Kenzo Denda

Open pergolide treatment of tricyclic and heterocyclic antidepressant-resistant depression

Background: Recently, a dopamine hypothesis of depression was put forward, and several studies have demonstrated that direct and indirect dopamine agonists have antidepressant effects. Methods: Using Clinical Global Impressions, we evaluated the efficacy of 4-week treatment of pergolide as an antidepressant adjuvant involving 20 unipolar depressed patients who were refractory to standard treatment with antidepressants. Results: One patients (5%) were very much improved, seven (35%) much improved, four (20%) minimally improved, six (30%) no change or worse, and two (10%) not assessed. There was no significant difference in any clinical factors between the pergolide responder and non-responder group. Limitations: This study was a non-blind open trial, and pergolide was added to tricyclic and heterocyclic antidepressants. Conclusion: Pergolide may be useful as an antidepressant adjuvant, suggesting a potential role for dopamine-2 stimulation in the antidepressant response.

Possible role of preproghrelin gene polymorphisms in susceptibility to bulimia nervosa

Previous investigations have suggested that ghrelin, an endogenous orexigenic peptide, is involved in the pathology of eating disorders. We conducted a study to determine whether any preproghrelin gene polymorphisms are associated with eating disorders. Three hundred thirty‐six eating disorder patients, including 131 anorexia nervosa (AN)‐restricting types (AN‐R), 97 AN‐binge eating/purging types (AN‐BP) and 108 bulimia nervosa (BN)‐purging types (BN‐P), and 300 healthy control subjects participated in the study. Genotyping was performed to determine the polymorphisms present, and with this information, linkage disequilibrium (LD) between the markers was analyzed and the distributions of the genotypes, the allele frequencies, and the haplotype frequencies were compared between the groups. The Leu72Met (408 C > A) (rs696217) polymorphism in exon 2 and the 3056 T > C (rs2075356) polymorphism in intron 2 were in LD (D′ = 0.902, r2 = 0.454). Both polymorphisms were significantly associated with BN‐P (allele‐wise: P = 0.0410, odds ratio (OR) = 1.48; P = 0.0035, OR = 1.63, for Leu72Met and 3056 T > C, respectively). In addition, we observed a significant increase in the frequency of the haplotype Met72‐3056C in BN‐P patients (P = 0.0059, OR = 1.71). Our findings suggest that the Leu72Met (408 C > A) and the 3056 T > C polymorphisms of the preproghrelin gene are associated with susceptibility to BN‐P.

Assessment of Depressive Symptoms in Japanese School Children and Adolescents Using the Birleson Depression Self-Rating Scale:

Objective: The aim of this study was to investigate the prevalence of depressive symptoms in children and adolescents in the general Japanese population using a depression self-rating scale and determine whether this prevalence varies according to age, gender, or region. Method: The Birleson Depression Self-Rating Scale for children (DSRS) was used to examine the extent to which depressive tendencies were present among 2,453 elementary and middle-school children (6 to 15 years old) in two cities in Japan. Results: The mean DSRS score was high at 8.75 + 5.66. A significant increase in score was observed with increasing age. There were no significant differences between regions. Using a DSRS cutoff score of 15 points as a risk of depression, the scores of 14.9% of the subjects exceeded the cutoff. Conclusions: As determined using the DSRS, a high proportion of Japanese children and adolescents have depressive tendencies.

The effects of cognitive remediation therapy using the frontal/executive program for autism spectrum disorder

Objective The cognitive features and treatment of autism spectrum disorder have been the subject of much debate in recent years. Therapeutic approaches to date have focused on skills acquisition, support tailored to the characteristics of autism spectrum disorder, and interventions in social cognitive functioning; there have been few reports describing interventions aimed at neurocognitive dysfunction. In this study, we focus on impairment of executive functioning in autism spectrum disorder patients and investigate improvements in executive functioning and their generalization to social functioning. Method The intervention adopted for this study was cognitive remediation therapy using the frontal/executive program. To investigate the effectiveness of frontal/executive program, 15 subjects who consented to participate in the study were randomly assigned to an intervention group or control group. Frontal/executive program was administered to the intervention group for about six months. Both groups were evaluated using the same scales: BACS-J, WCST, and CPT for cognitive assessment; SCoRS-J, GAF, and LASMI for social functioning; and GSE for self-efficacy. Results Both groups had lower scores for cognitive functioning than normal individuals at baseline. After completion of frontal/executive program, the intervention group showed improved performance on BACS-J for overall score, digit sequencing, verbal fluency, and Tower of London tasks. Improvements were also seen on SCoRS-J and LASMI scales of social functioning. Conclusions This was the first study to use frontal/executive program to focus on neurocognitive dysfunction in autism spectrum disorder patients. Frontal/executive program is effective in improving impaired executive functioning in autism spectrum disorder patients and may also lead to improvements in some aspects of social functioning.

Pilot Study of the Effects of Cognitive Remediation Therapy Using the Frontal/Executive Program for Treating Chronic Schizophrenia

Department of Functioning and Disability, Faculty of Health Science, Hokkaido University Kita 12, Nishi 5, Kita-ku, Sapporo, Hokkaido 060-0812, Japan Department of Psychiatry, Asahiyama Hospital 4-3-33, Futagoyama, Chuou-ku, Sapporo, Hokkaido 064-0946, Japan Department of Psychiatry, Matsumoto Mental Clinic 7-1, Kita 7, Nishi5, Kita-ku, Sapporo, Hokkaido 060-0807, Japan Department of Psychology, Toyama University 2630 Sugitani, Toyama, Toyama 930-0194, Japan Department of Psychiatry, Hokkaido University Graduate School of Medicine Kita 15, Nishi 7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan

Differences between bipolar and unipolar depression on Rorschach testing

Background The bipolar-unipolar distinction in patients with a major depressive episode is the most important issue related to the diagnosis and treatment of mood disorders, but remains unresolved. This study was undertaken to compare bipolar and unipolar depression on Rorschach testing using the Comprehensive System with reference to healthy Japanese controls. Methods Patients with bipolar or unipolar depression who had undergone the Rorschach test for routine clinical purposes were followed up naturalistically for a long period. Based on diagnostic confirmation after long-term follow-up, scores on this test for patients with bipolar and unipolar depression were compared with those published elsewhere for healthy Japanese controls. Results The bipolar depression group showed significantly higher scores or positive findings in five variables of the Rorschach test, ie, WSum6, DR2 > 0, (CF + C) > FC + 2, PureC > 1, and Populars > 7, as assessed using the Comprehensive System, than did the unipolar depression group and healthy controls. These scores did not differ between the unipolar depression and control groups. Conclusion The results of this study show thought disorder or cognitive slippage and marked laxness in modulating emotion in bipolar depression, indicating the psychopathological characteristics of bipolar disorder.