Yoshitake Takebayashi

Detailed course of depressive symptoms and risk for developing depression in late adolescents with subthreshold depression: a cohort study

Purpose Despite its clinical importance, adolescent subthreshold depression remains a largely neglected topic. The aims of this study were to accurately identify the natural course of depressive symptoms and the risk for developing major depressive episode (MDE) in late adolescents with subthreshold depression over 1 year. Patients and methods One hundred and seventy-two participants <20 years of age (mean age: 18.32 years, standard deviation: 0.50), who did not meet the full criteria for an MDE, were selected from 2,494 screened freshmen based on the Beck Depression Inventory, 2nd edition (BDI-II). We conducted a cohort study of three groups (low-, middle-, and high-symptom groups) divided based on BDI-II scores, over a 1 year period with the use of bimonthly assessments. Temporal changes of depressive symptoms were analyzed using linear mixed modeling and growth mixture modeling. Results First, we found that late adolescents with subthreshold depression (high depressive symptoms) were split between the increasing and decreasing depressive symptoms groups, whereas the majority of the less-symptoms group remained stable during 1 year. Second, in comparison with late adolescents with less depressive symptoms, those with subthreshold depression had an elevated risk of later depression. Conclusion Some late adolescents with subthreshold depression had increased depressive symptoms and developed an MDE during 1 year. Therefore, it is necessary for us to rigorously assess the changes in subthreshold depressive symptoms over time in late adolescents.

Risk Perception and Anxiety Regarding Radiation after the 2011 Fukushima Nuclear Power Plant Accident: A Systematic Qualitative Review

The purpose of this study was to provide a review of the publications of the risk perceptions or anxiety regarding radiation among people living in Japan after the 2011 Fukushima nuclear power plant accident. Two database (MEDLINE and PsycINFO) and hand-searched the references in identified publications were searched. For each identified publication, the measurements and time related-change of risk perception and anxiety regarding radiation were summarized. Twenty-four publications were identified. Quantitative measures of risk perception or anxiety were roughly divided into two types: single-item Likert scales that measure anxiety about radiation; and theoretical, or model-based measures. Rates of Fukushima residents with radiation-related anxiety decreased from 2012 to 2015. Factors governing risk perception or radiation-related anxiety were summarized by demographics, disaster-related stressors, trusted information, and radiation-related variables. The effects of risk perception or anxiety regarding radiation were summarized as severe distress, intention to leave employment or not to return home, or other dimensions. This review provides summary of current findings on risk perception or anxiety regarding radiation in Japan after the accident. Further researches are needed about detailed statistical analysis for time-related change and causality among variables.

cognitive behavioral therapy for depression in Japanese Parkinson's disease patients: a pilot study

Objectives This study evaluated the feasibility of cognitive behavioral therapy (CBT) for Japanese Parkinson’s disease (PD) patients with depression. To increase cultural acceptability, we developed the CBT program using manga, a type of Japanese comic novel. Methods Participants included 19 non-demented PD patients who had depressive symptoms (GRID-Hamilton Rating Scale for Depression score ≥8). A CBT program comprising six sessions was individually administered. We evaluated the feasibility and safety of the CBT program in terms of the dropout rate and occurrence of adverse events. The primary outcome was depressive symptom reduction in the GRID-Hamilton Rating Scale for Depression upon completion of CBT. Secondary outcomes included changes in the self-report measures of depression (Beck Depression Inventory-II, Hospital Anxiety and Depression Scale-Depression), anxiety (Hospital Anxiety and Depression Scale-Anxiety, State and Trait Anxiety Inventory, Overall Anxiety Severity and Impairment Scale), functional impairment, and quality of life (Medical Outcomes Study 36-Item Short-Form Health Survey). Results Of the 19 participants (mean age =63.8 years, standard deviation [SD] =9.9 years; mean Hohen–Yahr score =1.7, SD =0.8), one patient (5%) withdrew. No severe adverse event was observed. The patients reported significant improvements in depression (Hedges’ g =−1.02, 95% confidence interval =−1.62 to −0.39). The effects were maintained over a 3-month follow-up period. Most of the secondary outcome measurements showed a small-to-moderate but nonsignificant effect size from baseline to post-intervention. Conclusion This study provides preliminary evidence that CBT is feasible among Japanese PD patients with depression. Similar approaches may be effective for people with PD from other cultural backgrounds. The results warrant replication in a randomized controlled trial.

Do Individuals with Alcohol Dependence Show Higher Unfairness Sensitivity? The Relationship Between Impulsivity and Unfairness Sensitivity in Alcohol-Dependent Adults.

BACKGROUND Alcohol-dependent patients are known to be generally more unfairness sensitive. The ultimatum game (UG) is an experimental task designed to provoke feelings of perceived unfairness. A previous study using the UG has reported more unfairness sensitivity in patients with alcohol dependence than in a nondependent control group; it has been speculated that this increased sensitivity might be due to a difficulty in impulse control. However, the mechanism of this relationship has not been clarified. Therefore, the relationship between unfairness sensitivity in interpersonal relationships and impulsivity was investigated using UG and delay discounting (DD) paradigms. METHODS Subjects were 32 individuals with alcohol dependency and 36 healthy control individuals; both groups performed UG and DD tasks. RESULTS Participants with alcohol dependence rejected monetary offers deemed unfair at a significantly higher rate than did control participants. Moreover, the proportion of accepting unfairness was negatively correlated with impulsivity in patients with alcohol dependence. CONCLUSIONS Perceived unfairness is related to impulsivity in patients with alcohol dependence. These results provide insights concerning the psychopathology of alcohol dependence.

Cognitive-Behavioral Therapy for Obsessive–Compulsive Disorder with and without Autism Spectrum Disorder: Gray Matter Differences Associated with Poor Outcome

Cognitive behavioral therapy (CBT) is an effective treatment for obsessive–compulsive disorder (OCD) and is also applicable to patients with both OCD and autism spectrum disorder (ASD). However, previous studies have reported that CBT for patients with both OCD and ASD might be less effective than for patients with OCD alone. In addition, there is no evidence as to why autistic traits might be risk factors. Therefore, we investigated whether comorbidity between ASD and OCD may significantly affect treatment outcome and discovered predictors of CBT outcomes using structural magnetic resonance imaging (MRI) data. A total of 39 patients, who were diagnosed with OCD, were enrolled in this study. Of these, except for 2 dropout cases, 15 patients were diagnosed with ASD, and 22 patients were diagnosed with OCD without ASD. Both groups took CBT for 11–20 sessions. First, to examine the effectiveness of CBT for OCD patients with and without ASD, we compared CBT outcomes between the two groups. Second, to investigate how the structural abnormality profile of the brain at pretreatment influenced CBT outcomes, we performed a structural MRI comparison focusing on the gray matter volume of the whole brain in both patients with only OCD, and those with both OCD and ASD. In order to discover neurostructural predictors of CBT outcomes besides autistic traits, we divided our samples again into two groups of those who did and those who did not remit after CBT, and repeated the analysis taking autistic traits into account. The results showed that OCD patients with ASD responded significantly less well to CBT. The OCD patients with ASD had much less gray matter volume in the left occipital lobe than OCD patients without ASD. The non-remission group had a significantly smaller volume of gray matter in the left dorsolateral prefrontal cortex (DLPFC) compared with the remission group, after having partialed out autistic traits. These results indicate that the abnormalities in DLPFC negatively affect the CBT outcome, regardless of the severity of the autistic traits.

Social Capital Enhanced Disaster Preparedness and Health Consultations after the 2011 Great East Japan Earthquake and Nuclear Power Station Accident

After the Great East Japan Earthquake and the subsequent Fukushima Daiichi Nuclear Power Station accident in 2011, there was a strong demand to promote disaster preparedness approaches and health checkups for the prevention of lifestyle diseases. This study examined the yearly change in the percentage of those who prepared for disasters and who utilized health checkups in Fukushima Prefecture, and identified the factors governing disaster preparedness and utilization of health checkups. We used the public opinion survey from 2011 to 2015 (n = 677–779 each year) on prefectural policies that is conducted every year by the Fukushima Prefecture government Public Consultation Unit. We found that the percentage of those who prepare for disasters decreased, while that for health checkups did not significantly change. With regard to disaster preparedness, experiences of disaster enhance disaster preparedness, while bonds with other local people help to maintain preparedness. For health checkups, familiarity with the welfare service was the most important factor governing such consultations. The findings suggest that social capital should be promoted in order to improve disaster preparedness. The findings also suggest that residents’ accessibility to medical and welfare services is also important in promoting the utilization of health checkups.

Longitudinal Network Stability of the Functional Impairment of Anxiety and Depression

Anxiety and depression are comorbid conditions with significant functional impairment. This study examines the temporal changes in the network structure of the functional impairment associated with anxiety and depression. A clinical sample (n = 1,667) of individuals from Japan completed a battery of self-report instruments to assess the degree and level of impairment of anxiety and depression. The network structure was estimated at two time points using partial correlation coefficients and the glasso regularization procedure. Several permutation tests were conducted to examine network changes over time. Global and individual features of the network were stable across time. Furthermore, depression was more central than anxiety at both time points. Results should be interpreted in light of cultural factors involving the Japanese sample. These results underscore the temporal stability of the functional impairment of anxiety and depression as well as the importance of depression in the overall comorbid network.

Factorial validity and invariance of the Patient Health Questionnaire (PHQ)-9 among clinical and non-clinical populations

The Patient Health Questionnaire-9 (PHQ-9) is commonly used to screen for depressive disorder and for monitoring depressive symptoms. However, there are mixed findings regarding its factor structure (i.e., whether it has a unidimensional, two-dimensional, or bi-factor structure). Furthermore, its measurement invariance between non-clinical and clinical populations and that between patients with major depressive disorder (MDD) and MDD with comorbid anxiety disorder (AD) is unknown. Japanese adults with MDD (n = 406), MDD with AD (n = 636), and no psychiatric disorders (non-clinical population; n = 1,163) answered this questionnaire on the Internet. Confirmatory factor analyses showed that the bi-factor model had a better fit than the unidimensional and two-dimensional factor models did. The results of a multi-group confirmatory factor analysis indicated scalar invariance between the non-clinical and only MDD groups, and that between the only MDD and MDD with AD groups. In conclusion, the bi-factor model with two specific factors was supported among the non-clinical, only MDD, and MDD with AD groups. The scalar measurement invariance model was supported between the groups, which indicated the total or sub-scale scores were comparable between groups.

Psychometric evaluation of the simplified Japanese version of the Athens Insomnia Scale: The Fukushima Health Management Survey

We investigated the psychometric properties of the simplified Japanese version of the Athens Insomnia Scale (AIS‐SJ) using baseline data from the Fukushima Health Management Survey. Data from 22 878 men and 27 669 women aged 16 years and older were analysed (Mage = 52.9 ± 18.6). Participants lived in the Fukushima evacuation zone and experienced the Great East Japan Earthquake. The AIS‐SJ was used to assess participants’ insomnia symptoms, and its validity was examined by administering the Kessler 6‐item Psychological Distress Scale (K6) and assessing education, self‐rated health and disaster‐related experiences. A confirmatory factor analysis revealed that the two‐factor model was a better fit than the one‐factor model. The AIS‐SJ and its subscales had acceptable reliability (Cronbachs alpha, 0.81). Test of measurement invariance confirmed strict invariance across groups for the participants’ characteristics of gender and mental illness history, but not for participants’ age. AIS‐SJ scores exhibited a near‐normal distribution (skewness, 0.45; kurtosis, −0.89). There were significant age differences only among women, and gender differences in AIS‐SJ scores with small effect sizes. The AIS‐SJ scores had weak‐to‐moderate correlations with mental illness history, bereavement, experiencing the tsunami, experiencing the nuclear power plant incident, housing damage and losing ones job (polyserial correlations, 0.36, 0.17, 0.13, 0.18, 0.13, and 0.15, respectively), and strong correlations with self‐rated health (polyserial correlation, 0.51), psychological distress (rs, 0.60) and post‐traumatic stress disorder (rs, 0.60). The AIS‐SJ is a useful instrument for assessing community dwellers’ insomnia symptoms.

Changes in Risk Perception of the Health Effects of Radiation and Mental Health Status: The Fukushima Health Management Survey

After the Fukushima nuclear power plant accident, numerous evacuees reported poor mental health status and high-risk perceptions of the health effects of radiation. However, the temporal associations between these variables have not yet been examined. Using data from the Fukushima Health Survey, we examined changes in risk perception of the health effects of radiation over time and assessed the effects of mental health on such changes using logistic regression analysis. Risk perception for delayed effect pertains a brief on health effect in later life (delayed effect), whereas that of genetic effect pertains a brief on health effect of future children and grandchildren (genetic effect). We found that many participants showed consistently high or low-risk perceptions over all three study years (2011–2013) (for delayed effect: 59% and 41% of participants were in the low and high-risk perception groups, respectively; for genetic effect: 47% and 53%, respectively). Stronger traumatic reactions (≥50 on the PTSD Checklist–Specific) significantly affected the odds of being in the high-risk perception group for the delayed and genetic effects, with the associations being strongest soon after the disaster: The adjusted ORs (95%CIs) were 2.05 (1.82–2.31), 1.86 (1.61–2.15), and 1.88 (1.62–2.17) for the delayed effect in 2011, 2012, and 2013, respectively, and 2.18 (1.92–2.48), 2.05 (1.75–2.40), and 1.82 (1.55–2.15) for the genetic effect. As initial mental health status had the strongest impact on later risk perceptions of radiation, it should be considered in early response and communication efforts.