Search

Aims: Hikikomori is a common phenomenon reported in Japan and many other countries. However, the broad trends of the research publications on hikikomori are unclear. Therefore, this study examined the patterns of research on hikikomori using bibliometric analysis. Methods: Relevant publications were searched in Web of Science. Bibliometric analyses were performed with CiteSpace, R and VOSviewer. Results: In total, 297 publications on hikikomori met the eligibility criteria. The International Journal of Social Psychiatry (IF = 10.461) published the most papers (K = 17, or 5.7%) on hikikomori. Takahiro A. Kato from Kyushu University (41; 13.8%; H‐index = 18) was the most influential author, while Takahiro A. Kato (total link strength [TLS]: 235), Alan R. Teo (TLS: 157), and Masaru Tateno (TLS: 153) separately had the strongest research collaboration with other researchers. Of all countries that published on hikikomori, Japan had the highest number of publications (K = 91). The keywords "United States" and "psychiatric diagnosis" received the most attention between 2013 and 2015, whereas "health" and "autism spectrum disorder" received the most attention in 2021 and 2022. Conclusions: Peer‐reviewed research publications on hikikomori are growing rapidly and the research trends in this field are also changing. [ABSTRACT FROM AUTHOR]

A healthy diet and regular physical activity (PA) are delineated as healthy behaviours. Their implementation is associated with better health outcomes and improved quality of life. There is less evidence of a relationship between dietary patterns (DP) and PA, especially in adults aged ≥ 85. Hence, this cross-sectional study investigates the association between DP and PA in people of this age group, using the data from The Kawasaki Aging and Well-Being Project. Brief-type self-administered diet history questionnaire was used to estimate the intake of fifty-eight types of food. After energy adjustment, principal component analysis was performed to identify DP. PA was measured objectively using an accelerometer and subjectively using a questionnaire validated for this age group. Thousand participants (median age: 86·9 years, men: 49·9 %) were included in the analysis. Three major DP (DP1 'various foods', DP2 'red meats and coffee', DP3 'bread and processed meats') were identified. DP1 'various foods' was similar to DP previously named 'healthy' or 'prudent' and showed a positive association with PA time (PAT) as measured by accelerometer (B, 6·25; 95 % CI 0·13, 12·37) and relatively shorter sedentary behaviour (SB) time. DP2 'red meats and coffee' and DP3 'bread and processed meats' were negatively associated with PAT and positively associated with SB time. This study observed the relationship between diet and PA behaviours in adults aged ≥ 85, with healthier and more food-diverse DP associated with longer PAT and relatively unhealthy DP with shorter PAT. [ABSTRACT FROM AUTHOR]

The utilization of natural gas hydrates as an alternative energy source has garnered significant attention due to their proven potential. Despite the successful offshore natural gas hydrate production tests, commercial exploitation has not been achieved. This study aims to enhance the understanding of gas production behavior through simulations from a single vertical well in the Nankai Trough and assess the effectiveness of the step-wise depressurization method for gas production using TOUGH + HYDRATE. The simulation results showed that the effective permeability for the water phase decreased as the hydrates were decomposed, and the invasion of the pore water from the underburden eliminated this effect. Compared with the direct depressurization method, the step-wise depressurization method significantly increased the cumulative gas production by more than 10% and mitigated the rapid generation of gas and water production during the moment of depressurization. The results also indicated that the depressurization gradient was more sensitive to the cumulative gas production than the maintenance time of depressurization. In view of the gas and water production characteristics coupled with the challenges in carrying out the step-wise depressurization method, it is suggested that a depressurization gradient of 1 MPa and a maintenance time of 1 day should be employed. [ABSTRACT FROM AUTHOR]

Objective: Optimizing treatment and outcomes for people with schizophrenia requires understanding of how evidence-based treatments are utilized. Clozapine is the most effective antipsychotic drug for treatment-refractory schizophrenia, but few studies have investigated trends and patterns of its use over time internationally. This study examined the prescription patterns of clozapine and its demographic and clinical correlates in Asia from 2001 to 2009. Method: Clozapine prescriptions were collected in a sample of 6761 hospitalized schizophrenia patients in nine Asian countries and regions using a standardized protocol and data collection procedure. Results: Overall, the proportion of patients receiving clozapine prescriptions was stable across the three surveys from 2001 to 2009, ranging from 14.5% to 15.9%. However, the rates and patterns observed within different regions and countries at each survey differed considerably. Clozapine use decreased significantly over time in China, while it increased in Korea and Singapore. Multiple logistic regression analysis revealed that patients taking clozapine were significantly younger, had a higher dose of antipsychotic drugs in chlorpromazine equivalents, were more likely to be female, had fewer extrapyramidal symptoms, and had more negative symptoms, admissions and weight gain in the past month than those not receiving clozapine. Conclusion: The variability in overall rates and changes in prescription rates over time in these samples suggest that factors other than psychopharmacological principles play an important role in determining the use of clozapine in schizophrenia in Asia. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to investigate the sex differences in prescribing patterns of psychotropic drugs and drug-induced side effects in schizophrenia patients in Asia using the data of the Research on Asian Psychotropic Prescription Pattern (REAP) surveys. Method: The prescription patterns of 6,441 schizophrenia inpatients in six Asian countries and regions were investigated during the 2001--2009 period. The patients' socio-demographic and clinical characteristics and their prescriptions for psychotropic drugs were recorded using a standardized protocol and data collection procedure. Results: Univariate analyses found the following factors to be significantly associated with the male sex: a younger age, higher doses of antipsychotics, less prominent delusions and hallucinations, more prominent negative symptoms, less likelihood of a prescription for second-generation antipsychotics (SGAs), greater use of antipsychotic polypharmacy, mood stabilizers and depot antipsychotics, more frequent tardive dyskinesia (TD), and less weight gain. In multivariate analyses, fewer prescriptions for SGAs, greater use of mood stabilizers, anticholinergics, antipsychotic polypharmacy and depot antipsychotics, extrapyramidal side effects (EPS) and TD, and less weight gain were independently associated with the male sex. Conclusions: Sex is one of the independent contributors to psychotropic prescription and side effects in Asian schizophrenia patients. Psychopharmacological treatment guidelines for schizophrenia should consider the sexes separately. [ABSTRACT FROM AUTHOR]

• Details about 2017 methane hydrate production test in Nankai Trough were reported. • Short-term simulations of gas production were conducted to replicate real test data. • Long-term gas and water production behaviors were predicted for a period of 5 y. • Effect of production intervals on hydrate dissociation/gas production was examined. • Gas-water separation devices and water production management are necessary. Since the first offshore methane hydrate production test was conducted in the Nankai Trough of Japan in 2013, the second production test was also conducted at the same test site in 2017, but information about this field test is limited. Thus, in this study, we aimed to report detailed information about the 2017 production test for the first time, and conducted short-term simulations of the oceanic methane hydrate production from the multilayered reservoir models for model validation. Then, we predicted the long-term gas production behavior for a production period of 5 y, and investigated the effect of the production intervals on the processes of hydrate dissociation and gas production. The simulation results indicated that most of the released gas from hydrate dissociation was actually produced indirectly in the aqueous phase rather than directly in the gas phase, and the proper utilization of the packers on the wellbore could effectively promote gas production, but also caused excess water production. Therefore, high-performance gas-water separation devices and water production management are necessary for future production tests. Furthermore, the 5-y average gas production rates for each case designed in this study were estimated as 1.01 × 104–1.21 × 104 ST m3/d, which were far less than the commercial exploration level of 3.0 × 105 ST m3/d, so improvements in the production strategies should be considered for future production tests. [ABSTRACT FROM AUTHOR]

Serving size may be the appropriate reference for calculating food nutritional value. We aimed to assess the nutritional values of Japanese foods based on serving sizes rather than per 100 g by adapting the Meiji Nutritional Profiling System (Meiji NPS). Given the variability in serving sizes across countries, we used Japanese serving sizes to calculate the Meiji NPS scores. We confirmed the convergent validity of the Meiji NPS scores per serving size with the Nutrient-Rich Food Index 9.3 using Spearman's correlation coefficients (r = 0.51, p < 0.001). Food groups recommended by official guidelines, such as pulses, nuts and seeds, fish and seafood, fruits, vegetables, and milk and milk products, scored relatively high. Furthermore, the nutrient density scores of food items with small serving sizes, such as mushrooms, algae, seasonings, and fats and oils, were moderated when calculated by per serving size, despite having considerably higher or lower scores per 100 g. These results indicate that calculating NPS per serving size allows for the assessment of the nutritional value of food items in accordance with actual consumption quantities. Therefore, the Meiji NPS calculated per serving size, alongside the per 100 g version, may be useful for dietary management depending on specific purposes.

This study introduces the Meiji Nutritional Profiling System (Meiji NPS), which was specifically designed to respond to age-related shifts in nutrient requirements among Japanese adults (<65 years old) and older adults (≥65 years old). Japan has one of the most aged societies in the world. The health issues of interest are malnutrition and lifestyle-related diseases among adults and frailty among older adults. Two versions of the NPS were developed based on nutrients to encourage (protein, dietary fibers, calcium, iron, and vitamin D), food groups to encourage (fruits, vegetables, nuts, legumes, and dairy), and nutrients to limit (energy, saturated fatty acids, sugars, and salt equivalents). The Meiji NPS for older adults did not include iron or saturated fatty acids. The algorithms were based on the Nutrient-Rich Foods Index (NRF). The convergent validity between the Meiji NPS and the existing NPSs for the same foods was confirmed using Spearman's correlation coefficients (NRF: r = 0.67 for adults and r = 0.60 for older adults; Health Star Rating: r = 0.64 for adults and r = 0.61 for older adults). The Meiji NPS may be useful for nutritional evaluation and reformulation of food products, tailored to adults and older adults to ameliorate health issues in Japan.

Introduction: Drug-induced extrapyramidal syndrome (EPS) remains a major problem in clinical psychiatry. This study aimed to examine the factor structure of drug-induced extrapyramidal symptoms observed in patients with schizophrenia and assessed using the Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS)., Methods: The participants were 1478 patients with a diagnosis of schizophrenia whose EPS was assessed using the DIEPSS in India, Indonesia, Japan, Malaysia, and Taiwan in the 2016 REAP AP-4 study. The records of the participants were randomly divided into two subgroups: the first for exploratory factor analysis of the eight DIEPSS items, and the second for confirmatory factor analysis., Results: The factor analysis identified three factors: F1 (gait and bradykinesia), F2 (muscle rigidity and tremor), and F3 (sialorrhea, akathisia, dystonia, and dyskinesia)., Conclusion: The results suggest that the eight individual items of the DIEPSS could be composed of three different mechanisms: acute parkinsonism observed during action (F1), acute parkinsonism observed at rest (F2), and central dopaminergic mechanisms with pathophysiology other than acute parkinsonism (F3)., (© 2022 John Wiley & Sons Ltd.)

High-quality diets and regular physical activity (PA) are considered healthy behaviors (HBs). HBs are associated with many health outcomes and are expected to improve quality of life. Although implementing HBs is important, the relationship between dietary patterns (DPs) and PA has not been well investigated, especially among those aged ≥ 85. This study used data from the Tokyo Oldest Old survey on Total Health study to examine the relationship between DPs and PA in a cross-sectional study. The dietary survey used the brief self-administered diet history questionnaire to estimate the intake of 58 foods. After energy adjustment, principal component analysis was performed to identify major DPs. A validated questionnaire was used to evaluate PA, and linear regression analysis was used to investigate the association between DPs and PA, considering confounders. A total of 519 participants were included. Three major DPs ('Various plant foods', 'Fish and mushrooms', 'Cooked rice and miso soup') were identified. 'Various plant foods' was similar to DPs previously named 'Healthy' or 'Prudent', and its trend was positively associated with higher PA. This study observed the implementation of HBs even among those aged ≥ 85, suggesting that a trend toward a healthier diet is associated with higher PA.

To investigate the potential long-term impact of the Fukushima Dai-ichi Nuclear Power Plant Accident (FDNPPA) on the South China Sea (SCS) and the East China Sea (ECS), radiocesium isotopes 134 Cs and 137 Cs in seawater from 2011 to 2015 were measured. The highest activities of 134 Cs and 137 Cs in seawater were 0.73 Bq/m 3 and 3.34 Bq/m 3 , respectively. The results demonstrated that FDNPPA-derived radiocesium intruded into the Northeast SCS and the ECS in 2013 and reached a maximum in 2014. The intrusion occurred within the upper 100 m and contributed ≤72.5% of the total 137 Cs in the seawater of the SCS and ECS. The formation, subduction, and transport of subtropical mode water (STMW)/central mode water (CMW) trapped FDNPPA-derived radiocesium in the ocean interior and transported it southwestward from the high-latitude open ocean to the low-latitude western boundary area. Then, the FDNPPA-derived radiocesium entered the Northeast SCS and the ECS by the intrusion of the subsurface high-salinity water of the Kuroshio Current into the Northeast SCS and the ECS., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

To understand the transport of Fukushima Dai-ichi Nuclear Power Plant Accident (FDNPPA)-derived nuclear contaminated water, which will be discharged into the Pacific Ocean in the future, the distributions of 134 Cs and 137 Cs in seawater in the public areas east of Japan in winter 2011 were reported in this study. The ranges of 134 Cs and 137 Cs activities were 3 and 1.3-85.9 Bq/m 3 , respectively. The average decay corrected FDNPPA-derived 134 Cs/ 137 Cs activity ratio was 0.97. The FDNPPA-derived radiocesium existed in the seawater at a relatively high level at most stations. The 134 Cs and 137 Cs activities were comparable throughout the upper 50 m at each station. The FDNPPA-derived radiocesium was mainly distributed north of 36.5°N due to the boundary formed by the Kuroshio Extension. The temporal variations of FDNPPA-derived 134 Cs and 137 Cs suggested that their environmental half-lives in the study area were 61 d and 63 d in the period of June 2011 to June 2012, respectively., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

The Fukushima Dai-ichi Nuclear Power Plant Accident (FDNPPA) derived 134 Cs, 137 Cs and 110m Ag in blue sharks captured in the Northwest Pacific during 2011-2018 were assessed for the first time in the aspects of radioactive contamination, temporal variation, maternal-to-fetus transfer, tissue distribution and radiation dose, to demonstrate the impacts of the FDNPPA on blue sharks. The contribution of the FDNPPA derived radiocesium in blue sharks (>52%) was estimated based on 134 Cs/ 137 Cs activity ratios . The effective and ecological half-lives of the FDNPPA derived 134 Cs (270 d, 410 d), and 137 Cs (430 d, 450 d) were calculated. These contaminations decreased with time and returned to the level before the FDNPPA during the period of Sep. 2017-Sep. 2018. 134 Cs and 137 Cs tended to distribute in muscles, while 110m Ag mainly distribute in their guts. 134 Cs and 137 Cs were also transferred to fetuses and the activities were up to ~30% of the maternal activities. Dose assessment demonstrated that the highest FDNPPA derived dose rate in blue sharks (~0.42 nGy/h) was far below the ERICA ecosystem screening benchmark of 10 μGy/h and the committed effective dose in humans from ingesting blue shark meat (0.06-0.90 μSv) was far less than that from annual consumption of food and water. It was far from causing radiation harm to blue sharks and humans, suggesting that the impacts of the FDNPPA on blue sharks were not significant., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Satellite observations show that the rapid urbanization and emergence of megacities with 10 million or more residents have raised PM2.5 concentrations across the globe during the past few decades. This study examines PM2.5 dynamics for the 33 cities included on the UN list of megacities published in 2018. These megacities were classified into densely (>1500 residents per km 2 ), moderately (300-1500 residents per km 2 ) and sparsely (<300 residents per km 2 ) populated areas to examine the effect of human population density on PM2.5 concentrations in these areas during the period 1998-2016. We found that: (1) the higher population density areas experienced higher PM2.5 concentrations; and (2) the megacities with high PM2.5 concentrations in these areas had higher concentrations than those in the moderately and sparsely populated areas of other megacities as well. The numbers of residents experiencing poor air quality is substantial: approximately 452 and 163 million experienced average annual PM2.5 levels exceeding 10 and 35 μg/m 3 , respectively in 2016. We also examined PM2.5 trends during the past 18 years and predict that high PM2.5 levels will likely continue in many of these megacities in the future without substantial changes in their economies and/or pollution abatement practices. There will be more megacities in the highest PM2.5 pollution class and the number of megacities in the lowest PM2.5 pollution class will likely not change. Finally, we analyzed how the PM2.5 pollution burden varies geographically and ranked the 33 megacities in terms of PM2.5 pollution in 2016. The most polluted regions are China, India, and South Asia and the least polluted regions are Europe and Japan. None of the 33 megacities currently fall in the WHO's PM2.5 attainment class (<10 μg/m 3 ) while 9 megacities fall into the PM2.5 non-attainment class (>35 μg/m 3 ). In 2016, the least polluted megacity was New York and most polluted megacity was Delhi whose average annual PM2.5 concentration of 110 μg/m 3 is nearly three times the WHO's non-attainment threshold., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Aim: We aimed to estimate the network structures of depressive symptoms using network analysis and evaluated the geographic regional differences in theses network structures among Asian patients with depressive disorders., Methods: Using data from the Research on Asian Psychotropic Prescription Patterns for Antidepressants (REAP-AD), the network of the ICD-10 diagnostic criteria for depressive episode was estimated from 1174 Asian patients with depressive disorders. The node strength centrality of all ICD-10 diagnostic criteria for a depressive episode was estimated using a community-detection algorithm. In addition, networks of depressive symptoms were estimated separately among East Asian patients and South or Southeast Asian patients. Moreover, networks were estimated separately among Asian patients from high-income countries and those from middle-income countries., Results: Persistent sadness, fatigue, and loss of interest were the most centrally situated within the network of depressive symptoms in Asian patients with depressive disorders overall. A community-detection algorithm estimated that when excluding psychomotor disturbance as an outlier, the other nine symptoms formed the largest clinically meaningful cluster. Geographic and economic variations in networks of depressive symptoms were evaluated., Conclusion: Our findings demonstrated that the typical symptoms of the ICD-10 diagnostic criteria for depressive episode are the most centrally situated within the network of depressive symptoms. Furthermore, our findings suggested that cultural influences related to geographic and economic distributions of participants could influence the estimated depressive symptom network in Asian patients with depressive disorders., (© 2020 The Authors. Psychiatry and Clinical Neurosciences published by John Wiley & Sons Australia, Ltd on behalf of Japanese Society of Psychiatry and Neurology.)

Clozapine is an effective antipsychotic medication for treatment resistant schizophrenia and is widely used in Asian countries. This study investigated clozapine prescription patterns and their associated factors in Asian countries and territories based on the database of the Research on Asian Psychotropic prescription study (REAP) conducted in 2016. Demographic and clinical information of 3744 schizophrenia patients in 15 Asian countries and territories was collected with a standardized data collection form. In total, 18.4% of the sample received clozapine, ranging from 2.6% in Japan to 32.3% in Hong Kong. Binary logistic regression analysis revealed that higher antipsychotic dose (OR = 1.002, P < 0.001), less frequent first admission in the sample (OR = 0.6, P < 0.001), more severe negative symptoms (OR = 1.4, P = 0.001) and less first generation antipsychotics (FGAs) (OR = 0.2, P < 0.001) were independently and significantly associated with clozapine prescription. Clozapine is frequently and increasingly prescribed for schizophrenia in Asia, with large variation across countries and territories. Given the diverse prescription patterns of clozapine found in Asian countries/territories, the clinical rationale of clozapine prescription needs careful consideration in Asia with more local input., (Copyright © 2019 Elsevier B.V. All rights reserved.)

After the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident, radionuclides released by this event were observed in the Pacific Ocean. Models predicted that these radionuclides would be transported to the Bering Sea; however, limited evidence currently reveals the transportation of these radionuclides to the Arctic Ocean. Here, we provide the first direct observation showing that FDNPP-derived 134 Cs and 137 Cs were present in subarctic regions and the Arctic Ocean (Chukchi Sea) in 2017. Furthermore, we conclude that these radionuclides were transported from the Pacific Ocean into the Bering and Chukchi Seas by ocean currents. Additionally, the 137 Cs activity concentrations in the Bering Sea exceed those in all previous reports. Due to the continuous leaking of radionuclides from the FDNPP, we hypothesize that FDNPP-derived radionuclides will be continuously transported to the Arctic Ocean in the next several years. Our results suggest that though far away from Fukushima, the accident-derived anthropogenic radionuclides also influenced the Arctic Ocean by ocean currents., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Aim: Depressive disorders are common in old age. Antipsychotics (APs) are often used as an adjunctive treatment with antidepressants (ADs) in this population but its patterns of use in Asia are not known. This study explored the rate of combination of APs and ADs in older adult psychiatric patients in Asia., Methods: This is a secondary analysis of the database of a multicentre study which recorded participants' basic demographical and clinical data in standardised format in 10 Asian countries and territories. The data were analysed using univariate and multivariate logistic regression analyses., Results: A total of 955 older adult psychiatric in- and outpatients were included in this study. The proportion of concurrent AP and AD use was 32.0%, ranging from 23.3% in Korea to 44.0% in Taiwan. Multivariate logistic regression analysis found that younger age, inpatient status and diagnosis of schizophrenia, anxiety and other mental disorders were significantly related to a higher proportion of concurrent use of APs and ADs., Conclusion: Around a third of older adult psychiatric patients had concurrent AP and AD use in the Asian countries/regions surveyed. Considering the uncertain effectiveness and questionable safety of the AP and AD combination in this patient population, such should be cautiously used., (© 2019 Japanese Psychogeriatric Society.)

Purpose: Little is known regarding the trend of polypharmacy in Asia. We used data from 5 Asian countries to examine the patterns of antidepressant (AD) prescription and trends of psychotropic polypharmacy over time., Methods: We used the cross-sectional, pharmacoepidemiological data from 2004 and 2013 REAP-AD (Research on Asian Psychotropic Prescription Patterns for Antidepressants) to examine the patterns of AD prescriptions in clinical settings in China, Japan, Korea, Singapore, and Taiwan. We compared the trend in polypharmacy (ie, concomitant use of ≥2 classes of psychotropic) among individuals receiving AD prescriptions in 2004 and 2013 using multivariable logistic regression models in different diagnostic categories., Results: The proportion of patients with psychotropic polypharmacy decreased from 2004 to 2013 in all 3 diagnostic categories, including mood disorders (adjusted odds ratio [aOR], 0.44 [0.35-0.56]; P < 0.001), anxiety disorders (aOR, 0.58 [0.36-0.94]; P = 0.028), and psychotic disorders (aOR, 0.18 [0.05-0.60]; P = 0.006). Among individuals with AD prescriptions, concomitant use of anxiolytics (including sedative-hypnotics) decreased in patients with mood disorders (aOR, 0.34 [0.27-0.42]; P < 0.001) and anxiety disorders (aOR, 0.43 [0.27-0.67]; P < 0.001). In contrast, concomitant use of antipsychotics in patients with mood disorders increased (aOR, 1.43 [1.15-1.77]; P = 0.001), and concomitant use of mood stabilizers in patients with psychotic disorders also increased (aOR, 3.49 [1.50-8.14]; P = 0.004)., Conclusions: This is the first study examining trends in psychotropic polypharmacy in East Asia. We found a generally decreasing trend of psychotropic polypharmacy in contrast to the increasing trend reported from Western countries. These findings could offer significant implications for health system reform or policy making.

Introduction: Research in prescription pattern of antidepressants in Asia is lacking. This study aims to compare the antidepressants prescription pattern in Asia in 2003-2004 and 2013., Methods: The Research in East Asia Psychotropic Prescription Pattern on Antidepressants (REAP-AD) had worked collaboratively in 2003-2004 (REAP-AD 2003/2004) and 2013 (REAP-AD 2013) to study the prescription pattern of antidepressants in Asia. The REAP-AD 2013 study was conducted in China, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, Singapore, Taiwan, and Thailand using a unified research protocol and questionnaire., Results: Forty psychiatric centers participated in REAP-AD 2013 and a total of 2,319 patients receive antidepressants were analyzed. In 2013, 39.6% of the antidepressant prescriptions were for diagnoses other thandepressive disorder compared with 38.4% in REAP-AD 2003/2004. Out of all the antidepressants listed in the Anatomical Therapeutic Chemical Classification index by the World Health Organization Collaborating Center for Drug Statistics Methodology (Oslo), only 38% antidepressants were prescribed in participating centers in 2013 compared with 46% in REAP-AD 2003/2004. The selective serotonin reuptake inhibitors were the most common antidepressant prescribed in the participating centers, which was similar to the 2003-2004 survey. Prescription of newer generation antidepressants had increased in 2013 survey; on the contrary, prescription of tricyclic antidepressants had reduced., Discussion: This study has contributed significantly in relation to the changing patterns of antidepressant use in all the participating Asian centers in the last 10 years. The findings are important in shaping optimal antidepressant prescription and future policy making., (© 2015 Wiley Publishing Asia Pty Ltd.)

Background: This study examined the use of low doses of antipsychotic medications (300 mg/day CPZeq or less) in older Asian patients with schizophrenia and its demographic and clinical correlates., Methods: Information on hospitalized patients with schizophrenia, aged 55 years or older, was extracted from the database of the Research on Asian Psychotropic Prescription Patterns (REAP) study (2001-2009). Data on 1,452 patients in eight Asian countries and territories including China, Hong Kong, Japan, Korea, Singapore, Taiwan, India, and Malaysia were analyzed. Sociodemographic and clinical characteristics and antipsychotic prescriptions were recorded using a standardized protocol and data collection procedure., Results: The prescription frequency for low doses of antipsychotic medications was 40.9% in the pooled sample. Multiple logistic regression analysis of the whole sample showed that patients on low doses of antipsychotic medications were more likely to be female, have an older age, a shorter length of illness, and less positive symptoms. Of patients in the six countries and territories that participated in all the surveys between 2001 and 2009, those in Japan were less likely to receive low doses of antipsychotics., Conclusion: Low doses of antipsychotic medications were only applied in less than half of older Asian patients with schizophrenia.