Michihiko Nakamura

Reliability and validity of the Japanese version of the Yale-Brown Obsessive-Compulsive Scale.

Abstract The reliability and validity of the Japanese version of the Yale‐Brown Obsessive‐Compulsive Scale (JY‐BOCS) were determined by 20 raters for 12 Japanese patients with obsessive compulsive disorder at four institutions. Interrater reliability for the total JY‐BOCS score was excellent, and the intraclass correlation coefficient was high (ICC = 0.960). Internal consistency was also excellent (Cronbachs α= 0.889). Concurrent and discriminant validity of the JY‐BOCS was examined by comparing the scores on the JY‐BOCS with those on the Maudsley Obsessional Compulsive Inventory (MOCI) and scales for depression and anxiety. A slight correlation was found between scores on the JY‐BOCS and MOCI, but no significant correlations were found between scores on the JY‐BOCS and those on scales for depression or anxiety.

The topographical features of EEGs in patients with affective disorders

EEG data were obtained in the basic state from 16 scalp sites of 44 patients with affective disorder, diagnosed by DSM-III criteria, and 44 normal controls. The EEG power spectra were computed and the t statistic significance probability mapping (SPM) was applied to visualize regions where the patient group showed differences in the EEG topogram from the controls. The results show: (1) left occipital predominance (P3, O1) of alpha activities in the patients with affective disorders, (2) decreased alpha activities in Fp2 and F8 areas in patients with major depression without melancholia, (3) decreased alpha activities in F7 area in patients with bipolar disorder, manic, and (4) increased beta 2 activity in F4 and C4 areas in patients with major depression with melancholia. These results suggest that inter-hemispheric and intra-hemispheric relationships may be disturbed in patients with affective disorder.

A comparison of the CNV in young and old subjects: Its relation to memory and personality

Abstract Memory and personality of 16 healthy old subjects (8 preseniles and 8 seniles) were assessed by the CLTR of selective reminding (Buschke and Fuld 1974) and the Maudsley Personality Inventory (MPI), respectively, and were correlated with the CNVs recorded in the serial conditions of habituation—reinforcement—motor extinction (free attention)—reinforcement—motor extinction (forced attention), and compared with those in 8 young subjects. The mean CNV amplitude under the reinforcement condition decreased prominently at ages over 65 years. The mean reaction time (RT) was prolonged with aging and correlated with the CNV amplitude. The mean CNV amplitude under the motor extinction (free attention) condition decreased from the young to the presenile and senile ages. The mean CNV amplitudes under the habituation and motor extinction (forced attention) conditions did not show any definite changes among the groups. The CNV amplitude in the reinforcement had significant correlations with the CLTR value, extraversion and neuroticism scores of the MPI, while the RT had a significant correlation with the neuroticism score. Resistance against the motor extinction was enhanced with a decrease of the CLTR value and the extraversion score. We concluded that the CNV in the old people was more influenced by senile changes in memory and personality than by chronological age.

The prevalence of obsessive-compulsive disorder in Japan: A study of students using the Maudsley Obsessional-Compulsive Inventory and DSM-III-R

Abstract The prevalence of obsessive‐compulsive disorder (OCD) was measured in 424 Japanese students using a Japanese version of the Maudsley Obsessional‐Compulsive Inventory (MOCI‐J). Six students (1.7%) of 350 interviewed students were diagnosed as OCD according to DSM‐III‐R. When the cut‐off point of the MOCI‐J was 12, the sensitivity was 100% and the specificity was 96%. Our results suggest that individuals with OCD are not rare among the young Japanese population and that the MOCI‐J is a useful tool for screening OCD.

CNV-like potentials on the cortical surface associated with conditioning in head-restrained rats ☆

Head-restrained rats were conditioned to perform a CNV task: to press a lever in response to an imperative auditory stimulus (S2) given 1.5 sec after a warning stimulus (S1) for a drop of jelly food. With an electrode on the surface of the forelimb cortex, (1) sharp wave complexes immediately after S1 and S2, and (2) a negative slow potential (SP) between S1 and S2, on which early and late components were discernible, were recorded in association with performance of this task. With the electrode at a depth of 2 mm in the same cortical area, the corresponding field potential showed a long-lasting positive shift in addition to the components of the surface potential. These monopolar recordings were obtained with respect to a common reference at the frontal sinus. The surface-minus-depth potential (the transcortical potential), consequently, showed a surface-negative tonic wave, confirming Pirchs report (1980). During extinction of this conditioning, the SP between S1 and S2 disappeared, while the sharp waves following S1 and S2 remained with little modification, suggesting that the sharp waves are a kind of evoked potential (EP) elicited by the stimuli. Recording from 5 surface electrodes set in an array over the left hemisphere contralateral to the used forelimb during development of the conditioning revealed not only a spatial distribution of the SP but also a transition of the potentials. As the conditioning progressed, the negativity of the early SP component tended to increase, while that of the late component tended to decrease and was confined to the sensorimotor cortex.(ABSTRACT TRUNCATED AT 250 WORDS)

A behavior therapy program combined with liquid nutrition designed for anorexia nervosa

We have introduced behavior therapy as standard in‐patient treatment for anorexia nervosa and have modified the treatment program. At first, we used Fukamachis activity restriction therapy (FT), followed by Token economy therapy (TET), which combined token economy with FT. Finally, we have developed Kyoto Prefectural University of Medicine Behavior Therapy (KPT). According to KPT, only liquid formula is given in the early stages of hospitalization and a target weight is not set at admission. We examined the effect of these three programs with respect to bodyweight gain. Thirty‐five anorexic patients participated in these three programs in our hospital: seven completed FT, seven completed TET and 21 coompleted KPT. We compared the effects of these three programs on body mass index (BMI). Furthermore, the effects of these three programs on BMI were compared at admission, 1 month after admission and at discharge, 6 months after discharge. In addition, the rate of increase of BMI for the following three periods was investigated: 1 month after admission, total hospitalization (from admission to discharge) and from admission to 6 months after discharge. The result is that KPT was the most effective of the three programs with regard to both the amount and the rate of increase of BMI at all points and there is a significant difference between KPT and FT. This effectiveness may be attributable to the use of an oral liquid formula, the setting of target weight at a later stage of hospitalization and the release of activity restriction based on weight gain.

Modification of visual, auditory, and somatosensory evoked responses in cortical primary receiving areas by nigral stimulation

Nachweis einer «unspezifischen» fördernden Wirkung von Stimulation der Substantia nigra auf «evoked potential» in den primären sensorischen Zentren des Grosshirns.

Computerized tomographic study on the brain of patients with alcohol dependence

Abstract: One hundred ten patients with alcohol dependence and 56 psychiatric patients with either senile dementia, amphetamine psychosis, epilepsy or chronic schizophrenia were investigated with a CT scan of the brain. The maximum width of the 3rd ventricle was measured, and the presence/absence of enlargement of the lateral ventricle and of atrophy of the frontal lobe was determined independently by 3 physicians. The width of the 3rd ventricle in alcoholic and the other patients examined was gradually enlarged with aging, and the width in these patients was significantly larger than that in the age‐matched control patients who were selected from the patients with amphetamine psychosis, epilepsy or schizophrenia. The enlargement of the lateral ventricles observed in the alcoholic patients always accompanied the enlargement of the 3rd ventricle, but not vice versa. The alcoholic patients with frontal lobe atrophy showed a higher incidence of withdrawal delirium than the patients without atrophy. These findings suggest that the chronic intake of alcohol might affect primarily the area around the 3rd ventricle, resulting in enlargement of this ventricle and consequential enlargement of the lateral ventricles and also that the alcoholic patients with frontal lobe atrophy could have a high risk for a manifestation of alcoholic withdrawal delirium.

Treatment for inpatients with anorexia nervosa : Comparison of liquid formula with regular meals for improvement from emaciation

Abstract A new refeeding program using only liquid formula was given to six anorexic inpatients (LF group) at the initial stage of hospitalization. These patients were compared with six other inpatients who regular meals (RM group). The LF group did not develop a phobia of gaining weight, while the RM group showed a vicious cycle of gastrointestinal discomforts leading to fat phobia and stagnation in weight gain. By comparison, the LF group had fewer gastrointestinal symptoms, which resulted in the disruption of this cycle and seemed to help motivate these patients to obtain a steady gain in bodyweight.

Body Image Changes in Adolescents I Development of Self-Rating Body Image (SRBI) Test and Effects of Sex, Age and Body Shape

Abstract: We investigated the effects of sex, age and body shape on self‐body image estimated by our Self‐Rating Body Image (SRBI) test in 687 adolescents. Three factors were derived from the 20 items of the SRBI by using a factor analysis. They were interpreted as the images of “body shape,”“face” and “visceral organ.” Scores of these images in the females were significantly higher than those in the males. There was a significantly negative correlation between the body shape and “body shape” image for the female adolescents 13 years of age (middle) and 18 years of age (late), while no correlation was found for the male and female adolescents 10 years of age (early) and late male adolescents. Our results suggest that a female adolescent wants to be thinner and that the body image showed critical changes during the early and middle periods of adolescence, leading to unsatisfactory images of self‐body.