Atsuko Tomoda

One-year prevalence and incidence of depression among first-year university students in Japan: A preliminary study

Abstract A structured interview was used to examine the 1‐year incidence and prevalence of depression among 116 first‐year university students. While 24 of the subjects (20.7%) met the Diagnostic and Statistical Manual of Mental Disorders 4th ed. (DSM‐IV) criteria for Major Depressive Episode (MDE), 62 (53.4%) met the Diagnostic and Statistical Manual of Mental Disorders 3rd ed. Revised (DSM‐III‐R) criteria for MDE, and 27 (23.3%) also met the Research Diagnostic Criteria (RDC) for Major Depressive Disorder (MDD) for the 12 months prior to the interview. Moreover, 23 of the subjects (19.8%) had onset of the DSM‐IV criteria for MDE, 54 (46.6%) had onset of the DSM‐III‐R criteria for MDE, 24 (20.7%) had onset of the RDC for MDD, during the same time period. These high rates of depression may be explained by the students’ difficulties in and by their readjustment after entering university.

Factor structures of the Zung Self-Rating Depression Scale (SDS) for undergraduates

In order to categorize the items of the Zung Self-Rating Depression Scale (SDS) so as to allow the construction of subscales, the Japanese version of the SDS was administered to a total of 2,258 undergraduates. Principal-component analyses of the SDS extracted three factors interpretable as cognitive, affective, and somatic symptoms. The SDS was then administered to 597 undergraduates in order to cross-validate the factor structures. The coefficient of congruence and the goodness-of-fitness index generated by a confirmatory factor analysis showed good cross-validity of the factor structures.

Method for Assessment of Competency to Consent in the Mentally Ill: Rationale, Development, and Comparison with the Medically Ill

The doctrine of informed consent has been widely accepted and the patient’s right to self-determination highly respected, particularly in Western countries. In Japan, the doctrine of informed consent was introduced quite recently. The necessity of doctor’s disclosure of medical information has been discussed since the 1970s. The term “medical ethics” was introduced in the 1980s and the concept of informed consent was increasingly respected in Japan. In 1988 the Ministry of Health issued an interim report relating to the future medical practice in Japan. It said that in view of the introduction of the concept of informed consent, it is desirable to take into account that patients receive satisfactory medical information—purpose, expected effects, and alternative of the

Validity and reliability of structured interview for competency incompetency assessment testing and ranking inventory

The Structured Interview for Competency and Incompetency Assessment Testing and Ranking Inventory (SICIATRI) is a structured interview guide to assess the competency for giving informed consent to treatment among psychiatric and medical patients. The competency levels of 48 psychiatric and medical inpatients were assessed by SICIATRI. A relatively high- inter-rater reliability of the SICIATRI items (over half of the items had kappa > or = .60) and concurrent validity (sensitivity = .83, specificity = .67 as measured against the global judgement of competency rating by the attending physician) were obtained. In addition to its brevity (it takes about 20 minutes to complete), these findings may warrant application of this instrument in a clinical setting.

Labeling Effect of Seishin-Bunretsu-Byou, the Japanese Translation for Schizophrenia: an Argument for Relabeling

Stigma attached to individuals with schizophrenia may be derived from its diag nostic label. Two forms of a questionnaire were distributed to 189 Japanese university students. Each questionnaire contains case vignettes of schizophrenia and major depression. In one form, the students were told at the close of each vignette the diagnostic label assigned to that case (the label group) whereas in another form, they were not done so (the control group). The students were also asked to rate negative image of the case in four items each. The label group was significantly higher than the control group in three of the four negative image items for the vignette of schizophrenia. They did not differ in any of the negative image items for the vignette of depression. This suggests that the label of schizophrenia (the Japanese translation Seishin-bunretsu-byou) has stigmatizing effect. We discussed these findings in the light of the implications of a relabeling, and argued for a change of name.

Validity and reliability of the Japanese version of the Temperament and Character Inventory: A study of university and college students

OBJECTIVE The Temperament and Character Inventory (TCI) is a widely used self-report measure of adult personality. METHOD We studied 586 Japanese university and college students with the 125-item version of the Japanese TCI. RESULTS The factor structure of the TCI scales was similar to that reported in other languages. Depression was positively correlated with Novelty Seeking and Harm Avoidance but inversely correlated with Persistence, Self-Directedness, and Cooperativeness. Good Self-Image in the framework of adult attachment was correlated positively with Self-Directedness but inversely with Harm Avoidance and Reward Dependence. Good Other-Image in the framework of adult attachment was positively correlated with Reward Dependence and Cooperativeness. The scores of the TCI scales were stable over a time span of 1.5 to 2 months. CONCLUSION The Japanese version of the TCI may be a valid and reliable measure of temperament and character, at least among the adolescent and young adult population.

Psychiatric disorders among Japanese children.

OBJECTIVE To generate current data on the prevalence of psychiatric disorders among Japanese children, using DSM-III-R criteria. METHOD As part of an ongoing longitudinal study in a Japanese community sample, 114 mother-child dyads were interviewed when the children were approximately 8 years old. DSM-III-R disorders of the children were diagnosed through the administration of a structured diagnostic instrument, the parent and child versions of the Child Assessment Schedule, to both the children and their mothers. RESULTS The prevalence rate for any diagnosis was 49.1%, which is similar to that of U.S. children and adolescents. CONCLUSION The Child Assessment Schedule is an appropriate scale for assessing the psychopathology of Japanese children, which is as prevalent as in a U.S. sample.

PATIENTS' DESIRE TO PARTICIPATE IN DECISION-MAKING IN PSYCHIATRY: A QUESTIONNAIRE SURVEY IN JAPAN

Japanese national sentiment has been described as paternalistic, which has potentially wide-ranging implications for the manner in which psychiatric patients should participate in medical decision-making. To examine the extent and possible determinants of the desire to participate in medical decision-making among Japanese people, we distributed a packet of questionnaires to 747 (nonmedical) university students and 114 of their parents. The questionnaires included an imaginary case vignette of psychotic depression. The participants were asked whether they would want various types of medical information, i.e., diagnosis, aetiology, treatment, outcomes, medical charts, etc., disclosed to them were they in such a psychiatric condition. Also included was the 1995 Scale for Independent and Interdependent Construal of the Self by Kiuchi. More than half of the participants wanted all the types of medical information disclosed to them. Those participants who wanted to have all types of information disclosed to them (n = 413) as compared to those who did not want to know at least one type of information (n = 445), tended to be male and to have an educational background in psychiatry (9.7% vs 5.4%) as well as an assertive attitude as indicated by a higher score on Independence on the Scale for Independence and Interdependent Construal of the Self. These results suggest that the Japanese in this sample are more likely to want to make an autonomous contribution to the psychiatric decision-making process and that less desire for information can be predicted by some demographic and personality factors.

CORRELATES OF RETROSPECTIVE EARLY LIFE EXPERIENCE WITH PERSONALITY IN YOUNG JAPANESE WOMEN

To examine the influence of early experiences on the development of personality, we used the Temperament and Character Inventory to assess 98 young women who had first entered a company. Different early experiences were linked, albeit weakly, to test scores. Both partial correlations and multiple regression analyses indicated that Self-directedness was higher if women reported more care of parents. Partial correlation, but not multiple regression analyses, showed that Cooperativeness was greater if women reported more care of parents and less frequent abuse. Reports of early parental loss or negative or positive early life events showed no correlation with scores on any of the Temperament and Character Inventory subscales.

The Relationship Among Major Depression, Depressive Symptoms, and Self-Preoccupation

The present study investigates whether highly self-preoccupied people (exhibiting a tendency to focus primarily on the self and to maintain self-focused attention) were more likely to experience major depressive episodes (MDEs) than those without such tendencies. One hundred nineteen young community residents, aged 18 to 21, took part in semistructured interviews, during which we investigated their past and present history of mental illness, including MDEs, as delineated by the Diagnostic and Statistical Manual of Mental Disorders (3rd ed. rev.; DSM-III-R). Self-preoccupation was measured by the Self-Preoccupation Scale (SPS). Of the 119 participants interviewed, the lowest and highest quarters in the SPS scores formed the low- and high-self-preoccupation (SP) groups. The lifetime prevalence of the DSM-III-R MDE was significantly greater among those high in SP than in the low SP group. Moreover, the high-SP group had significantly more depressive symptoms than the low-SP group. The contributory role of self-preoccupation to suicide ideation and the interpersonal aspects of self-preoccupation were discussed.