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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

Tetsu Tomita,1 Norio Yasui-Furukori,1 Taku Nakagami,2 Shoko Tsuchimine,3 Masamichi Ishioka,4 Ayako Kaneda,1 Kazuhiko Nakamura1 1Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan; 2Department of Psychiatry, Nakagami Mental Clinic, Odate, Japan; 3Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan; 4Department of Psychiatry, Minato Hospital, Hachinohe, Japan Background: We studied the differences between groups that were divided according to personality characteristics with respect to the relationship between drug concentration and symptom improvement.Methods: A total of 120 patients with major depressive disorder were treated with paroxetine for 6 weeks, and 89 patients completed the protocol. The Montgomery–Åsberg Depression Rating Scale (MADRS) was used to evaluate the patients. Patients’ paroxetine plasma concentrations at week 6 were measured. Their personalities were evaluated by the Temperament and Character Inventory (TCI) at the first visit. We divided the patients into two groups according to the median of each TCI dimension. We compared the responder rate between “high” and “low” groups in each TCI dimension and analyzed Pearson’s correlation coefficients of paroxetine plasma concentration and MADRS-improvement rate.Results: A total of 62 patients completed the TCI. Low-novelty-seeking, high-harm-avoidance, low-reward-dependence, and low-self-directedness groups exhibited significant negative correlations between paroxetine plasma concentration and MADRS improvement. Among the groups with combined personality traits, the high-harm-avoidance and low-self-directedness groups showed a markedly significant negative correlation.Conclusion: Patients with depression exhibiting specific personality traits, especially those with high harm-avoidance and low self

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

Shuhei Kudo,1 Tetsu Tomita,1 Norio Sugawara,1,2 Yasushi Sato,1 Masamichi Ishioka,3 Koji Tsuruga,4 Taku Nakagami,5 Kazuhiko Nakamura,1 Norio Yasui-Furukori1 1Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, 2Aomori Prefectural Center for Mental Health and Welfare, Aomori, 3Department of Psychiatry, Hirosaki Aiseikai Hospital, Hirosaki, 4Department of Psychiatry, Aomori Prefectural Tsukushigaoka Hospital, Aomori, 5Department of Neuropsychiatry, Odate City General Hospital, Odate, Japan Background: We used self-administered questionnaires to investigate the level of understanding of depression among outpatients who were administered antidepressants. Methods: A total of 424 outpatients were enrolled in this study. We used an original self-administered questionnaire that consisted of eight categories: (A) depressive symptoms, (B) the course of depression, (C) the cause of depression, (D) the treatment plan, (E) the duration of taking antidepressants, (F) how to discontinue antidepressants, (G) the side effects of the antidepressants, and (H) psychotherapy. Each category consisted of the following two questions: “Have you received an explanation from the doctor in charge?” and “How much do you understand about it?” The level of understanding was rated on a scale of 0–10 (11 anchor points). The Quick Inventory of Depressive Symptomatology Japanese version, Global Assessment of Functioning, and Clinical Global Impression – Severity scale were administered, and clinical characteristics were investigated. Results: The percentages of participants who received explanations were as follows: 61.8% for (A), 49.2% for (B), 50.8% for (C), 57.2% for (D), 46.3% for (E), 28.5% for (F), 50.6% for (G), and 36.1% for (H). The level of understanding in participants who received explanations from their physicians was significantly higher compared with patients who did not

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

Tetsu Tomita, Yasui-Furukori Norio, Yasushi Sato, Taku Nakagami, Shoko Tsuchimine, Ayako Kaneda, Sunao KanekoDepartment of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, JapanBackground: We investigated cutoff values for the early response of patients with major depressive disorder to paroxetine and their sex differences by using a receiver operating characteristic (ROC) curve analysis to predict the effectiveness of paroxetine.Methods: In total, 120 patients with major depressive disorder were enrolled and treated with 10–40 mg/day paroxetine for 6 weeks; 89 patients completed the protocol. A clinical evaluation using the Montgomery–Asberg Depression Rating Scale (MADRS) was performed at weeks 0, 1, 2, 4, and 6.Results: In male subjects, the cutoff values for MADRS improvement rating in week 1, week 2, and week 4 were 20.9%, 34.9%, and 33.3%, respectively. The sensitivities and the specificities were 83.3% and 80.0%, 83.3% and 80.0%, and 100% and 90%, respectively. The areas under the curve (AUC) were 0.908, 0.821, and 0.979, respectively. In female subjects, the cutoff values for the MADRS improvement rating in week 1, week 2, and week 4 were 21.4%, 35.7%, and 32.3%, respectively. The sensitivities and the specificities were 71.4% and 84.6%, 73.8% and 76.9%, and 90.5% and 76.9%, respectively. The AUCs were 0.781, 0.735, and 0.904, respectively.Conclusion: Early improvement with paroxetine may predict the long-term response. The accuracy of the prediction for the response is higher in male subjects.Keywords: antidepressants, paroxetine, early response, sex differences, receiver operating characteristic curve analysisCorrigendum for this paper has been published

Tomita T, Norio YF, Sato Y, et al. Neuropsychiatr Dis Treat. 2014;10:599–606.On page 599, there is an error in the author list "Yasui-Furukori Norio" should read "Norio Yasui-Furukori".Read the original article