Yasuhito Ishimoto

Brief Assessment of Cognition in Schizophrenia: Validation of the Japanese version

Abstract  This preliminary study was performed to test the reliability and validity of the Brief Assessment of Cognition in Schizophrenia (BACS) as an assessment tool in a Japanese‐language version (BACS‐J). The subjects for the present study were 30 outpatients with chronic schizophrenia. Each subject gave written informed consent to participate in the research. Cronbachs alpha for the BACS‐J was 0.77. The BACS‐J composite score was significantly correlated with all primary measures of BACS‐J (verbal memory, working memory, motor speed, verbal fluency, attention, and executive function). All BACS‐J primary measures and the composite score were significantly correlated between two assessments. The mean score of the Digit Sequencing Task and composite score on the second assessment were significantly larger than those on the first assessment. All BACS‐J primary measures except the Symbol Coding Task were significantly correlated with relevant standard neurocognitive tests. Also, the BACS‐J composite score was significantly correlated with all standard neurocognitive tests except the Continuous Performance Test. A principal components analysis with varimax rotation resulted in a three‐factor solution (executive function and memory; motor speed and general cognitive functions; and working memory). This preliminary study indicates that the BACS‐J is a reliable and practical scale to evaluate cognitive function.

Brain-derived neurotrophic factor (BDNF) Val66Met polymorphism in schizophrenia is associated with age at onset and symptoms

Brain-derived neurotrophic factor (BDNF) is a neurotrophic factor that promotes several functions of neurons and modulates neurotransmissions. It has been reported that there are alterations of BDNF levels in schizophrenic brains and that BDNF gene expressional changes would be responsible for the etiology of schizophrenia. Recent studies have shown that a variation of BDNF gene (Val66Met polymorphism) affects the function of neurons, and is associated with several neurological and psychiatrical disorders. We investigated the relationship between BDNF Val66Met polymorphism and the onset age as well as levels of clinical symptoms in 159 of chronic schizophrenia in-patients diagnosed by DSM-IV. The mean onset ages were 27.5+/-9.5 for BDNF Val/Val, 25.5+/-7.4 for BDNF Val/Met and 22.9+/-6.0 for BDNF Met/Met and this polymorphism was significantly associated with age at onset (P=0.023). The mean Brief Psychiatric Rating Scale scores (BPRS) were significantly different among those three groups (P=0.003). No significant differences were demonstrated comparing the BDNF genotype distributions of positive and negative family history (P=0.21). Our investigation indicates that the BDNF gene Val66Met polymorphism is related to the onset age of schizophrenia and the levels of clinical symptoms that remain after long-term antipsychotic treatment.

Predictors of subjective and objective quality of life in outpatients with schizophrenia

Aim:  In recent years, greater attention has been given to quality of life (QOL) in schizophrenia and several studies reported that negative and depressive symptoms and cognitive dysfunction are related to patient QOL. But because a variety of QOL measures have been used in the previous studies, there seems to be no unanimous predictors for subjective and objective QOL. The purpose of the present study was to elucidate the relationship between clinical variables and subjective and objective QOL in outpatients with schizophrenia, using schizophrenia disease‐specific QOL measures. Particular attention was paid to cognitive function as a predictor of QOL.

Subjective and Objective Measures of Quality of Life Have Different Predictors for People with Schizophrenia

This study investigated the relationship between subjective and objective quality of life and assessed predictors in people with schizophrenia. The study population consisted of 99 stabilized outpatients with schizophrenia (DSM-IV) who had been regularly receiving outpatient treatment at the Department of Psychiatry, The Tokushima University Hospital. Subjective and objective quality of life were estimated using the Schizophrenia Quality of Life Scale and the Quality of Life Scale, respectively. Psychiatric symptoms were also measured with the Brief Psychiatric Rating Scale and the Calgary Depression Scale for Schizophrenia. Scores on the Schizophrenia Quality of Life Scale Motivation and Energy scales significantly correlated with the Quality of Life Scale total scores –.40 (p <.001), and with the scores on Interpersonal Relations subscale –.42 (p <.001), Instrumental Role subscale –.28 (p = .005), Intrapsychic Foundations subscale –.39 (p <.001), and Common Objects and Activities subscale –.25 (p = .014). The Schizophrenia Quality of Life Scale Psychosocial scale significantly correlated with only the Quality of Life Scale total score –.20 (p = .05), and there was no significant correlation between the scores on the Schizophrenia Quality of Life Scale Symptoms and Side-effects scales and the Quality of Life Scale. Stepwise regression analyses showed that the Calgary Depression Scale for Schizophrenia score was the most important predictor of each scale of the Schizophrenia Quality of Life Scale, and the Brief Psychiatric Rating Scale Negative Symptoms score was the most important predictor of the Quality of Life Scale total score and each subscale. These results suggest that subjective and objective quality of life have different predictors and should be considered as separate and complementary outcome variables.

Mild Serotonin Syndrome on Fluvoxamine

Objective This preliminary study was performed to investigate the prevalence and severity of the serotonin-related symptoms for a group of patients in a clinical setting during fluvoxamine (FLU) using the Japanese version of the Serotonin Syndrome Scale (JSSS). Methods The subjects for the present study were 37 patients (20 and 17 patients with mood and anxiety disorders, respectively), meeting a diagnosis of DSM-IV. Each subject gave informed consent for the research involved in this study. Presence and severity of the serotonin-related symptoms were determined by Sternbachs criteria and the JSSS, respectively. Results (1) At the time of assessment, none of the patients fulfilled the diagnostic criteria of SS proposed by Sternbach, or none of the total JSSS scores of the patients was sufficient to reach the cutoff point of 7. (2) Sixteen of the 37 patients (43.2%) showed at least one symptom in the JSSS. (3) Spearmans rank correlations showed that there was a positive but nonsignificant correlation between the total JSSS scores and dosages of FLU. Conclusion This preliminary study suggested that milder forms of the serotonin syndrome may exist for a group of patients in a clinical setting during FLU therapy.

Electroencephalographic changes during and after water intoxication.

Abstract: A case of water intoxication with remarkable hyponatremia was investigated with a special reference to EEG changes during and after the episode. The patient recovered his EEG as his consciousness disturbance had improved through an intravenous infusion of high osmolality saline, correlating with the serum sodium level. Further, the clinical importance of recording EEG for water intoxication was stressed.

Temperament, character, and eating attitudes in Japanese college women

The present study investigated associations between dimensions of personality characteristics and eating attitudes in Japanese college women. 91 college women with a mean age of 20.7 yr. (SD ! 2.3 yr.), attending a School of Nursing or a School for Kindergarten Teachers, voluntarily responded to the Japanese version of the Temperament and Character Inventory and the Eating Attitudes Test. A significant positive correlation was found between the scores on the Temperament and Character Inventory subscale of Harm Avoidance and the Eating Attitudes Test total scores (Spearman ρ = .24, p ! .02) and the scores on the Eating Attitudes Test subscale of Food Preoccupation (Spearman ρ = .33, p ! .002). The scores on the Temperament and Character Inventory subscale of Self-directedness showed significant negative correlations with the Eating Attitudes Test total scores (Spearman ρ = –.35, p ! .001) and the scores on the Eating Attitudes Test subscales of Dieting (Spearman ρ = –.29, p ! .005) and Food Preoccupation (Spearman ρ = –.43, p = .0001). The present results suggest that Japanese college women who score high on Harm Avoidance and low on Self-directedness may be more likely to develop inappropriate eating attitudes.