal phase, and a higher incidence of insidious onset and negative symptoms compared with the group without such prodromal symptoms. Schizophrenic patients with obsessive‐compulsive symptoms during the prodromal phase were clinically distinct from those without, which suggests the possibility of subtype categorization.
Application of the relaxation technique in general hospital psychiatry
Authors: HOSAKA TAKASHI , YAMAMOTO KENJI , IKEDA KEN , TANIYAMA FUMIAKI , MD JUNGO YANAGISAWA
Published: March 2008

Abstract The present article demonstrates the clinical application and the efficacy of relaxation techniques in general hospital psychiatry in Japan. During April to December 1993, 20 patients were treated with progressive muscle relaxation and ‘modified’ autogenic training therapies. The targeted symptoms were anxiety attacks (or panic attacks), neurotic insomnia, hyperventilation syndrome, agoraphobia, chronic pain, and distress. Most patients (18/20) improved rapidly with the use of these techniques and their excellence encourages increased use in general hospital psychiatry for the following reasons. First, physically ill patients are likely to show unexpected reactions to psychotropic medications. Second, some patients prefer these treatment methods rather than medications because they feel that they are participating voluntarily in their own treatment and also because they are fearful of being addicted to tranquilizers. Third, these treatments have produced rapid improvement especially for patients with panic attacks and/or hyperventilation. This study strongly suggests that progressive muscle relaxation and ‘modified’ autogenic training are simple and useful methods which can be easily employed in the clinical practice of general hospital psychiatry.
Levodopa induces AP‐1 and CREB DNA‐binding activities in the rat striatum
Authors: KASHIHARA KENICHI , ISHIHARA TAKESHI , AKIYAMA KAZUHUMI , KURODA SHIGETOSHI , MORIMASA TADAOMI , SHOMORI TOSHIKIYO
Published: March 2008

Abstract In order to elucidate the effect of levodopa and bromocriptine on the DNA‐binding activities of transcription factors, AP‐1 and CREB DNA‐binding activities were investigated using gel‐shift assay. Intraperitoneal administration of 100 mg/kg levodopa with 50 mg/kg benserazide in rats increased both AP‐1 and CREB DNA‐binding activities in the dorsolateral aspect of the striatum. The major proteins composing the increased AP‐1 were JunB and JunD. Bromocriptine at doses of 2.5 and 5.0 mg/kg, however, did not increase these binding activities. Present results suggest that levodopa but not bromocriptine induces these transcription‐regulating proteins in the striatum with normal dopaminergic functioning.
Mental disorders and suicide prevention
Authors: LÖNNQVIST JOUKO K. , HENRIKSSON MARKUS M. , SISOMETSÄ ERKKI T. , MARTTUNEN MAURI J. , HEIKKINEN MARTTI E. , ARO HILLEVI M. , KUOPPASALMI KIMMO I.
Published: March 2008

Abstract In the research phase of the National Suicide Prevention Project, all suicides (n= 1397) in Finland between March 1987 and April 1988 were examined retrospectively using the psychological autopsy method. Careful retrospective diagnostic evaluation of the victims according to DSM‐III‐R criteria was done by weighing and integrating all available information. A series of studies addressing the mental disorders among suicide victims, the treatment received before death and the life events is now reviewed.

Among a random sample of suicide victims from the nationwide suicide population, at least one psychiatric diagnosis was made for 93% of the victims. The most prevalent disorders were depressive syndromes (66%) and alcohol dependence/abuse (43%). The prevalence of major depression was higher among women than among men. Major depression as the principal diagnosis was more common among the elderly suicides. Among adolescent victims, depressive syndromes were also the most prevalent disorders. Adjustment disorders were common (25%) among male adolescent suicides. The majority of suicide victims of all ages suffered from comorbid mental disorders.

Among suicide victims who had had contact with a health carer before death, inadequacy of treatment for mental disorders seems to have been common. Of the major depressive victims only 3% were found to have received adequate psychopharmacological treatment, and only 7% received weekly psychotherapy by a trained therapist.

The analysis of the massive database collected in the research phase of the National Suicide Prevention Project in Finland is still ongoing, and the implications of the findings for suicide prevention will be refined during the research process. The necessity to improve recognition and treatment for comorbid depressive disorders in all age groups seems evident already.
Psychosocial and spiritual issues in terminal care
Authors: KASHIWAGI TETSUO
Published: March 2008

Abstract The author has been working as a psychiatrist over the past 30 years, engaging in clinical work and in research. During his career as a psychiatrist the author began to develop a special interest in terminal care. This led to additional study in a residency program in internal medicine and oncology, and culminated in the establishment of a hospice in 1984. Through this close association with hospice patients the author has experienced approximately 2000 deaths over the past 10 years. These experiences have reinforced in his mind the viewpoints that people die as a whole person.
Clinical evaluation of suicide risk
Authors: LEENAARS ANTOON A.
Published: March 2008

Abstract Suicide risk assessment may well be the most complex clinical task that mental health professionals face. Tests have shown to be of little use. To confront this complexity, assessment and prediction are best seen as interwoven with understanding suicide, a multi‐dimensional malaise. With the essential concepts of lethality and perturbation, a clinical theory of suicide is presented. Intrapsychic aspects (i.e., unbearable psychological pain, cognitive constriction, indirect expressions, inability to adjust, and ego) as well as interpersonal aspects (i.e., interpersonal relations, rejection‐aggression, identification‐egression), are outlined to aid in assessment. Transference and countertransference issues in assessment are noted. A case illustration to aid in clinical insight is provided. It is concluded that all assessment and prediction of suicide risk ultimately depends on the skill of the clinician.
Suicide risk in the general hospital
Authors: BERGER DOUGLAS
Published: March 2008

Abstract This paper reviews the relationship between physical illness and suicide, reviews the studies of attempters and completers of suicide in general hospitals, and discusses those studies which have investigated the characteristics of patients in the medical setting with suicidal ideation. Study of suicidal ideation in a general hospital setting aimed at characterizing patients' suicidality may allow psychiatrists to better discriminate those patients at greater risk for completed suicide. Comparison of medical patients with suicidal ideation with those who had attempted or completed suicide, and recommendations to reduce suicidal impulses and treat these patients are discussed.
Attempted suicide: Efficacy of treatment programs
Authors: KURZ ALEXANDER , MÖLLER HANS‐JÜRGEN
Published: March 2008

Abstract Persons with a history of attempted suicide have an increased risk of eventually committing suicide. Eleven controlled perspective studies are reviewed on treatment programs aimed at reducing the rates of suicide and of repeated suicidal attempt in these considered at risk. None of these aftercare programs had a demonstrable impact on the suicide rate, and only in one investigation was a significant reduction of repeated attempts observed. Lack of statistical power and inadequate treatment strategies are discussed as major contributors to this failure. Recent evidence of a reduction of suicide rates and mortality by consequent and long‐term treatment of patients with affective disorders, as well as reports of undertreatment of depression prior to completed suicide, might provide a new stimulus for the development and evaluation of aftercare programs for those who attempt suicide. The available evidence advocates a shift of emphasis from crisis management to the identification and treatment of psychiatric illness in this risk group.
Analyses of the molecular basis of kindling development
Authors: McNAMARA JAMES O.
Published: March 2008

Abstract Kindling has become the most widely studied animal model of limbic epilepsy. Understanding the molecular basis of kindling development may provide novel therapeutic approaches to prevention of limbic epileptogenesis. I briefly describe the kindling model and outline the basis for my thinking that kindling represents a synaptic reorganization triggered by pathologic activity in the mature nervous system. The pathologic activity is postulated to evoke a cascade of gene expression driven, at least in part, by glutamate receptor activation. Evidence in support of this hypothesis is presented, as are future challenges that permit critical tests of these ideas.
Lennox‐Gastaut syndrome: A new vista
Authors: OHTAHARA SHUNSUKE , OHTSUKA YOKO , KOBAYASHI KATSUHIRO
Published: March 2008

Abstract Lennox‐Gastaut syndrome (LGS) is regarded as a model of the epileptic syndrome because of its specific clinicoelectrical manifestation. However, a close investigation reveals that its outline is somewhat vague, having the borderland around it. Precise diagnosis in an individual case is not always easy. In this paper, the diagnostic criteria of LGS are described. According to these criteria, cases with LGS were subclassified into the typical and the atypical cases, and also cases in the borderland of LGS were reviewed. On the other hand, our prospective long‐term follow‐up study revealed that cortical mechanisms played an important role in the pathophysiology, clinical features and refractoriness of LGS.

Secondary bilateral synchrony (SBS) is supposed to be a mode of expression of cortical mechanisms of LGS. A newly developed method with coherence and phase analysis demonstrated that the pathophysiology was based on SBS in 33% of the typical LGS cases. This finding is not only crucial for the choice of rational treatment including epilepsy surgery, such as callosotomy, but also contributes to a more refined subclassification of LGS.
Single photon emission computed tomography studies of partial epilepsies
Authors: JIBIKI ITSUKI
Published: March 2008

Abstract At present, in the field of clinical epilepsy, it has been established that single photon emission computed tomography (SPECT) is useful for the regional determination of epileptic foci. In particular, it seems to be of great advantage to the field of clinical epilepsy that epileptic foci situated in the deep regions of the brain are detectable by the three‐dimensional resolution power in SPECT, because such foci are not often represented on routine scalp electroencephalograph (EEG). In reference to our review published previously,1 recent findings in SPECT studies of partial epilepsies are surveyed here.
Age differences of psychiatric inpatients presenting with physical complications
Authors: NAGATOMO ITSUGI , NAGASE FUMIHIRO , SHIMOJIMA KEIZO , NOMAGUCHI MITSUO , TAKIGAWA MORIKUNI
Published: March 2008

Abstract We reviewed the records of 292 inpatients in the psychiatric ward of Kagoshima University Hospital who were referred from other medical facilities over a 5‐year period in order to clarify age differences in the reason for referral. Patients were classified into groups of physically and mentally ill individuals based on indications for admission. Both groups were further divided into four subgroups based on age. The incidence of inpatients with physical illnesses increased with age. Conditions related to pregnancy, childbirth and the puerperium occurred at high frequency in female patients in the 20‐ to 39‐year‐old subgroup. Individuals in the 40‐ to 59‐year‐old and in the > 60 years subgroups suffered more frequently from neoplasms. The proportion of patients manifesting a defective state in all age subgroups with the exception of the under 19‐year‐old subgroup was significantly higher in the physical illness group than in the mental illness group. The proportion of patients in a depressive state in the > 60 years subgroup was significantly higher in the mental illness group than in the physical illness group. Hence, it is necessary to find a method to be able to cope with psychiatric patients with physical complications to solve this problem.
Survey of the living conditions and psychosomatic states of the elderly in Japan who receive home help
Authors: HORIGUCHI JUN , SUKEGAWA TSURUHEI , INAMI YASUSHI
Published: March 2008

Abstract The living conditions and psychosomatic states of 2828 elderly people receiving care from home helpers were investigated. The physical condition of men was significantly lower than that of women. With regard to daily life (i.e. eating, sitting, standing, excretion, dressing, bathing, walking, tidiness) 70% were rated as being self‐supporting. Eighty per cent of subjects were judged as having normal intelligence. Twenty‐two per cent of subjects had more than one psychiatric symptom (e.g. memory impairment, insomnia, talking to oneself, and delusions). Among the various medico‐welfare supports, home help was recommended most often.
Periodicity and prediction of mania onsets in biopolar I affective disorders
Authors: MIZUKAWA ROKURO , TSUSHIMA JOJI , TAKADA TERUO , NAGABUCHI TADABUMI , WATANABE KEN , HAZAMA HIDEBUMI
Published: March 2008

Abstract In studying the periodicity of mania onsets, cycle‐oriented diagrams were made of the clinical course from 257 manic episodes analyzed retrospectively in 34 bipolar I manic‐depressive patients for a period of about 5 years. Using these diagrams, the frequent period of mania onsets located in one‐quarter of the follow‐up period was pre‐estimated, and the accordance ratio during a 25 month follow‐up period was analyzed. The accordance ratio in all subjects was 39% (11/28) for the first episode and 35% (7/20) for the second episode. These ratios were not significantly different from the expected level (25%). The number of subjects was limited to 11 patients (10 rapid and 1 non‐rapid cyclers) whose number of episodes used for the determination of the index cycle was eight or more. The accordance ratio was 64% (7/11) and 60% (6/10) for the first and second episodes, respectively. Their levels were significantly higher than those expected. Periodicity of mania onsets existed at least in rapid cyclers with abundant past data.
Brief reactive psychosis induced by sensitivity training: Similarities between sensitivity training and brainwashing situations
Authors: SATOH SHINJI , MORITA NOBUAKI , MATSUZAKI ICHIYO , SENO EIICHI , ATA SHUGO OB , YOSHIKAWA MAIKO , OKADA TAKAYUKI , NISHIMURA AKIO , KONISHI TAKAKO , YAMAGAMI AKIRA
Published: March 2008

Abstract Sensitivity training (ST), which originated in the USA during the late 1940s, has been used as part of training seminars in Japanese corporations since the late 1950s. The possibility of negative psychiatric effects of ST, and especially its role in inducing psychiatric symptoms, is yet to be clarified. A case of a 41‐year‐old male company worker whose brief psychosis was induced by a sensitivity training seminar held by the company he worked for is presented. In reviewing the psychopathology of the case with records from the ST seminar, we found similarities between the patient's ST seminar and brainwashing situations. Specifically, the patient experienced severe conflict (of thought process) between his Christian beliefs and being labeled a coward at the seminar. We conclude that monitoring of the ST programs is crucial in order to ensure the psychological safety of ST participants in Japan.
Relationship between odor perception and depression in the Japanese elderly
Authors: SATOH SHINJI , MORITA NOBUAKI , MATSUZAKI ICHIYOU , KONISHI TAKAKO , NAKANO TAKASHI , MINOSHITA SEIKO , ARIZONO HIROKO , SAITO SACHIKO , AYABE SAHO
Published: March 2008

Abstract Odor perception has been studied in patients with various mental disorders; however, no consensus has been reached as to its detection, identification, or pleasantness/unpleasantness of odors especially in patients with depression. One hundred and nineteen normal elderly individuals living at home were exposed to odors of rose, perfume, white ginger, Indian ink, cigarette smoke, milk, feces and orange scent using the scratch and sniff method. They were asked to rate the strength of each odor, its pleasantness or unpleasantness, their liking for it, and their familiarity with it. They were also asked to complete a self‐rating depression scale (SDS). The relationship of the score of each psychological olfactory scale with the SDS score and the difference in the score of each psychological scale between high‐SDS and low‐SDS groups are discussed.
The differences of self‐ratings of sleep quality associated with epinephrine and wake time during 4 hour sleep
Authors: NISHIHARA KYOKO , MORI KAZUKO
Published: March 2008

Abstract The present study examined the differences of self‐ratings of 4h sleep in three states: L‐WE, where the percentage of waking time and urinary epinephrine are low (< 20% waking time); H‐W, where the percentage of waking time and epinephrine levels increase along the basal regression line as determined by a previous study (20–100% waking time and < 7 ng/min); H‐E, where epinephrine levels increase more than expected from the basal regression line for the two parameters (> 7 ng/min). Eight healthy male subjects participated twice in a 4 h polysomnograph experiment with four types of sleep onset (total of 64 observations). In group L‐WE (52 observations for eight subjects), there were no excessively negative feelings on sleep latency, sleep depth, and feelings of sleep compared with usual sleep according to the questionnaire. Subjective sleep diagrams in group L‐WE were similar to polysomnographic findings. Thus, group L‐WE was thought objectively and subjectively to have a good sleep state. Groups H‐W (eight observations for four subjects) and H‐E (four observations for two subjects) had negative feelings regarding sleep depth and feelings of sleep compared with usual sleep. Approximately half the group H‐W underrated their sleep compared with objective diagrams, while all cases in group H‐E remarkably underrated their sleep in the subjective diagrams. The state of remarkable adrenal medullary secretory activity seen in group H‐E and that of the slightly increased activity shown in group H‐W were included in poor sleep states objectively and subjectively.
Improvement of schizophrenic symptoms and changes in plasma HVA concentrations, plasma anti‐D2 and anti‐5‐HT2 receptor activities with clozapine
Authors: YAMADA KAZUO , KANBA SHIGENOBU , ZU‐CHENG WANG , SUZUKI EIJI , YI‐YU FANG , HE‐GIN YAN , NIBUYA MASASHI , YAGI GOHEI , ASAI MASAHIRO
Published: March 2008

Abstract In order to investigate the biological mechanisms underlying the clinical efficacy of clozapine, 200 mg/day of clozapine was added to the drug regimens of 19 patients with chronic, anti‐psychotic‐resistant schixophrenia, and the plasma homovanillic acid (HVA), clozapine concentrations, anti‐dopamine D2 and anti‐serotonin 5‐HT2 receptor activities were measured. After 28 days, six patients showed an improvement of more than 20% over baseline Brief Psychiatric Rating Scale (BPRS) scores. Mean plasma HVA concentrations and anti‐D2 receptor activities did not change significantly in the entire group or in the six patients showing improvement. However, anti‐5‐HT2 receptor activities increased significantly in all 19 patients. Changes in BPRS scores did not correlate significantly with changes in plasma HVA or with changes in clozapine concentrations, or with anti‐D2 and anti‐5‐HT2 receptor activities.
Serum carnitine and disabling fatigue in multiple sclerosis
Authors: FUKAZAWA TOSHIYUKI , SASAKI HIDENAO , KIKUCHI SEIJI , HAMADA TAKESHI , TASHIRO KUNIO
Published: March 2008

Abstract The serum concentrations of total, free and acylcarnitine were compared in 25 patients with multiple sclerosis (MS) and among age‐ and sex‐matched normal controls by the new enzymatic cycling method in order to clarify whether the fatigue in MS might be due to possible carnitine‐related fatty acid metabolic abnormalities in the mitochondria of skeletal muscles. Patients with MS were divided into those with and those without excessive fatigue. Levels of total and free carnitine were not significantly different between MS patients and normal controls. Levels of acylcarnitine, whose decrease in chronic fatigue syndrome has been reported, were also similar between MS patients and normal controls. There was no difference in these carnitine levels between MS patients with and without excessive fatigue. We argue that acylcarnitine deficiency and fatty acid metabolic dysfunction in mitochondria are not relevant to the excessive fatigue in patients with MS, and further explanatory investigations are to be sought.
Hallucinations after a therapeutic dose of benzodiazepine hypnotics with co‐administration of erythromycin
Authors: TOKINAGA NOBORU , KONDO TSUYOSHI , KANEKO SUNAO , OTANI KOICHI , MIHARA KAZUO , MORITA SHIGERU
Published: March 2008

Abstract A case of repetitive hallucinations during treatment with a therapeutic dosage of triazolam (0.25 mg/day) and nitrazepam (5 mg/day) is presented. The patient suffered from acute pneumonia and chronic renal failure. Such non‐psychotic symptoms as anxiety, tremor and depressed feeling were observed initially. However, after co‐administration of erythromycin (600 mg/day), visual hallucinations and abnormal bodily sensations developed repeatedly after each administration of triazolam or nitrazepam. This report suggests that benzodiazepine hypnotics even at a therapeutic dosage with co‐administration of erythromycin causes serious psychotic symptoms in vulnerable patients with physical complications.
Olfactory evoked potentials in Parkinson's disease, Alzheimer's disease and anosmic patients
Authors: SAKUMA KENJI , NAKASHIMA KENJI , TAKAHASHI KAZURO
Published: March 2008

Abstract Olfactory evoked potential (OEP) recordings were undertaken using amyl acetate stimulation in 20 patients with Parkinson's disease, nine patients with Alzheimer's disease, seven patients with olfactory dysfunction with no other neurological disorder, and 17 control subjects. In order to eliminate the somatosensory factor from the combined somatosensory and olfactory components produced by amyl acetate stimulation, we subtracted the potentials using odorless air from those using amyl acetate. In normal subjects, three components were observed, the mean latencies of which were 309 ± 46, 484 ± 61 and 710 ± 55 ms. In all subjects with anosmia (n= 7), no responses were observed. In the patients with Alzheimer's disease, the components were fewer despite having no olfactory dysfunction. In the 20 patients with Parkinson's disease, four patients showed no components, seven patients showed one component and eight patients showed two components. The components rarely were detected in spite of whether the patients had olfactory dysfunction or not. Olfactory evoked potentials are useful in detecting olfactory dysfunction and the early stages of Alzheimer's disease and Parkinson's disease.
Adolescents with developmental psychopathology in adulthood
Authors: TSUTSUMI SATOSHI
Published: March 2008

Abstract We conducted a comparative study of the outcomes at 7 years and at 17 years after initial diagnosis of 77 cases of adolescent developmental psychopathology. The results suggest that the prognosis of adolescent developmental psychopathology could be derived at 5–6 years after commencement of medical treatment. The parent‐child relationships during infancy to adolescence, considered to affect the long‐term prognosis of adolescent developmental psychopathology, was studied. It is believed that the emotional bond between parents and children in early to middle childhood are vital which seems to affect their relationships during pre‐adolescence to early adolescence and to the development of adolescent turmoil. It can be considered vital that the development of the infantile provocative state during preadolescence to early adolescence should progress to a more mature ability to negotiate and which forms the core of adolescent turmoil. The function of the latter will bring better results to adolescent developmental psychopathologies.
Trazodone for aggression in an adolescent with hydrocephalus
Authors: MASHIKO HIROBUMI , YOKOYAMA HIDEKATSU , MATSUMOTO HIDEO , NIWA SHIN‐ICHI
Published: March 2008

Abstract A case of 19 year old male with hydrocephalus is reported whose aggressive self‐injurious behaviors were resistant to conventional pharmacotherapy but successfully treated by trazodone. In addition to the self‐injurious behaviors, this patient displayed withdrawal and eating refusal, which initially resulted in his admission to a psychiatric ward. Various conventional treatments with pharmacotherapy (e.g., tricyclic antidepressants, antipsychotics, anxiolytics and anticonvulsants) in combination with psychotherapy and family therapy proved not to be effective for 15 months. Neither was electroconvulsive therapy successful. Administration of trazodone for 5 months after tapering of the above agents improved his aggressive behaviors. A survey of previous cases with organic brain syndromes who had aggressive behaviors and responded well to trazodone revealed that most of the cases were aged individuals and that cases in adolescence are rare.
Clinical studies of pervasive developmental disorders in Japan
Authors: KURITA HIROSHI
Published: March 2008

Articles on pervasive developmental disorders (PDD) published manily by Japanese child psychiatrists in international journals for the last 20 years were reviewed for the purpose of clarifying the accomplishment and aimes of Japanese PDD research. Although Japanese child psychiatrists inventigated 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 Japansee 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.
A multicenter study of sleep‐wake rhythm disorders: Therapeutic effects of vitamin B12, bright light therapy, chronotherapy and hypnotics
Authors: YAMADERA HIROSHI , TAKAHASHI KIYOHISA , OKAWA MASAKO
Published: March 2008

One hundred and six subjects with primary sleep‐wake rhythm disorders [13 non‐24 hour sleep‐wake syndrome (non‐24), 76 delayed sleep phase syndrome (DSPS), 11 irregular sleep‐wake pattern (irregular) and six long sleepers] were treated with vitamin B12, bright light, chronotherapy and/or hypnotics. These therapies caused moderate or remarkable improvement in 32% of the non‐24, 42% of DSPS, 45% of irregular and 67% of long sleepers. A lack of adequate sleep, unpleasant feelings at waking and daytime drowsiness were also improved in DSPS.
A magnetic resonance imaging study in first‐episode disorganized‐type patients with schizophrenia
Authors: OHNUMA TOHRU , KIMURA MICHIHIRO , TAKAHASHI TADASHI , IWAMOTO NORIHIKO , ARAI HEII
Published: March 2008

Abstract Although a number of radiological studies have suggested that brains of patients suffering from schizoprenia have morphological abnormalities, the results are inconsistent. In the present study, in order to examine the brain, morphological features of homogeneous schizophrenics' brain magnetic resonance imagings (MRI) were taken, before neuroleptic treatment, from subjects suffering from disorganized‐type schizophrenia, (DOS) during their first episodes. Results showed that DOS had significantly smaller indices for bilateral frontal gray matter (GM), left hippocampal formation (HF), left parahippocampal gray matter (PHGM) and left cingulate gyrus gray matter (CGM) than normal controls. These findings support the previous computed tomography (CT) and MRI studies on schizophrenic brains, although the subjects were not defined as disorganized‐type, and may suggest the involvement of a neurocircuit between the bilateral frontal lobe and the left side of limbic system in the first‐episode DOS group.
Serum cholesterol levels in patients with panic disorders: A comparison with major depression and schizophrenia
Authors: YAMADA KUMIKO , TSUTSUMI TAKASHI , FUJII ISAO
Published: March 2008

Abstract Results of several long‐term follow‐up studies suggest that mortality due to cardiovascular diseases is high in males with panic disorder (PD). Based on these data, various studies have been undertaken to determine the relationship between PD and total cholesterol (TC) levels; however the results obtained so far have not been consistent. We compared TC levels in 46 PD patients to those in 46 sex, age, smoking and alcohol consumption matched patients with major depression and 46 matched patients with schizophrenia. The relationship between TC and the severity of PD was investigated, and before‐ and after‐treatment TC change was compared. TC levels were significantly higher in the PD group than in the other groups, regardless of sex. The severity of PD was not correlated with TC levels. TC levels did not decrease in remitted PD patients. These findings suggest that relatively high TC levels in PD patients are attributable to endogenous disease‐specific factors. Clinicians should pay close attention to the correlation between high mortality due to cardiovascular diseases and relatively high TC levels in male PD patients.
Serotonin syndrome during clomipramine monotherapy: Comparison of two diagnostic criteria
Authors: KUDO KIYOMI , SASAKI ICHIRO , TSUCHIYAMA KONOSUKE , AKIYOSHI JOTARO , NAGAYAMA HARUO , FUJII ISAO
Published: March 2008

Abstract Incidence of serotonin syndrome was determined by two different diagnostic criteria during clomipramine monotherapy. Incidence, determined by Sternbach's criteria, was 12.1% (8/66 patients), and that determined by the criteria of Dursun et al. was 3.0% (2/66 patients). The two patients who met the latter criteria also met the former criteria. The lower incidence with the latter was attributable to the fact that it does not include certain symptoms, such as tremors and diaphoresis, which are included in the former, and were seen in a relatively large number of patients; as well as the fact that the latter more strictly define certain symptoms. Both criteria have pros and cons. Sternbach's diagnostic criteria make it possible to diagnose serotonin syndrome in a wider range of patients, but they sometimes make it difficult to make differential diagnosis in the presence of certain limited symptoms. In contrast, the criteria of Dursun et al. may make a more accurate diagnosis possible, though only in severe cases.
Risk factors for postpartum depression in Japan
Authors: TAMAKI RYOJI , MURATA MARIKO , OKANO TADAHARU
Published: March 2008

Abstract We conducted a longitudinal study to identify risk factors for postpartum depression. At the late phase of pregnancy, 627 pregnant women agreed to take the State‐Trait Anxiety Inventory Trait (STAIT) test and to remain in the study until 4 months postpartum. At 1, 3 and 4 months postpartum, they took the Edinburgh Postnatal Depression Scale (EPDS) test and the State‐Trait Anxiety Inventory State (STAIS) test. At 3 months postpartum, they were asked about socio‐psychological and obstetric factors. High scores in the EPDS and STAIS tests were correlated with primiparity, premature delivery, difficult labor, experience of life events and worries about baby care. Furthermore, high scores in the STAIT test in late pregnancy were strongly correlated with high scores in the EPDS and STAIS tests in the postpartum period.
A sighted man with non‐24‐hour sleep‐wake syndrome shows damped plasma melatonin rhythm
Authors: NAKAMURA KOUJI , HASHIMOTO SATOKO , HONMA SATO , HONMA KEN‐ICHI , TAGAWA YOSHITSUGU
Published: March 2008

Abstract Twenty‐four‐hour profiles of plasma melatonin, cortisol and rectal temperature were measured longitudinally in a sighted man who has been suffering from sleep disorders for more than 10 years. The sleep‐wake rhythm of this subject free‐ran, despite his routine life, and occasionally showed a sign of internal desyn‐chronization, where sleep was lengthened up to 30 h. These states were classified into the non‐24‐hour sleep‐wake syndrome. Plasma melatonin concentrations in the subjective night remained at a low level and showed a damped circadian rhythm. At the same time, robust circadian rhythms were detected in plasma cortisol and rectal temperature, indicating that the circadian pacemaker was intact. The causal relationship between the damping of nocturnal melatonin rise and a failure of entrainment of the sleep‐wake cycle is discussed.
Negative correlation of reaction times and the auditory P50 in a Go, No‐Go paradigm
Authors: NINOMIYA HIDEAKI , ONITSUKA TOSHIAKI , CHEN CHUNG‐HO
Published: March 2008

Abstract We investigated the relationship between reaction times in a Go, No‐Go paradigm and various components of the auditory event‐related potentials. The P50 latencies in the Go trials were significantly earlier than those in the No‐Go trials. The N200 and P300 were positively associated with the reaction times. However, the P50 latencies showed negative correlation with the reaction times, and the negative correlation at F3 was the largest. Referring to source studies on P50, it is suggested that the activation of either the ascending activating system or the left premotor area through that system might affect the speed of reaction.
Typus melancholicus is not the premorbid personality trait of unipolar (endogenous) depression
Authors: FURUKAWA TOSHIAKI , NAKANISHI MASAO , HAMANAKA TOSHIHIKO
Published: March 2008

Abstract  The present paper aims to examine whether Typus melancholicus is a distinguishing premorbid personality of unipolar (endogenous) depressive patients vis‐à‐vis psychiatric patients with different diagnoses and healthy control subjects. Two observer‐rated scales for Typus melancholicus were administered to a consecutive series of psychiatric patients (n= 140) and a group of control subjects (n= 84). To the authors' own surprise, the only statistically significant finding was the low Typus melancholicus score among unipolar (endogenous) depressives in comparison with normal controls but not with other psychiatric patients. In addition, this finding held only for one of the two rating scales and among women only. According to the other rating scale for Typus melancholicus, there was no difference between unipolar (endogenous) depressives and the normal control or other psychiatric patients. These findings are discussed with particular emphasis on the methodological aspects of studies of premorbid personality of psychiatric disorders, a favored subject in the psychiatric science for decades.
Effect of the tricyclic antidepressant desipramine on protein kinase C in rat brain and rabbit platelets in vitro
Authors: MORISHITA SHIGERU , WATANABE SYOSUKE
Published: March 2008

Abstract  Protein kinase C (PKC), which participates in cellular responses to various stimuli such as hormones, neurotransmitters and growth factors, is essential for cell proliferation and differentiation. Desipramine, which is a tricyclic antidepressant, inhibited PKC activity in concentrations starting from 0.1 mmol/L in rat brain and its inhibitory effect on PKC activity did not involve competitive inhibition with calcium. However, rabbit platelets incubated with desipramine showed a biphasic dose—response change in PKC activity in vitro. The stimulatory effect of desipramine on PKC activity in rabbit platelets was observed over a concentration range of 0.5–2.0 mmol/L, and an inhibitory effect on PKC activity in platelets began to be seen at a concentration of 3.0 mmol/L desipramine. The stimulatory effects of desipramine and calcium on PKC activity in platelets appear to be occurring by the same mechanism. Several lines of evidence indicate that neurotransmitter uptake is linked to PKC activation. The present study supposes that the inhibitory effect of desipramine on neurotransmitter uptake may, at least in part, be associated with its inhibitory or stimulatory effect on PKC.
Effects of genetic defects in the CYP2C19 gene on the N‐demethylation of imipramine, and clinical outcome of imipramine therapy
Authors: MORINOBU SHIGERU , TANAKA TAKESHI , KAWAKATSU SHINOBU , TOTSUKA SHIRO , KOYAMA ERIKO , CHIBA KAN , ISHIZAKI TAKASHI , KUBOTA TAKAHIRO
Published: March 2008

Abstract  The relationship between the genetic polymorphism of S‐mephenytoin 4′‐hydroxylation catalyzed by CYP2C19 and the N‐demethylation of imipramine was examined in 10 Japanese depressed patients. Five patients, who were poor metabolizers of S‐mephenytoin, were determined to be either homozygous for a mutation in exon 5 or heterozygous for mutations in exon 4 and exon 5 of the CYP2C19 gene. In contrast, five patients, who were extensive metabolizers, had no mutations. The demethylation index (the desipramine/imipramine ratio) was significantly lower in patients with genetic defects. Plasma levels of imipramine and 2‐hydroxyimipramine normalized by the daily dose (mg) per weight (kg) were significantly higher in patients with genetic defects. This suggests that the N‐demethylation of imipramine is impaired in patients with genetic defects in the CYP2C19 gene, and that genotype determination may be useful in preventing side effects induced by unexpectedly elevated levels of imipramine.
Neurochemical studies of schizophrenia in Japan
Authors: OTSUKI SABURO , AKIYAMA KAZUFUMI
Published: March 2008

Abstract  Neurobiological research in schizophrenia has been hampered by several confounding factors such as the heterogeneity of the illness and the paucity of biological markers. Recent progress in research methods, how‐ever, has enabled the improvement in our understanding its pathophysiology. This paper reviews recent neurochemical investigations of schizophrenia and its animal models which were conducted in Japan in the last decade. The research areas reviewed are (i) monoamine and their metabolites in body fluids, (ii) phospholipids and prostaglandins, (iii) neurochemistry in autopsy brains, (iv) inmiunological measures, (v) magnetic resonance spectroscopy, (vi) regional cerebral blood flows (rCBF), (vii) molecular genetics, and (viii) animal models. It is worth noting that there exist abnormalities of amino acidergic (glutamatergic and GABAergic) neurotransmission as well as monoaminergic (dopaminergic and serotonergic) one in postmortem schizophrenic brains. These abnormalities and also the findings of altered rCBF indicate the existence of disturbed neuronal circuits that contribute to the diverse symptoms of schizophrenia. Also, dysfunction of membrane phospholipids derived from studies on magnetic resonance spectroscopy may underlie negative symptoms in schizophrenia. Given that schizophrenia is considered to comprise a group of disorders with a diverse heterogeneity of etiologies, research in the next decade is expected to identify putative genes that are involved in vulnerability to schizophrenic phenotype.
Alpha‐delta sleep in a case with non‐24 h sleep‐wake syndrome: Quantitative electroencephalogram analysis of alpha and delta band waves
Authors: HONDA MAKOTO , KOGA EINOSUKE , ISHIKAWA TOHRU , KOBAYASHI TOSHINORI , SAWA AKIRA , TAKAHASHI YASURO , HONDA YUTAKA
Published: March 2008

Abstract  Four all‐night polysomnograms of a 39‐year‐old male patient with non‐24 h sleep‐wake syndrome were recorded. We analysed electroencephalograms (EEG) with the power spectrum method and the wave pattern recognition analysis of Fujimori. The EEC of the rest waking condition showed normal patterns. High‐voltage diffuse alpha band waves were observed in sleep stages 2, 3 and 4. The integrated area of the alpha band waves in the analysis epochs showed a strong positive correlation to the delta hand components in the power spectrum of the same epoch during sleep (correlation coefficients r= 0.762–0.815). Alpha hand waves during sleep were clearly different from the alpha waves in the rest waking condition, with respect to slower peak frequency and the frontal dominant voltage distribution.
Muscle sympathetic nerve activity during central, mixed and obstructive apnea: Are there any differences?
Authors: SHIMIZU TETSUO , TAKAHASHI YUJI , KOGAWA SUSUMU , TAKAHASHI KEN‐ICHI , SAITO YASUSHI , HISHIKAWA YASUO , BROUGHTON ROGER J.
Published: March 2008

Abstract  We recorded muscle sympathetic nerve activity (MSNA) from the peroneal nerve during sleep in three OSAS patients who showed three kinds of apnea. During central apneas and central component of mixed apnea, bursts of MSNA appeared in high probability with almost each heart beat. During obstructive apneas and the obstructive component of mixed apneas, bursts of MSNA appeared in a cluster after the end of each inspiratory effort. Burst rate of MSNA during apnea were higher in central apneas and the central component of mixed apnea than in obstructive apneas and the obstructive component of mixed apneas. These findings indicate that activity in the sympathetic nervous system is enhanced not only in obstructive apnea but also in central and mixed apnea.
Efficacy of lithium carbonate on public and compulsive masturbation: A female case with mild mental disability
Authors: NISHIMURA HIROSHI , SUZUKI MINEKO , KASAHARA HIROO , USHIJIMA SADANOBU
Published: March 2008

Abstract  The efficacy of lithium carbonate in the first reported case of a female with mild mental disability who engaged in public and compulsive masturbation is described. The patient was born in 1975, and was 19 years old at first admission. A diagnosis of schizophrenia was initially suspected, therefore the patient was given medication including pimozide, haloperidol, carbamazepine, diazepam and levomepromazine. These medications, however, did not control the symptoms, and the patient showed several side effects, such as incontinence. Only lithium carbonate was efficacious among the medications administered; the patient's abnormal sexual beavior was significantly reduced and no conspicuous side effects were recognized. The mechanisms of lithium carbonate in controlling abnormal sexual behavior are discussed.
Abnormal behavior of elderly people residing in institutions of medical and social welfare systems
Authors: NAGATOMO ITSUGI , IWAGAWA SYUNJI , TAKIGAWA MORIKUNI
Published: March 2008

Abstract We investigated factors correlated with abnormal behavior in the elderly residing in a special nursing home (group A) and a psychiatric hospital (group B) using the dementia behavior disturbance scale, the mini mental state examination, the Japanese version of the Philadelphia Geriatric Center morale scale, and the ADL assessment scale. The cognitive function of group B was decreased compared with that of group A, but most activities of daily living (ADL) in the latter group were disrupted compared with those in the former. Only a few categories of ADL correlated with abnormal behavior in group A, whereas cognitive function, quality of life, and most categories of ADL correlated with abnormal behavior in group B. These results suggest that factors correlated with abnormal behavior in the elderly differ within institutions of medical and social welfare systems.
Screening for depression among first‐visit psychiatric patients: Comparison of different scoring methods for the Center for Epidemiologic Studies Depression Scale using receiver operating characteristic analyses
Authors: FURUKAWA TOSHIAKI , ANRAKU KAZUTAKA , HIROE TAKAHIRO , TAKAHASHI KIYOSHI , KITAMURA TOSHINORI , HIRAI TOSHIYUKI , TAKAHASHI KIYOHISA , IIDA MAKOTO
Published: March 2008

Abstract The present paper aims to compare the ability of eight scoring methods for the Center for Epidemiologic Studies Depression Scale (CES‐D), one of the most widely used self‐report inventories for depression, to screen for a major depressive episode. The subjects were 591 patients who constituted representative samples of the first‐visit patients to 23 psychiatric hospitals and clinics all over Japan. The criterion diagnoses were given by a semi‐structured interview with established inter‐rater reliability. The eight alternative scoring methods included the conventional Likert method, which gives the weights 0,1,2 and 3 to the four anchor points of the CES‐D; the presence method, which gives the weights 0, 1, 1 and 1, respectively; the GHQ method, which gives the weights 0, 0, 1 and 1, respectively; the persistence method, which gives the weights 0, 0, 0 and 1, respectively; 10‐item version, 5‐item version, single‐item version and the algorithmic method. On the basis of the receiver operating characteristic (ROC) analyses, it was found that the traditional Likert scoring method of the full CES‐D performed best in detecting major depressive episodes among first‐visit psychiatric patients. The presence method, the GHQ method and the 10‐item version appeared to have a similar ability. The persistence method, the 5‐item version and the single‐item version resulted in significantly worse performance.
A history of investigation on the mood stabilizing effect of carbamazepine in Japan
Authors: OKUMA TERUO , KISHIMOTO AKIRA
Published: March 2008

Abstract A history of investigation on the antimanic and prophylactic effects of carbamazepine in Japan is described. Following the initial open trials in the early 1970s in which the antimanic and prophylactic effects of carbamazepine were indicated for the first time in the world, the mood stabilizing effect was confirmed by the double blind studies which were performed with a multi‐institutional cooperation in Japan in the late 1970s. During the course of the double blind trials, the problem of different therapeutic dosages of psychotropic drugs between Japan and Western countries emerged; that is, the doses of chlorpromazine and lithium carbonate, which were used as the control drugs to carbamazepine in the two double‐blind group‐comparison studies in Japan, were both much lower than the dosage used in most of the Western countries. The low dosage of control drugs made the evaluation of the results of the double blind studies performed in Japan difficult, and caused a delay of publication in the Western journals of the results. Whether the difference is due to biological factors or to psychosocial and cultural factors is an important problem in psychopharmacology and should be investigated further.