Okayama University Medical SchoolActa Medica Okayama0386-300X7722023Venous Thromboembolism in Eating Disorders: A Retrospective Observational Study131137ENMayukoSendaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSeishiTeradaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasakiFujiwaraDepartment of Neuropsychiatry, Okayama University HospitalNorihitoYamadaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/65142Eating disorders (EDs) are associated with a high mortality rate. Patients with EDs often experience severe dehydration due to food restriction and/or vomiting. Severely underweight patients are often prescribed bed rest during inpatient care to reduce their energy consumption, and they may thus develop multiple risk factors for venous thromboembolism (VTE). We compared the clinical features of ED inpatients with VTE to those of ED inpatients without VTE. Seventy-one inpatients with ED were treated at Okayama University Hospital’s psychiatric ward in 2016-2020; five were experienced a VTE. Compared to the non-VTE group, the VTE group’s median age and disease duration were greater and the median body mass index (BMI) was lower. The VTE group’s D-dimer peak values were > 5 mg/L. Physical restraint and central venous catheter use were associated with VTE. Longer ED duration and lower BMI might be risk factors for VTE. To make inpatient treatment for ED safer, it is important to avoid the use of physical restraints and central venous catheters. Continuous D-dimer monitoring is necessary for the early detection of VTE in ED patients at high risk of VTE.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155813412022看護師の性別違和への関わりにくさについての尺度作成2227ENMakiMiyakeDepartment of Nursing, Okayama University HospitalYoshitakaOshimaDepartment of Neuropsychiatry, Okayama University HospitalShihokoNambaDepartment of Center for Innovative Clinical Medicine, Okayama University HospitalYosukeMatsumotoDepartment of Gender Center, Okayama University HospitalMakikoHoriuchiDepartment of Medical Support, Clinical Psychology section, Okayama University HospitalNorihitoYamadaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences This study aimed to develop a scale to measure the perceived difficulty experienced by nurses in treating and caring for patients diagnosed with gender dysphoria and examine its reliability and validity. We developed a 26-item preliminary scale through discussions with experts in gender dysphoria treatment. We administered a questionnaire including this scale to 1,010 nurses working at Okayama University Hospital and analyzed the data of 346 nurses who had been involved in the treatment of gender dysphoria and had no missing responses.<br>
A total of 20 items consisting of two factors, “relationship building” and “negative emotion for gender dysphoria,” were extracted by exploratory factor analysis, and we used them in the final version of the scale. Cronbach's alpha coefficient for the entire scale was 0.879, indicating a high degree of internal consistency.<br>
However, the correlations with a communication skills scale (ENDCOREs) and the Scale of Gender Conception were limited, and the external validity could not be proven. This scale may be useful for evaluating nursing practice and educational support for nurses; however, there is room for further study on the scale validation.No potential conflict of interest relevant to this article was reported.BMCActa Medica Okayama1471-23772212022Secondary autoimmune hypothalamitis with severe memory impairment 7 years after the onset of diabetes insipidus due to lymphocytic hypophysitis: a case report371ENTakahiroAsadaDepartment of Neuropsychiatry, Okayama University HospitalShintaroTakenoshitaDepartment of Neuropsychiatry, Okayama University HospitalMayukoSendaDepartment of Neuropsychiatry, Okayama University HospitalKoichiroYamamotoDepartment of General Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityRyoSasakiDepartment of Neurology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityFumioOtsukaDepartment of General Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySeishiTeradaDepartment of Neuropsychiatry, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNorihitoYamadaDepartment of Neuropsychiatry, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityBackground Autoimmune hypothalamitis is a very rare neuroendocrine disorder that causes central diabetes insipidus, headache, visual impairment, and sometimes cognitive impairment. Autoimmune hypothalamitis may occur in association with autoimmune hypophysitis, including lymphocytic hypophysitis, or in isolation. It is not known whether autoimmune hypothalamitis and autoimmune hypophysitis are consecutive diseases. Case presentation A 52-year-old woman developed autoimmune hypothalamitis 7 years after developing central diabetes insipidus due to lymphocytic hypophysitis, resulting in severe memory impairment. High-dose intravenous methylprednisolone therapy improved her cognitive function and decreased the size of the lesion. Conclusion This case presented a unique clinical course, with a long period of time between the onset of autoimmune hypopituitaritis and the development of autoimmune hypothalamitis.No potential conflict of interest relevant to this article was reported.BMJ Publishing GroupActa Medica Okayama2044-60551262022Patients' acceptability and implementation outcomes of a case management approach to encourage participation in colorectal cancer screening for people with schizophrenia: a qualitative secondary analysis of a mixed-method randomised clinical triale060621ENYutoYamadaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMasakiFujiwaraDepartment of Neuropsychiatry, Okayama University HospitalTaichiShimazuDivision of Behavioral Sciences, National Cancer Center Institute for Cancer ControlTsuyoshiEtohDepartment of Nursing, Shimane University HospitalMasafumiKodamaOkayama Psychiatric Medical CenterRyuheiSoOkayama Psychiatric Medical CenterTakanoriMatsushitaZikei HospitalYusakuYoshimuraZikei HospitalShigeoHoriiZikei HospitalMaikoFujimoriDivision of Supportive Care, Survivorship and Translational Research, National Cancer Center Institute for Cancer ControlHirokazuTakahashiDivision of Screening Assessment and Management, National Cancer Center Institute for Cancer ControlNaokiNakayaTohoku Medical Megabank Organization, Tohoku UniversityTempeiMiyajiDepartment of Clinical Trial Data Management, Graduate School of Medicine, The University of TokyoShiroHinotsuDepartment of Biostatistics and Data Management, Sapporo Medical UniversityKeitaHaradaDepartment of Gastroenterology, Okayama University HospitalHiroyukiOkadaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYosukeUchitomiGroup for Supportive Care and Survivorship Research, National Cancer Center Institute for Cancer ControlNorihitoYamadaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMasatoshiInagakiDepartment of Psychiatry, Faculty of Medicine, Shimane UniversityObjectives We examined the efficacy of case management (CM) interventions to encourage participation in colorectal cancer screening for patients with schizophrenia. This study aimed to clarify patients' acceptability of the intervention and the helpful components of the intervention. Simultaneously, the study aimed to determine the acceptability, appropriateness and feasibility of the intervention from the perspective of psychiatric care providers. Study design and setting This study was a secondary qualitative analysis of a mixed-method randomised controlled trial that evaluated the efficacy of the CM approach to encourage participation in cancer screening for people with schizophrenia. The intervention comprised education and patient navigation for colorectal cancer screening. Interviews were conducted with patients who received the intervention and staff from two psychiatric hospitals in Japan who delivered the intervention. Participants Of the 172 patients with schizophrenia who participated in the trial, 153 were included. In addition, three out of six providers were included. Data collection and analysis Using a structured interview, the case manager asked participants about patient acceptability and the helpful components of the intervention. Content analysis was conducted for the responses obtained, and the number of responses was tabulated by two researchers. For the interviews with the providers, opinions obtained from verbatim transcripts were extracted and summarised. Results Forty-three of the 56 patients perceived that the intervention was acceptable. For the intervention component, inperson counselling with an explanation of the screening process by psychiatric care providers was most frequently reported by the patients as helpful (48 of the 68 respondents). Psychiatric care providers evaluated the intervention as acceptable, appropriate and easy to understand and administer. However, providing the intervention to all patients simultaneously was considered difficult with the current human resources. Conclusions This study showed that the CM intervention was perceived as acceptable by patients and acceptable and appropriate by psychiatric care providers.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7622022Changes in Plasma Clozapine Levels after Smoking Cessation in Japanese Inpatients with Schizophrenia: A Retrospective Cohort Study137143ENMasaruTsukaharaDepartment of Psychiatry, Okayama Psychiatric Medical CenterRyuheiSoDepartment of Psychiatry, Okayama Psychiatric Medical CenterYujiYadaDepartment of Psychiatry, Okayama Psychiatric Medical CenterMasafumiKodamaDepartment of Psychiatry, Okayama Psychiatric Medical CenterYoshikiKishiDepartment of Psychiatry, Okayama Psychiatric Medical CenterNorihitoYamadaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/63407Although reported for Caucasians, changes in plasma clozapine levels after smoking cessation in East Asians remain unclear. We here investigated plasma clozapine levels before and after smoking cessation in Japanese inpatients with schizophrenia. We conducted a retrospective chart review of 14 inpatients with schizophrenia who were being treated with clozapine between June 1, 2019, and July 31, 2019 and who were smokers as of July 1, 2019, the day on which a smoking ban was instituted in the tertiary public psychiatric hospital. The primary outcome was individual differences in plasma clozapine levels between before and after the smoking ban, which were compared using paired t-tests. The mean plasma clozapine level was significantly increased, by 213.4 ng/mL (95% CI 119.9-306.8; p<0.01) or 53.2%. Four of the 14 inpatients experienced clinically significant side effects, such as myoclonus, drooling, and amnesia, due to the development of high plasma clozapine levels. Our findings indicated that close monitoring of plasma clozapine levels before and after smoking cessation and prior dose adjustment of clozapine may be necessary, to prevent a significant risk of developing high plasma clozapine levels, even in Japanese patients.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155813332021精神科の分かりにくさについて ―学生たちの質問から考えること―169174ENNorihitoYamadaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNo potential conflict of interest relevant to this article was reported.Oxford Univ PressActa Medica Okayama1461-14572452020Mechanisms Underlying the Comorbidity of Schizophrenia and Type 2 Diabetes Mellitus367382ENYutakaMizukiDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinjiSakamotoDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukoOkahisaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYujiYadaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNozomuHashimotoDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesManabuTakakiDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNorihitoYamadaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesThe mortality rate of patients with schizophrenia is high, and life expectancy is shorter by 10 to 20 years. Metabolic abnormalities including type 2 diabetes mellitus (T2DM) are among the main reasons. The prevalence of T2DM in patients with schizophrenia may be epidemiologically frequent because antipsychotics induce weight gain as a side effect and the cognitive dysfunction of patients with schizophrenia relates to a disordered lifestyle, poor diet, and low socioeconomic status. Apart from these common risk factors and risk factors unique to schizophrenia, accumulating evidence suggests the existence of common susceptibility genes between schizophrenia and T2DM. Functional proteins translated from common genetic susceptibility genes are known to regulate neuronal development in the brain and insulin in the pancreas through several common cascades. In this review, we discuss common susceptibility genes, functional cascades, and the relationship between schizophrenia and T2DM. Many genetic and epidemiological studies have reliably associated the comorbidity of schizophrenia and T2DM, and it is probably safe to think that common cascades and mechanisms suspected from common genes' functions are related to the onset of both schizophrenia and T2DM. On the other hand, even when genetic analyses are performed on a relatively large number of comorbid patients, the results are sometimes inconsistent, and susceptibility genes may carry only a low or moderate risk. We anticipate future directions in this field.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1015-63053042020Factors associated with development and distribution of granular/fuzzy astrocytes in neurodegenerative diseases811830ENTomokoMikiDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOsamuYokotaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakashiHaraguchiDepartment of Neurology, National Hospital Organization Minami‐Okayama Medical CenterHidekiIshizuDepartment of Laboratory Medicine and Pathology, Zikei Institute of PsychiatryMasatoHasegawaDementia Research Project, Tokyo Metropolitan Institute of Medical ScienceTakeshiIshiharaDepartment of Psychiatry, Kawasaki Medical SchoolShu‐ichiUenoDepartment of Neuropsychiatry, Ehime University Graduate School of MedicineShintaroTakenoshitaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSeishiTeradaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNorihitoYamadaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesGranular/fuzzy astrocytes (GFAs), a subtype of “aging‐related tau astrogliopathy,” are noted in cases bearing various neurodegenerative diseases. However, the pathogenic significance of GFAs remains unclear. We immunohistochemically examined the frontal cortex, caudate nucleus, putamen and amygdala in 105 cases composed of argyrophilic grain disease cases (AGD, N = 26), and progressive supranuclear palsy (PSP, N = 10), Alzheimer’s disease (AD, N = 20) and primary age‐related tauopathy cases (PART, N = 18) lacking AGD, as well as 31 cases bearing other various neurodegenerative diseases to clarify (i) the distribution patterns of GFAs in AGD, and PSP, AD and PART lacking AGD, (ii) the impacts of major pathological factors and age on GFA formation and (iii) immunohistochemical features useful to understand the formation process of GFAs. In AGD cases, GFAs consistently occurred in the amygdala (100%), followed by the putamen (69.2%) and caudate nucleus and frontal cortex (57.7%, respectively). In PSP cases without AGD, GFAs were almost consistently noted in all regions examined (90–100%). In AD cases without AGD, GFAs were less frequent, developing preferably in the putamen (35.0%) and caudate nucleus (30.0%). PART cases without AGD had GFAs most frequently in the amygdala (35.3%), being more similar to AGD than to AD cases. Ordered logistic regression analyses using all cases demonstrated that the strongest independent factor of GFA formation in the frontal cortex and striatum was the diagnosis of PSP, while that in the amygdala was AGD. The age was not significantly associated with GFA formation in any region. In GFAs in AGD cases, phosphorylation and conformational change of tau, Gallyas‐positive glial threads indistinguishable from those in tufted astrocytes, and the activation of autophagy occurred sequentially. Given these findings, AGD, PSP, AD and PART cases may show distinct distributions of GFAs, which may provide clues to predict the underlying processes of primary tauopathies.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0964-263364122020Validation of the Japanese version of the Dementia Screening Questionnaire for Individuals with Intellectual Disabilities970979ENShintaroTakenoshitaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesS.TeradaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesR.KuwanoAsahigawaso Research Institute, Asahigawaso Medical Welfare CenterT.InoueAsahigawaso Research Institute, Asahigawaso Medical Welfare CenterT.KurozumiAsahigawaso Research Institute, Asahigawaso Medical Welfare CenterA.ChojuAsahigawaso Research Institute, Asahigawaso Medical Welfare CenterS.SuemitsuAsahigawaso Research Institute, Asahigawaso Medical Welfare CenterNorihitoYamadaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesBackground,<br>
Dementia in people with intellectual disabilities (IDs) is difficult to detect because of preexisting cognitive deficits. An effective screening method is required. The Dementia Screening Questionnaire for Individuals with Intellectual Disabilities (DSQIID) was developed as an observer rating tool to screen dementia in people with ID. The aim of this study was to verify the screening accuracy of the DSQIID for Japanese people with ID.<br>
Methods<br>
Four‐hundred ninety‐three subjects with ID participated in this study. Caregivers who had observed the participants for more than 2 years scored the Japanese version of the DSQIID (DSQIID‐J) of the participants. Three doctors examined participants directly and diagnosed dementia using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria. To identify the key screening items that predict dementia, the specificities of a single and pairs of items with 100% sensitivity were evaluated relative to the dementia diagnosis. <br>
Results<br>
Of 493 participants, 34 were people with Down syndrome (DS), and 459 were people without DS. Seventeen participants were diagnosed with dementia. The suitable cut‐off score of the DSQIID‐J was 10/11 (sensitivity 100% and specificity 96.8%) for screening dementia. The inter‐rater reliability, test–retest reliability and internal consistency of the DSQIID‐J were excellent. Regarding key items, there was no single item with 100% sensitivity, and the best two‐item combination was the pair of ‘Cannot dress without help’ and ‘Walks slower’ (sensitivity 100% and specificity 93.5%).<br>
Conclusions<br>
We identified several important question items of the DSQIID‐J related to the diagnosis of dementia in people with ID. The DSQIID‐J is a useful screening tool for dementia in adults with ID.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155813212020倉敷で第32回日本総合病院精神医学会総会を開催4445ENNorihitoYamadaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinichiroInoueDepartment of Neuropsychiatry, Okayama University HospitalNo potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama088562303542020Prevalence of dementia in people with intellectual disabilities: Cross‐sectional study414422ENShintaroTakenoshitaOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSeishiTeradaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyozoKuwanoAsahigawaso Research Institute, Asahigawa Medical Welfare CenterTomokazuInoueAsahigawaso Research Institute, Asahigawa Medical Welfare CenterAtsushiCyojuAsahigawaso Research Institute, Asahigawa Medical Welfare CenterShigeruSuemitsuAsahigawaso Research Institute, Asahigawa Medical Welfare CenterNorihitoYamadaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesBackground
There are only a few studies of the prevalence of dementia in people with intellectual disability (ID) without Down syndrome (DS), and there is a large difference in the prevalences between reported studies. Moreover, the prevalence of mild cognitive impairment (MCI) in ID has not been reported. We aimed to evaluate the prevalence of dementia in adults of all ages and the prevalence of MCI in people with ID. Furthermore, we tried to clarify the differences depending on the various diagnostic criteria.
Methods
The survey included 493 adults with ID at 28 facilities in Japan. The caregivers answered a questionnaire, and physicians directly examined the participants who were suspected of cognitive decline. Dementia and MCI were diagnosed according to ICD‐10, DC‐LD, and DSM‐5 criteria.
Results
The prevalence of dementia was 0.8% for the 45 to 54 years old group, 3.5% for the 55 to 64 years old group, and 13.9% for the 65 to 74 years old group in people with ID without DS. The prevalence of MCI was 3.1% for patients 45 to 54, 3.5% for patients 55 to 64, and 2.8% for patients 65 to 74 with ID without DS. DSM‐5 was the most inclusive in diagnosing dementia and MCI in people with ID.
Conclusions
People with ID without DS may develop dementia and MCI at an earlier age and higher rate than the general population. Among the diagnostic criteria, DSM‐5 was the most useful for diagnosing their cognitive impairment.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1346-35001962019Clinical characteristics of elderly depressive patients with low metaiodobenzylguanidine uptake566573ENShintaroTakenoshitaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSeishiTeradaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesEtsukoOshimaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMegumiYamaguchiDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSatoshiHayashiDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKenjiHinotsuDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSatoruEsumiDepartment of Pharmacy, Okayama University HospitalTakayoshiShinyaDepartment of Pediatric Radiology, Okayama University HospitalNorihitoYamadaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesBACKGROUND:<br/>
Recently, depression with Lewy body pathology before the appearance of parkinsonism and cognitive dysfunction has been drawing attention. Low cardiac metaiodobenzylguanidine (MIBG) uptake is helpful for early differentiation of Lewy body disease (LBD) from late-onset psychiatric disorders even before parkinsonism or dementia appears. In this study, we used MIBG uptake as a tool in suspected LBD, and evaluated the relationship of MIBG results to clinical characteristics and depressive symptoms.<br/>
METHODS:<br/>
Fifty-two elderly inpatients with depression were included in this study. The Hamilton Depression Rating Scale (HDRS) was administered at admission, and 123 I-MIBG cardiac scintigraphy was performed. Of 52 patients, 38 had normal and 14 had reduced MIBG uptake.<br/>
RESULTS:<br/>
Correlation analyses of the late phase heart-to-mediastinum (H/M) ratio on the MIBG test and each item of the HDRS revealed that the H/M ratio was significantly correlated with scores of 'agitation', 'anxiety-somatic', and 'retardation' on the HDRS. Mean HDRS composite scores of 'somatic and psychic anxiety (Marcos)' and 'somatic anxiety/somatization factor (Pancheri)' were higher in the low uptake group than in the normal uptake group.<br/>
CONCLUSION:<br/>
Elderly patients with depression who manifested an obvious somatic anxiety tend to show low MIBG uptake, and are more likely to have Lewy body pathology.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1444-15861922018Social problems in daily life of patients with dementia113118ENSeishiTeradaDepartment of Neuropsychiatry, Okayama University Graduate School of MedicineMakotoNakashimaDepartment of Psychiatry, Okayama Red Cross HospitalYosukeWakutaniDepartment of Neurology, Kurashiki Heisei HospitalKenjiNakataDepartment of Psychiatry, Taiyo Hills HospitalYumikoKutoku Department of Neurology, Kawasaki Medical SchoolYoshihideSunada Department of Neurology, Kawasaki Medical SchoolKeikoKondoDepartment of Psychiatry, Sekizen HospitalHidekiIshizuDepartment of Psychiatry, Zikei HospitalOsamuYokotaDepartment of Neuropsychiatry, Okayama University Graduate School of MedicineYohkoMakiCenter for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and GerontologyHideyukiHattoriDepartment of Psychiatry, National Hospital for Geriatric Medicine, NCGGNorihitoYamadaDepartment of Neuropsychiatry, Okayama University Graduate School of MedicineAIM:<br/>
Most patients with dementia frequently encounter various problems in their daily lives. Those troubles embarrass both the patients and their families, and cause problems for society. However, there have been few scientific reports on the difficulties in the daily life of patients with dementia. Therefore, we tried to clarify the frequency and characteristics of troubles experienced by patients with dementia.<br/>
METHODS:<br/>
Seven medical centers treating dementia patients in Okayama Prefecture, Japan, participated in this survey. A total of 737 patients were placed in one of the three groups: a dementia group (n = 478), a mild cognitive impairment group (n = 199) and a control group (n = 60). The frequency of 13 difficulties was scored for each patient.<br/>
RESULTS:<br/>
Among normal participants, no person caused these problems once a year or more frequently. "Massive, recurrent buying" and "acts that risk causing a fire" were reported once a year or more for >10% of mild cognitive impairment patients. "Troubles with wealth management" and "troubles with money management" were the most frequent problems of dementia patients.<br/>
CONCLUSIONS:<br/>
Several problems are already sometimes encountered in patients with mild cognitive impairment. It would be useful to know which social difficulties are often seen in dementia patients in order to protect the safety of the patients. It is always difficult to balance respecting the autonomy of dementia patients and ensuring their safely. No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama134635002022019Patient affect and caregiver burden in dementia189195ENYoshikoKawanoDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSeishiTeradaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShintaroTakenoshitaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSatoshiHayashiDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshitakaOshimaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomokoMikiOsamuYokotaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNorihitoYamadaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesBACKGROUND:<br/>
Numerous studies focusing on the burden of caregivers of dementia patients have been published. However, there have been few studies focusing on positive affect as an important factor affecting the caregiver burden, and only a few studies comparing the caregiver burden between different dementia diseases have been reported.<br/>
METHODS:<br/>
Three hundred and thirty-seven consecutive caregivers of people with dementia participated in this study. The caregiver burden was evaluated by the short version of the Japanese version of the Zarit Burden Interview.<br/>
RESULTS:<br/>
Positive affect scores had a significant relationship with the scores of the short version of the Zarit Burden Interview. Caregivers for patients with dementia with Lewy bodies or frontotemporal dementia suffered from a greater burden than those for patients with Alzheimer's disease dementia.<br/>
CONCLUSIONS:<br/>
The caregiver burden differed between people caring for patients with different dementia diseases. Positive affect of dementia patients has a significant relationship with caregiver burden, independently from neuropsychiatric symptoms of patients.No potential conflict of interest relevant to this article was reported.BMCActa Medica Okayama147123181912019Validation of Addenbrooke's cognitive examination III for detecting mild cognitive impairment and dementia in Japan123ENShintaroTakenoshitaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSeishiTeradaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHidenoriYoshidaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMegumiYamaguchiDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMayumiYabeDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNaoImaiDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMakikoHoriuchiDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomokoMikiDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOsamuYokotaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNorihitoYamadaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesBACKGROUND:Early detection of mild cognitive impairment (MCI) and dementia is very important to begin appropriate treatment promptly and to prevent disease exacerbation. We investigated the screening accuracy of the Japanese version of Addenbrooke's Cognitive Examination III (ACE-III) to diagnose MCI and dementia.</br>
METHODS:The original ACE-III was translated and adapted to Japanese. It was then administered to a Japanese population. The Hasegawa Dementia Scale-revised (HDS-R) and Mini-mental State Examination (MMSE) were also applied to evaluate cognitive dysfunction. In total, 389 subjects (dementia = 178, MCI = 137, controls = 73) took part in our study.</br>
RESULTS:The optimal ACE-III cut-off scores to detect MCI and dementia were 88/89 (sensitivity 0.77, specificity 0.92) and 75/76 (sensitivity 0.82, specificity 0.90), respectively. ACE-III was superior to HDS-R and MMSE in the detection of MCI or dementia. The internal consistency, test-retest reliability, and inter-rater reliability of ACE-III were excellent.</br>
CONCLUSIONS:ACE-III is a useful cognitive test to detect MCI and dementia. ACE-III may be widely useful in clinical practice.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812912017チーム医療による術後せん妄発症予防についての検討3134ENKojiOdaDepartments of Neuropsychiatry, Okayama University HospitalKieOyanagiDepartments of Medical Support, Okayama University HospitalMegumiYamaguchiDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKanakoBabaDepartments of Nursing, Okayama University Hospital,SatoruEsumiDepartments of Pharmacy, Okayama University HospitalMayukoSendaDepartments of Neuropsychiatry, Okayama University HospitalShinichirouInoueDepartments of Neuropsychiatry, Okayama University HospitalKiyohiroKawataDepartments of Neuropsychiatry, Okayama University HospitalNobuyukiOkabeDepartment of Psychiatry, Okayama City HospitalNorihitoYamadaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences We launched our Psychiatry Liaison Team in the Department of Neuropsychiatry of Okayama University Hospital in 2009. Since nearly half of all new cases had suffered delirium, we subsequently launched our Delirium Control Team in 2011.
The main purposes of the Delirium Control Team are to prevent the occurrence of delirium through early interventions by various medical staff, and to educate co-medical staff about delirium care. In this article, we present the recent activities and future outlook of both the Psychiatry Liaison Team and the Delirium Control Team.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7042016An Open-Label Feasibility Trial of Repetitive Transcranial Magnetic Stimulation for Treatment-Resistant Major Depressive Episodes307311ENMasakiFujiwaraDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceMasatoshiInagakiDepartment of Neuropsychiatry, Okayama University HospitalYujiHiguchiDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceYosukeUchitomiInnovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center HospitalSeishiTeradaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceMasafumiKodamaOkayama Psychiatric Medical CenterYoshikiKishiOkayama Psychiatric Medical CenterNorihitoYamadaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceClinical Study Protocols10.18926/AMO/54510Repetitive transcranial magnetic stimulation (rTMS) has been reported to be a new treatment option for treatment-resistant depression. In Japan, there has been limited research into its feasibility, efficacy, and tolerability. We have launched a trial of rTMS for treating medication-resistant major depressive disorder and bipolar depression. We are investigating low-frequency rTMS to the right dorsolateral prefrontal cortex and traditional high-frequency rTMS to the left dorsolateral prefrontal cortex, in 20 patients. The primary outcome of the study is the treatment completion rate. This study will provide new data on the usefulness of rTMS for treatment-resistant depression in Japan.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812732015「怒り」の精神医学的考察―緩和ケアの場面を中心に―197201ENNorihitoYamadaNo potential conflict of interest relevant to this article was reported.