Yuki Kako - Academia.edu (original) (raw)
Papers by Yuki Kako
Psychiatry and Clinical Neurosciences, 2021
This study is intended to ascertain whether a difference exists in depressive symptoms and psycho... more This study is intended to ascertain whether a difference exists in depressive symptoms and psychological distresses among first-year university students before and during the influence of the coronavirus disease 2019 (COVID-19) pandemic. New students at Hokkaido University participated before COVID-19: 1935 students from 2016 and 1717 students from 2017. During COVID-19, 1087 students were included from 2020. As part of their entrance orientation, participants were administered the Patient Health Questionnaire–9 (PHQ-9) to measure depressive symptoms and the Kessler Psychological Distress Scale–10 (K-10) to measure psychological distress based on their responses to questions about anxiety and depressive symptoms. Age at admission, sex, hometown, and residence after enrollment were also elicited. All participants gave consent for the use of anonymized data and for the use of results for research activities aimed at improving health activities. Ethical approval for collection of these...
Psychiatry Research, 2021
The euthymic state of bipolar disorder is often characterized by impaired cognitive function. In ... more The euthymic state of bipolar disorder is often characterized by impaired cognitive function. In this investigation, we hypothesized that subjective cognitive function is impaired and illness awareness is inadequate and we further explored the associations among cognitive complaints, objective cognitive functions, and current illness awareness in Japanese patients. Twenty-seven patients in remission and 27 healthy subjects were recruited in this study. The Japanese version of the Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA) and Scale to Assess Unawareness in Mental Disorders (Japanese, SUMD-J) were used to assess each patient. All patients underwent neuropsychological tests for the assessment of objective cognitive functions. Only SUMD2.C (current awareness of the effects of medication) was significantly correlated with COBRA, and the objective cognitive assessments, Word Fluency Test and Stroop Test Reaction Time, represented significant correlations with SUMD...
PLoS ONE, 2021
Aim To enable early identification of university students at high risk for suicide, we examined p... more Aim To enable early identification of university students at high risk for suicide, we examined personality as a predictive factor for major depressive episodes and suicide-related ideation. Methods From 2011 to 2013, we administered the Patient Health Questionnaire-9 (PHQ-9) and the Temperament and Character Inventory (TCI) to 1,997 university students at enrollment (T1). We previously conducted a study using the same data set; this is a re-analysis of the dataset. To prevent contamination of data, participants diagnosed with a depressive episode were excluded at T1. Three years after enrollment (T2), we re-administered the PHQ-9 to the same students. We statistically compared TCI scores at T1 among depressive episode groups and suicide-related ideation groups. Two-way ANOVA and Cochran-Armitage trend tests were used to analyze the relationships between personality traits, depressive episodes, and suicide-related ideation. Results The PHQ-9 summary scores at baseline (T1) were 3.0 ...
OBJECTIVES Depression has been associated with impaired neural processing of reward and punishmen... more OBJECTIVES Depression has been associated with impaired neural processing of reward and punishment. However, to date, little is known regarding the relationship between depression and intertemporal choice (delay discounting) for gain and loss. This examination is potentially important for advances in neuroeconomics of intertemporal choice, because depression is associated with reduced serotonergic activities in the brain. DESIGN AND SETTING We compared impulsivity and inconsistency in intertemporal choice for monetary gain and loss between depressive patients and healthy control subjects. METHODS We conducted delay discounting tasks for gain and loss in depressed and healthy control subjects. We then quantified impulsivity and inconsistency in the delay discounting with parameters in the q-exponential discount function based on Tsallis' statistics. RESULTS We observed that depressive patients were more impulsive and time-inconsistent in intertemporal choice action for gain and l...
Journal of Affective Disorders Reports
Abstract Background : Suicide is a serious social health problem, especially among young adults. ... more Abstract Background : Suicide is a serious social health problem, especially among young adults. This study aimed to investigate the link between self-esteem, social anxiety, hopelessness, and suicidal ideation among Japanese university students. Methods : Data were collected from 322 university students (Mage = 21; 61.8% male) who visited the Hokkaido University Health Care Center in Japan for psychiatric consultation. Participants completed questionnaires including the Rosenberg Selfesteem Scale, Liebowitz Social Anxiety Scale, Beck Hopelessness Scale, and Patient Health Questionnaire 9, to measure the severity of depression and suicidal ideation. Structural equation models were created to examine the direct and indirect effects of self-esteem and social anxiety on suicidal ideation through hopelessness. Results : Multiple regression analysis showed that self-esteem and social anxiety were significant predictors of suicidal ideation. Results from structural equation modeling indicated that the effects of self-esteem and social anxiety on suicidal ideation were partially mediated by hopelessness. Bootstrap results indicated that the direct and indirect effects were significant. In a sub-analysis, hopelessness also partially mediated the relationship between self-esteem, social anxiety and depression. Limitations : The cross-sectional nature and sample collecting method of the study may prevent the results from being generalized to the overall populations. Additionally, the reliability of the ninth item of PHQ-9 in evaluating suicidal ideation remains conflicted. Conclusion : This study demonstrated the mediating role of hopelessness in suicidal university students with low self-esteem and high social anxiety. Our results suggest that future suicide prevention programs may be more effective when targeting subjects' self-esteem, social anxiety, and hopelessness levels.
BMJ Case Reports
A 40-year-old man presented with generalised dissociative amnesia. At 2 weeks after onset, N-isop... more A 40-year-old man presented with generalised dissociative amnesia. At 2 weeks after onset, N-isopropyl-[123I] p-iodoamphetamine-single-photon emission CT imaging of the brain revealed hypoperfusion in the right medial temporal area. Organic brain damage was ruled out. His inability to recall information was attributed to psychological stress related to his employment. Consistent with this diagnosis, his generalised dissociative amnesia lasted 6 years and 10 months; however, he recovered from amnesia naturally on starting a new job. Perfusion of his right medial temporal area also returned to normal levels. Longitudinal reports for generalised dissociative amnesia with natural recovery are exceedingly rare. It is important to confirm whether dissociative amnesia and cerebral blood flow recover in parallel, even in cases where dissociative amnesia is long-lasting.
International Journal of Urology
DOI: 10.1111/iju.14073 PROs represent an important aspect of a patient’s health status assessment... more DOI: 10.1111/iju.14073 PROs represent an important aspect of a patient’s health status assessment that come without bias of the healthcare provider. PROs allow clinicians to evaluate the effects of illness and medical treatments by quantifying symptoms that are by definition, subjective, and therefore, unmeasured by medical devices. PROs can include both general and disease-specific quality of life. Although several bladder cancer-specific HRQOL instruments exist, there is only one with a Japanese translation – FACT-Bl – previously validated by Hinotsu et al. However, assessment with FACT-Bl is limited to systemic symptoms, as it lacks items specific to urinary, bowel and sexual function, which are important components for assessing bladder cancer patients. In the previous report, the Japanese version of the EPIC was used to evaluate HRQOL after bladder preservation therapy instead of FACT-Bl. Although reasonable and acceptable outcomes were obtained, further assessment needs to be carried out. That is because EPIC was designed for male prostate cancer patients. The BCI was developed and validated in the USA to assess the severity of symptoms for urinary, bowel and sexual domains (Appendix S1). The BCI was intended to be a sexand diversion-neutral instrument for patients treated with cystectomy, transurethral resection with/without intravesical therapy and radiation. The BCI has been translated and validated into French, Spanish, Arabian and Hungarian languages. Furthermore, the BCI was recently used to evaluate function HRQOL among patients treated for bladder cancer in a comparative study. According to the previously reported method for cross-cultural translation of HRQOL, we carried out a multistage procedure to develop a preliminary Japanese version after permission from the original developer (JT Wei) to translate and use the BCI. Two Japanese translations of the BCI were carried out independently by two native Japanese physicians who had English as a second language. Subsequently, the reconciled translation was back-translated into English by a native English professional translator. Of 34 items in the BCI, 22 items overlapped with the EPIC, and therefore, the Japanese version of EPIC is applied with the permission of JT Wei and Y Kakehi. The two forms of the BCI (original and backward translation) were compared, and qualities lost in the translation due to cultural nuances were discussed and resolved in a consensus meeting with JT Wei, resulting in the draft Japanese BCI version. This draft version was then reviewed by laypersons fluent in Japanese to develop a linguistically valid, easy-to-understand Japanese version (Appendix S2; Fig. S1). Statistical validation was undertaken. The reliability of the Japanese version of the BCI was evaluated for internal consistency using Cronbach’s alpha coefficient for each domain of the BCI. All statistical tests were carried out using the JMP software (SAS Institute, Cary, NC, USA). After obtaining approval from the institutional review board (015-0504), cognitive interviews and pilot testing of the BCI were carried out with 14 patients (nine males and five females), with a mean age of 69.5 years (range 47–93 years) and disease duration of 31.5 months (range 11–272 months). Of these patients, eight patients underwent transurethral resection of bladder tumor and six patients underwent radical cystectomy (among them two patients had ileal conduit, two had neobladder, one had cutaneous ureterostomy and one had continent catheterizable pouch). The Cronbach’s alpha coefficients were 0.86, 0.72 and 0.92 for the urinary domain, bowel domain and sexual domain, respectively. These were all in the range of 0.70–0.95, indicating high internal consistency (Table 1). The average length of the interview was 30 min. Most patients completed the questionnaire without difficulty, and further modifications were unnecessary. In a final consensus review that included urologists and clinical psychologists, the Japanese version was finalized (Appendix S1). This Japanese version of the BCI has demonstrable face validity and reliability. It can be used for evaluating HRQOL among Japanese patients with bladder cancer and for cross-cultural comparisons. The copyright of the BCI resides strictly with The University of Michigan. The University of Michigan has granted the right to use the Japanese version of the BCI to healthcare providers who do not obtain profit using this.
JMIR Mental Health
Background A strong and growing body of evidence has demonstrated the effectiveness of cognitive ... more Background A strong and growing body of evidence has demonstrated the effectiveness of cognitive behavioral therapy (CBT), either face-to-face, in person, or as self-help via the Internet, for depression. However, CBT is a complex intervention consisting of several putatively effective components, and how each component may or may not contribute to the overall effectiveness of CBT is poorly understood. Objective The aim of this study was to investigate how the users of smartphone CBT use and benefit from various components of the program. Methods This is a secondary analysis from a 9-week, single-blind, randomized controlled trial that has demonstrated the effectiveness of adjunctive use of smartphone CBT (Kokoro-App) over antidepressant pharmacotherapy alone among patients with drug-resistant major depressive disorder (total n=164, standardized mean difference in depression severity at week 9=0.40, J Med Internet Res). Kokoro-App consists of three cognitive behavioral skills of sel...
Psychiatry Research
During the euthymic state in bipolar disorder, cognitive functions often remain affected. Specifi... more During the euthymic state in bipolar disorder, cognitive functions often remain affected. Specifically, subjective and objective cognitive impairment might distinctly affect patients' quality of life (QoL); however, this question had not been examined previously in Japanese patients. Therefore, the current study investigated the associations between cognitive complaints, QoL, and objective cognitive functions. Forty patients in remission were recruited from the Hokkaido University Hospital, Sapporo, Japan and assessed with the translated version of the cognitive complaints in bipolar disorder rating assessment (COBRA), medical outcomes study 36-item short-form health survey version 2 (SF-36v2), and Sheehan disability scale (SDS). The Japanese adult reading scale, Wisconsin card sorting test, word fluency, continuous performance test, trail making test (TMT), auditory verbal learning, and Stroop test evaluated objective cognitive functions. Significant correlations were observed between the COBRA, SF-36v2, and SDS results, as well as the TMT scores. Overall, euthymic patients were aware of their cognitive dysfunction, which could be understood in relation to the decrease in satisfaction in their daily life. Therefore, even mild cognitive impairments can have ramifications for patients in the euthymic state of bipolar disorder.
PloS one, 2018
Suicide has been a leading cause of death among young adult populations in Japan. The aim of this... more Suicide has been a leading cause of death among young adult populations in Japan. The aim of this study was to predict major depressive episodes (MDEs) and suicide-related ideation among university students using the Patient Health Questionnaire-9 (PHQ-9) and the Temperament and Character Inventory (TCI). The subjects were 2194 university students who completed the PHQ-9 and TCI in the 1st year (T1) and the PHQ-9 in the 4th year (T2) of university. Multiple logistic regression analysis was performed to predict MDEs and suicide-related ideation at T2. Moreover, recursive partitioning analyses were conducted to reveal the future risk of MDEs and suicide-related ideation. The multiple logistic regression analyses of MDEs and suicide-related ideation at T2 revealed that depressive episodes, suicide-related ideation, and low self-directedness(SD) scores at T1 were significant predictors. The area under the curve of the model for MDEs was 0.858 and that for suicide-related ideation was 0....
Psychiatry research, Nov 1, 2017
Previous studies indicated that personality traits have a mediator effect on the relationship bet... more Previous studies indicated that personality traits have a mediator effect on the relationship between childhood abuse and depressive symptoms in major depressive disorder and nonclinical general adult subjects. In the present study, we aimed to test the hypothesis that personality traits mediate the relationship between childhood abuse and depressive symptoms in schizophrenia. We used the following questionnaires to evaluate 255 outpatients with schizophrenia: the Child Abuse and Trauma Scale, temperament and character inventory, and Patients Health Questionnire-9. Univariate analysis, multiple regression analysis, and structured equation modeling (SEM) were used to analyze the data. The relationship between neglect and sexual abuse and the severity of depressive symptoms was mostly mediated by the personality traits of high harm avoidance, low self-directedness, and low cooperativeness. This finding was supported by the results of stepwise multiple regression analysis and the accep...
PLOS ONE
Background Social anxiety disorder (SAD) develops in the early teens and is a common disorder amo... more Background Social anxiety disorder (SAD) develops in the early teens and is a common disorder among university students. Understanding the predictive factors of SAD comorbid with major depressive episode (MDE) is important for student mental health care. The aim of this study was to identify the personality traits that predict SAD with MDE by analyzing longitudinal data of Japanese university students. Methods In this retrospective study, Japanese university students who visited the health care center of Hokkaido University for the first time were divided into the following four groups: “Control” (n = 43), “MDE” (n = 16), “SAD” (n = 28), and “SAD with MDE” (n = 61) based on the Patient Health Questionnaire-9 (PHQ-9), the Liebowitz Social Anxiety Scale, and core anxiety symptoms for SAD in the Mini International Neuropsychiatric Interview during screening. Predictors for SAD with MDE were identified by a four-group comparison of the Temperament and Character Inventory and PHQ-9 data ...
Keywords: Depression, Discounting, Neuroeconomics, Impulsivity, Inconsistency, Tsallis' statistics
Schizophrenia Research: Cognition, 2015
Neuro endocrinology letters, 2008
Depression has been associated with impaired neural processing of reward and punishment. However,... more Depression has been associated with impaired neural processing of reward and punishment. However, to date, little is known regarding the relationship between depression and intertemporal choice (delay discounting) for gain and loss. This examination is potentially important for advances in neuroeconomics of intertemporal choice, because depression is associated with reduced serotonergic activities in the brain. We compared impulsivity and inconsistency in intertemporal choice for monetary gain and loss between depressive patients and healthy control subjects. We conducted delay discounting tasks for gain and loss in depressed and healthy control subjects. We then quantified impulsivity and inconsistency in the delay discounting with parameters in the q-exponential discount function based on Tsallis' statistics. We observed that depressive patients were more impulsive and time-inconsistent in intertemporal choice action for gain and loss, in comparison to healthy controls. Depres...
Seishin shinkeigaku zasshi = Psychiatria et neurologia Japonica, 2014
Over 10 years have passed since the Japanese term for "schizophrenia" was changed from ... more Over 10 years have passed since the Japanese term for "schizophrenia" was changed from "seishin-bunretsu-byo" to "togo-shiccho-sho" in 2002. An awareness survey targeting doctors suggested that notification of the diagnosis has been encouraged since the Japanese name for schizophrenia was changed. However, no heuristic surveys targeting patients themselves have clarified an increased notification rate, and no multicenter studies of the notification rates have been conducted in recent years. This study targeted schizophrenia patients and their attending physicians to investigate the status of notification of the diagnosis at five medical facilities in Hokkaido, Japan. Questionnaires were distributed to the attending physicians of a total of 869 patients; in addition, the patients themselves filled out questionnaires. Questionnaires were collected from 858 physicians, and valid responses were recovered from 529 patients. This study investigated the status...
Progress in neuro-psychopharmacology & biological psychiatry, 2011
Second-generation antipsychotics (SGAs) tend to induce weight gain, dyslipidemia and diabetes mel... more Second-generation antipsychotics (SGAs) tend to induce weight gain, dyslipidemia and diabetes mellitus. For those reasons, patients treated with SGAs should receive appropriate monitoring to avoid morbidity and mortality associated with cardiovascular disease. We conducted a one-year follow-up study using Japanese blood glucose monitoring guidance in schizophrenia patients treated with SGAs to evaluate the detection capability of the guidance in real clinical settings and to assess the importance of longitudinal monitoring. This retrospective cohort study included schizophrenia patients receiving at least one SGA, who were enrolled during June 2008-January 2009 at multiple sites and who had both baseline data and follow-up monitoring data at month 12. After one-year follow-up, the probable diabetes type (fasting blood glucose is higher than 125 mg/dL, casual blood glucose is higher than 179 mg/dL, or glycosylated hemoglobin (Hb(A1c)) is greater than 6.4%) was detected in 30 (8%) of ...
Progress in neuro-psychopharmacology & biological psychiatry, 2008
Impairment in mismatch negativity (MMN) potentials is a robust finding in schizophrenia. There ar... more Impairment in mismatch negativity (MMN) potentials is a robust finding in schizophrenia. There are few studies which examined the correlation between MMN deficits and neuropsychological performances. The purpose of this study was to investigate the relationship between deficits of tone duration MMN and various neuropsychological measures in schizophrenic patients (n=23). The results demonstrated a significant correlation between low MMN amplitude and poor performances of executive function in Wisconsin Card Sorting Test, Stroop Test and Trail Making Test. Our finding suggests MMN deficits in schizophrenia predict deficits of executive function and might reflect ongoing functional abnormality of fronto-temporal interaction.
Diffusion tensor imaging (DTI) is considered to be able to non-invasively quantify white matter i... more Diffusion tensor imaging (DTI) is considered to be able to non-invasively quantify white matter integrity. This study aimed to use DTI to evaluate white matter integrity in non-geriatric patients with major depressive disorder (MDD) who were free of antidepressant medication. DTI was performed on 19 non-geriatric patients with MDD, free of antidepressant medication, and 19 age-matched healthy subjects. Voxel-based and histogram analyses were used to compare fractional anisotropy (FA) and mean diffusivity (MD) values between the two groups, using two-sample t tests. The abnormal DTI indices, if any, were tested for correlation with disease duration and severity, using Pearson product-moment correlation analysis. Voxel-based analysis showed clusters with FA decrease at the bilateral frontal white matter, anterior limbs of internal capsule, cerebellum, left putamen and right thalamus of the patients. Histogram analysis revealed lower peak position of FA histograms in the patients. FA values of the abnormal clusters and peak positions of FA histograms of the patients exhibited moderate correlation with disease duration and severity. These results suggest the implication of frontal-subcortical circuits and cerebellum in MDD, and the potential utility of FA in evaluation of brain parenchymal integrity.
Psychiatry and Clinical Neurosciences, 2021
This study is intended to ascertain whether a difference exists in depressive symptoms and psycho... more This study is intended to ascertain whether a difference exists in depressive symptoms and psychological distresses among first-year university students before and during the influence of the coronavirus disease 2019 (COVID-19) pandemic. New students at Hokkaido University participated before COVID-19: 1935 students from 2016 and 1717 students from 2017. During COVID-19, 1087 students were included from 2020. As part of their entrance orientation, participants were administered the Patient Health Questionnaire–9 (PHQ-9) to measure depressive symptoms and the Kessler Psychological Distress Scale–10 (K-10) to measure psychological distress based on their responses to questions about anxiety and depressive symptoms. Age at admission, sex, hometown, and residence after enrollment were also elicited. All participants gave consent for the use of anonymized data and for the use of results for research activities aimed at improving health activities. Ethical approval for collection of these...
Psychiatry Research, 2021
The euthymic state of bipolar disorder is often characterized by impaired cognitive function. In ... more The euthymic state of bipolar disorder is often characterized by impaired cognitive function. In this investigation, we hypothesized that subjective cognitive function is impaired and illness awareness is inadequate and we further explored the associations among cognitive complaints, objective cognitive functions, and current illness awareness in Japanese patients. Twenty-seven patients in remission and 27 healthy subjects were recruited in this study. The Japanese version of the Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA) and Scale to Assess Unawareness in Mental Disorders (Japanese, SUMD-J) were used to assess each patient. All patients underwent neuropsychological tests for the assessment of objective cognitive functions. Only SUMD2.C (current awareness of the effects of medication) was significantly correlated with COBRA, and the objective cognitive assessments, Word Fluency Test and Stroop Test Reaction Time, represented significant correlations with SUMD...
PLoS ONE, 2021
Aim To enable early identification of university students at high risk for suicide, we examined p... more Aim To enable early identification of university students at high risk for suicide, we examined personality as a predictive factor for major depressive episodes and suicide-related ideation. Methods From 2011 to 2013, we administered the Patient Health Questionnaire-9 (PHQ-9) and the Temperament and Character Inventory (TCI) to 1,997 university students at enrollment (T1). We previously conducted a study using the same data set; this is a re-analysis of the dataset. To prevent contamination of data, participants diagnosed with a depressive episode were excluded at T1. Three years after enrollment (T2), we re-administered the PHQ-9 to the same students. We statistically compared TCI scores at T1 among depressive episode groups and suicide-related ideation groups. Two-way ANOVA and Cochran-Armitage trend tests were used to analyze the relationships between personality traits, depressive episodes, and suicide-related ideation. Results The PHQ-9 summary scores at baseline (T1) were 3.0 ...
OBJECTIVES Depression has been associated with impaired neural processing of reward and punishmen... more OBJECTIVES Depression has been associated with impaired neural processing of reward and punishment. However, to date, little is known regarding the relationship between depression and intertemporal choice (delay discounting) for gain and loss. This examination is potentially important for advances in neuroeconomics of intertemporal choice, because depression is associated with reduced serotonergic activities in the brain. DESIGN AND SETTING We compared impulsivity and inconsistency in intertemporal choice for monetary gain and loss between depressive patients and healthy control subjects. METHODS We conducted delay discounting tasks for gain and loss in depressed and healthy control subjects. We then quantified impulsivity and inconsistency in the delay discounting with parameters in the q-exponential discount function based on Tsallis' statistics. RESULTS We observed that depressive patients were more impulsive and time-inconsistent in intertemporal choice action for gain and l...
Journal of Affective Disorders Reports
Abstract Background : Suicide is a serious social health problem, especially among young adults. ... more Abstract Background : Suicide is a serious social health problem, especially among young adults. This study aimed to investigate the link between self-esteem, social anxiety, hopelessness, and suicidal ideation among Japanese university students. Methods : Data were collected from 322 university students (Mage = 21; 61.8% male) who visited the Hokkaido University Health Care Center in Japan for psychiatric consultation. Participants completed questionnaires including the Rosenberg Selfesteem Scale, Liebowitz Social Anxiety Scale, Beck Hopelessness Scale, and Patient Health Questionnaire 9, to measure the severity of depression and suicidal ideation. Structural equation models were created to examine the direct and indirect effects of self-esteem and social anxiety on suicidal ideation through hopelessness. Results : Multiple regression analysis showed that self-esteem and social anxiety were significant predictors of suicidal ideation. Results from structural equation modeling indicated that the effects of self-esteem and social anxiety on suicidal ideation were partially mediated by hopelessness. Bootstrap results indicated that the direct and indirect effects were significant. In a sub-analysis, hopelessness also partially mediated the relationship between self-esteem, social anxiety and depression. Limitations : The cross-sectional nature and sample collecting method of the study may prevent the results from being generalized to the overall populations. Additionally, the reliability of the ninth item of PHQ-9 in evaluating suicidal ideation remains conflicted. Conclusion : This study demonstrated the mediating role of hopelessness in suicidal university students with low self-esteem and high social anxiety. Our results suggest that future suicide prevention programs may be more effective when targeting subjects' self-esteem, social anxiety, and hopelessness levels.
BMJ Case Reports
A 40-year-old man presented with generalised dissociative amnesia. At 2 weeks after onset, N-isop... more A 40-year-old man presented with generalised dissociative amnesia. At 2 weeks after onset, N-isopropyl-[123I] p-iodoamphetamine-single-photon emission CT imaging of the brain revealed hypoperfusion in the right medial temporal area. Organic brain damage was ruled out. His inability to recall information was attributed to psychological stress related to his employment. Consistent with this diagnosis, his generalised dissociative amnesia lasted 6 years and 10 months; however, he recovered from amnesia naturally on starting a new job. Perfusion of his right medial temporal area also returned to normal levels. Longitudinal reports for generalised dissociative amnesia with natural recovery are exceedingly rare. It is important to confirm whether dissociative amnesia and cerebral blood flow recover in parallel, even in cases where dissociative amnesia is long-lasting.
International Journal of Urology
DOI: 10.1111/iju.14073 PROs represent an important aspect of a patient’s health status assessment... more DOI: 10.1111/iju.14073 PROs represent an important aspect of a patient’s health status assessment that come without bias of the healthcare provider. PROs allow clinicians to evaluate the effects of illness and medical treatments by quantifying symptoms that are by definition, subjective, and therefore, unmeasured by medical devices. PROs can include both general and disease-specific quality of life. Although several bladder cancer-specific HRQOL instruments exist, there is only one with a Japanese translation – FACT-Bl – previously validated by Hinotsu et al. However, assessment with FACT-Bl is limited to systemic symptoms, as it lacks items specific to urinary, bowel and sexual function, which are important components for assessing bladder cancer patients. In the previous report, the Japanese version of the EPIC was used to evaluate HRQOL after bladder preservation therapy instead of FACT-Bl. Although reasonable and acceptable outcomes were obtained, further assessment needs to be carried out. That is because EPIC was designed for male prostate cancer patients. The BCI was developed and validated in the USA to assess the severity of symptoms for urinary, bowel and sexual domains (Appendix S1). The BCI was intended to be a sexand diversion-neutral instrument for patients treated with cystectomy, transurethral resection with/without intravesical therapy and radiation. The BCI has been translated and validated into French, Spanish, Arabian and Hungarian languages. Furthermore, the BCI was recently used to evaluate function HRQOL among patients treated for bladder cancer in a comparative study. According to the previously reported method for cross-cultural translation of HRQOL, we carried out a multistage procedure to develop a preliminary Japanese version after permission from the original developer (JT Wei) to translate and use the BCI. Two Japanese translations of the BCI were carried out independently by two native Japanese physicians who had English as a second language. Subsequently, the reconciled translation was back-translated into English by a native English professional translator. Of 34 items in the BCI, 22 items overlapped with the EPIC, and therefore, the Japanese version of EPIC is applied with the permission of JT Wei and Y Kakehi. The two forms of the BCI (original and backward translation) were compared, and qualities lost in the translation due to cultural nuances were discussed and resolved in a consensus meeting with JT Wei, resulting in the draft Japanese BCI version. This draft version was then reviewed by laypersons fluent in Japanese to develop a linguistically valid, easy-to-understand Japanese version (Appendix S2; Fig. S1). Statistical validation was undertaken. The reliability of the Japanese version of the BCI was evaluated for internal consistency using Cronbach’s alpha coefficient for each domain of the BCI. All statistical tests were carried out using the JMP software (SAS Institute, Cary, NC, USA). After obtaining approval from the institutional review board (015-0504), cognitive interviews and pilot testing of the BCI were carried out with 14 patients (nine males and five females), with a mean age of 69.5 years (range 47–93 years) and disease duration of 31.5 months (range 11–272 months). Of these patients, eight patients underwent transurethral resection of bladder tumor and six patients underwent radical cystectomy (among them two patients had ileal conduit, two had neobladder, one had cutaneous ureterostomy and one had continent catheterizable pouch). The Cronbach’s alpha coefficients were 0.86, 0.72 and 0.92 for the urinary domain, bowel domain and sexual domain, respectively. These were all in the range of 0.70–0.95, indicating high internal consistency (Table 1). The average length of the interview was 30 min. Most patients completed the questionnaire without difficulty, and further modifications were unnecessary. In a final consensus review that included urologists and clinical psychologists, the Japanese version was finalized (Appendix S1). This Japanese version of the BCI has demonstrable face validity and reliability. It can be used for evaluating HRQOL among Japanese patients with bladder cancer and for cross-cultural comparisons. The copyright of the BCI resides strictly with The University of Michigan. The University of Michigan has granted the right to use the Japanese version of the BCI to healthcare providers who do not obtain profit using this.
JMIR Mental Health
Background A strong and growing body of evidence has demonstrated the effectiveness of cognitive ... more Background A strong and growing body of evidence has demonstrated the effectiveness of cognitive behavioral therapy (CBT), either face-to-face, in person, or as self-help via the Internet, for depression. However, CBT is a complex intervention consisting of several putatively effective components, and how each component may or may not contribute to the overall effectiveness of CBT is poorly understood. Objective The aim of this study was to investigate how the users of smartphone CBT use and benefit from various components of the program. Methods This is a secondary analysis from a 9-week, single-blind, randomized controlled trial that has demonstrated the effectiveness of adjunctive use of smartphone CBT (Kokoro-App) over antidepressant pharmacotherapy alone among patients with drug-resistant major depressive disorder (total n=164, standardized mean difference in depression severity at week 9=0.40, J Med Internet Res). Kokoro-App consists of three cognitive behavioral skills of sel...
Psychiatry Research
During the euthymic state in bipolar disorder, cognitive functions often remain affected. Specifi... more During the euthymic state in bipolar disorder, cognitive functions often remain affected. Specifically, subjective and objective cognitive impairment might distinctly affect patients' quality of life (QoL); however, this question had not been examined previously in Japanese patients. Therefore, the current study investigated the associations between cognitive complaints, QoL, and objective cognitive functions. Forty patients in remission were recruited from the Hokkaido University Hospital, Sapporo, Japan and assessed with the translated version of the cognitive complaints in bipolar disorder rating assessment (COBRA), medical outcomes study 36-item short-form health survey version 2 (SF-36v2), and Sheehan disability scale (SDS). The Japanese adult reading scale, Wisconsin card sorting test, word fluency, continuous performance test, trail making test (TMT), auditory verbal learning, and Stroop test evaluated objective cognitive functions. Significant correlations were observed between the COBRA, SF-36v2, and SDS results, as well as the TMT scores. Overall, euthymic patients were aware of their cognitive dysfunction, which could be understood in relation to the decrease in satisfaction in their daily life. Therefore, even mild cognitive impairments can have ramifications for patients in the euthymic state of bipolar disorder.
PloS one, 2018
Suicide has been a leading cause of death among young adult populations in Japan. The aim of this... more Suicide has been a leading cause of death among young adult populations in Japan. The aim of this study was to predict major depressive episodes (MDEs) and suicide-related ideation among university students using the Patient Health Questionnaire-9 (PHQ-9) and the Temperament and Character Inventory (TCI). The subjects were 2194 university students who completed the PHQ-9 and TCI in the 1st year (T1) and the PHQ-9 in the 4th year (T2) of university. Multiple logistic regression analysis was performed to predict MDEs and suicide-related ideation at T2. Moreover, recursive partitioning analyses were conducted to reveal the future risk of MDEs and suicide-related ideation. The multiple logistic regression analyses of MDEs and suicide-related ideation at T2 revealed that depressive episodes, suicide-related ideation, and low self-directedness(SD) scores at T1 were significant predictors. The area under the curve of the model for MDEs was 0.858 and that for suicide-related ideation was 0....
Psychiatry research, Nov 1, 2017
Previous studies indicated that personality traits have a mediator effect on the relationship bet... more Previous studies indicated that personality traits have a mediator effect on the relationship between childhood abuse and depressive symptoms in major depressive disorder and nonclinical general adult subjects. In the present study, we aimed to test the hypothesis that personality traits mediate the relationship between childhood abuse and depressive symptoms in schizophrenia. We used the following questionnaires to evaluate 255 outpatients with schizophrenia: the Child Abuse and Trauma Scale, temperament and character inventory, and Patients Health Questionnire-9. Univariate analysis, multiple regression analysis, and structured equation modeling (SEM) were used to analyze the data. The relationship between neglect and sexual abuse and the severity of depressive symptoms was mostly mediated by the personality traits of high harm avoidance, low self-directedness, and low cooperativeness. This finding was supported by the results of stepwise multiple regression analysis and the accep...
PLOS ONE
Background Social anxiety disorder (SAD) develops in the early teens and is a common disorder amo... more Background Social anxiety disorder (SAD) develops in the early teens and is a common disorder among university students. Understanding the predictive factors of SAD comorbid with major depressive episode (MDE) is important for student mental health care. The aim of this study was to identify the personality traits that predict SAD with MDE by analyzing longitudinal data of Japanese university students. Methods In this retrospective study, Japanese university students who visited the health care center of Hokkaido University for the first time were divided into the following four groups: “Control” (n = 43), “MDE” (n = 16), “SAD” (n = 28), and “SAD with MDE” (n = 61) based on the Patient Health Questionnaire-9 (PHQ-9), the Liebowitz Social Anxiety Scale, and core anxiety symptoms for SAD in the Mini International Neuropsychiatric Interview during screening. Predictors for SAD with MDE were identified by a four-group comparison of the Temperament and Character Inventory and PHQ-9 data ...
Keywords: Depression, Discounting, Neuroeconomics, Impulsivity, Inconsistency, Tsallis' statistics
Schizophrenia Research: Cognition, 2015
Neuro endocrinology letters, 2008
Depression has been associated with impaired neural processing of reward and punishment. However,... more Depression has been associated with impaired neural processing of reward and punishment. However, to date, little is known regarding the relationship between depression and intertemporal choice (delay discounting) for gain and loss. This examination is potentially important for advances in neuroeconomics of intertemporal choice, because depression is associated with reduced serotonergic activities in the brain. We compared impulsivity and inconsistency in intertemporal choice for monetary gain and loss between depressive patients and healthy control subjects. We conducted delay discounting tasks for gain and loss in depressed and healthy control subjects. We then quantified impulsivity and inconsistency in the delay discounting with parameters in the q-exponential discount function based on Tsallis' statistics. We observed that depressive patients were more impulsive and time-inconsistent in intertemporal choice action for gain and loss, in comparison to healthy controls. Depres...
Seishin shinkeigaku zasshi = Psychiatria et neurologia Japonica, 2014
Over 10 years have passed since the Japanese term for "schizophrenia" was changed from ... more Over 10 years have passed since the Japanese term for "schizophrenia" was changed from "seishin-bunretsu-byo" to "togo-shiccho-sho" in 2002. An awareness survey targeting doctors suggested that notification of the diagnosis has been encouraged since the Japanese name for schizophrenia was changed. However, no heuristic surveys targeting patients themselves have clarified an increased notification rate, and no multicenter studies of the notification rates have been conducted in recent years. This study targeted schizophrenia patients and their attending physicians to investigate the status of notification of the diagnosis at five medical facilities in Hokkaido, Japan. Questionnaires were distributed to the attending physicians of a total of 869 patients; in addition, the patients themselves filled out questionnaires. Questionnaires were collected from 858 physicians, and valid responses were recovered from 529 patients. This study investigated the status...
Progress in neuro-psychopharmacology & biological psychiatry, 2011
Second-generation antipsychotics (SGAs) tend to induce weight gain, dyslipidemia and diabetes mel... more Second-generation antipsychotics (SGAs) tend to induce weight gain, dyslipidemia and diabetes mellitus. For those reasons, patients treated with SGAs should receive appropriate monitoring to avoid morbidity and mortality associated with cardiovascular disease. We conducted a one-year follow-up study using Japanese blood glucose monitoring guidance in schizophrenia patients treated with SGAs to evaluate the detection capability of the guidance in real clinical settings and to assess the importance of longitudinal monitoring. This retrospective cohort study included schizophrenia patients receiving at least one SGA, who were enrolled during June 2008-January 2009 at multiple sites and who had both baseline data and follow-up monitoring data at month 12. After one-year follow-up, the probable diabetes type (fasting blood glucose is higher than 125 mg/dL, casual blood glucose is higher than 179 mg/dL, or glycosylated hemoglobin (Hb(A1c)) is greater than 6.4%) was detected in 30 (8%) of ...
Progress in neuro-psychopharmacology & biological psychiatry, 2008
Impairment in mismatch negativity (MMN) potentials is a robust finding in schizophrenia. There ar... more Impairment in mismatch negativity (MMN) potentials is a robust finding in schizophrenia. There are few studies which examined the correlation between MMN deficits and neuropsychological performances. The purpose of this study was to investigate the relationship between deficits of tone duration MMN and various neuropsychological measures in schizophrenic patients (n=23). The results demonstrated a significant correlation between low MMN amplitude and poor performances of executive function in Wisconsin Card Sorting Test, Stroop Test and Trail Making Test. Our finding suggests MMN deficits in schizophrenia predict deficits of executive function and might reflect ongoing functional abnormality of fronto-temporal interaction.
Diffusion tensor imaging (DTI) is considered to be able to non-invasively quantify white matter i... more Diffusion tensor imaging (DTI) is considered to be able to non-invasively quantify white matter integrity. This study aimed to use DTI to evaluate white matter integrity in non-geriatric patients with major depressive disorder (MDD) who were free of antidepressant medication. DTI was performed on 19 non-geriatric patients with MDD, free of antidepressant medication, and 19 age-matched healthy subjects. Voxel-based and histogram analyses were used to compare fractional anisotropy (FA) and mean diffusivity (MD) values between the two groups, using two-sample t tests. The abnormal DTI indices, if any, were tested for correlation with disease duration and severity, using Pearson product-moment correlation analysis. Voxel-based analysis showed clusters with FA decrease at the bilateral frontal white matter, anterior limbs of internal capsule, cerebellum, left putamen and right thalamus of the patients. Histogram analysis revealed lower peak position of FA histograms in the patients. FA values of the abnormal clusters and peak positions of FA histograms of the patients exhibited moderate correlation with disease duration and severity. These results suggest the implication of frontal-subcortical circuits and cerebellum in MDD, and the potential utility of FA in evaluation of brain parenchymal integrity.