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Norio Yasui-Furukori,1,2 Yasushi Kawamata,1,3 Taro Sasaki,1,4 Saaya Yokoyama,1,5 Hiroaki Okayasu,1,6 Masataka Shinozaki,1,7 Yoshitaka Takeuchi,1,8 Aoi Sato,1,9 Takaaki Ishikawa,1,10 Hazuki Komahashi-Sasaki,1,11 Kensuke Miyazaki,12 Takashi Fukasawa,13 Hanako Furukori,14 Norio Sugawara,1,2 Kazutaka Shimoda1 1Department of Psychiatry, Dokkyo Medical University, School of Medicine, Tochigi, Japan; 2Department of Psychiatry, TMC Shimotsuga, Tochigi, Japan; 3Department of Psychiatry, Kikuchi Hospital, Tochigi, Japan; 4Department of Psychiatry, Asahi Hospital, Tochigi, Japan; 5Department of Psychiatry, Aoki Hospital, Tochigi, Japan; 6Department of Psychiatry, Fudogaoka Hospital, Saitama, Japan; 7Department of Psychiatry, Takizawa Hospital, Tochigi, Japan; 8Department of Psychiatry, Okamotodai Hospital, Tochigi, Japan; 9Department of Psychiatry, Muroi Hospital, Tochigi, Japan; 10Department of Psychiatry, Saitama-Konan Hospital, Saitama, Japan; 11Department of Psychiatry, Kanuma Hospital, Tochigi, Japan; 12Department of Neuropsychiatry, Hirosaki-Aiseikai Hospital, Aomori, Japan; 13Department of Psychiatry, Seinan Hospital, Aomori, Japan; 14Department of Neuropsychiatry, Kuroichi-Akebono Hospital, Aomori, JapanCorrespondence: Norio Yasui-Furukori, Department of Psychiatry, Dokkyo Medical University, School of Medicine, Mibu, Shimotsuga, Tochigi, 321-0293, Japan, Tel +81-282-86-1111, Fax +81-282-86-5187, Email furukori@dokkyomed.ac.jpBackground: Recent pharmacoepidemiology data show an increase in the proportion of patients receiving second-generation antipsychotic (SGA) monotherapy, but no studies have analyzed the same patients over a long period of time. Therefore, in this study, we retrospectively evaluated schizophrenia patients with available data for 20 years to determine whether the drug treatments in the same patients have changed in the past 20 years.Methods: The study began in April 2021 and was conducted in 15 psychiatric hospitals in Japan. Schizophrenia patients

Yasushi Kawamata,1 Norio Sugawara,1,2 Masamichi Ishioka,3 Kazutoshi Kubo,4 Katsuji Suzuki,5 Akira Fujii,6 Hanako Furukori,7 Taku Nakagami,8 Norio Yasui-Furukori,1,2 Kazutaka Shimoda1 1Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Japan; 2Department of Neuropsychiatry, Hirosaki University Graduate School of Medicine, Hirosaki, Japan; 3Department of Psychiatry, Minato Hospital, Hachinohe, Japan; 4Department of Neuropsychiatry, Hirosaki-Aiseikai Hospital, Hirosaki, Japan; 5Department of Psychiatry, Aomori Central Hospital, Aomori, Japan; 6Department of Neuropsychiatry, Mutsu General Hospital, Mutsu, Japan; 7Department of Neuropsychiatry, Kuroishi-Akebono Hospital, Kuroishi, Japan; 8Department of Psychiatry, Nakagami Mental Clinic, Ohdate, JapanCorrespondence: Norio Yasui-FurukoriDepartment of Psychiatry, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, JapanTel +81-28-287-2153Fax +81-28-286-5187Email furukori@dokkyomed.ac.jpBackground: Concern regarding the benefit/risk ratio of the long-term use of benzodiazepines (BDZs) and Z-drugs is increasing. To prevent the risk of dependence in BDZ long-term use, it is essential to understand the attitudes of patients and psychiatrists toward BDZ treatment. The aims of this investigation were to 1) obtain information on patients’ attitudes with long-term BDZ use and their referring psychiatrists’ attitudes toward BDZ treatment, including their perception of the difficulty of reducing the dose of BDZs, and 2) identify discrepancies between patients’ and psychiatrists’ perceptions.Methods: A brief questionnaire was constructed to investigate the attitudes of patients receiving BDZ treatment and their referring psychiatrists. Our sample comprised 155 patients who received BDZ treatment for more than one year and their referring eight psychiatrists. Both the patients and their psychiatrists completed our questionnaire bet

Natsumi Tarakita,1,2 Kazutaka Yoshida,1 Norio Sugawara,3 Kazutoshi Kubo,1,4 Hanako Furukori,5 Akira Fujii,2 Kazuhiko Nakamura,1 Norio Yasui-Furukori1 1Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan; 2Department of Mental Health, Mutsu City Hospital, Mutsu, Japan; 3Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan; 4Department of Neuropsychiatry, Hirosaki-Aiseikai Hospital, Hirosaki, Japan; 5Department of Neuropsychiatry, Kuroishi-Akebono Hospital, Kuroishi, Japan Objectives: To determine whether etiological beliefs are different among schizophrenia patients, their family, and medical staff. Patients and methods: A cross-sectional study was performed at five hospitals and one mental clinic and included 212 patients, 144 family members, and 347 medical staff other than psychiatrists. A questionnaire about the possible etiological causes of schizophrenia was used. Results: There were significant differences in response scores among the three groups on using Angermeyer’s and Goulding’s classifications. Factor analyses revealed the following four subscales: Psychosocial, Biological, Environmental, and Cultural connotations. The structure varied among patients, family, and medical staff. Conclusion: The perspectives of schizophrenia etiology were different among patients, family, and medical staff. Keywords: schizophrenia, etiology, perception, family, caregivers, beliefs, etiological causes, patients, medical staff

Norio Sugawara,1,2 Kazuma Danjo,3 Hanako Furukori,4 Yasushi Sato,2,5 Tetsu Tomita,2,6 Akira Fujii,7 Taku Nakagami,2,8 Kazuyo Kitaoka,9 Norio Yasui-Furukori2 1Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo, 2Department of Neuropsychiatry, Hirosaki University School of Medicine, Hirosaki, Aomori, 3Mizoguchi Mental Hospital, Shizuoka, 4Department of Psychiatry, Kuroishi-Akebono Hospital, Kuroishi, 5Department of Psychiatry, Mutsu General Hospital, Mutsu, 6Department of Psychiatry, Hirosaki-Aiseikai Hospital, Kitazono, Hirosaki, 7Department of Psychiatry, Seihoku-Chuoh Hospital, Goshogawara, Aomori, 8Department of Psychiatry, Odate Municipal General Hospital, Odate, Akita, 9Mental Health Nursing, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan Background: Occupational stress among mental health nurses may affect their psychological health, resulting in reduced performance. To provide high-quality, sustainable nursing care, it is necessary to identify and control the factors associated with psychological health among mental health nurses. The purpose of this study was to examine the role of work–family conflict (WFC) in the well-known relationship between occupational stress and psychological health among mental health nurses in Japan. Methods: In this cross-sectional study, data were gathered from 180 mental health nurses who had a coresident child or were married. Data from the Work–Family Conflict Scale, the Generic Job Stress Questionnaire, the Maslach Burnout Inventory-General Survey, and the Center for Epidemiologic Studies for Depression Scale were obtained via self-report questionnaires. The effects of occupational stress and WFC on psychological health were explored by hierarchical linear regression analysis. Results: The relationship between emotional exhaustion and occupational factors, including quantitat

Masamichi Ishioka, Norio Yasui-Furukori, Norio Sugawara, Hanako Furukori, Shuhei Kudo, Kazuhiko Nakamura Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan Objective: The strong association between psychiatric patients who receive antipsychotics and the incidence of venous thromboembolism (VTE) is known. Although previous reports suggest that hyperprolactinemia often increases markers of activated coagulation, few studies have examined the direct relationship between the prolactin level elevated by antipsychotics and activated markers of activated coagulation.Method: The participants included 182 patients with schizophrenia (male =89, female =93) who received antipsychotic treatments for at least 3 months. Markers of VTE (D-dimer, fibrin/fibrinogen degradation products, and thrombin–antithrombin complex) and serum prolactin concentrations were measured.Results: Prolactin levels were significantly correlated with the logarithmic transformation of the D-dimer (r=0.320, P=0.002) and fibrin/fibrinogen degradation product levels (r=0.236, P=0.026) but not of the thrombin–antithrombin complex level (r=0.117, ns) among men. However, no correlations were found between the VTE markers and prolactin levels among women. These results were confirmed using multiple regression analyses that included demographic factors and antipsychotic dosages. Conclusion: The current study indicates that hyperprolactinemia is associated with an increase in markers of activated coagulation among men receiving antipsychotics. This finding clinically implies that monitoring and modulating prolactin levels among men are important to decrease the risk of VTE. Keywords: prolactin, antipsychotics, venous thromboembolism

Koji Tsuruga,1 Norio Sugawara,1 Yasushi Sato,1 Manabu Saito,1 Hanako Furukori,2 Taku Nakagami,3 Kazuhiko Nakamura,1 Ippei Takahashi,4 Shigeyuki Nakaji,4 Norio Yasui-Furukori1 1Department of Neuropsychiatry, Hirosaki University School of Medicine, Hirosaki, Japan; 2Department of Psychiatry, Kuroishi-Akebono Hospital, Kuroishi, Japan; 3Department of Neuropsychiatry, Odate Municipal General Hospital, Odate, Japan; 4Department of Social Medicine, Hirosaki University School of Medicine, Hirosaki, Japan Background: It has been reported that the onset of schizophrenia and the physical complications after its onset are related to diet. Diet has been considered as a variable factor of the pathogenesis of schizophrenia. However, the results of studies on this relationship have been inconsistent. Nutrients are consumed as a mixture in the diet. It is difficult to study them in isolation because they may have mutually complementary effects. The aim of this study was to assess the association between dietary patterns and schizophrenia in Japan.Methods: The subjects comprised 237 outpatients aged 30–60 years (123 males and 114 females) with diagnoses of either schizophrenia or schizoaffective disorder. The patient diagnoses were determined based on medical records. Patients were recruited between June 2011 and August 2011. As a reference group, 404 healthy volunteers aged 30–60 years (158 males and 246 females) were also included. Demographic data (age, sex, and level of education) were collected by face-to-face method interviews and self-administered questionnaires. We assessed eating habits over the last month using a validated brief self-administered diet history questionnaire. We detected dietary patterns through a principal component analysis of calorie-adjusted intake; two principal components were retained. The principal components for each dietary pattern and for each individual were divided into tertiles by principal component scores. Results: We deri

Norio Sugawara,1 Norio Yasui-Furukori,1 Tetsu Tomita,1,2 Hanako Furukori,3 Kazutoshi Kubo,1,4 Taku Nakagami,1,4 Sunao Kaneko1 1Department of Neuropsychiatry, Hirosaki University School of Medicine, Hirosaki, 2Department of Psychiatry, Hirosaki-Aiseikai Hospital, Hirosaki, 3Department of Psychiatry, Kuroishi-Akebono Hospital, Kuroishi, 4Department of Psychiatry, Odate Municipal General Hospital, Odate, Japan Background: Recently, a relationship between obesity and schizophrenia has been reported. The prediction of resting energy expenditure (REE) is important to determine the energy expenditure of patients with schizophrenia. However, there is a lack of research concerning the most accurate REE predictive equations among Asian patients with schizophrenia. The purpose of the study reported here was to compare the validity of four REE equations for patients with schizophrenia taking antipsychotics. Methods: For this cross-sectional study, we recruited patients (n=110) who had a Diagnostic and Statistical Manual of Mental Disorders, fourth edition, diagnosis of schizophrenia and were admitted to four psychiatric hospitals. The mean (± standard deviation) age of these patients was 45.9±13.2 years. Anthropometric measurements (of height, weight, body mass index) were taken at the beginning of the study. REE was measured using indirect calorimetry. Comparisons between the measured and estimated REEs from the four equations (Harris–Benedict, Mifflin–St Jeor, Food and Agriculture Organization/World Health Organization/United Nations University, and Schofield) were performed using simple linear regression analysis and Bland–Altman analysis. Results: Significant trends were found between the measured and predicted REEs for all four equations (P<0.001), with the Harris–Benedict equation demonstrating the strongest correlation in both men and women (r=0.617, P<0.001). In all participants, Bland&ndash