bluuebunny/crossref_metadata_2025 huggingface dataset:
Epidemiological Survey of Dementia and Depression among the Aged Living in the Community in Japan
Authors: Komahashi Toru , Ohmori Kenichi , Nakano Takashi , Fujinuma Hitoshi , Higashimoto Tsutomu , Nakaya Makoto , Kuroda Jinichi , Asahi Haruhiko , Yoshikawa Jun , Matsumura Shigeru , Shimizu Teruhiko , Suwa Hiroshi , Sato Hayato , Kanamori Ryo , Hara Junko , Kosugi Makoto , Komahashi Masamori , Miyasaka Matsue
Published: March 2008

Abstract: The authors surveyed the prevalence of depression and dementia in the elderly in Ohira town in Japan from 1989 to 1990. The total population of this town was 26,712, with 2,778 people aged 65 and above, constituting 10.4% of the total population. The prevalence of dementia (n=128) was 6.1% and that of major depression (n=9) was 0.4%, according to the DSM‐III‐R criteria. The prevalence of a depressive state which did not fulfill the criteria for major depression (n=55) was 2.4%. The patients with multi‐infarct dementia (n=49) suffered from depression (42.8%) more frequently than those with dementia of the Alzheimer type (11.1%). The rate of depression coexisting with dementia increased with aging, while the rate of depression without dementia did not change in all the age groups.
Body Image Changes in Adolescents I Development of Self‐Rating Body Image (SRBI) Test and Effects of Sex, Age and Body Shape
Authors: Tadai Toshiaki , Kanai Hideko , Nakamura Michihiko , Nakajima Teruo
Published: March 2008

Abstract: We investigated the effects of sex, age and body shape on self‐body image estimated by our Self‐Rating Body Image (SRBI) test in 687 adolescents. Three factors were derived from the 20 items of the SRBI by using a factor analysis. They were interpreted as the images of “body shape,”“face” and “visceral organ.” Scores of these images in the females were significantly higher than those in the males. There was a significantly negative correlation between the body shape and “body shape” image for the female adolescents 13 years of age (middle) and 18 years of age (late), while no correlation was found for the male and female adolescents 10 years of age (early) and late male adolescents. Our results suggest that a female adolescent wants to be thinner and that the body image showed critical changes during the early and middle periods of adolescence, leading to unsatisfactory images of self‐body.
MR Appearance of Subacute Combined Degeneration of the Spinal Cord
Authors: Tajima Yasutaka , Mito Yasunori , Owada Yoshiko , Moriwaka Fumio , Tashiro Kunio
Published: March 2008

Abstract: Subacute combined degeneration (SCD) of the spinal cord is well known to produce degenerative lesions in the spinal cord histopathologically, but a few reports on the neuroradiological findings have so far been reported. We presented the MRI findings of the spinal cord in a case of SCD. The localization of the radiologically proven lesions was similar to that of the previous pathological reports.
Transient and All‐Night Effects of Passing Truck Noise on the Number of Sleep Spindle
Authors: Kawada Tomoyuki , Suzuki Shosuke
Published: March 2008

Abstract: Changes in the number of transient and all‐night sleep spindles by traffic noise of 55 to 65 dB(A) were studied. The sleep parameters were the number of spindles per minute in stages 2, 3, and 4 (S2, S3, S4) and the total number of spindles divided by the total sleep time. A transient decrease in the number of spindles was recognized and after noise exposure, the number of spindles increased to near the pre‐exposure level. Spindles were counted from S2, S3 and S4 for all‐night sleep. The number of spindles in all‐night sleep by noise exposure increased. The authors explain discrepancies in the results by a compensatory brain mechanism of sleep disturbance due to passing truck noise.
A Method for Analyzing Biological Rhythms in Healthy Subjects and Depressed Patients
Authors: Nagayama Haruo , Tsuchiyama Kounosuke , Yamada Kumiko , Hasama Naomi
Published: March 2008

Abstract: Rectal temperature rhythms of healthy subjects and patients with depression were fitted to a waveform having cosine components of periods 8, 12, and 24 hours using the least squares method. The nadir was then used as an index of phase. The results suggest that this method gives more exact data than the conventional method of analyzing biological rhythms, which uses a least squares fit to a single, 24‐hour‐period cosine waveform.
Expression of Ganglioside GD3 in Choroid Plexus
Authors: Kawai Kensuke , Kuroda Shigetoshi , Watarai Shinobu , Takahashi Hitoshi
Published: March 2008

Abstract: Immunocytochemical staining for ganglioside GD3 (II3α(Neu Acα2–8 NeuAc)‐LacCer) in the choroid plexus of the adult rat brain was carried out. A peroxidase reaction product for GD3 was predominantly present along the surface of microvilli of the choroidal cells, suggesting that ganglioside GD3 may be concerned with the formation or secretion of the cerebrospinal fluid.
Ethical Issues in Psychotherapy
Authors: Nishizono Masahisa
Published: March 2008

Abstract: The goal of psychotherapy is not only the dissolution of the symptoms, but also to attempt to bring about an improvement in adaptability and deepening the achievement of self‐understanding. The nature of psychotherapy is based on the relationship between the therapist and patient. Such a goal and nature mean that some kinds of psychotherapy are beyond the medical model. In this paper ethical issues in psychotherapy are discussed as follows. 1) some complicated matters in informed‐consent, 2) the hit or miss techniques of the poorly trained therapist, 3) the protection of privacy, 4) the sexual misconduct of therapists with patients, 5) special consideration for child‐adolescent patients.
Ethical Issues in Sexual Misconduct by Clinicians
Authors: Gutheil Thomas G.
Published: March 2008

Abstract:Sexual misconduct by clinicians in the form of sexual relations with patients has long been recognized as an ethics violation and an activity suitable for assessment by the ethics committees of institutions and local and national professional organizations. The issue can be examined from the vantage point of several types of duties which bear ethical implications; these ethical duties proceed from the following four notions in this area: Sexual misconduct represents a violation of professional ethics as a fiduciary breach, abuse of a power asymmetry, exploitation of vulnerability and use of undue influence. While objections to these criteria may be raised in terms of freedom of association and consent, the violation of ethical principles by sexual misconduct remains clear.
Reform of “Hogosha” System and Psychiatric Practice in Japan
Authors: Shiraishi Hiromi
Published: March 2008

Abstract: In this paper, the author examines the current working and drawbacks of the “hogosha” system as set out in the Mental Health Law of 1988, and goes on to suggest a plan for reform. Crities point to two main problems with the current system. One is that the hogosha's powers infringe on the patient's human rights. The other is that the system places too heavy a burden on hogoshas in its efforts to protect the community from the patient. The author argues that the hogosha should retain the power to consent for admission for medical care and custody, but other responsibilities should be reduced. The author stresses that local mayors must be prepared to take their responsibilities seriously when they assume the role of the hogosha.
Extraction of Potential Difficult‐to‐Manage Psychiatric Cases among Criminal Offenders: 5‐Year Data from the Tokyo District Public Prosecutors Office
Authors: Inada Toshiya , Minagawa Fumiko , Iwashita Satoru , Tokui Tatsuji
Published: March 2008

Abstract: In order to examine the characteristics of potential difficult‐to‐manage psychiatric cases, seven potential subgroups were extracted from the criminal offenders who were sent to the division of psychiatric diagnosis, Tokyo District Public Prosecutors Office for Pre‐Prosecution Psychiatric Justice (PPPJ). The following criteria were used to select the potential subgroups: offenders who had experienced compulsory discharge from a mental hospital, those who had experienced Involuntary Admission to the mental hospital by the Prefectural Governor at least twice, those who had experienced admission to mental hospitals on more than 5 occasions, those who had been put on PPPJ previously for other criminal matters at least 3 times, those who had previously attempted suicide, and those who had committed homicide or arson. From the results of this study, it could be concluded that at least two types of “difficult‐to‐manage” psychiatric cases exist in the criminal offenders.
A Cross‐Cultural Study of Inpatient Alcoholics in Japan and China
Authors: Harada Kenichi , Zu‐chang Wang , Kaneko Yoshihiko , Yi‐Ru Fang , He‐Ding Xu , He‐qin Yan , Okudaira Kenichi , Iizuka Hiroshi , Yabana Tatsuo , Takahashi Hideo
Published: March 2008

Abstract: A total of 103 cases of inpatient alcoholics in Japan and 67 cases in China were compared on the patient history, family history, marital status, course of dependence‐formation, alcohol‐related psychoses, etc. Between Japan, which is suffering from an already increased rate of alcoholics, and China, which is now confronted with an increasing rate of alcoholics, the following findings were observed. The period from the beginning of habitual drinking to the first drinking bout fit was found to be shorter in China, that is to say, alcohol dependence may be formed more rapidly in China. The frequency of types of withdrawal psychoses was similar in both countries. The jealousy delusion seldom appeared in Japan and yet often in China. The condition whereby family bonds are not destroyed in China was discussed as a considerable factor for the manifestation of jealousy delusion.
Image Parentale Lors des Troubles de la Conduite Alimentaire: par l'Instrument de Liaison Parentale
Authors: Suzuki Tomomi
Published: March 2008

Abstract: Fifty‐two single females (ED group) were the subjects who satisfied the diagnostic criteria of DSM‐III‐R eating disorders. Using the Parental Bonding Instrument (PBI), first, the characteristics of upbringing images displayed by the ED group and, next, the differences in upbringing images between the subclassified clinical type groups in the ED group were studied. Lastly, whether the upbringing image can be changed by the therapeutic approach was pursued along with the course of treatment. The ED group's PBI score was low for “care” and high for “protection” regarding both parents. For the subclassified ED groups, the BN group scored lower for PBI's protectiveness than the AN group. As to the change in PBI scores during the course of treatment of the ED group, the score for “care” rose and that for “protection” declined in the middle and end period of therapy, compared with the beginning period.
A Clinical Study on Premorbid Personality and Personality Change in Patients with Age Associated Dementia
Authors: Kasahara Hiroo , Karasawa Akihide , Wakutsu Noriyuki , Yamada Hideo , Tanno Munehiko , Kobayashi Mitsuru , Ushijima Sadanobu
Published: March 2008

Abstract: A survey was made on 502 elderly people living at home in Tokyo, and reliable data were obtained from 486 (96.8%) of them. A total of 198 persons who were judged to have dementia according to our clinical diagnostic criteria were subjected to the present study as the demented group (Group D). Other people who had no dementia or mental disorder were studied as controls (Group C); they were subdivided into two groups, i. e., a group of 83 persons who had a decline in ADL (Group C1) and a group of 181 persons who had no decline in ADL (Group Cn). Their personalities were classified in terms of the personality trend and personality type according to SPI. 1. According to the classification by SPI, 28.2% of people who were syntonic in their younger days were in Group D. The corresponding rate was 11.6% for the nervous type, 45.3% for the immodithymic type, 1.7% for the viscous type, 5.5% for the autistic type, and 7.7% for the hysterical type. Thus, people who were syntonic, immodithymic or nervous in younger days were less likely to develop dementia, while those who were autistic or hysterical were more likely to develop dementia. The viscous type was associated with a low incidence of dementia in the present study. 2. Personality change was found more frequently in Group D (55.6%) than in Groups CI and CII (39.4%). 3. A personality change was either to nonadaptive personality (selfish, obstinate, suspicious or hot‐tempered) or to adaptive personality (mellow or extroverted). In particular, the former four types of nonadaptive personality change were significantly more frequent in Group D. A change toward selfishness, obstinateness, suspi‐ciousness or hot‐tempcredness was closely related to the development of dementia rather than to ADL. There was no consistent relationship between the severity of dementia and nonadaptive personality change. Thus, among the personality in younger days, personality change and age associated dementia, we found a certain relationship between the personality in younger days and dementia. However, a relationship between the personality in younger days and later personality change was found in only a small group of subjects. However, the personality change toward selfishness, obstinateness, suspiciousness or hot‐temperedness was closely related to the development of dementia.
Incidence of “Typical Cases” and “Incomplete Cases” of Neuroleptic Malignant Syndrome and Their Epidemiological Study
Authors: Tsutsumi Yasuhiko , Yamamoto Kenji , Hata Shunji , Sakai Masao , Shirakura Katsuyuki
Published: March 2008

Abstract: In order to find the incidence of “typical cases” and “incomplete cases” of neuroleptic malignant syndrome (NMS), we reviewed 30 cases, which were treated as NMS among 888 inpatients, in light of Adityanjee's and Pope's diagnostic criteria. Further to consider the differences between the cases which could be diagnosed with NMS or not, we studied the epidemiological matters between the cases which met Pope's diagnostic criteria (Group P) and not (Group N). As a result, the proportion of the cases which met Adityanjee's diagnostic criteria was 0.23% (n=2) and Pope's was 2.36% (n=21). An interesting difference between Group P and Group N was the dose of neuroleptics. The dose in terms of an equivalent dose of chlorpromazine was high in Group N at 801 mg against 580 mg in Group P.
Clinical Types and Outcomes of Panic Disorder
Authors: Takeuchi Tatsuo , Hayashi Ryosuke , Nemoto Toyomi , Hasegawa Masahiko , Tomiyama Gakujin , Ikeda Masatoshi , Hanazawa Hisashi
Published: March 2008

Abstract: Two hundred and ten subjects with panic disorder were studied and classified into four clinical types according to symptomatology and clinical courses. The outcomes of 181 of these subjects were categorized in three ways (good, fair, or poor). Through an examination of the relationship between these clinical types and categories of outcome, it was found that the subjects with little or no “neurotization” had a favorable outcome, while those with remarkable “neurotization” or with comorbid depressive states had an unfavorable outcome. It is suggested that concomitant “neurotic” symptoms, such as somatoform symptoms, as well as concomitance of depressive states, predict an unfavorable outcome of panic disorder.
Single Photon Emission Computed Tomography (SPECT) Findings Using N‐Isopropyl‐p‐[123I]iodoamphetamine (123I‐IMP) in Schizophrenia and Atypical Psychosis
Authors: Suga Hidemichi , Hayashi Takuji , Mitsugi Ohara
Published: March 2008

Abstract: As a basis for possible classification of schizophrenic psychoses into schizophrenia and atypical psychosis, we studied the brain functional differences among 16 schizophrenic patients, 16 atypical psychosis patients and 16 healthy volunteers by single photon emission computed tomography (SPECT) using N‐isopropyl‐p‐[123I]iodoamphetamine. As a result, schizophrenics showed hypofrontality. On the other hand, atypical psychotics had no such hypofrontality but showed a reduced uptake rate in the right thalamic region. No influence of sex, duration of illness and medication was confirmed by the findings. The results suggest that schizophrenics might have some lesions in the frontal regions, whereas atypical psychotics might have no such lesions, but dysfunction in the right thalamic region. Consequently, the SPECT findings at least indicate possibly different etiologies for schizophrenia and atypical psychosis.
Two Cases of Priapism Caused by Long‐Term Antipsychotic Administration
Authors: Kagami Masato , Asada Takashi , Miyata Ryouji , Fujii Yasuo , Kariya Tetsuhiko
Published: March 2008

Abstract: We report two cases of priapism that developed in patients with chronic schizophrenia after long‐term use of antipsychotic drugs. Almost all cases of this type of priapism reported previously have developed within a month after the start of administration of the drugs responsible. However, the present patients had taken a variety of antipsychotics for a long period, and they developed priapism more than one year after the introduction of the causative drugs, which were perphenazine, thiothixene and propericiazine. There are few previous reports of priapism related to each of these drugs. The present cases suggest that priapism may develop at any time after introduction of a variety of antipsychotics.
Two Autopsied Cases of Familial Sudanophilic Leukodystrophy
Authors: Kazamatsuri Hajime , Hirose Tetsuya , Kanno Osamu , Kato Nobumasa , Yasuda Hiromoto
Published: March 2008

Abstract: Two autopsied female sibling cases of sudanophilic leukodystrophy are reported. Case A and case B were the second and third of seven siblings, and a sister and a brother died from severe progressive neurological disease with similar symptoms. Consanguineous marriages were noted in the family of both cases through the past three generations. Case A gradually developed intellectual deterioration and tetraplegia at the age of 29, progressed to akinetic mutism within one year and thereafter survived for 14 years. Neuropathologically, a severe atrophy and degeneration were noted in the white matter of the whole cerebrum, sparing the subcortical U‐fibers. Myelin and axons were severely damaged with peripheral astrocytic gliosis. Case B developed similar clinical symptoms at the age of 20 and survived for 7 years in the state of akinetic mutism. Similar postmortem findings as those of case A were found in the white matter of the cerebrum with formation of sudanophilic breakdown products and with thick fibrillary gliosis. The pyramidal tract was completely degenerated. There was no accumulation of abnormal lipid in the brains of both cases.
Quantitative EEG Study on Zen Meditation (Zazen)
Authors: Murata Tetsuhito , Koshino Yoshifumi , Omori Masao , Murata Ichiro , Nishio Masashi , Sakamoto Kazumasa , Horie Tan , Isaki Kiminori
Published: March 2008

Abstract: Quantitative EEG was continuously recorded prior to and during Zen meditation (Zazen) in 20 monks of the Soto sect (Group P: 10 priests; Group D: 10 disciples) and 10 control subjects with no experience in Zen training (Group C). As shown by an EEG topography during meditation, slow alpha appeared in the majority of subjects regardless of their experience in Zen training, while theta appeared only in Groups P and D predominantly in the frontal region, with its frequency increasing in proportion to an increasing length of experience in Zen training. In the quantitative analysis, in the monks with experience in Zen training, it was suggested that theta 2–3 (6.0–8.0 Hz) waves increased while the degree of increase in alpha 2 (9.0–10.0 Hz) wave was attenuated during the temporal course of meditation. The present EEG changes occurring during meditation may reflect intrinsic changes induced by Zazen, namely a mental state in which despite the attainment of relaxation the quality of consciousness is heightened.
Temporal Delta Wave and Ischemic Lesions on MRI
Authors: Inui Koji , Kawamoto Hozumi , Kawakita Masahiko , Wako Kazuhisa , Nakashima Hiromichi , Kamihara Masanori , Nomura Junichi
Published: March 2008

Abstract: The present study was designed to determine the clinical significance of a temporal low‐voltage irregular delta wave (TLID) on EEG. Among 808 EEG records examined during one year at our hospital, the TLID was commonly detected in patients with clinically diagnosed ischemic brain diseases such as multiple infarction. Subsequently, a relation of the TLID to ischemic lesions on MRI was examined in 50 elderly depressive patients. It was found that there was a close correlation between the occurrence of the TLID and small ischemic lesions on MRI (p<0.001). These results suggest that the TLID is a valuable indicator of minor ischemic changes of the brain.
An Improved PCR Assay of Viral DNA in Cerebrospinal Fluid from Patients with Herpes Simplex Virus Type‐1 Encephalitis
Authors: Doi Takashi , Mizobuchi Mutsuhiko , Murao Koji , Takeda Ryohei
Published: March 2008

Abstract: Several investigators have attempted to establish a simple, sensitive and quantitative method for a PCR assay of viral DNA in the cerebrospinal fluid (CSF). However, the rate of a positive DNA test differs between laboratories using the same CSF samples from patients with herpes simplex virus type‐1 (HSV‐1) encephalitis because of differences in sensitivity of the detection. In the present study, we compared the sensitivity and quantity of nested PCR amplification from the pretreated CSF (nested PCR) with those of direct PCR that was performed by direct PCR amplification of the small amounts of CSF to the PCR “cocktail.” We studied the advantages of the two different methods, “the direct and nested PCR,” and established a two‐step method as an improved PCR assay. HSV‐1 DNA from the CSF samples obtained within 4 weeks after onset was detected in all seven cases.
Behavioral and neuroimaging studies on schizophrenia in Japan
Authors: SHIMAZONO YASUO , MATSUSHIMA EISUKE
Published: March 2008

Abstracts Chronic methamphetamine psychotics became a major problem in Japan after World War II. On one hand, the clinical symptoms of chronic methamphetamine psychotics were noted to resemble those of schizophrenics quite closely but, on the other hand, their respective personality profiles appeared to differ. Recent research on exploratory eye movements has also shown such similarities and differences. In long‐term remitted chronic methamphetamine psychotics, extremely small doses of drugs, or stress, can be enough to cause a recurrence of symptoms. This phenomenon resembles the recurrence of schizophrenia, and animal experiments and basic research are being actively conducted in order to elucidate the mechanism involved.

Some 20 years ago, unique studies were conducted that objectively looked at the characteristic behavior of severe chronic schizophrenics in a playground situation. Exploratory eye movements can also be regarded as a kind of behavior and, in this paper, eye movement patterns made in response to a maze test are discussed. In addition, much research on brain imaging in schizophrenia is being conducted in Japan and several interesting studies have also been chosen by the authors for presentation in this paper.
Parental perceptions of borderline personality disorders in video‐recorded interviews
Authors: HAYASHI NAOKI , SUZUKI RIE , YAMAMOTO NORIKO
Published: March 2008

Abstract Parental perceptions of thirteen patients with DSM III‐R borderline personality disorder (BPD) and thirteen without BPD were investigated in video‐recorded interviews. The interview records of multifacet parental experiences were reviewed and rated independently by three psychiatrists, blinded to the diagnostic information, on 4‐point Likert scale (0–3) on three items of each parent: care, overprotection and neglect and/or hostility on the descriptive basis. The major finding was that BPD patients perceived both parents as less caring and more neglecting and/or hostile than patients without BPD. This finding reflects BPD patients' troubled relationship with their parents and the biparental failure hypothesis in the development of BPD.
Suicide and suicide attempts in general hospital psychiatry: Clinical and statistical study
Authors: HATTORI TAKAO , TAKETANI KAZUO , OGASAWARA YUMI
Published: March 2008

Abstract Thirty‐six psychiatric patients with completed suicide, 162 with attempted suicide and 154 patients referred for suicidal behavior, four of whom died, were investigated and classified according to the ICD‐10. Thirty‐six patients with completed suicide among 9085 new psychiatric patients (1969‐92) gave a suicide rate of 82.6/100 000 per year. Schizoaffective and depressive disorder in psychiatric patients with completed suicide and schizophrenia, depressive disorder and adjustment disorders in patients with attempted suicide were significantly more frequent than in 312 controls. Intrafamilial conflicts, divorce or loss of love and death or severe disease of family member were the most common precipitants. Loneliness from living alone in males, losing a spouse and intrafamilial conflicts within a large family of three generations in females were supposed to be risk factors. A high referral rate of 48% in attempted suicide indicated the important role of consultation‐liaison psychiatry in emergency medicine.
Carbamazepine‐induced thrombocytopenia and carbamazepine‐10,11‐epoxide: A case report
Authors: KIMURA MASAHIKO , YOSHINO KUNIO , MAEOKA YUKINORI , SUZUKI NORIKO
Published: March 2008

Abstract The case of a patient who developed thrombocytopenia during treatment with carbamazepine (CBZ) is described. The platelet count recovered soon after discontinuation of CBZ. Lymphocyte stimulation test with carbamazepine‐10,11‐epoxide (CBZ‐10,11‐EPOX), a major metabolite of CBZ, was positive, although with CBZ it was negative. These findings suggest that CBZ‐10,11‐EPOX was possibly causative in the pathogenesis of CBZ‐induced thrombocytopenia in this case.
Effects of the dopamine‐related drug bromocriptine on event‐related potentials and its relation to the law of initial value
Authors: NISHIMURA NAOYUKI , OGURA CHIKARA , OHTA IKUYA
Published: March 2008

Abstract Effects of the dopamine‐related drug bromocriptine (BCT) on event‐related potentials (ERP) were investigated in 18 healthy volunteers. Bromocriptine 2.5 mg or an inactive placebo was administered according to a completely randomized double‐blind, cross‐over design. The ERP were recorded 3 h after medication was given. Although BCT prolonged the P300 latency, it had no effect on the amplitudes of the ERP components as a whole. Bromocriptine increased the latencies of N100, P200 and P300 in the respective short‐latency subject group, and decreased the latency of N200 in the long‐latency subject group. It increased the amplitude of N200 in the low‐amplitude subject group. It was concluded that the prolongation of P300 latency as a whole and the different responses that take place are dependent on the initial values and were recognized in the effect of a single administration of BCT 2.5 mg. The results of this study are discussed in relation to the law of initial value.
Sleep disorders in Chinese culture: Experiences from a study of insomnia in Taiwan
Authors: LEE YUE‐JOE
Published: March 2008

Abstract Traditional Chinese culture‐constituted health beliefs continue to influence the Taiwanese people after more than one hundred years of contact with Western medicine. Medicine for sleep disorders, as well as psychiatric medicine, meets some specific difficulties in the professional development. A study of insomnia in Taiwan showed that patients might seek help from a traditional physician and visit a modern hospital at the same stage of medication. General internists and neurologists help to differentiate organic conditions underlying sleep problems but may generalize insomnia to a psychogenic illness. The culture‐conditioned attribution of insomnia could also exert certain effects upon pharmacotherapeutic response.
Historical perspectives in epileptic psychosis in Japan
Authors: MD TEIICH ONUMA
Published: March 2008

Abstract It was as long ago as 1908 when the first study of epileptic psychosis appeared from Japan. Major literatures since that time with regard to psychoses in patients with epilepsy in Japan are reviewed. The history of epileptic psychoses could be divided into five eras according to the main interests in that period: (i) dawn of the history of epileptic psychoses; (ii) the early era; (iii) the era of periodic psychoses; (iv) the middle era; and (v) the present era. The main topics in each era are described and re‐evaluated herein.
Validity and reliability of the Japanese version of the Stress and Coping Inventory
Authors: FUKUNISHI ISAO , NAKAGAWA TAKAYUKI , NAKAGAWA HIROSHI , SONE YASUHIRO , KAJI NORIE , HOSAKA TAKASHI , RAHE RICHARD H.
Published: March 2008

Abstract We examined the validity and reliability of the Japanese version of the Stress and Coping Inventory (SCI) among 170 Japanese college students and 234 healthy subjects. The validity and reliability of this version of the SCI in the college student group were supported by significant test‐retest correlations, relatively high internal consistency coefficients, and adequate correlations with the Coping Inventory for Stressful Situations (CISS). AS for the healthy subject group, the reliability was supported by relatively high internal consistency coefficients, although further analyses, such as test‐retest, are required. The Japanese version of the SCI appears to be suitable for use among college students.
The effect of coping on the caregiver of elderly patients with dementia
Authors: MATSUDA OSAMU
Published: March 2008

Abstract Ninety‐eight caregivers of elderly patients with cognitive impairment were surveyed by questionnaires in order to examine the relationship between their coping strategies and subjective burden. Confrontative coping and avoidance coping were significantly associated with their burden. The severity of cognitive impairment and the behavioral problems of the patients were also significantly associated with the caregivers' burden. However, a multiple regression analysis suggested that the caregivers' coping strategies may be more important than the patients' condition in terms of the effects on the burden.
Effect of antiepileptic drugs on thyroid function
Authors: KIMURA MASAHIKO , YOSHINO KUNIO , SUZUKI NORIKO , MAEOKA YUKINORI
Published: March 2008

Abstract Chronic treatment with antiepileptic drugs (AED) is known to reduce serum thyroid hormone levels. Serum thyrotropin (TSH) level is unchanged despite low thyroxine (T4) level. We studied serum tri‐iodothyronine (T3), T4 and TSH in 30 epileptic patients prior to discontinuation and 2, 4, 8 and 16 weeks after AED discontinuation. One AED was discontinued in each patient. Serum T3 levels were reduced consistently after AED discontinuation. Serum T4 and rT3 levels were increased, but not persistently. Serum TSH levels were unchanged. Our results suggest that during AED treatment serum T3 level was increased. This could be an increased conversion of T4 to T3. An acceleration of thyroid hormones degradation by enzyme induction is physiologically balanced by an increased conversion of T4 to T3.
Effectiveness of nilvadipine in two cases of chronic schizophrenia
Authors: YAMADA KAZUO , ASHIKARI IYOKO , ONISHI KIMIO , KANBA SHIGENOBU , YAGI GOHEI , ASAI MASAHIRO
Published: March 2008

Abstract Nilvadipine is a calcium channel inhibitor used commonly for the treatment of cerebrovascular insufficiency. We observed two patients with schizophrenia whose psychiatric symptoms and tardive dyskinesia improved after the addition of nilvadipine to their antipsychotic drug regimen. The total score of the brief psychiatric rating scale (BPRS) in case 1 fell from 56 to 42 after 8 weeks on nilvadipine; while that of case 2 fell from 44 to 32. The total score of the abnormal involuntary movement scale (AIMS) in case 2 decreased from 12 to 7. No adverse effects occurred during treatment. Nilvadipine may thus offer a new approach to the adjunctive treatment of schizophrenia.
Morita therapy: 1919 to 1995
Authors: KITANISHI KENJI , MORI ATSUYOSHI
Published: March 2008

Abstract Morita therapy was founded in 1919 by Shoma Morita (1874–1938) and is a systematic psychotherapy based on Eastern psychology. Since its founding 75 years ago, the treatment theory, treatment environment, treatment population and its cultural environment have been examined and modified in some areas. In this review, we first examine Morita theory and discuss the changes that have ocurred in subsequent theories and methodologies. Our discussion presents the founding of Morita therapy and the characteristics of Morita theory; the practice of Morita therapy; Morita therapy from the perspectives of transcultural psychiatry and comparative psychotherapy; subsequent developments and modifications of Morita therapy; and the biological studies of Morita therapy. We attempt to clarify the universality and uniqueness of Morita therapy and provide a new framework for understanding Morita therapy.
Somatoform pain disorder in a case of Klinefelter's syndrome with multiply operated lower back
Authors: AKIMOTO MICHIKO , FUKUNISHI ISAO , SAKATA MAYO , SATO MAKOTO , SAITO YUICHI , AOTA YOICHI , YAMADA TOSHIYUKI , SASAKI KEIICHI
Published: March 2008

Abstract We report a case of Klinefelter's syndrome with multiply operated low back (MOB). Psychological and/or psychosocial problems related to MOB have been of recent interest in the field of orthopedic surgery. Based on psychiatric interviews, this case was diagnosed as a somatoform pain disorder of the DSM‐III‐R somatoform disorders. In addition to psychological problems, the pain was partly explicable by severe osteoporosis, which was prematurely caused by endocrinological disturbances associated with Klinefelter's syndrome. Patients with this syndrome are more likely to develop severe osteoporosis. In the presenile period of Klinefelter's syndrome with severe osteoporosis, liaison psychiatrists may pay attention to somatoform disorders (e.g. somatoform pain disorder and conversion disorder) linked with the MO.
Effects of hCRH on sleep and body temperature rhythms
Authors: TSUCHIYAMA YUICHIRO , UCHIMURA NAOHISA , SAKAMOTO TETSURO , MAEDA HISAO , KOTORII TATAYU
Published: March 2008

Abstract We investigated the effects of human corticotropin‐releasing hormone (hCRH) on the sleep structure and body temperature rhythms of seven healthy young men. Polysomnographic recordings were obtained and body temperatures were monitored continuously for 48 h in each subject following the intravenous administration of saline or of 100 μg hCRH. The administration of hCRH was associated with a significant phase‐advancement in body temperature rhythm vs the saline control. The administration of hCRH affected non‐rapid eye movement (NREM) sleep by reducing significantly slow wave sleep (SWS) and sleep efficiency, whereas the percentage of sleep stages 1 and 2 were increased significantly. These changes in body temperature rhythms and sleep structure induced by hCRH resembled those observed in patients with endogenous depression, except for the findings during rapid eye movement (REM) sleep. We hypothesize that a hypersecretion of hCRH in patients with endogenous depression may help to explain the changes in body temperature rhythms and sleep structure often reported in such patients.
Dying in dignity: The pros and cons of assisted suicide
Authors: DIEKSTRA RENÉ F. W.
Published: March 2008

Abstract This paper describes the historical background and the current situation regarding the practice of assisted suicide in The Netherlands. It outlines and discusses what is considered to be the ‘golden standard’ of conduct for doctors and other health professionals in this area, it describes experiences with the application of this standard and discusses some of the major pitfalls involved. It also describes the results of several empirical studies on the attitudes of the general public, and the nature and magnitude of the practice of assisted suicide in the country.

It is concluded that although perfect application of the ‘Dutch Protocol’ encourages and supports careful and responsible professional conduct regarding assisted suicide and provides satisfactory safeguards both for the patients involved, (potential) survivors and society as a whole, there are many cases where the desired perfection is far from feasible, hence assistance with suicide remains very hazardous. It is also concluded, however, that health care policy makers, as well as professionals, should confront the issue of assisted suicide, since, as the historical development in The Netherlands has shown, repression and denial implicates the worst of all possible scenarios, and does not contribute at all to the primordial goals of a humane health care system: the alleviation of suffering and the prevention of premature death.
Post‐traumatic epilepsy: Mechanisms and prevention
Authors: WILLMORE L. JAMES
Published: March 2008

Abstract An effective method to disrupt the process of post‐traumatic epilepsy must await scientific understanding of epileptogenesis. If hemorrhage‐induced focal lipid peroxidation is operant, then a strategy designed to disrupt initiation reactions may prove successful.
Shortening of the hippocampal formation in first‐episode schizophrenic patients
Authors: FUKUZAKO HIROSHI , KODAMA SATOSHI , FUKUZAKO TSUYOSHI , YAMADA KOICHIRO , HOKAZONO YOSHIRO , UEYAMA KENICHI , HASHIGUCHI TOMO , TAKENOUCHI KAORU , TAKIGAWA MORIKUNI , TAKEUCHI KOUZOU , MANCHANDA SURENDRA
Published: March 2008

Abstract Shortening of hippocampal formation (HF) in chronic schizophrenic patients have been demonstrated in our previous study. The purpose of the present study is to test if shortening of the HF occurs in schizophrenic patients suffering their initial psychotic episode. We performed contiguous, 1 mm thick, magnetic resonance imaging scans in 20 first‐episode schizophrenic patients, 21 chronic schizophrenic patients, and 25 healthy subjects. Both groups of schizophrenic patients demonstrated significant shortening of the HF compared with normal controls (first‐episode schizophrenia, 5.3%; chronic schizophrenia, 8.0%). However, the HF length was not significantly different between the first‐episode and chronic schizophrenic patients. No significant correlation was seen between the HF length and the duration of illness in chronic schizophrenic patients. These results suggest that the HF shortening observed in schizophrenic patients may be genetic and/or developmental in origin.
Prognosis of epilepsy withdrawn from antiepileptic drugs
Authors: NAKAZAWA YOICHI , ISHIDA SHIGENOBU , MAEDA HISAO , SAKURAI SEISHI , MOTOOKA HIROMICHI
Published: March 2008

Abstract Antiepileptic drugs (AED) were discontinued in 55 epileptics who had been free from seizures treated with AED, in accordance with the following criteria and procedures. (i) A reduction in AED commences when patients have been free from seizures for at least 2 years and epileptic discharges have also disappeared in repeated electroencephalogram (EEG) recordings during that period. (ii) AED are gradually reduced if no relapse is seen in clinical seizures and epileptic discharges in EEG. (iii) As a rule at least 2 years are required as the interval from the onset of a reduction to the withdrawal of AED. Forty‐three patients were followed up by a questionnaire and/or by telephone and the follow‐up period from the withdrawal of AED to the survey ranged from 0.9 to 8.8 years; in 38 patients (88.4%) the period was longer than 2 years. No relapse of seizures was found in any of the 43 patients. The severity of epilepsy judged by the total number and frequency of seizures, the presence of neuropsychiatric complications, the combination of different types of seizures, and the duration of epilepsy from the seizure onset to the last seizure appeared not to be risk factors for the recurrence of seizure. Normal EEG was, however, considered to be an important prerequisite for a good prognosis.
Epidemiology of inflammatory neurological and inflammatory neuromuscular diseases in Tottori Prefecture, Japan
Authors: KUSUMI MASAYOSHI , NAKASHIMA KENJI , NAKAYAMA HIDEAKI , TAKAHASHI KAZURO
Published: March 2008

Abstract We investigated the incidence of the following conditions: inflammatory neurological and neuromuscular diseases, adult meningitis and adult encephalitis in Yonago City, and Guillain‐Barré syndrome (GBS), chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), polymyositis/dermatomyositis (PM/DM), periarteritis nodosa (PN) and HTLV‐1 associated myelopathy (HAM) during the period 1988–1992 in Tottori Prefecture, Japan. The annual incidence per 100 000 population was as follows: meningitis, 4.38; encephalitis, 0.90; GBS, 1.14; PM/DM, 1.01; and PN, 0.32. The prevalence per 100 000 population CIDP, 0.81; PM/DM, 9.92; PN, 2.59; and HAM, 1.30. There was marked localization of HAM in western Tottori, and there was seasonal variation in the prevalence of meningitis, encephalitis and GBS. The mean age at onset of meningitis was lower than that for encephalitis. Comparison with reported data revealed interracial differences in the epidemiology of PM/DM and PN.
Longitudinal change in youth suicide mortality in Okinawa after World War II: A comparative study with mainland Japan
Authors: KAGEYAMA TAKAYUKI , NAKA KOICHI
Published: March 2008

Abstract Okinawa prefecture has a unique socio‐cultural status in Japan including the experience of having been occupied by the USA from the end of World War II to 1972. In this study, the longitudinal change in youth suicide mortality for those aged 10–29 years in Okinawa (1960–90) was compared with that for the same sex‐age groups in mainland Japan (1950–90). In contrast with mainland Japan, no dramatic change in the youth suicide mortality was observed in Okinawa in the 1960s. The rise and fall of teenage suicide mortality in Okinawa during the 1970–80s might be associated with ‘reversion anxiety’, rather than with the traumatic experience of World War II itself. This seems to be inconsistent with previous speculation regarding the change in youth suicide mortality in mainland Japan. The suicide mortality for men aged 20–29 in Okinawa was significantly higher than that for the same sex‐age group in mainland Japan through the observed period. The possible effects of the USA occupation, economic anomie or migration on the suicide in Okinawa should be further examined.
The wish to be held: Female patients with borderline personality disorder
Authors: HAYASHI NAOKI
Published: March 2008

Abstract Two female patients expressed in psychotherapy their wish to be held. This reflects their pathology, intense loneliness and defective sense of self and reality. The ‘holding’ function of the psychotherapist can place the wish to be held into the mutual interaction even if it seems unacceptable, similar to the holding in mother‐child communication. The deliberate efforts by the psychotherapist to ‘hold’ lead to an improvement of the pathology, and contribute to form an endurable therapeutic relationship. Unavoidable body contact with patients who are in regressive states is discussed, and the need to re‐establish the communicative value of contact experiences is emphasized.
Evaluation of the first Medical Psychiatry Unit in Japan
Authors: NOMURA SOICHIRO , SHIGEMURA JUN , NAKAMURA MAKOTO , HOSAKA TAKASHI , BERGER DOUGLAS , TAKAHASHI YOSHITOMO
Published: March 2008

Abstract The first Medical Psychiatry Unit (MPU) in Japan was established in 1990. The clinical experience during the first 4 years of this unit is presented, and the characteristics of the Unit between its first 2 years and its latter 2 years are compared. The number of patients, the average length of stay, the primary psychiatric disorders, the combined physical diseases and their outcomes are presented. The data suggest that while the experience of the MPU is limited, it plays an important role in Japan as (i) an appropriate clinical setting for patients with combined medical and psychiatric illnesses, (ii) a strategic model for dealing with psychiatric patients in the general hospital, (iii) an educational setting for psychiatric residents to become more familiar with medicine and surgery, and (iv) an opportunity for non‐psychiatric residents to become familiar with psychiatric illnesses and treatments.
A case of possessive state with onset influenced by ‘door‐to‐door’ sales
Authors: SATOH SHINJI , OBATA SHUGO , SENO EIICHI , OKADA TAKAYUKI , MORITA NOBUAKI , SAITO TAMAKI , YOSHIKAWA MAIKO , YAMAGAMI AKIRA
Published: March 2008

Abstract Recently in Japan, ‘door‐to‐door sales’ has become of concern because it has created numerous legal and social problems. In this paper, a 47 year old dissociative trance disorder case who presented with possession by God is discussed. Specific types of door‐to‐door sales is known to use superstition and folk beliefs as tools to lure customers. In this particular case, these religious factors seemed to have played an important role in the precipitation of the disorder and its presentation. In addition, the brain‐washing environment observed in video lectures used in door‐to‐door sales seemed to play an important role in the development of the possessive state. We also performed social psychiatric analysis of the occurrence of the possessive state in a city area, which has been considered to develop within traditional culture. Phenomenological classification by one of the authors was useful for diagnosing underlying disorders in the possessive state.
Higher cerebral dysfunction in a case with atypical multiple sclerosis with concentric lesions
Authors: MORIOKA CHIKAKO , NAMETA KEN , KOMATSU YOICHI , TSUTIO TAKEHIKO , KONDO HIDEKI
Published: March 2008

Abstract A patient with atypical multiple sclerosis (MS) with clear concentric structure was studied using high field magnetic resonance imaging (MRI). This case was considered to be Balo's concentric sclerosis. Magnetic resonance imaging showed diffuse multiple concentric demyelinating lesions in the bilateral centrum semiovales, which finally regressed with the necrotic lesions remaining when the patient was discharged. During his clinical course, he showed some higher cerebral dysfunctions, such as memory disturbance, constructual apraxia and acalculia. He was treated with glycerin, prednisone and rehabilitation; all of which were effective in his recovery. Over a 4 month period, the patient recoveredclinically, but some intellectual impairment remained.
A neuropathologic study of long‐term, Economo‐type postencephalitic parkinsonism with a prolonged clinical course
Authors: MIZUKAMI KATSUYOSHI , SASAKI MEGUMI , SHIRAISHI HIROYASU , IKEDA KENJI , KOSAKA KENJI
Published: March 2008

Abstract In this report, the neuropathologic features of five autopsied cases of postencephalitic parkinsonism of the Economo‐type (PEPE) with a mean age of 66.6 years and a mean duration of the illness of 53.6 years are described. All five patients had presented with personality changes and severe parkinsonism. In addition, four patients had also had ocular symptoms. A pronounced chronic progression of the symptoms characterized all five cases. Active degenerating lesions were found in the substantia nigra (patients 3, 4 and 5) and the oculomotor nucleus (patient 5) which might explain the clinical observation of chronic active disease in these patients. We found that the intraneuronal neurofibrillary tangles (NFT) were immunoreactive to paired helical filaments (PHF), tau and ubiquitin; but ghost tangles demonstrated immunoreactivity only to glial fibrillary acid protein (GFAP). The ghost tangles consisted of dispersed bundles of abnormal tubules, and electron‐dense glial filaments would surround and occasionally invade the ghost tangles. The present study suggests that NFT in PEPE are similar in their immunohistochemistry and ultrastructure to those observed in the case of Alzheimer‐type dementia.