Kanichiro Fujisawa

Somatic symptoms most often associated with depression in an urban hospital medical setting in Japan

Somatic symptoms are known to be the major manifestation in patients with depression. The aim of the present study was to investigate the major somatic and psychiatric symptoms associated with depression in each sex. Patients with a DSM-IV diagnosis of depressive disorders (n=335) and comparison patients without depression (n=425) among new outpatients in an urban hospital medical setting were eligible for study. The relationship between the three most distressing subjective symptoms at the first visit, confirmed by the patients description on a health questionnaire and the admitting physicians interview, and depression was investigated in each sex. Most (77.4%) of the complaints in patients with depression were somatic. In a simple logistic regression analysis, diarrhea, excessive sweating and psychomotor retardation in men, and headache, depressed mood and grief in women were associated with depression. In multiple logistic regression analysis, diarrhea, excessive sweating and weight loss in men, and headache, dysesthesia and grief in women, as well as sleep disturbance, loss of appetite, general fatigue, loss of interest and agitation in both sexes, were statistically significantly associated with depression. Fever in men was also associated with depression by Fishers exact test.

Gender differences in psychiatric symptoms related to suicidal ideation in Japanese patients with depression

Abstract  Recent figures show that more than 30 000 people suicide each year in Japan, and that many of them are considered to suffer from depression. In addition, the suicide rate among Japanese women has been shown to be higher than in other countries. However, it is not clear whether the psychiatric symptoms leading to suicide differ by gender. The authors examined gender differences in psychiatric symptoms related to suicidal ideation (SI) in Japanese patients with depression. Study subjects were 199 new patients (66 men and 133 women) who were diagnosed with a major depressive disorder. SI and psychiatric symptoms were assessed by several psychological tests using questionnaires. Logistic regression analysis was used to calculate the odds ratio (OR) and 95% confidence interval (CI) with an adjustment for all relevant factors simultaneously. The stepwise method was also used for selecting variables. In univariate analysis, several psychosocial factors such as self‐reproach, derealization, depressive moods, depersonalization, and anxiety traits were statistically significantly associated with SI in both men and women. However, multivariate analysis using the stepwise method distinguished gender differences. Low social/family support and depersonalization were statistically significantly associated with SI in men, while depressive moods and an anxiety state were significantly associated with SI in women. The relation between derealization and SI was statistically significant in women but not significant in men.

Multiple calcium channels regulate neurotransmitter release from vagus nerve terminals in the cat bronchiole.

Twitch‐like contractions and non‐adrenergic non‐cholinergic (NANC) relaxations evoked by electrical field stimulation (EFS) of the cat bronchiole were used to examine the voltage‐activated calcium channels involved in excitatory and inhibitory neurotransmission in the cat bronchiole. Nifedipine (50 μM), the L‐type calcium channel antagonist, did not affect the twitch‐like contraction and NANC relaxations. However, low concentrations of the N‐type calcium channel blocker ω‐conotoxin GVIA (ω‐CgTX GVIA) (0.1 μM) irreversibly abolished twitch‐like contractions evoked by trains of EFS 10 stimuli at 20 Hz. After the prolonged treatment with 0.1 μM ω‐CgTX GVIA, EFS evoked initial fast and later slow NANC relaxations in the presence of 5‐HT (10 μM), atropine and guanethidine (1 μM each). However increased concentration of ω‐CgTX GVIA (1 μM) completely suppressed the slow NANC relaxation without affecting the initial fast component. ω‐agatoxin IVA (100 nM), the P‐ and Q‐type calcium channel inhibitor, and nimodipine (10 μM), the L‐ and T‐type calcium channel blocker, did not affect the amplitude of the initial fast NANC relaxation in the absence or presence of ω‐CgTX GVIA (1 μM). The contraction or relaxation induced by exogenous acetylcholine (ACh) (0.5 μM) or the nitric oxide donor, s‐nitroso‐N‐acetyl penicillamine (SNAP) (1 μM) were not affected by ω‐CgTX GVIA (1 μM). Taken together, these results suggest that generation of twitch‐like contraction and later slow NANC relaxation are regulated by N‐type calcium channels, whereas generation of the initial fast NANC relaxation possibly involves R‐type calcium channel.

Mental and somatic symptoms related to suicidal ideation in patients visiting a psychosomatic clinic in Japan

Patients with suicidal ideation (SI) have various mental or somatic symptoms. A questionnaire-based interview elicited details concerning mental and somatic symptoms in patients visiting a psychosomatic clinic in Japan. Univariate logistic regression analyses followed by multiple regression models using a stepwise method were selected for identifying the candidate symptoms. Overall, symptoms related to depression were associated with SI in both sexes. Although women showed more various somatic symptoms associated with SI than men, many of those associations were diminished once severity of the depression was controlled. The current results suggest that a variety of self-reported symptoms, mainly related to depression, might reveal suicidal risk in outpatients with an urban hospital clinical setting.