Yoji Nakatani

New legislation for offenders with mental disorders in Japan.

This article describes the recent law reform on forensic mental health and its background in Japan, focusing on the enactment of the Medical Treatment and Supervision Act in 2005. The new system-under which a person who commits a serious criminal offence in a state of insanity or diminished responsibility shall be referred by the public prosecutor to the District Court-aims to provide intensive psychiatric treatment to offenders with mental disorders, attaching great importance to their reintegration into society. The court panel, which consists of a judge and a specially qualified psychiatrist, plays a key role in the treatment procedure. Upon the agreement of the two panel members, the panel delivers a verdict that takes into account the outcome of psychiatric evaluation; possible verdicts are inpatient treatment order, outpatient treatment order (mental health supervision), and no treatment order. Designated facilities are currently being established for inpatient and outpatient treatment. Referring to the published data on outcomes of enforcement, this article discusses particularities, current problems, and future prospects of the system, drawing comparisons between the German and Japanese systems.

Correlation between addictive behaviors and mental health in university students

Aims:  The present study aims to clarify the relationships of addictive behaviors and addiction overlap to stress, acceptance from others and purpose in life.

Challenges in interfacing between forensic and general mental health: a Japanese perspective.

This article highlights the characteristics of forensic mental health services in Japan, with special emphasis on outpatient treatment of offenders with mental disorders, and discusses the potential implications of the Japanese experience in view of Western trends. The literature suggests that forensic patients tend to be left behind by the overall psychiatric reforms in developed countries. The recent law reform on forensic mental health in Japan is intended to be compatible with the contemporary ideas of psychiatry, such as normalization and community-based care. The primary objective of the new legislation is to provide intensive psychiatric treatment to offenders with mental disorders, attaching great importance to their re-integration into society. However, the system has already been faced with major challenges, including the insufficiency of human and financial resources in community and the accumulation of long-stay, treatment-resistant patients in special facilities. This article stresses the importance of active participation of general mental health services in the rehabilitation of offenders with mental disorders.

Sociodemographic and clinical characteristics of psychiatric patients coercively brought to hospitals

Abstract In order to clarify the sociodemographic and clinical characteristics of psychiatric patients with poor motivation for treatment, we examined patients who were coercively brought to hospitals. Sociodemographic and clinical data on 287 inpatients from two private psychiatric hospitals in Japan were retrospectively analyzed. All patients were in the hospitals on 1 April 1997 and had received treatment prior to this admission. Of these inpatients, 67 (23.3%) were coercively brought to hospitals. Multiple logistic regression was performed on the data of these patients to identify the factors associated with their resistance to visiting the hospital. From the results of multivariate analysis, four characteristics were associated with patients coercively brought to hospitals, namely medication compliance, receiving regular outpatient treatment or not, a history of self‐aggression or aggressive behavior towards others, and living arrangements. For patients who had lived with relatives before hospitalization, the primary caregiver being a parental caregiver was associated with patients coercively brought to hospitals, although it was not statistically significant. In addition, agitation was associated with patients not coercively brought to the hospital according to multivariate analysis. The present results suggest that psychiatric patients with poor motivation are more likely to have poor medication compliance, to have not received regular outpatient treatment, to have a history of aggressive behavior and to live alone. For patients who lived with their caregivers prior to hospitalization, poorly motivated patients tended to have parental caregivers and were less likely to be agitated.

Parental Post-Traumatic Stress Symptoms as Predictors of Psychosocial Problems in Children Treated for Cancer

The purpose of this study was to explore the association between psychosocial functioning of children treated for cancer and that of their parents. Factors associated with psychosocial functioning were also examined. The present study was a cross-sectional survey of 33 mothers and one father (mean age: 37.9), each of whom had a child that had been treated for cancer. The participants answered a package of questionnaires consisting of the Impact of Event Scale-Revised (IES-R), the Parent Experience of Child Illness (PECI), and the Child Behavior Checklist (CBCL). Information about the children’s illnesses was collected from medical records. The CBCL total problems T score was correlated with the parental IES-R total scores. Intensity of treatment independently predicted the variance of parental long-term uncertainty. In conclusion, psychosocial problems of children with cancer were associated with parental post-traumatic stress symptoms (PTSS). Provision of early, adequate support to parents who are vulnerable to PTSS will help not only the parents, but also their children with cancer.