Language：Japanese   Publishing type：Research paper (scientific journal)  

Publishing type：Research paper (scientific journal)  

Language：Japanese   Publishing type：Research paper (scientific journal)  

Language：English   Publishing type：Research paper (scientific journal)  

A functional MRI comparison of patients with obsessive-compulsive disorder and normal controls during a Chinese character Stroop task

DOI： 10.1016/j.pscychresns.2004.12.004

Language：English   Publishing type：Research paper (scientific journal)  

Brain activation of patients with obsessive-compulsive disorder during neuropsychological and symptom provocation tasks before and after symptom improvement

DOI： 10.1016/j.biopsycg.2004.12.039

Language：English   Publisher：Dialogues in Clinical Neuroscience  

Introduction: Depression includes different phenotypes. Modern-type depression (MTD) is a gateway disorder to pathological social withdrawal, known as hikikomori. Adverse childhood experiences (ACEs) are also important aetiologies of depression. Recently, immune imbalance has been proposed as a biological basis of depression. We hypothesised that peripheral immunological characteristics may be involved in subtyping of depression. Methods: 21 patients with major depressive disorder (MDD) and 24 healthy controls (HC) were recruited. Peripheral blood mononuclear cells (PBMCs) were examined for surface antigens by flow cytometry. Participants were administered psychological scales such as Patient Health Questionnaire (PHQ)-9, Modern-Type Depression Trait Scale (TACS-22), Hikikomori Questionnaire (HQ-25), Child Abuse and Trauma Scale (CATS). Results: MDD group showed significantly higher percentage of B cells than HC group (p = 0.032). MDD group presented a negative correlation between: PHQ-9 and CD8 T effector memory cells (r= –0.639, p = 0.002), TACS-22 and monocytes (r= –0.459, p = 0.036), HQ-25 and NK T cells (r= –0.638, p = 0.004), CATS and Intermediate monocytes (r= –0.594, p = 0.009). Conclusions: MTD traits, hikikomori tendencies, and ACEs were correlated with specific characteristics of peripheral immune cells. Our results suggest that immune imbalance influences the diverse presentations of depression. Further validation is warranted by large-scale prospective studies.

DOI： 10.1080/19585969.2025.2452842

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Language：English   Publisher：Psychiatry and Clinical Neurosciences  

Aims: Schizophrenia (SZ) is associated with abnormalities in both spontaneous and task-evoked neural oscillations, and growing evidence shows that shift patterns of oscillatory activity between resting and task states are also disturbed. However, no study has simultaneously examined the frequency- and state-specific characteristics of oscillatory deficits in SZ. Using an auditory steady-state response (ASSR) paradigm, we aimed to examine the differential sensitivity of oscillatory measures to SZ and to assess rest–task shifts across multiple frequency bands. Methods: We recorded resting-state activity and 40 Hz ASSR of 66 neurotypical controls (NC) and 68 SZ patients using electroencephalography (EEG). 40 Hz stimulus-evoked activity was measured using evoked power, phase-locking factor (PLF), and phase-locking angle, whereas multi-frequency (4–100 Hz) spontaneous activity during ASSR and resting states was assessed using induced and resting power. The state-dependent shifts in spontaneous activity between the resting and ASSR states were evaluated over a broad frequency range. Results: Both induced and resting power in the low-frequency range (4–10 Hz) were elevated over widespread regions in SZ patients relative to NC. Gamma-band (39–100 Hz) induced power then demonstrated excellent ability to discriminate between SZ and NC. In addition, SZ patients showed a reduced rest–task shift in the theta-beta band (5–23 Hz) spontaneous power, most pronounced in the alpha-band (8–13 Hz). Conclusion: The present study confirmed the utility of gamma-band induced power during ASSR stimulation for differentiating SZ patients from NC. Importantly, our results also highlight the pathophysiological significance of the reduced rest–task shift pattern of spontaneous activity mainly in the alpha-band in SZ patients.

DOI： 10.1111/pcn.13880

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Language：English   Publisher：Psychiatry and Clinical Neurosciences  

DOI： 10.1111/pcn.13837

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PubMed

Language：English   Publisher：John Wiley & Sons Australia, Ltd  

Language：English   Publisher：Psychiatry and Clinical Neurosciences Reports  

Aim: The aim of this study was to investigate whether psychiatrists around the world believe they might encounter cases of hikikomori (prolonged social isolation), and how they formulate and treat such cases. Methods: A hikikomori case vignette was sent to psychiatrists of 34 countries around the world. Participants rated for the vignette: frequency of similar cases in one's practicing country; and aspects of formulation, diagnosis, suicide risk, and treatment plan. Results: In total, 344 complete responses from 34 countries were returned. Eight countries/areas had 10 or more respondents: Japan (61), South Korea (54), Nepal (48), Iran (40), Thailand (32), India (23), Hong Kong (12), and UK (10); the remainder were placed in the “others” group (64). Respondents from all countries except Thailand felt that similar cases were seen. Diverse patterns of response were obtained regarding formulation and treatment. Japan, South Korea, and “others” favored psychosocial aspects in the formulation, while Iran, Nepal, and India favored biological factors. Most respondents felt the case could be treated by an outpatient visit, while others preferred hospitalization. Psychotherapy was rated highly as an intervention; Iran, South Korea, and “others” also rated pharmacotherapy highly. Conclusion: Despite its limitations as an exploratory study, we found evidence that hikikomori-like cases might exist around the world. However, opinions on how such cases should be formulated and treated vary significantly among countries. We believe this reflects how the experience of hikikomori is dependent on the related sociocultural context. Further comparative work, preferably with standardized assessment tools, will help to clarify how society might influence the individual experiences of practitioner and hikikomori patients.

DOI： 10.1002/pcn5.70120

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Authorship：Last author   Language：English   Publisher：Journal of Neuropsychology  

Decision-making has been suggested as an endophenotype candidate for obsessive-compulsive disorder (OCD). However, few studies have examined whether decision-making under ambiguity is an endophenotype of OCD. This study aimed to investigate decision-making under ambiguity, as assessed by the Iowa Gambling Task (IGT), in patients with OCD and unaffected first-degree relatives (UFDR). Forty-seven non-medicated, non-co-morbid patients with OCD, 30 UFDR, and 47 healthy controls (HC) were compared in terms of decision-making using the IGT. The correlation between obsessive-compulsive symptoms and IGT performance was also investigated. Patients with OCD and UFDR performed worse than HC on the IGT. No correlation was found between obsessive-compulsive symptoms and IGT performance. A deficit in decision-making under ambiguity may be a trait and an endophenotype candidate for OCD.

DOI： 10.1111/jnp.12407

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Authorship：Last author   Language：English   Publisher：Journal of Psychiatric Research  

Despite recent studies suggesting an important association of hoarder disorder (HD) and attention-deficit/hyperactive disorder (ADHD), no neuroimaging study has investigated the differences between patients with HD comorbid with ADHD and those without ADHD. This study investigated the regional spontaneous activity and functional connectivity in HD, focusing on the comorbidity with ADHD. Resting-state functional magnetic resonance imaging (MRI) data were obtained from 24 patients with HD and 31 healthy individuals. We investigated the group differences using the fractional amplitude of low-frequency fluctuation (fALFF). The altered regions in the fALFF were used as seeds in a functional connectivity analysis where we conducted group comparisons among the three groups: healthy controls (HCs), HD with ADHD (HD +ADHD), and HD without ADHD (HD -ADHD). Compared to HCs, patients with HD had a reduced fALFF in the right inferior frontal gyrus (IFG). Functional connectivity analysis revealed that patients with HD + ADHD had reduced functional connectivity between the IFG and dorsolateral prefrontal cortex (DLPFC) compared to HCs, while the HD -ADHD group was intermediate level between HD +ADHD and HCs groups. In conclusion, patients with HD have altered spontaneous activity of the IFG. Additionally, patients with HD + ADHD had significantly reduced functional connectivity between the IFG and the DLPFC. Our findings suggest the potential need to distinguish between subgroups of HD+ADHD to identify novel neurobiological models of HD that could guide future therapeutic strategies.

DOI： 10.1016/j.jpsychires.2025.03.055

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Language：English   Publisher：National Center for Global Health and Medicine  

<p>The COVID-19 pandemic highlighted the essential role of nursing professionals in infection control and patient care across various healthcare settings in Japan. Despite their dedication, the crisis exposed significant gaps in preparedness, training, and leadership development. This paper examines the challenges nurses and public health nurses faced during the pandemic and proposes a framework for strengthening capacity development to enhance future public health emergency responses. Fundamental infection control education must be systematically incorporated into basic nursing curricula, equipping nurses with essential skills such as proper use of personal protective equipment, zoning principles, and infection prevention strategies. Simulation-based training should complement theoretical instruction to ensure practical application. Continuous professional development through structured on-the-job training is crucial, particularly for smaller hospitals and elderly care facilities where infection control expertise remains limited. Public health nurses require specialized training in epidemiological investigations and outbreak management to coordinate community health responses effectively. Leadership in clinical settings and public health must be reinforced. The Infectious Disease Health Emergency Assistance Team (IHEAT) and supervisory public health nurses played key roles in the pandemic response. Still, challenges in rapid deployment and infrastructure readiness hindered their effectiveness. Strengthening managerial education and crisis response training will be critical to improving future outcomes. Additionally, networking and knowledge-sharing systems should be expanded to enhance communication and coordination. Mental health support for nursing professionals engaged in infection control must also be prioritized. This paper advocates a comprehensive approach to nursing education, training, and leadership development to fortify Japan's healthcare system against future pandemics.</p>

DOI： 10.35772/ghm.2025.01019

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CiNii Research

Language：English   Publisher：Psychiatry and Clinical Neurosciences  

Aim: To investigate the association of olfactory identification ability with both the prevalence of mild cognitive impairment (MCI) and regional brain atrophy in a community-dwelling older population. Methods: A total of 1293 participants without dementia aged 65 years or older underwent a Japanese version of the 4-Item Pocket Smell Test, an assessment of cognitive function, and brain magnetic resonance imaging scanning in 2017–2018. Regional gray matter volumes (GMVs) and white matter lesions volume (WMLV) were estimated using FreeSurfer software. The association of impaired olfactory identification with the presence of MCI and regional GMVs or WMLV was estimated by logistic regression analysis and ANCOVA, respectively. We also assessed the association between impaired olfactory identification and GMVs without regions of interest, using a voxel-based morphometry (VBM) analysis. Results: Participants with impaired olfactory identification had a significantly higher likelihood of MCI than those without (odds ratio, 1.99 [95% confidence interval, 1.36–2.91]). In the FreeSurfer analysis, participants with impaired olfactory identification had significantly lower GMVs in the entorhinal cortex, inferior temporal gyrus, amygdala, thalamus, hippocampus, and cingulate gyrus, and higher WMLV than those without. The VBM analysis also showed that impaired olfactory identification was significantly associated with lower volume of the left entorhinal cortex, left amygdala, left hippocampus, bilateral thalami, and bilateral subcallosal areas. Conclusion: Our findings suggest that cognitive function and brain changes may need to be evaluated in older individuals with impaired olfactory identification, which may reflect the extent of neurodegeneration, WMLV, and subsequent cognitive impairment.

DOI： 10.1111/pcn.13813

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Publisher：株式会社医学書院  

DOI： 10.11477/mf.048812810670030260

CiNii Research

Authorship：Last author   Language：English   Publisher：Journal of Psychiatric Research  

DOI： 10.1016/j.jpsychires.2025.02.040

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DOI： 10.1093/ijnp/pyae059.511

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Language：English   Publisher：Japan Atherosclerosis Society  

<p> <b>Aim:</b> To investigate the association between a prolonged heart rate-corrected QT (QTc) interval on a 12-lead electrocardiogram and the risk of developing dementia and its subtypes using long-term prospective longitudinal data from a Japanese community.</p><p><b>Methods:</b> A total of 1,082 residents ≥ 60 years old without dementia were followed up for 24 years. The QT interval was corrected for the heart rate using Bazett’s equation. QTc prolongation was defined as QTc ≥ 440 ms, and participants with QTc ＜440 ms were divided into tertiles. Therefore, QTc interval levels at baseline were divided into 4 ranges: ≤ 401, 402–417, 418–439, and ≥ 440 ms. The Cox proportional hazards model was used to estimate the hazard ratios (HRs) of QTc interval levels on the risk of dementia.</p><p><b>Results:</b> During the follow-up period, 475 participants developed all-cause dementia, 146 had vascular dementia (VaD), and 295 had Alzheimer’s disease (AD). Compared with the lowest QTc level (≤ 401 ms), the multivariable-adjusted HRs for VaD increased significantly with longer QTc intervals (HR [95% confidence interval] 1.80 [1.05 to 3.08] for 402–417 ms, 1.93 [1.12 to 3.34] for 418–439 ms, and 2.64 [1.49 to 4.68] for ≥ 440 ms; <i>p</i> for trend = 0.01). No significant association was found between QTc interval and the risk of both all-cause dementia and AD.</p><p><b>Conclusion:</b> The present findings suggest that QTc prolongation serves as a potential indicator for identifying individuals at a high risk of developing VaD. QTc measurement may assist in the primary prevention of VaD.</p>

DOI： 10.5551/jat.65686

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Language：English   Publisher：Jbi Evidence Synthesis  

Objective: This review will identify and compare diverse approaches to group cognitive behavioral therapy (CBT) for obsessive-compulsive disorder (OCD). Introduction: CBT is an established treatment for OCD. Although the benefits of group CBT are well known, its practice varies widely. Despite the growing number of studies on group CBT, the extent of heterogeneity in its structure and content has not been examined. Inclusion criteria: Eligibility criteria will include adult patients (18 years or older) of any gender, with a primary diagnosis of OCD. Articles must report on group CBT implemented as a treatment, specifically focusing on the number, frequency, duration, and format of sessions; number of participants; program content; and therapists' profession. The review will include both experimental and quasi-experimental designs, analytical observational studies, qualitative research, mixed methods studies, and textual evidence from key documents. Conference abstracts, research protocols, and systematic reviews will also be examined. All cultures, geographical contexts, races, and therapeutic settings will be considered. While sub-group analyses (eg, cultural or geographical variations) will not be conducted quantitatively due to the scoping nature of this review, relevant sub-group differences will be explored. Methods: This review will follow the JBI methodology for scoping reviews. Published and unpublished articles in English and Japanese from database inception to the present will be searched for in PubMed, Web of Science Core Collection, Scopus, the Cochrane Library (including the Cochrane Central Register of Controlled Trials and the Cochrane Database of Systematic Reviews), CINAHL, PsycINFO, Open Access Theses and Dissertations, WHO International Clinical Trials Registry Platform, MedNar, and Google Scholar. Two reviewers will screen papers against predetermined inclusion criteria and extract data for specific variables. Data will be presented as tables and figures, accompanied by a narrative summary.

DOI： 10.11124/JBIES-24-00380

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PubMed

Language：English   Publisher：Psychiatry and Clinical Neurosciences Reports  

Background: Attention-deficit/hyperactivity disorder (ADHD) symptoms, including executive function, emotional regulation, and motivation, can persist into adulthood and are often associated with mental illnesses. Cognitive behavioral therapy (CBT) may help ADHD adults in Japan, but the lack of studies and the variability in group CBT approaches make its effects unclear. Japan lacks unified CBT programs and adult ADHD guidelines, making it difficult to implement international individual CBT recommendations due to cultural differences. This study will assess the feasibility of a novel CBT program for Japanese adult ADHD patients. Methods: This feasibility study will be open, nonrandomized, single-arm, multicenter study. Twelve ADHD patients aged 20–65 years who are currently receiving treatment will be included based on Conners' Adult ADHD Rating Scale (CAARS) clinical severity threshold. An intervention phase of 12–16 weeks and a 12-week follow-up will total 24–28 weeks for all participants. The intervention will use a new CBT program tailored to individual assessments. Results: The primary objective is to determine feasibility using dropout rates, adverse events, and CAARS score changes between Weeks 1 and 16. The secondary outcomes will assess long-term effects of treatment beyond the intervention period and provide descriptive statistics on sex, depression, quality of life, and autistic scores in relation to the intervention outcomes. The full analysis set and per protocol set will be used for statistical analysis. Conclusions: This study is essential for the development of CBT interventions in accordance with Japan's healthcare system that are tailored to the unique needs of its population.

DOI： 10.1002/pcn5.70036

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Language：English   Publisher：BMC Psychiatry  

Background: To identify risk factors for mental distress and investigate whether the factors were different between men and women during the coronavirus disease 2019 (COVID-19), using KOKOROBO data, which is an online platform that aims to facilitate access to mental health services. Methods: We used baseline data on KOKOROBO users 13 years of age or older in Japan who accessed it from October 11, 2021, to April 6, 2023, excluding those receiving treatment for mental health problems. Global severity, based on the most severe measure on Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Insomnia Severity Index (ISI), was analyzed using multivariable logistic regression with baseline characteristics for each gender, and for under 30 and 30 years of age or older in women. We conducted the same analysis of suicidal ideation for each gender. Results: In the 686 men and 1274 women, 117 (17.1%) and 100 (7.8%) had minimal global severity respectively, and the rest suffered from mental distress to some extent. For women, ages under 30 years (adjusted OR (aOR): 0.352, 95%CI: 0.231–0.539, P < 0.001), marriage (aOR: 0.453, 95%CI: 0.274–0.746, P = 0.002), and concerns about COVID-19 infection were associated with global severity, while having children (aOR: 0.509, 95% CI: 0.284–0.909, P = 0.023) and decrease of going out during the COVID-19 pandemic had a protective effect on global severity and suicidal ideation for men, respectively. Living with family was a risk factor for mental distress in unmarried women over 30 years of age. Less communication with family or others and responding to the questionnaire late at night (00:00–05:59) were associated with severe global severity in both genders. Conclusions: Age, living arrangement, marriage, having children, concerns about COVID-19 infection, and lifestyle changes during the COVID-19 pandemic had gender-specific effects on mental distress, while frequent communication and regular life rhythm maintained mental health in both genders. Young women and, unmarried middle-aged women living with their families tended to experience mental distress during the COVID-19 pandemic. Trial registration: The Ethics Committee of the National Center of Neurology and Psychiatry approved this study (approval number B2020141) on April 15, 2021.

DOI： 10.1186/s12888-024-06200-5

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Authorship：Last author   Language：English   Publisher：Psychiatry Research Neuroimaging  

Obsessive-compulsive disorder (OCD) is characterized by structural alteration within white matter tissues of cortico-striato-thalamo-cortical, temporal and occipital circuits. However, the presence of microstructural changes in the white matter tracts of unaffected first-degree relatives of patients with OCD as a vulnerability marker remains unclear. Therefore, here, diffusion-tensor magnetic resonance imaging (DTI) data were obtained from 29 first-degree relatives of patients with OCD and 59 healthy controls. We investigated the group differences in FA using whole-brain analysis (DTI analysis). For additional regions of interest (ROI) analysis, we focused on the posterior thalamic radiation and sagittal stratum, shown in recent meta-analysis of patients with OCD. In both whole-brain and ROI analyses, using a strict statistical threshold (family-wise error rate [FWE] corrected p<.05 for whole-brain analyses, and p<.0125 (0.05/4) with Bonferroni correction for ROI analyses), we found no significant group differences in FA. Subtle reductions were observed in the anterior corona radiata, forceps minor, cingulum bundle, and corpus callosum only when a lenient statistical was applied (FWE corrected p<.20). These findings suggest that alterations in the white matter microstructure of first-degree relatives, as potential vulnerability markers for OCD, are likely subtle.

DOI： 10.1016/j.pscychresns.2024.111884

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Publisher：株式会社医学書院  

DOI： 10.11477/mf.1405207381

CiNii Research

Language：English   Publisher：Journal of Affective Disorders  

Background: In the 1990s, the concepts of hikikomori and modern-type depression (MTD) emerged in Japan. Hikikomori is a condition of social avoidance or isolation, characterized by staying at home and being physically isolated for at least six months. MTD is characterized by depressive symptoms—mainly in stressful work or school situations during adolescence and early adulthood—which tend to rapidly reduce or disappear after leaving the stressful situation. We hypothesized that childhood maltreatment can form MTD traits that lead to hikikomori. Methods: As a first step, we conducted a multigroup path analysis between childhood maltreatment, MTD traits, and physical isolation in the hikikomori group. This study utilized the nine-item Patient Health Questionnaire (PHQ-9), Home Environment Questionnaire (HEQ), 22-item Tarumi Modern-Type Depressive Trait Scale (TACS-22), 25-item Hikikomori Questionnaire (HQ-25), and Hamilton Depression Rating Scale (HDRS). The HQ-25 contains three factors: physical isolation, lack of socialization, and lack of emotional support. Results: The hikikomori group included 92 patients and the control group comprised 137 healthy individuals. All total and subscale scores of PHQ-9, HEQ, TACS-22, HQ-25, and HDRS were significantly higher in the hikikomori group than in the control group. The risk model of childhood maltreatment for physical isolation via MTD traits obtained good fit with a goodness-of-fit index of.982. Limitations: The study's limitations were its sample selection bias, cross-sectional design, and use of self-report scales. Conclusions: Our findings support the hypothesis that childhood maltreatment is an important risk factor for hikikomori via MTD traits.

DOI： 10.1016/j.jad.2024.05.094

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Language：English   Publisher：Psychiatry and Clinical Neurosciences Reports  

The aim of this scoping review was to synthesize published studies and ongoing clinical trials of psychological interventions for mental health problems associated with COVID-19 infection. The study protocol was developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews. We conducted systematic searches for studies published or registered between January 2020 and October 2022 using eight scientific databases and clinical trial registries, which identified 40 complete published studies and 53 ongoing clinical trials. We found that most studies were randomized controlled trials (74%) while the remaining used study designs of lower methodological quality. Most studies investigated interventions for acute COVID-19 patients (74%) and others explored post-COVID conditions (PCC) or recovered patients. Cognitive and behavioral therapies were the main intervention approaches (31%), followed by multidisciplinary programs (21%) and mindfulness (17%). The most frequently evaluated outcomes were anxiety (33%), depression (26%), quality of life (13%), and insomnia (10%). No studies on youths, older people, or marginalized communities were found. These findings summarize the burgeoning research on a range of psychological interventions for individuals infected with COVID-19. However, the field is in its infancy and further research to develop an evidence base for targeted care is necessary. The gaps identified in the current study also highlight the need for more research on youths, older people, and members of marginalized communities, and PCC patients. It is important to ascertain interventions and delivery strategies that are not only effective and affordable but also allow high scalability and accessibility.

DOI： 10.1002/pcn5.223

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Authorship：Last author   Language：English   Publisher：Journal of Clinical Psychopharmacology  

DOI： 10.1097/JCP.0000000000001904

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Language：Japanese   Publisher：(株)医学書院  

＜文献概要＞クロザピンとバルプロ酸の併用療法に対して効果が不十分であったクロザピン治療抵抗性統合失調症(clozapine resistant schizophrenia:CRS)に対して,リチウムの追加が著効した症例を経験した。精神症状が改善した機序は不明であるが,バルプロ酸とリチウムはともにクロザピン増強療法の選択肢として考えられており,その併用がCRSに対して有効である可能性が示唆された。また,その併用が好中球数の改善やけいれん発作のリスク軽減に寄与している可能性もある。CRSに対して確立した治療法はないため,治療に関する実証的な知見の蓄積が必要である。

Language：English   Publisher：John Wiley & Sons Australia, Ltd  

COVID-19感染症に伴う精神症状への精神療法介入の有用性を検討した。各種文献データベースを検索し、文献93件を抽出してスコーピングレビューを行った。文献40件は公表された臨床試験、53件は進行中の臨床試験であり、その内訳は無作為化比較試験(RCT)が69件、単群試験が5件、非無作為化比較試験が4件、準実験的研究が3件で、小規模RCTが43件、中規模～大規模RCTが29件となっていた。検討対象とされたのは急性COVID-19感染症患者が74%、COVID-19感染症から回復した患者が12%、COVID-19感染後(PCC)患者が7%、退院患者が7%、COVID-19疑い患者が4%であり、精神療法介入として認知行動療法(CBTs)が31%、集学的プログラムが21%、マインドフルネスアプローチが17%に行われていた。公表されている臨床試験の成績をみると、CBTsと集学的プログラムの実施は不安、うつ、睡眠障害、PTSD症状、急性ストレス、QOLの改善に有用であり、マインドフルネスアプローチはうつと不安、眼球運動による脱感作および再処理法は不安、うつ、PTSD症状の軽減に有用であることが示されていた。また、精神療法の介入期間は8週以内が64%と最も多く、8～12週が13%となっていた。COVID-19感染症に伴う精神症状に対して精神療法が有用であることが示されたが、さらに若年者や高齢者を対象に検討を重ねる必要があると思われた。

Language：English   Publisher：(一社)日本疫学会  

<Highlight>●preserved ratio impaired spirometry(PRISm)と認知症との関連は明らかにされていない。●本研究では、認知症のない65歳以上の日本人地域高齢住民1,202人を対象に、中央値5.0年間の追跡調査を行った。●PRISm群は、呼吸機能正常群と比べ認知症の発症リスクが約2倍であった。●PRISmは、認知症の発症リスクが高い集団であり、呼吸機能障害の重要なサブタイプといえる。(著者抄録)

Publisher：株式会社医学書院  

DOI： 10.11477/mf.1405207324

CiNii Research

Language：English   Publisher：Japan Epidemiological Association  

<p><b>Background:</b> Studies on the association between preserved ratio impaired spirometry (PRISm) and dementia are limited. Indeed, PRISm has often been overlooked or ignored as an index of lung function impairment. Therefore, we investigated the association of PRISm with the risk for the development of dementia in an older Japanese population.</p><p><b>Methods:</b> A total of 1,202 community-dwelling, older Japanese participants aged ≥65 years without dementia were followed up for a median of 5.0 years. Participants were categorized by spirometry as follows: normal spirometry (FEV₁/FVC ≥0.70 and FEV₁ ≥80% predicted), PRISm (≥0.70 and <80%), airflow limitation (AFL) Global Initiative for Chronic Obstructive Lung Disease (GOLD) 1 (<0.70 and ≥80%), and AFL GOLD 2 to 4 (<0.70 and <80%). Hazard ratios (HRs) and their 95% confidence intervals (CIs) were computed using a Cox proportional hazards model.</p><p><b>Results:</b> During the follow-up period, 122 participants developed dementia. The age- and sex-adjusted incidences of dementia in the participants with normal spirometry, PRISm, AFL GOLD 1, and AFL GOLD 2 to 4 were 20.5, 37.0, 18.4, and 28.6 per 1,000 person-years, respectively. Participants with PRISm had a higher risk of dementia (HR 2.04; 95% CI, 1.19–3.49) than those with normal spirometry after adjusting for confounders. Moreover, both reduced FEV₁% predicted values and FVC% predicted values were associated with the risk of dementia.</p><p><b>Conclusion:</b> PRISm was associated with an increased risk of dementia in a general older Japanese population.</p>

DOI： 10.2188/jea.je20230207

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Authorship：Last author   Language：English   Publisher：Frontiers in Psychiatry  

Background: Hoarding disorder (HD) is characterized by cognitive control impairments and abnormal brain activity in the insula and anterior cingulate cortex (ACC) during disposal of personal items or certain executive function tasks. However, whether there are any changes in resting-state functional connectivity of the insula and ACC remains unclear. Methods: A total of 55 subjects, including 24 patients with HD and 31 healthy controls (HCs), participated in the study. We acquired resting-state functional magnetic resonance imaging data and examined group differences in functional connectivity from the insula and ACC in whole-brain voxels. Results: In patients with HD, functional connectivity was significantly lower between the right insula and right inferior frontal gyrus (IFG) and left superior temporal gyrus (STG) compared to HCs. There was no correlation between these connectivities and HD symptoms. Conclusions: Although the clinical implication is uncertain, our results suggest that patients with HD have resting-state functional alterations between the insula and IFG and STG, corresponding with the results of previous fMRI studies. These findings provide new insight into the neurobiological basis of HD.

DOI： 10.3389/fpsyt.2024.1399062

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Language：English   Publisher：Scientific Reports  

We investigated the association of retinopathy with the risk of dementia in a general older Japanese population. A total of 1709 population-based residents aged 60 years or older without dementia were followed prospectively for 10 years (2007–2017). They underwent color fundus photography in 2007. Retinopathy was graded according to the Modified Airlie House Classification. Main outcome was the Incidence of dementia. A Cox proportional hazards model was used to estimate the hazard ratios (HRs) and their 95% confidence intervals (CIs) for the risk of dementia by the presence of retinopathy. During the follow-up period, 374 participants developed all-cause dementia. The cumulative incidence of dementia was significantly higher in those with retinopathy than those without (p < 0.05). Individuals with retinopathy had significantly higher risk of developing dementia than those without after adjustment for potential confounding factors (HR 1.64, 95% CI 1.19–2.25). Regarding the components of retinopathy, the presence of microaneurysms was significantly associated with a higher multivariable-adjusted HR for incident dementia (HR 1.94, 95% CI 1.37–2.74). Our findings suggest that, in addition to systemic risk factors, retinal microvascular signs from fundus photography provide valuable information for estimating the risk of developing dementia.

DOI： 10.1038/s41598-024-62688-7

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Publisher：株式会社医学書院  

DOI： 10.11477/mf.1405207267

CiNii Research

Language：English   Publisher：Psychiatry and Clinical Neurosciences  

DOI： 10.1111/pcn.13647

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Language：English   Publisher：European Journal of Neuroscience  

Prominent pathological hypotheses for schizophrenia include auditory processing deficits and dysconnectivity within cerebral networks. However, most neuroimaging studies have focused on impairments in either resting-state or task-related functional connectivity in patients with schizophrenia. The aims of our study were to examine (1) blood oxygen level-dependent (BOLD) signals during auditory steady-state response (ASSR) tasks, (2) functional connectivity during the resting-state and ASSR tasks and (3) state shifts between the resting-state and ASSR tasks in patients with schizophrenia. To reduce the functional consequences of scanner noise, we employed resting-state and sparse sampling auditory fMRI paradigms in 25 schizophrenia patients and 25 healthy controls. Auditory stimuli were binaural click trains at frequencies of 20, 30, 40 and 80 Hz. Based on the detected ASSR-evoked BOLD signals, we examined the functional connectivity between the thalamus and bilateral auditory cortex during both the resting state and ASSR task state, as well as their alterations. The schizophrenia group exhibited significantly diminished BOLD signals in the bilateral auditory cortex and thalamus during the 80 Hz ASSR task (corrected p < 0.05). We observed a significant inverse relationship between the resting state and ASSR task state in altered functional connectivity within the thalamo-auditory network in schizophrenia patients. Specifically, our findings demonstrated stronger functional connectivity in the resting state (p < 0.004) and reduced functional connectivity during the ASSR task (p = 0.048), which was mediated by abnormal state shifts, within the schizophrenia group. These results highlight the presence of abnormal thalamocortical connectivity associated with deficits in the shift between resting and task states in patients with schizophrenia.

DOI： 10.1111/ejn.16298

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Publisher：診断と治療社  

DOI： 10.34433/dt.0000000674

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Language：English   Publisher：Journal of Psychiatric Research  

Background: Depression is a common mental disorder and causes significant social loss. Early intervention for depression is important. Nonetheless, depressed patients tend to conceal their symptoms from others based on shame and stigma, thus hesitate to visit psychiatrists especially during early phase. We hypothesize that application of humanoid robots would be a novel solution. Depressed patients may feel more comfortable talking with such robots than humans. Methods: We recruited 13 patients with major depressive disorder (MDD) and 27 healthy volunteers as controls. Participants took both tele-operated humanoid robot and human interviews to evaluate severity of depression using the Hamilton Depression Rating Scale (HDRS). In addition, participants completed a self-administered questionnaire asking about their impressions of the robot interview. Results: Confidence interval and t-test analysis have revealed that the HDRS scores are equally reliable between robot and human interviews. No significant differences were observed between the two interviews regarding “nervousness about the interview” and “hesitancy to talk about depressed moods and suicidal ideation.” Compared to human interviews, robot interviews yielded significantly lower scores on shame-related factors especially among patients with MDD. Limitation: Small sample size, and the evaluator is male only. Conclusions: This is the first report to show the reliability of tele-operated humanoid robot interviews for assessment of depression. Robot interviews are potentially equally reliable as human interviews. Robot interviews are suggested to be more appropriate in assessing shame-related suppressed emotions and hidden thoughts of depressed patients in clinical practice, which may reduce the stigma associated with depression.

DOI： 10.1016/j.jpsychires.2023.12.014

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Language：Japanese   Publisher：日本認知療法・認知行動療法学会  

2020年1月1日から2021年9月30日に、福岡県下でCOVID-19罹患患者の受け入れを行った主要9医療機関に入院した患者(2743例)を対象に、Diagnosis Procedure Combination(DPC)データを用いて、COVID-19罹患後の精神症状について調査を行った。DPC調査と同一期間に同一の9医療機関の診療録調査を実施した。DPC調査において精神症状に関連する因子として向精神薬の投与状況を解析し、睡眠薬の投与が9施設全体で991症例(36.1%)に認められた。診療録調査ではCOVID-19の入院患者で精神科受診となった患者の総数は221名(男性135名、女性86名、平均年齢62.7±17.6歳)であった。精神科初診時における主たる精神症状は不眠が29%、混乱19.5%、不安16.3%、易怒性5.9%、徘徊3.2%、抑うつ2.7%であった。ホテル療養者の健康調査では、三つの精神保健センターに調査期間中に不安(59.5%)、隔離によるストレス(10.1%)などの総計518件の相談が寄せられた。

Language：English   Publisher：Psychiatry and Clinical Neurosciences  

DOI： 10.1111/pcn.13614

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Publisher：株式会社医学書院  

DOI： 10.11477/mf.1405207137

CiNii Research

Publisher：(株)金剛出版  

DOI： 10.69291/j00762.2024073067

CiNii Research

Publisher：株式会社医学書院  

DOI： 10.11477/mf.1405207120

CiNii Research

Language：English   Publisher：Frontiers in Neuroscience  

Introduction: Gamma-band oscillatory deficits have attracted considerable attention as promising biomarkers of schizophrenia (SZ). Notably, a reduced auditory steady-state response (ASSR) in the low gamma band (40 Hz) is widely recognized as a robust finding among SZ patients. However, a comprehensive investigation into the potential utility of the high-gamma-band ASSR in detecting altered neural oscillations in SZ has not yet been conducted. Methods: The present study aimed to assess the ASSR using magnetoencephalography (MEG) data obtained during steady-state stimuli at frequencies of 20, 30, 40, and 80 Hz from 23 SZ patients and 21 healthy controls (HCs). To evaluate the ASSR, we examined the evoked power and phase-locking factor (PLF) in the time-frequency domain for both the primary and secondary auditory cortices. Furthermore, we calculated the phase-locking angle (PLA) to examine oscillatory phase lead or delay in SZ patients. Taking advantage of the high spatial resolution of MEG, we also focused on the hemispheric laterality of low- and high-gamma-band ASSR deficits in SZ. Results: We found abnormal phase delay in the 40 Hz ASSR within the bilateral auditory cortex of SZ patients. Regarding the 80 Hz ASSR, our investigation identified an aberrant phase lead in the left secondary auditory cortex in SZ, accompanied by reduced evoked power in both auditory cortices. Discussion: Given that abnormal phase lead on 80 Hz ASSR exhibited the highest discriminative power between HC and SZ, we propose that the examination of PLA in the 80 Hz ASSR holds significant promise as a robust candidate for identifying neurophysiological endophenotypes associated with SZ. Furthermore, the left-hemisphere phase lead observed in the deficits of 80 Hz PLA aligns with numerous prior studies, which have consistently proposed that SZ is characterized by left-lateralized brain dysfunctions.

DOI： 10.3389/fnins.2023.1277733

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Language：English   Publisher：Molecular Psychiatry  

Correction to: Molecular Psychiatry, published online 2 May 2023 In this article Honami Arai, Irene Bollettini, Rosa Calvo Escalona, Ana Coelho, Federica Colombo, Leila Darwich, Martine Fontaine, Toshikazu Ikuta, Jonathan C. Ipser, Asier Juaneda-Seguí, Hitomi Kitagawa, Gerd Kvale, Mafalda Machado-Sousa, Astrid Morer, Takashi Nakamae, Jin Narumoto, Joseph O’Neill, Sho Okawa, Eva Real, Veit Roessner, Joao R. Sato, Cinto Segalàs, Roseli G. Shavitt, Dick J. Veltman, Kei Yamada were missing from the author list indexed under the ENIGMA-OCD Working Group. Additionally, there was an error regarding Tokiko Yoshida’s name, where the first name and last name were written in the wrong order. The original article has been corrected.

DOI： 10.1038/s41380-023-02211-y

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Authorship：Last author   Language：English   Publisher：Frontiers in Psychiatry  

Background: Patients with obsessive-compulsive disorder (OCD) have deficits in decision-making in the Iowa Gambling Task (IGT). However, no study has investigated the parameters of the prospect valence learning (PVL) model in the IGT for OCD. Aims: This study aimed to investigate deficits in decision-making in OCD using the PVL model and identify whether the parameters of the PVL model were associated with obsessive-compulsive severity. Methods: Forty-seven medication-free patients with OCD were compared with 47 healthy controls (HCs). Decision-making was measured using the total net and block net scores of the IGT. A PVL model with a decay-reinforcement learning rule (PVL-DecayRI) was used to investigate the parameters of the model. Correlation analysis was conducted between each parameter of the PVL-DecayRL and obsessive-compulsive symptoms. Results: The total net score of patients with OCD was significantly lower than that of the HCs. The block net scores of the OCD group did not differ across the five blocks, whereas in the HCs, the fifth block net score was significantly higher than the block net scores of the first and second blocks. The values of the recency and response consistency parameters of the PVL-DecayRI in patients with OCD were significantly lower than those in HCs. The recency parameter positively correlated with the Y-BOCS obsessive score. Meanwhile, there was no correlation between consistency parameter values and symptom severity in OCD. Conclusion: Our detailed analysis of the decision-making deficit in OCD suggests that the most recent outcome has a small influence on the expectancy of prospect valence, as indicated by the lower recency parameter, and is characterized by more impulsive choices, as indicated by the lower consistency parameter.

DOI： 10.3389/fpsyt.2023.1227057

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Language：English   Publisher：Scientific Reports  

Angiogenic factors associated with Moyamoya disease (MMD) are overexpressed in M2 polarized microglia in ischemic stroke, suggesting that microglia may be involved in the pathophysiology of MMD; however, existing approaches are not applicable to explore this hypothesis. Herein we applied blood induced microglial-like (iMG) cells. We recruited 25 adult patients with MMD and 24 healthy volunteers. Patients with MMD were subdivided into progressive (N = 7) or stable (N = 18) group whether novel symptoms or radiographic advancement of Suzuki stage within 1 year was observed or not. We produced 3 types of iMG cells; resting, M1-, and M2-induced cells from monocytes, then RNA sequencing followed by GO and KEGG pathway enrichment analysis and qPCR assay were performed. RNA sequencing of M2-induced iMG cells revealed that 600 genes were significantly upregulated (338) or downregulated (262) in patients with MMD. Inflammation and immune-related factors and angiogenesis-related factors were specifically associated with MMD in GO analysis. qPCR for MMP9, VEGFA, and TGFB1 expression validated these findings. This study is the first to demonstrate that M2 microglia may be involved in the angiogenic process of MMD. The iMG technique provides a promising approach to explore the bioactivity of microglia in cerebrovascular diseases.

DOI： 10.1038/s41598-023-41456-z

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Publisher：Psychiatry International  

Introduction: A positive association between Internet usage time and Internet addiction among adolescents and adults has been frequently reported; however, studies of working adults focusing on weekdays and holidays are limited. Therefore, this study aimed to elucidate the association between Internet usage time and psychometric tests among working adults in their 30s, focusing on weekdays and holidays. Methods: A total of 129 workers aged 30–39 years participated in this study. Participants completed a questionnaire and interview regarding psychometric tests, including Internet usage time, Internet addiction tendency, smartphone addiction tendency, depression tendency, and personality traits. A correlation analysis focusing on differences between weekdays and holidays was conducted. Results: The scores on Internet addiction scales are weakly positively correlated with holiday Internet usage time. The scores of smartphone addiction scales are also weakly positively correlated with the holiday Internet time. No correlation was found between weekdays Internet usage time and scores on Internet addiction scales. Conclusions: Internet usage time during holidays is associated with Internet addiction tendency among the working adult samples. Holiday Internet usage time could be a useful indicator of risk of Internet addiction. Our pilot findings provide clues to the mental health affected by the Internet, especially among adults.

DOI： 10.3390/psychiatryint4030020

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Authorship：Last author   Language：English   Publisher：Psychiatry Research Neuroimaging  

Recent evidence suggests that broad brain regions, not limited to the fronto-striato-thalamo-cortical circuit, play an important role in motor response inhibition. However, it is still unclear which specific key brain region is responsible for impaired motor response inhibition observed in obsessive-compulsive disorder (OCD). We calculated the fractional amplitude of low-frequency fluctuations (fALFF) and measured response inhibition ability using the stop-signal task in 41 medication-free patients with OCD and 49 healthy control (HC) participants. We explored the brain region that shows different association between the fALFF and the ability of motor response inhibition. Significant differences in fALFF associated with the ability of motor response inhibition were identified in dorsal posterior cingulate cortex (PCC). There was a positive correlation between increased fALFF in the dorsal PCC and impaired motor response inhibition in OCD. In the HC group, there was a negative correlation between the two variables. Our results suggest that the magnitude of resting-state blood oxygen level-dependent oscillation of the dorsal PCC is a key brain region for the underlying mechanisms of impaired motor response inhibition in OCD. Future studies should examine whether this characteristic of dorsal PCC affects other large-scale networks responsible for motor response inhibition of OCD.

DOI： 10.1016/j.pscychresns.2023.111669

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Language：English   Publisher：Psychiatry and Clinical Neurosciences  

DOI： 10.1111/pcn.13564

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Language：English   Publisher：Cerebral Cortex  

Gyrification patterns ref lect early neurodevelopment and could be highly heritable. While some discrepant results have been reported, the most consistent finding was that patients with obsessive-compulsive disorder showed altered gyrification patterns in the orbitofrontal cortex. Nevertheless, no study has investigated the alterations in gyrification in unaffected first-degree relatives of patients with obsessive-compulsive disorder. We measured local gyrification by the FreeSurfer software in 23 unaffected first-degree relatives of patients with obsessive-compulsive disorder and 52 healthy control participants. We explored differences in the local gyrification index using vertex-wise whole-brain analysis and a region of interest-based approach in the medial and lateral orbitofrontal cortex. There was no significant difference in the local gyrification index between the 2 groups in the vertex-wise whole-brain analysis. Region of interest analyses showed that, compared with healthy controls, first-degree relatives showed significantly reduced local gyrification index in the left medial and lateral orbitofrontal cortex. A negative correlation was observed between the reduced local gyrification index in lateral orbitofrontal cortex and the subclinical anxiety scores of first-degree relatives. Our results showed that first-degree relatives of patients with obsessive-compulsive disorder had an altered local gyrification index in the orbitofrontal cortex. Especially, reduced local gyrification index in lateral orbitofrontal cortex associated with subclinical anxiety symptom could be a potential neurodevelopmental marker for the illness onset.

DOI： 10.1093/cercor/bhad170

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Authorship：Last author   Language：English   Publisher：Cerebral Cortex  

Previous studies have suggested that specific fronto-striatal circuits are associated with impaired motor response inhibition in patients with obsessive-compulsive disorder (OCD) and their relatives. However, no study has investigated the underlying resting-state network associated with motor response inhibition in the unaffected first-degree relatives of patients with OCD. We measured motor response inhibition using stop-signal task, and obtained resting-state fMRI in 23 first-degree relatives and 52 healthy control participants. We explored the group differences in the functional network from seed regions-of-interest (ROIs) associated with motor response inhibition abilities. We used the inferior frontal gyrus (IFG) and pre-supplementary motor area (pre-SMA) as seed-ROIs. A significant group difference was observed in functional connectivity between the pre-SMA and inferior parietal lobule. In the relative group, reduced functional connectivity between these areas was associated with a longer stop-signal reaction time. Additionally, relatives showed significantly greater functional connectivity between the IFG and SMA, precentral, and postcentral areas. Our results could provide new insights into the resting-state neural activity of the pre-SMA underlying impaired motor response inhibition of unaffected first-degree relatives. In addition, our results suggested that relatives have an altered connectivity of the sensorimotor region, similar to that of patients with OCD shown in previous literature.

DOI： 10.1093/cercor/bhad058

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Authorship：Last author   Language：English   Publisher：Psychiatry and Clinical Neurosciences Reports  

There is insufficient research on the usefulness of psychological interventions, such as psychological first aid (PFA), during outbreaks. We searched for and critically appraised systematic reviews that examined the effectiveness of PFA during infectious disease outbreaks, such as the novel coronavirus disease (COVID-19). Systematic reviews that examined the efficacy of PFA in the severe acute respiratory syndrome, Middle East respiratory syndrome coronavirus, Ebola virus disease, and COVID-19 outbreaks were searched through PubMed on February 19, 2021. The three included systematic reviews were critically appraised and assessed using AMSTAR-2. One review's overall confidence in its findings was evaluated as “high,” which suggested that PFA training had a favorable effect on healthcare personnel. Furthermore, the review also demonstrated that PFA was commonly used during outbreaks and could be delivered through multiple methods, such as a phone or video call. Although it was anticipated that PFA would improve subjective well-being, reports showed no evidence of reduced depression or insomnia. Future studies should examine additional numbers of PFA recipients and conduct quasi-experimental studies to better understand the effectiveness of PFA. Evidence on its effectiveness in infectious disease outbreaks is still lacking, along with research and evaluation methods. Quasi-experimental studies, such as comparisons with other psychological interventions, are required to better understand the effectiveness of PFA.

DOI： 10.1002/pcn5.107

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Language：English   Publisher：John Wiley & Sons Australia, Ltd  

高齢者集団における白質病変容積(WMLV)及び脳萎縮と認知症リスクの関係について検討した。福岡県久山町の認知症がない65歳以上の住民のうち、脳MRIを実施した1158人(男性512人、女性646人、平均73.6±6.2歳)を対象とした。WMLVをLesion Segmentation Toolboxを用いてセグメント化し、全脳容積(TBV)と局所灰白質容積をvoxel-based morphometryを用いて推定した。頭蓋内脳容積(ICV)に対するWMLVの比(WMLV/ICV)を計算し、WMLV/ICVと認知症リスクの関連をCox比例ハザードモデルにより推定した。ICVに対するTBVの比(TBV/ICV)で定義された全脳萎縮と、著者等の過去の報告で定義された認知症関連の脳局所萎縮を算出した。5年間の経過観察期間中に113人が認知症を発症した。認知症リスクはWMLV/ICVとともに有意に増加した。WMLV/ICVが大きくTBV/ICVが小さい住民と、WMLV/ICVが大きく認知症関連の脳局所萎縮の数が多い住民では認知症リスクが相加的に増加することが観察された。

Authorship：Last author   Language：English   Publisher：John Wiley & Sons Australia, Ltd  

COVID-19などの感染症アウトブレイク時における心理的応急処置の有用性を明らかにすることを目的として、関連するシステマティックレビューの内容をまとめた。PubMedを用いて、感染症アウトブレイク時(SARS、MERS、エボラウイルス、COVID-19)の有効性に関するシステマティックレビューを検索した。3件のシステマティックレビューを対象とした。その結果、AMSTAR-2の総合信頼性評価が「高」であったのは1レビューのみであり、心理的応急処置トレーニングが医療従事者に好ましい効果をもたらすことが示唆された。さらに、本レビューでは心理的応急処置はアウトブレイク時に一般的に使用されており、電話やビデオ通話など複数の方法で実施可能であるとも示された。心理的応急処置は主観的well-beingを改善することが期待されたが、抑うつや不眠症を減少させたというエビデンスは報告されなかった。以上のように、感染症アウトブレイク発生時における心理的応急処置の有効性に関するエビデンスは研究・評価方法とともに未だ不足していることが示された。

Language：English   Publisher：Psychiatry and Clinical Neurosciences  

Aim: To investigate the association of white matter lesions volume (WMLV) levels with dementia risk and the association between dementia risk and the combined measures of WMLV and either total brain atrophy or dementia-related gray matter atrophy in a general older population. Methods: One thousand one hundred fifty-eight Japanese dementia-free community-residents aged ≥65 years who underwent brain magnetic resonance imaging were followed for 5.0 years. WMLV were segmented using the Lesion Segmentation Toolbox. Total brain volume (TBV) and regional gray matter volume were estimated by voxel-based morphometry. The WMLV-to-intracranial brain volume ratio (WMLV/ICV) was calculated, and its association with dementia risk was estimated using Cox proportional hazard models. Total brain atrophy, defined as the TBV-to-ICV ratio (TBV/ICV), and dementia-related regional brain atrophy defined based on our previous report were calculated. The association between dementia risk and the combined measures of WMLV/ICV and either total brain atrophy or the number of atrophied regions was also tested. Results: During the follow-up, 113 participants developed dementia. The risks of dementia increased significantly with higher WMLV/ICV levels. In addition, dementia risk increased additively both in participants with higher WMLV/ICV levels and lower TBV/ICV levels and in those with higher WMLV/ICV levels and a higher number of dementia-related brain regional atrophy. Conclusion: The risk of dementia increased significantly with higher WMLV/ICV levels. An additive increment in dementia risk was observed with higher WMLV/ICV levels and lower TBV/ICV levels or a higher number of dementia-related brain regional atrophy, suggesting the importance of prevention or control of cardiovascular risk factors.

DOI： 10.1111/pcn.13533

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Publisher：株式会社医学書院  

DOI： 10.11477/mf.1405206861

CiNii Research

Publisher：株式会社医学書院  

DOI： 10.11477/mf.1405206876

CiNii Research

Language：English   Publisher：Archives of Gerontology and Geriatrics  

Background: To investigate the association of gait speed with regional brain volumes and the risk of incident dementia. Methods: A total of 1112 dementia-free Japanese residents aged ≥65 years who underwent brain magnetic resonance imaging were followed for 5.0 years (median). The participants were classified into the age- and sex-specific quartile levels of maximum gait speed. Regional gray matter volumes (GMV) and white matter hyperintensities volumes (WMHV) were measured by applying voxel-based morphometry methods. The cross-sectional association of maximum gait speed with regional GMV was examined using an analysis of covariance. We also estimated the association between maximum gait speed level and the risk of developing dementia using a Cox proportional hazards model. Mediation analyses were conducted to determine the contribution of regional brain volumes to the association between maximum gait speed and dementia. Results: Lower maximum gait speed was significantly associated with lower GMV of the total brain, frontal lobe, temporal lobe, cingulate gyrus, insula, hippocampus, amygdala, basal ganglia, thalamus, and cerebellum, and increased WMHV at baseline. During the follow-up, 108 participants developed dementia. The incidence rate of all dementias increased significantly with decreasing maximum gait speed after adjusting for potential confounders (P for trend = 0.03). The mediating effects of the GMV of the hippocampus, GMV of the insula, and WMHV were significant. Conclusions: Lower maximum gait speed was significantly associated with an increased risk of dementia. Reduced GMV of the hippocampus or insula, and an increase in WMHV was likely to be involved in this association.

DOI： 10.1016/j.archger.2022.104883

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Authorship：Last author   Language：Japanese   Publisher：(公財)メンタルヘルス岡本記念財団  

2019年4月から2022年3月に九州大学病院精神科神経科を受診した、ためこみ症(Hoarding disorder:HD)患者で、研究に参加協力が可能な患者にHD発症前のライフイベントについて調査した。対象者を募り、同意を得た上で詳細な生育環境・生活環境について面接による調査を行った。さらにSocial Readjustment Rating Scale(SRRS)を用いて、ためこみ症発症前に認めたライフイベントを網羅的に調査した。対象となった患者は21名(男性6名、女性15名、平均年齢45.6±11.1歳、発症平均年齢19.9±8.38歳)、併存症はADHD 13名、気分障害12名(大うつ病性障害11名、双極性1型障害1名)などであった。発症前のライフイベントに関する調査では、分離に合致するライフイベントを認めた割合は21名中18名であった。発症前のネガティブなライフイベントとしての「児童青年期のライフイベント」と所有物への信念としての「感傷的な価値」間にのみ有意な関連が認められた。

Language：English   Publisher：BMJ Open  

Introduction Mental health symptoms such as depression, anxiety and sleep problems are commonly observed in individuals suffering from acute COVID-19 infection to post-COVID-19 syndrome. Studies have provided preliminary evidence for the efficacies of cognitive behavioural therapy, mindfulness-based interventions, acceptance and commitment therapy, and many other treatments for this population. Although there have been attempts to synthesise the literature on these psychological interventions, previous reviews have been limited in terms of the sources, symptoms and interventions that they included. Furthermore, most studies reviewed were conducted in early 2020, when COVID-19 had only recently been classified as a global pandemic. Since then, substantial research has been conducted. As such, we sought to provide an updated synthesis of the available evidence of treatments for the range of mental health symptoms associated with COVID-19. Methods and analysis This scoping review protocol was developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Systematic searches were carried out on scientific databases (PubMed, Web of Science, PsycINFO and Scopus) and clinical trial registries (ClinicalTrials.gov, WHO ICTRP, EU Clinical Trials Register and Cochrane Central Register of Controlled Trials) to identify studies that have or will assess the efficacy or any aspects of psychological treatment for acute to post-COVID-19 syndrome. The search was conducted on 14 October 2022 and identified 17 855 potentially eligible sources/studies published since 1 January 2020 (duplicates removed). Six investigators will independently carry out titles and abstract screening, full-text screening and data charting and the results will be summarised using descriptive statistics and narrative synthesis. Ethics and dissemination Ethical approval is not required for this review. The results will be disseminated through a peer-reviewed journal, conference presentations and/or academic newspapers. This scoping review has been registered with Open Science Framework (https://osf.io/wvr5t).

DOI： 10.1136/bmjopen-2022-069386

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Language：English   Publisher：Psychiatry and Clinical Neurosciences  

DOI： 10.1111/pcn.13505

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PubMed

Language：English   Publisher：John Wiley & Sons Australia, Ltd  

治療抵抗性統合失調症(TRS)に特異的な脳回形成異常と表面積異常を明らかにした。健常対照(HC)24名(平均41.5±13.5歳)、ファーストライン抗精神病薬(FL)に反応した患者(FL-Resp)20名(平均43.8±12.6歳)、クロザピンに反応したTRS患者(CLZ-Resp)19名(平均43.1±13.8歳)、FLおよびクロザピン抵抗性のTRS患者(URS)22名(平均45.9±11.9歳)を対象に、3T MRI画像の解析を行った。局所脳回指数(LGI)および関連する表面積を群間で解析・比較した。その結果、CLZ-RespとURSはともに左内側頭頂葉(Lt-MPC)においてHCおよびFL-Respより低いLGIであった。CLZ-RespとURSはともにFL-RespよりもLt-MPCの表面積が狭かった。LGIと表面積は非TRS(Fl-Resp)およびTRS(CLZ-Resp+URS)で正の相関を示した。Lt-MPCにおけるLGIと表面積を用いた非TRSとTRSのROC曲線下面積はそれぞれ0.79と0.85であった。Lt-MPCの表面積はTRSの陰性症状およびクロザピン血中濃度と逆相関していた。以上から、Lt-MPCのLGIと表面積の変化は、TRSの遺伝的脆弱性に関連する構造的特徴であると考えられた。

Publisher：(株)金剛出版  

DOI： 10.69291/j03600.2023067295

CiNii Research

Language：English   Publisher：Frontiers in Psychiatry  

Backgrounds: Hikikomori, pathological social withdrawal, is becoming a crucial mental health issue in Japan and worldwide. We have developed a 3-day family intervention program for hikikomori sufferers based on Mental Health First Aid (MHFA) and Community Reinforcement and Family Training (CRAFT). This study aims to confirm the effectiveness of the 3-day program by a randomized controlled trial. Methods: This study was registered on the UMIN Clinical Trials Registry (UMIN000037289). Fifteen parents were assigned to the treat as usual (TAU) group (TAU only; Age Mean, 65.6; SD, 7.8), and 14 to the Program group (program + TAU; Age Mean, 67.9; SD, 8.6). This study was discontinued due to the COVID-19 pandemic; the recruitment rate was 36.3% of our target sample size of 80. Results: Perceived skills improved temporally and stigma temporally worsened in the TAU group. Confidence decreased and attitude showed no change in both groups. Aggressive behaviors of hikikomori sufferers were significantly worsened in the Program group; however, no serious domestic violence was reported. In the TAU group, Avoidance and irregular life patterns were improved. Activity levels were worsened in both groups. Two participants (16.7%) in the Program group and one participant (7.7%) in the TAU group reported actual behavioral changes (e.g., utilizing support). Conclusion: We could not draw general conclusions on the effectiveness of the program due to the study discontinuation. Nevertheless, this study indicates the necessity for revision of the program to improve family members’ confidence in engaging with hikikomori sufferers, with safer approaching by families.

DOI： 10.3389/fpsyt.2022.1029653

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Language：English   Publisher：Journal of Affective Disorders  

Background: Widely used psychotropic medications for obsessive-compulsive disorder (OCD) may change the volumes of subcortical brain structures, and differently in children vs. adults. We measured subcortical volumes cross-sectionally in patients finely stratified for age taking various common classes of OCD drugs. Methods: The ENIGMA-OCD consortium sample (1081 medicated/1159 unmedicated OCD patients and 2057 healthy controls aged 6–65) was divided into six successive 6–10-year age-groups. Individual structural MRIs were parcellated automatically using FreeSurfer into 8 regions-of-interest (ROIs). ROI volumes were compared between unmedicated and medicated patients and controls, and between patients taking serotonin reuptake inhibitors (SRIs), tricyclics (TCs), antipsychotics (APs), or benzodiazepines (BZs) and unmedicated patients. Results: Compared to unmedicated patients, volumes of accumbens, caudate, and/or putamen were lower in children aged 6–13 and adults aged 50–65 with OCD taking SRIs (Cohen's d = −0.24 to −0.74). Volumes of putamen, pallidum (d = 0.18–0.40), and ventricles (d = 0.31–0.66) were greater in patients aged 20–29 receiving APs. Hippocampal volumes were smaller in patients aged 20 and older taking TCs and/or BZs (d = −0.27 to −1.31). Conclusions: Results suggest that TCs and BZs could potentially aggravate hippocampal atrophy of normal aging in older adults with OCD, whereas SRIs may reduce striatal volumes in young children and older adults. Similar to patients with psychotic disorders, OCD patients aged 20–29 may experience subcortical nuclear and ventricular hypertrophy in relation to APs. Although cross-sectional, present results suggest that commonly prescribed agents exert macroscopic effects on subcortical nuclei of unknown relation to therapeutic response.

DOI： 10.1016/j.jad.2022.08.084

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PubMed

Language：English   Publisher：Frontiers in Psychiatry  

Background: A number studies have been conducted on abnormalities in the cortical circuitry of gamma oscillations, including deficit in auditory steady-state response (ASSR) to gamma-frequency (≧ 30-Hz) stimulation, in patients with bipolar disorder (BD). In the current study, we investigated neural responses during click stimulation by blood oxygen level-dependent (BOLD) signals. We focused on Broadman 41 and 42, the main sources of ASSR. Materials and methods: We acquired BOLD responses elicited by click trains of 80-, 40-, 30- and 20-Hz frequencies from 25 patients with BD to 27 healthy controls (HC) with normal hearing between 22 and 59 years of age assessed via a standard general linear-model-based analysis. We extracted contrast values by identifying the primary auditory cortex and Brodmann areas 41 and 42 as regions of interest (ROI)s. Results: BD group showed significantly decreased ASSR-BOLD signals in response to 40-Hz stimuli compared to the HC group in the right Brodmann areas 41 and 42. We found significant negative correlations between the BOLD change in the right Brodmann areas 41 and 42 and Structured Interview Guide for the Hamilton Depression Rating Scale (SIGH-D) scores, also the BOLD change in the right Brodmann areas 41 and 42 and the Positive and Negative Syndrome Scale (PANSS)-Negative scores. Conclusion: The observed decrease in BOLD signal patterns in the right primary auditory cortex during 40-Hz ASSR may be a potential biomarker option for bipolar disorder.

DOI： 10.3389/fpsyt.2022.833896

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PubMed

Publisher：(株)金剛出版  

DOI： 10.69291/j00762.2022265828

CiNii Research

Authorship：Last author   Language：English   Publisher：International Journal of Environmental Research and Public Health  

Quarantine imposed due to COVID-19 infection can exacerbate psychological distress, and it is important for a public mental health agency to identify factors that are predictive of high psychological distress in such situation. The aim of this study was to investigate whether gender, age, and the presence or absence of infectious disease symptoms affected psychological distress among asymptomatic or mildly ill COVID-19 patients who were quarantined. Participants were 436 asymptomatic or mildly symptomatic COVID-19-infected patients who were quarantined in a treatment facility between 1 May 2020 and 30 September 2021. We used Quantification Theory I analysis to investigate the effects of gender, age, and the nature of infectious disease symptoms on psychological distress. The results of the analysis showed that the contribution rate was 0.06. Among gender, age, presence of symptoms, and the nature of symptoms, age had the greatest effect on psychological distress, and being in one’s teens to thirties was considered to exacerbate psychological distress the most. According to the results, the psychological distress of asymptomatic and mildly symptomatic COVID-19 patients isolated was affected by gender, age, and symptomology, especially due to age differences. However, the impact of these items on psychological distress was not considered significant.

DOI： 10.3390/ijerph19159083

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Language：English   Publisher：Scientific Reports  

We examined the association of serum s-adenosylmethionine (SAM), s-adenosylhomocysteine (SAH) (methionine metabolites), and their ratio on the risk of dementia and death in a community-dwelling population of older Japanese individuals. 1371 residents of Hisayama, Japan, aged 65 years or older and without dementia, were followed for a median of 10.2 years (2007–2017). We divided serum SAM, SAH, and SAM/SAH ratio into quartiles. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and their 95% confidence intervals (CIs) of serum SAM, SAH, and SAM/SAH ratio levels on the risk of a composite outcome of all-cause dementia or death, and each outcome. During the follow-up, 635 participants developed all-cause dementia and/or died, of which 379 participants developed dementia and 394 deaths occurred. The multivariable-adjusted HRs of the composite outcome decreased significantly with increasing serum SAM levels (P for trend = 0.01), while they increased significantly with higher serum SAH levels (P for trend = 0.03). Higher serum SAM/SAH ratio levels were significantly associated with a lower risk of the composite outcome (P for trend = 0.002), as well as with lower risk of each outcome. Our findings suggest that the balance of methionine metabolites may closely associate with the risk of dementia and death.

DOI： 10.1038/s41598-022-16242-y

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PubMed

Language：English   Publisher：Progress in Neuro Psychopharmacology and Biological Psychiatry  

Background It is gradually becoming clear that obsessive-compulsive disorder (OCD) patients have aberrant resting-state large-scale intrinsic networks of cingulo-opercular salience (SN), default mode (DMN), and front-parietal network (FPN). However, it remains unknown whether unaffected first-degree relatives of OCD patients have these alterations as a vulnerability marker to the disorder. Methods We performed resting-state functional magnetic resonance imaging (rsfMRI) scans of 47 medication-free OCD patients, 21 unaffected healthy first-degree relatives of OCD patients, and 62 healthy control (HC) participants. We explored differences between the three groups in the functional connectivity from SN (seeds: anterior-insula (AI) and dorsal anterior cingulate cortex (dACC)), DMN (seeds: medial prefrontal cortex (MPFC) and posterior parietal cortex (PCC)), and FPN (seeds: dorsolateral prefrontal cortex (DLPFC)). Results Compared to HC, both OCD patients and first-degree relatives showed significantly greater functional connectivity between AI and PCC and between DLPFC and the thalamus. Compared to first-degree relatives and HC, OCD patients showed reduced functional connectivity between PCC and DLPFC, and this altered functional connectivity was negatively correlated with anxiety and depressive symptom within OCD group. Conclusions OCD patients and unaffected first-degree relatives of OCD patients showed overlapping alterations in resting state functional connectivity between the regions of SN and DMN and between DLPFC and the thalamus. Our results suggested that alterations between large-scale intrinsic networks and within the dorsal cognitive cortico-striato-thalamo-cortical (CSTC) circuit could represent endophenotype markers of OCD.

DOI： 10.1016/j.pnpbp.2022.110516

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Language：English   Publisher：Ophthalmology Science  

Purpose: To assess the association of inner retinal thickness with prevalent dementia and regional brain atrophy in a general older population of Japanese. Design: Population-based, cross-sectional study. Participants: A total of 1078 residents aged 65 years or older who participated in an eye examination, a comprehensive survey of dementia, and brain magnetic resonance imaging scanning in 2017. Methods: The thicknesses of the inner retinal layers, namely, the ganglion cell-inner plexiform layer (GC-IPL) and retinal nerve fiber layer (RNFL)—were measured by swept-source OCT (SS-OCT). The association of these retinal thicknesses with the risk of the presence of dementia was estimated using restricted cubic splines and logistic regression models. Regional brain volumes were estimated separately by applying 2 different methods: voxel-based morphometry (VBM) and analysis by FreeSurfer software. The associations of GC-IPL and RNFL thickness with each brain regional volume were analyzed using multiple regression analysis. Main Outcome Measure: Prevalent dementia and regional brain atrophy. Results: Among the study participants, 61 participants (5.7%) were diagnosed with dementia. The likelihood of the presence of dementia significantly increased with lower GC-IPL thickness after adjusting for potential confounders (odds ratio, 1.62 [95% confidence interval, 1.30–2.01] per 1 standard deviation decrement in the GC-IPL thickness), but no significant association was observed with RNFL thickness. In the VBM analyses with the multivariable adjustment, lower GC-IPL thickness was significantly associated with lower volume of known brain regions related to cognitive functions (i.e., the hippocampus, amygdala, entorhinal area, and parahippocampal gyrus) and visual functions (i.e., the cuneus, lingual gyrus, and thalamus). Meanwhile, the volume of the thalamus significantly decreased with lower RNFL thickness, but none of the brain regions related to cognitive function exhibited a volume change in association with RNFL thickness. The sensitivity analysis using FreeSurfer analysis also showed that lower GC-IPL thickness was significantly associated with lower regional brain volume/intracranial volume of the hippocampus, amygdala, cuneus, lingual gyrus, and thalamus. Conclusions: Our findings suggest that the measurement of GC-IPL thickness by SS-OCT, which is a noninvasive, convenient, and reproducible method, might be useful for identifying high-risk individuals with dementia.

DOI： 10.1016/j.xops.2022.100157

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PubMed

Publisher：株式会社医学書院  

DOI： 10.11477/mf.1405206638

CiNii Research

Language：English   Publisher：Journal of Psychiatric Research  

Although preliminary neuroimaging research suggests that patients with hoarding disorder (HD) show widespread abnormal task-related activity in the brain, there has been no research on alterations in the white matter tracts in these patients. The aim of this study was to investigate the characteristics of the major white matter tracts in patients with HD. Tract-based spatial statistics were used to search for white matter tract abnormalities throughout the brain in 25 patients with HD and 36 healthy controls. Post hoc analysis of regions of interest was performed to detect correlations with clinical features. Compared with the controls, patients with HD showed decreased fractional anisotropy and increased radial diffusivity in anatomically widespread white matter tracts. Post hoc analysis of regions of interest revealed a significant negative correlation between the severity of hoarding symptoms and fractional anisotropy in the left anterior limb of the internal capsule and a positive correlation between the severity of these symptoms and radial diffusivity in the right anterior thalamic radiation. Patients with HD showed a broad range of alterations in the frontal white matter tracts, including the frontothalamic circuit, frontoparietal network, and frontolimbic pathway. The findings of this study indicate associations between frontal white matter abnormalities related to the severity of hoarding symptoms in HD and the cortical regions involved in cognitive dysfunction. The insights provided would be useful for understanding the neurobiological basis of HD.

DOI： 10.1016/j.jpsychires.2022.01.031

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Authorship：Last author  

Language：English   Publisher：Journal of the American Geriatrics Society  

Background: Little is known about the influence of serum level of soluble triggering receptor expressed on myeloid cells 2 (sTREM2), which is a soluble type of an innate immune receptor expressed on the microglia, on the association of the daily sleep duration with the risk of dementia. Methods: A total of 1230 Japanese community-residents aged 60 and older without dementia were followed prospectively for 10 years (2002–2012). Serum sTREM2 levels were divided into two groups using the median value (334.8 pg/ml). Self-reported daily sleep duration was grouped into three categories of <5.0, 5.0–7.9, and ≥8.0 h. A Cox proportional hazards model was used to estimate the hazard ratios (HRs) and their 95% confidence intervals (CIs) of daily sleep duration on the risk of dementia according to serum sTREM2 levels. Results: During the follow-up, 262 subjects developed dementia. In subjects with low serum sTREM2 levels, subjects with ≥8.0 h of daily sleep had a significantly greater risk of dementia (multivariable-adjusted HR 2.05 [95% CI 1.32–3.19]) than those with 5.0–7.9 h of daily sleep, but those with <5.0 h did not. In contrast, the risk of dementia increased significantly in subjects with both <5.0 (1.95 [1.03–3.68]) and ≥8.0 h of daily sleep (1.48 [1.06–2.07]) in the subjects with high serum sTREM2 levels. Conclusions: The influence of daily sleep duration on risk of dementia differed according to serum sTREM2 levels in the older Japanese population. Short daily sleep may be associated with greater risk of dementia only in subjects with a high serum sTREM2 level.

DOI： 10.1111/jgs.17634

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Language：English   Publisher：BMC Geriatrics  

Background: Several prospective Western studies have reported an inverse association of vegetable and fruit intake with dementia risk. However, there is limited epidemiologic evidence in Asians. This study investigated the association of intakes of vegetables, fruits, and their nutrients on the risk of incident dementia and its subtypes in a Japanese community. Methods: A total of 1071 participants (452 men and 619 women) aged ≥60 years without dementia at baseline were prospectively followed up for 24 years. Intakes of vegetables, fruits, and nutrients were evaluated using a 70-item semiquantitative food frequency questionnaire at baseline and were categorized into quartiles separately by gender. The outcome measure was the development of dementia and its subtypes—namely, Alzheimer’s disease (AD) and vascular dementia (VaD). The risk estimates of incident dementia were computed using a Cox proportional hazards model. Results: During the long-term follow-up period, 464 subjects developed dementia, of whom 286 had AD and 144 had VaD. Higher vegetable intake was associated gradually with lower risk of developing dementia and AD (both P-trend < 0.05), but not VaD, after adjusting for confounders. Subjects allocated the highest quartile of vegetable intake had 27 and 31% lower risk of dementia and AD, respectively, than those with the lowest quartile. The risk of dementia decreased significantly with higher intakes of vitamin A, riboflavin, vitamin C, magnesium, calcium, and potassium (all P-trend < 0.05). Subjects with higher total dietary fiber intake tended to be at decreased risk for total dementia (P-trend = 0.07). Meanwhile, there were no significant associations between fruit intake and the risk of dementia and its subtypes. Conclusion: Higher intakes of vegetables and their constituent nutrients were associated with a lower risk of dementia in Japanese older adults. A diet rich in vegetables may be beneficial in reducing the dementia risk in Asians.

DOI： 10.1186/s12877-022-02939-2

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Language：English   Publisher：Journal of Neurology Neurosurgery and Psychiatry  

Objective: To assess the association of regional grey matter atrophy with dementia risk in a general older Japanese population. Methods: We followed 1158 dementia-free Japanese residents aged ≥65 years for 5.0 years. Regional grey matter volume (GMV) at baseline was estimated by applying voxel-based morphometry methods. The GMV-to- total brain volume ratio (GMV/TBV) was calculated, and its association with dementia risk was estimated using Cox proportional hazard models. We assessed whether the predictive ability of a model based on known dementia risk factors could be improved by adding the total number of regions with grey matter atrophy among dementia-related brain regions, where the cut-off value for grey matter atrophy in each region was determined by receiver operating characteristic curves. Results: During the follow-up, 113 participants developed all-cause dementia, including 83 with Alzheimer's disease (AD). Lower GMV/TBV of the medial temporal lobe, insula, hippocampus and amygdala were significantly/marginally associated with higher risk of all-cause dementia and AD (all p for trend ≤0.08). The risks of all-cause dementia and AD increased significantly with increasing total number of brain regions exhibiting grey matter atrophy (both p for trend <0.01). Adding the total number of regions with grey matter atrophy into a model consisting of known risk factors significantly improved the predictive ability for AD (Harrell's c-statistics: 0.765.0.802; p=0.02). Conclusions: Our findings suggest that the total number of regions with grey matter atrophy among the medial temporal lobe, insula, hippocampus and amygdala is a significant predictor for developing dementia, especially AD, in the general older population.

DOI： 10.1136/jnnp-2021-326611

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Authorship：Last author   Language：English   Publisher：Human Brain Mapping  

Recent evidence suggests that presupplementary motor area (pre-SMA) and inferior frontal gyrus (IFG) play an important role in response inhibition. However, no study has investigated the relationship between these brain networks at resting-state and response inhibition in obsessive–compulsive disorder (OCD). We performed resting-state functional magnetic resonance imaging scans and then measured the response inhibition of 41 medication-free OCD patients and 49 healthy control (HC) participants by using the stop-signal task outside the scanner. We explored the differences between OCD and HC groups in the functional connectivity of pre-SMA and IFG associated with the ability of motor response inhibition. OCD patients showed a longer stop-signal reaction time (SSRT). Compared to HC, OCD patients exhibit different associations between the ability of motor response inhibition and the functional connectivity between pre-SMA and IFG, inferior parietal lobule, dorsal anterior cingulate cortex, insula, and anterior prefrontal cortex. Additional analysis to investigate the functional connectivity difference from the seed ROIs to the whole brain voxels revealed that, compared to HC, OCD exhibited greater functional connectivity between pre-SMA and IFG. Also, this functional connectivity was positively correlated with the SSRT score. These results provide additional insight into the characteristics of the resting-state functional connectivity of the regions belonging to the cortico-striato-thalamo-cortical circuit and the cingulo-opercular salience network, underlying the impaired motor response inhibition of OCD. In particular, we emphasize the importance of altered functional connectivity between pre-SMA and IFG for the pathophysiology of motor response inhibition in OCD.

DOI： 10.1002/hbm.25699

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Language：English   Publisher：Frontiers in Psychiatry  

Background: Modern-Type Depression (MTD) is a category of depression that has been studied mainly in Japan; however, no study has attempted to determine its relation to chronic pain. Aim: To determine possible associations between psychological traits related to MTD and the chronic pain of patients at psychiatric clinics. Method: Two hundred and twenty-one first time patients who visited the psychiatric clinic at a Japanese university medical center or an associated clinic were enrolled. The Hamilton Depression Rating Scale was used to measure depressive symptoms. The 22-item Tarumi's Modern-Type Depression Trait Scale (TACS-22), Achievement Motive, and 20-item Toronto Alexithymia Scale were used to assess psychological traits related to depression and chronic pain. The clinical diagnosis of each patient was confirmed by use of the Structured Clinical Interview for DSM-IV Axis I Disorders, administered by experienced specialists. The medians of the psychological traits identified were compared between patients with or without chronic pain. Analysis was also done of patients with Major Depressive Disorder (MDD). Result: Of the 221 patients, 139 had chronic pain. Patients with chronic pain had more severe depressive symptoms, Alexithymia, and high scores for the complaint trait of MTD. Seventy-three of the 221 patients met the criteria for MDD (53 had chronic pain). Patients with MDD comorbid with chronic pain had a higher competitive achievement score, severe depression, and difficulty identifying feelings. Conclusion: Complaint and competitive traits were shown to be related to chronic pain in psychiatric settings. Further study will allow us to design multidimensional approach for patients suffering from depression.

DOI： 10.3389/fpsyt.2022.825422

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Language：English   Publisher：Journal of Personalized Medicine  

Lower serum levels of low-density lipoprotein cholesterol (LDL-C) have been suggested to indicate higher suicide risk and various psychiatric symptoms. Previously, we reported that lower serum LDL-C levels are associated with loneliness, social phobia, isolated life with little social support, and lower trust in others among young non-clinical females. Thus, we hypothesize that schizoid personality traits may be associated with lower serum LDL-C. We here verified this hypothesis using non-clinical data and clinical data with schizophrenia. Using the database from the Midlife in Japan (MIDJA), a cohort of residents living in Tokyo, we analyzed whether schizoid-related interpersonal characteristics were associated with LDL-C. In addition, we assessed the association between blood biomarkers including LDL-C and schizoid personality traits in 101 adult non-clinical volunteers. Finally, we evaluated the interaction between LDL-C and social decision making of patients with schizophrenia. In female non-clinical volunteers, serum LDL-C level was a predictive factor and negatively correlated with schizoid personality traits. Female patients with schizophrenia, whose serum LDL-C levels were lower, tended not to trust other females. The present findings suggest that LDL-C may influence schizoid personality traits in females, which provide a basis for further investigation into the biological aspects of schizoid personality disorder.

DOI： 10.3390/jpm12020131

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Language：English   Publisher：Human Brain Mapping  

Neuroimaging has played an important part in advancing our understanding of the neurobiology of obsessive–compulsive disorder (OCD). At the same time, neuroimaging studies of OCD have had notable limitations, including reliance on relatively small samples. International collaborative efforts to increase statistical power by combining samples from across sites have been bolstered by the ENIGMA consortium; this provides specific technical expertise for conducting multi-site analyses, as well as access to a collaborative community of neuroimaging scientists. In this article, we outline the background to, development of, and initial findings from ENIGMA's OCD working group, which currently consists of 47 samples from 34 institutes in 15 countries on 5 continents, with a total sample of 2,323 OCD patients and 2,325 healthy controls. Initial work has focused on studies of cortical thickness and subcortical volumes, structural connectivity, and brain lateralization in children, adolescents and adults with OCD, also including the study on the commonalities and distinctions across different neurodevelopment disorders. Additional work is ongoing, employing machine learning techniques. Findings to date have contributed to the development of neurobiological models of OCD, have provided an important model of global scientific collaboration, and have had a number of clinical implications. Importantly, our work has shed new light on questions about whether structural and functional alterations found in OCD reflect neurodevelopmental changes, effects of the disease process, or medication impacts. We conclude with a summary of ongoing work by ENIGMA-OCD, and a consideration of future directions for neuroimaging research on OCD within and beyond ENIGMA.

DOI： 10.1002/hbm.24972

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Language：Japanese   Publisher：Japanese Society of Biological Psychiatry  

DOI： 10.11249/jsbpjjpp.33.2_43

CiNii Research

Language：English  

DOI： 10.1080/19585969.2022.2046978

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

Previous studies have reported clinical characteristics of hoarding disorder (HD), such as early onset, a chronic course, familiality, high unmarried rate, and high rates of comorbidities. However, clinical research targeting Japanese HD patients has been very limited. As a result, there is a low recognition of HD in Japan, leading to insufficient evaluation and treatment of Japanese HD patients. The aim of the current study was to delineate the clinical characteristics of Japanese HD patients. Thirty HD patients, 20 obsessive-compulsive disorder (OCD) patients, and 21 normal controls (NC) were targeted in this study. The HD group had a tendency toward higher familiality, earlier onset, and longer disease duration compared to the OCD group. In addition, the HD group showed a significantly higher unmarried rate than the NC group. The top two comorbidities in the HD group were major depressive disorder (56.7%) and attention-deficit/hyperactivity disorder (26.7%). The HD group had significantly higher scores on hoarding rating scales and lower scores on the Global Assessment of Functioning Scale than the other two groups. The current study showed a clinical trend in Japanese HD patients similar to previous studies in various countries, suggesting that HD may be a universal disease with consistent clinical symptoms.

DOI： 10.1016/j.heliyon.2020.e03527

Language：English   Publishing type：Research paper (scientific journal)  

Brain structural covariance networks reflect covariation in morphology of different brain areas and are thought to reflect common trajectories in brain development and maturation. Large-scale investigation of structural covariance networks in obsessive-compulsive disorder (OCD) may provide clues to the pathophysiology of this neurodevelopmental disorder. Using T₁-weighted MRI scans acquired from 1616 individuals with OCD and 1463 healthy controls across 37 datasets participating in the ENIGMA-OCD Working Group, we calculated intra-individual brain structural covariance networks (using the bilaterally-averaged values of 33 cortical surface areas, 33 cortical thickness values, and six subcortical volumes), in which edge weights were proportional to the similarity between two brain morphological features in terms of deviation from healthy controls (i.e. z-score transformed). Global networks were characterized using measures of network segregation (clustering and modularity), network integration (global efficiency), and their balance (small-worldness), and their community membership was assessed. Hub profiling of regional networks was undertaken using measures of betweenness, closeness, and eigenvector centrality. Individually calculated network measures were integrated across the 37 datasets using a meta-analytical approach. These network measures were summated across the network density range of K = 0.10–0.25 per participant, and were integrated across the 37 datasets using a meta-analytical approach. Compared with healthy controls, at a global level, the structural covariance networks of OCD showed lower clustering (P 5 0.0001), lower modularity (P 5 0.0001), and lower small-worldness (P = 0.017). Detection of community membership emphasized lower network segregation in OCD compared to healthy controls. At the regional level, there were lower (rank-transformed) centrality values in OCD for volume of caudate nucleus and thalamus, and surface area of paracentral cortex, indicative of altered distribution of brain hubs. Centrality of cingulate and orbito-frontal as well as other brain areas was associated with OCD illness duration, suggesting greater involvement of these brain areas with illness chronicity. In summary, the findings of this study, the largest brain structural covariance study of OCD to date, point to a less segregated organization of structural covariance networks in OCD, and reorganization of brain hubs. The segregation findings suggest a possible signature of altered brain morphometry in OCD, while the hub findings point to OCD-related alterations in trajectories of brain development and maturation, particularly in cingulate and orbitofrontal regions.

DOI： 10.1093/brain/awaa001

Language：English   Publishing type：Research paper (scientific journal)  

Hoarding disorder (HD) is a newly listed disease in the new category of Obsessive–Compulsive and Related Disorders in the DSM-5. Patients with HD find it difficult to discard possessions regardless of their actual value and to organize those things. As a result, the possessions overflow the living space and hinder living functions. Though the hoarding symptom had been regarded as a subtype of obsessive–compulsive disorder (OCD) to date, recent studies have revealed many differences in clinical characteristics, including onset, course, degree of insight, and treatment responses, between hoarding and other subtypes. Moreover, several neuroimaging studies have found specific changes of brain structure and function in OCD patients with hoarding symptoms compared to patients with non-hoarding OCD. Meanwhile, strategies for treatment of HD have not been standardized. At present, psychological treatment using cognitive behavioral therapy techniques has a certain effect. In this review, we outline the pathophysiology and treatment of HD.

DOI： 10.1111/pcn.12853

Language：English   Publishing type：Research paper (scientific journal)  

Background: Previous studies have shown that hoarding behavior usually starts at a subclinical level in early adolescence and gradually worsens; however, a limited number of studies have examined the prevalence of hoarding behavior and its association with developmental disorders in young adults. The aims of this study were to estimate the prevalence of hoarding behavior and to identify correlations between hoarding behavior and developmental disorder traits in university students. Methods: The study participants included 801 university students (616 men, 185 women) who completed questionnaires (ASRS: Adult ADHD Self-Report Scale version 1.1, AQ16: Autism-Spectrum Quotient with 16 items, and CIR: Clutter Image Rating). Results: Among 801 participants, 27 (3.4%) exceeded the CIR cut-off score. Moreover, the participants with hoarding behavior had a significantly higher percentage of ADHD traits compared to participants without hoarding behavior (HB(+) vs HB(-), 40.7% vs 21.7%). In addition, 7.4% of HB(+) participants had autism spectrum disorder (ASD) traits, compared to 4.1% of HB(-) participants. A correlation analysis revealed that the CIR composite score had a stronger correlation with the ASRS inattentive score than with the hyperactivity/impulsivity score (CIR composite vs ASRS IA, r = 0.283; CIR composite vs ASRS H/I, r = 0.147). Conclusions: The results showed a high prevalence of ADHD traits in the university students with hoarding behavior. Moreover, we found that the hoarding behavior was more strongly correlated with inattentive symptoms rather than with hyperactivity/impulsivity symptoms. Our results support the concept of a common pathophysiology behind hoarding behavior and ADHD in young adults.

DOI： 10.1186/s13030-019-0156-1

Language：English   Publishing type：Research paper (scientific journal)  

Background: Lateralized dysfunction has been suggested in obsessive-compulsive disorder (OCD). However, it is currently unclear whether OCD is characterized by abnormal patterns of brain structural asymmetry. Here we carried out what is by far the largest study of brain structural asymmetry in OCD. Methods: We studied a collection of 16 pediatric datasets (501 patients with OCD and 439 healthy control subjects), as well as 30 adult datasets (1777 patients and 1654 control subjects) from the OCD Working Group within the ENIGMA (Enhancing Neuro Imaging Genetics through Meta Analysis) Consortium. Asymmetries of the volumes of subcortical structures, and of measures of regional cortical thickness and surface areas, were assessed based on T1-weighted magnetic resonance imaging scans, using harmonized image analysis and quality control protocols. We investigated possible alterations of brain asymmetry in patients with OCD. We also explored potential associations of asymmetry with specific aspects of the disorder and medication status. Results: In the pediatric datasets, the largest case-control differences were observed for volume asymmetry of the thalamus (more leftward; Cohen's d = 0.19) and the pallidum (less leftward; d = −0.21). Additional analyses suggested putative links between these asymmetry patterns and medication status, OCD severity, or anxiety and depression comorbidities. No significant case-control differences were found in the adult datasets. Conclusions: The results suggest subtle changes of the average asymmetry of subcortical structures in pediatric OCD, which are not detectable in adults with the disorder. These findings may reflect altered neurodevelopmental processes in OCD.

DOI： 10.1016/j.biopsych.2019.04.022

Language：English   Publishing type：Research paper (scientific journal)  

Background: Impaired cognitive flexibility has been implicated in the genetic basis of obsessive-compulsive disorder (OCD). Recent endophenotype studies of OCD showed neural inefficiency in the cognitive control network and interference by the limbic network of the cognitive control network. Exploring the relationship between the functional brain network and impaired cognitive flexibility may provide novel information about the neurobiological basis of OCD. Methods: We obtained resting-state functional magnetic resonance imaging (rsfMRI) scans and measured the cognitive flexibility of 37 medication-free OCD patients and 40 healthy control (HC) participants using the Wisconsin Card Sorting Test (WCST). We explored the difference between OCD and HC groups in the functional brain network related to impaired cognitive flexibility from the amygdala and dorsal striatal regions of interest (ROIs) by using a seed-based approach. Results: Significant differences between the OCD and HC groups were identified in the resting state functional network from the dorsal caudate. Increased functional connectivity from the dorsal caudate to the dorsal anterior cingulate cortex (dACC) and anterior insula (AI) was associated with poorer cognitive flexibility in the OCD group, but better cognitive flexibility in the HC group. Conclusions: These results provide evidence that the impaired cognitive flexibility of OCD may be associated with dysfunctions of the brain network from the dorsal caudate (DC) to important nodes of the salience network. Our results extend the neuropsychological model of OCD by showing intrinsically different associations between OCD and HC in functional network and cognitive flexibility.

DOI： 10.1016/j.nicl.2019.102004

Language：English   Publishing type：Research paper (scientific journal)  

Background Hoarding disorder (HD) is a disease concept newly presented in DSM-5. As far as we know, no studies have examined the structural changes relevant to hoarding by applying the diagnostic criteria of HD in DSM-5. In the present study, we aimed to find abnormalities in gray matter (GM) structures of patients with HD. Methods Seventeen patients who met the DSM-5 criteria for HD, 17 obsessive-compulsive disorder (OCD) patients, and 17 healthy controls (HCs) participated in this study. All participants underwent MRI scanning of the brain by a 3.0-Tesla MRI scanner. In a voxel-based morphometric procedure, preprocessed GM structural images were used to compare the three groups. Thereafter we investigated the correlation between the clinical data (age of onset, symptomatic severity) and GM volume. Results The HD group showed a significantly increased GM volume compared to the OCD and healthy control groups (p<0.05) in both Brodmann area (BA)10 and BA11. There was no significant difference between OCD and healthy control groups. No significant correlation between the clinical data including age of onset, symptom severity score, and GM volume was observed in HD and OCD groups. Conclusions The results might help to explain the inconsistency of previous studies. As with OCD, HD is considered to have cognitive dysfunction as its basis. This result is convincing after considering the clinical features of HD and suggested that structural abnormalities in the prefrontal regions might relate to the pathophysiology of HD.

DOI： 10.1371/journal.pone.0200814

Language：English   Publishing type：Research paper (scientific journal)  

Objective: Brain imaging studies of structural abnormalities in OCD have yielded inconsistent results, partly because of limited statistical power, clinical heterogeneity, and methodological differences. The authors conducted meta- and mega-analyses comprising the largest study of cortical morphometry in OCD ever undertaken. Method: T1-weighted MRI scans of 1,905 OCD patients and 1,760 healthy controls from 27 sites worldwide were processed locally using FreeSurfer to assess cortical thickness and surface area. Effect sizes for differences between patients and controls, and associations with clinical characteristics, were calculated using linear regression models controlling for age, sex, site, and intracranial volume. Results: In adult OCD patients versus controls, we found a significantly lower surface area for the transverse temporal cortexand a thinner inferiorparietalcortex.Medicated adult OCD patients also showed thinner cortices throughout the brain. In pediatric OCD patients compared with controls, we found significantly thinner inferior and superior parietal cortices, but none of the regions analyzed showedsignificant differences in surface area. However, medicated pediatric OCD patients had lower surface area in frontal regions. Cohen's d effect sizes varied from 20.10 to 20.33. Conclusions: The parietal cortex was consistently implicated in both adults and children with OCD. More widespread cortical thickness abnormalities were found in medicated adult OCD patients, and more pronounced surface area deficits (mainly in frontal regions) were found in medicated pediatric OCD patients. These cortical measures represent distinct morphological features and may be differentially affected during different stages of development and illness, and possibly moderated by disease profile and medication.

DOI： 10.1176/appi.ajp.2017.17050485

Language：English   Publishing type：Research paper (scientific journal)  

Though problematic hoarding is believed to be a universal human behavior, investigations of clinically-defined hoarding disorder (HD) have been confined almost exclusively to Western countries. The current investigation sought to describe and directly compare the features of individuals meeting diagnostic criteria for HD across four distinct cultural settings. Participants were 82 individuals meeting DSM-5 diagnostic criteria for HD, recruited and assessed by trained clinicians at one of four project sites: London, Barcelona, Fukuoka, and Rio de Janeiro. A series of semi-structured interviews and self-report scales were administered, including assessments of socio-demographic characteristics, psychiatric comorbidity, and severity of hoarding and related features. Results indicate that the severity and core features of HD, as well as the cognitions and behaviors commonly associated with this condition, are largely stable across cultures. However, some differences in patient demographics—in particular age, marital status, and clinical expression—as well as comorbid psychiatric features also emerged. These findings confirm that HD, as defined in DSM-5, exists and presents with similar phenomenology across the studied cultures. Future, more fine-grained, research will be needed to study the features of the disorder in additional cultures (e.g., non-industrialized nations) and to evaluate the impact of these cultural aspects on the design of interventions for the disorder.

DOI： 10.1177/1363461518759203

Language：English   Publishing type：Research paper (scientific journal)  

We regret that Table 1 and Fig. 2 need correction. As for Table 1, we found a few critical errors. The patients' age is not 18–64 years old, correctly 17–64 years old. The patients' age of onset is not 4–38 years old, correctly 6–54 years old. The patients' duration of illness is not 0.6–42 years, correctly 0.6–51 years. As for Fig.2, several readers pointed us that it was difficult to see. So we would like to make corrections. We coloured the lines to make it distinguishable, and enlarged letters to make it more visible. We explained in footnote which line colour corresponds to which group. We attached the modified files. We are sorry to trouble you, but we hope that you will correct and replace them by the following files. We would like to apologise for any inconvenience caused.

DOI： 10.1016/j.jocrd.2017.11.005

Language：English   Publishing type：Research paper (scientific journal)  

Language：English   Publishing type：Research paper (scientific journal)  

Language：Japanese   Publishing type：Research paper (scientific journal)  

Language：English   Publishing type：Research paper (scientific journal)  

Aim Although many neuroimaging studies of obsessive-compulsive disorder (OCD) have reported broad abnormalities in gray matter (GM), their results remain inconsistent. One reason for this inconsistency could be the heterogeneity of OCD. In the present study, we aimed to classify alterations in brain anatomy by OCD subtype. Methods Magnetic resonance imaging examinations of 37 OCD patients and 37 matched healthy controls were conducted using a 3.0-Tesla scanner. In the voxel-based morphometric procedure, preprocessed GM structural images were used to compare the two groups, and multiple regression analysis was used to investigate the correlation between regional GM volume in OCD patients and the OCD symptom dimension type assessed by using the Dimensional Yale-Brown Obsessive-Compulsive Scale. Results We found significant reductions in GM volume in broad areas of the left prefrontal, right orbitofrontal, right parietal, right temporal, and right posterior cingulate cortex in the OCD patients compared to healthy controls. In addition, we found specific negative correlations between symptomatic dimension scores and regional GM volumes, mainly as decreased right cerebellum in 'aggression/checking' and decreased right insula in 'contamination/washing'. Conclusion The pathophysiology of OCD may involve widely distributed neural systems. Moreover, there are distinct correlations among symptomatic dimensions and structural abnormalities.

DOI： 10.1111/pcn.12269

Language：English   Publishing type：Research paper (scientific journal)  

Behavioral activation (BA) has recently attracted marked attention. While cognitive therapy focuses on the cognitive distortion of patients with depression and asks them to change their behaviors as the process of altering the cognitive distortion, BA pays attention to behavior to avoid an unpleasant situation or social situation as a key symptom that leads to persistence of the depression. Avoidance behaviors are often seen during every process of depression, from onset to recurrence. Avoidance behaviors, a decrease in pleasant phenomena, or increase in unpleasant phenomena, result in reinforcing a depressive mood. If patients can set appropriate behavioral targets and achieve them, the beneficial behaviors will be further promoted with positive feed-back. The behavioral change, as-a consequence, will result in improvement of the mood, cognition, and depression itself. In this manuscript, the author presents two clinical cases, in which BA assisted the patients in recovering from their depression. The first case was a male in his thirties who repeatedly took sick leave from his work because of maladjustment, which resulted in persistent depression. The second case was a female in her thirties who suffered from OCD and then became maladjusted to her place of work, depressive, and emotionally unstable. In both cases, avoidant behaviors caused their conditions to persist. Appropriate activities formed by BA improved their moods, and their self-efficacies were gradually regained. It was suggested that BA is markedly effective, especially in patients whose avoidant behaviors mainly cause the persistence of their depressive symptoms.

Language：English   Publishing type：Research paper (scientific journal)  

Individuals with antisocial behavior place a great physical and economic burden on society. Deficits in emotional processing have been recognized as a fundamental cause of antisocial behavior. Emerging evidence also highlights a significant contribution of attention allocation deficits to such behavior. A comprehensive literature search identified 12 studies that were eligible for inclusion in the meta-analysis, which compared 291 individuals with antisocial problems and 247 controls. Signed Differential Mapping revealed that compared with controls, gray matter volume (GMV) in subjects with antisocial behavior was reduced in the right lentiform nucleus (P < 0.0001), left insula (P=0.0002) and left frontopolar cortex (FPC) (P=0.0006), and was increased in the right fusiform gyrus (P < 0.0001), right inferior parietal lobule (P=0.0003), right superior parietal lobule (P=0.0004), right cingulate gyrus (P=0.0004) and the right postcentral gyrus (P=0.0004). Given the well-known contributions of limbic and paralimbic areas to emotional processing, the observed reductions in GMV in these regions might represent neural correlates of disturbance in emotional processing underlying antisocial behavior. Previous studies have suggested an FPC role in attention allocation during emotional processing. Therefore, GMV deviations in this area may constitute a neural basis of deficits in attention allocation linked with antisocial behavior.

DOI： 10.1093/scan/nst104

Language：English   Publishing type：Research paper (scientific journal)  

Individuals with antisocial behavior place a great physical and economic burden on society. Deficits in emotional processing have been recognized as a fundamental cause of antisocial behavior. Emerging evidence also highlights a significant contribution of attention allocation deficits to such behavior. A comprehensive literature search identified 12 studies that were eligible for inclusion in the meta-analysis, which compared 291 individuals with antisocial problems and 247 controls. Signed Differential Mapping revealed that compared with controls, gray matter volume (GMV) in subjects with antisocial behavior was reduced in the right lentiform nucleus (P < 0.0001), left insula (P = 0.0002) and left frontopolar cortex (FPC) (P = 0.0006), and was increased in the right fusiform gyrus (P < 0.0001), right inferior parietal lobule (P = 0.0003), right superior parietal lobule (P = 0.0004), right cingulate gyrus (P = 0.0004) and the right postcentral gyrus (P = 0.0004). Given the well-known contributions of limbic and paralimbic areas to emotional processing, the observed reductions in GMV in these regions might represent neural correlates of disturbance in emotional processing underlying antisocial behavior. Previous studies have suggested an FPC role in attention allocation during emotional processing. Therefore, GMV deviations in this area may constitute a neural basis of deficits in attention allocation linked with antisocial behavior.

DOI： 10.1093/scan/nst104

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1016/j.neures.2010.12.008

Language：English   Publishing type：Research paper (scientific journal)  

Obsessive-compulsive disorder (OCD) was previously considered refractory to most types of therapeutic intervention. There is now, however, ample evidence that selective serotonin reuptake inhibitors and behavior therapy are highly effective methods for treatment of OCD. Furthermore, recent neurobiological studies of OCD have found a close correlation between clinical symptoms, cognitive function, and brain function. A large number of previous neuroimaging studies using positron emission tomography, single-photon emission computed tomography or functional magnetic resonance imaging (fMRI) have identified abnormally high activities throughout the frontal cortex and subcortical structures in patients with OCD. Most studies reported excessive activation of these areas during symptom provocation. Furthermore, these hyperactivities were decreased after successful treatment using either selective serotonin reuptake inhibitors or behavioral therapy. Based on these findings, an orbitofronto-striatal model has been postulated as an abnormal neural circuit that mediates symptomatic expression of OCD. On the other hand, previous neuropsychological studies of OCD have reported cognitive dysfunction in executive function, attention, nonverbal memory, and visuospatial skills. Moreover, recent fMRI studies have revealed a correlation between neuropsychological dysfunction and clinical symptoms in OCD by using neuropsychological tasks during fMRI. The evidence from fMRI studies suggests that broader regions, including dorsolateral prefrontal and posterior regions, might be involved in the pathophysiology of OCD. Further, we should consider that OCD is heterogeneous and might have several different neural systems related to clinical factors, such as symptom dimensions. This review outlines recent neuropsychological and neuroimaging studies of OCD. We will also describe several neurobiological models that have been developed recently. Advanced findings in these fields will update the conventional biological model of OCD.

DOI： 10.1111/pcn.12195

Language：English   Publishing type：Research paper (scientific journal)  

Recently, ample evidence has suggested that selective serotonin reuptake inhibitors (SSRIs) and cognitive behavioral therapy are highly effective treatments for OCD. There are, however, certain patients who are refractory to almost all types of therapeutic intervention. In recent studies, atypical antipsychotic augmentation of SSRIs and deep brain stimulation have been suggested to be effective for these refractory-type patients. Dysfunction of neuro-circuits throughout the frontal cortex and associated subcortical structures is considered to be due to both serotonergic and dopaminergic nerve system impairment. A large number of previous neuroimaging studies identified abnormally high metabolic activities throughout the frontal cortex as well as subcortical and limbic structures. These over-activities are suggested to be biological markers of the treatment response. In addition, structural and nerve connective dysfunction of these regions may be associated with a severe, treatment-resistant, and treatment-refractory status. A treatment-refractory state may be attributable to the clinical subtypes of OCD. Associations between the symptom subtype and brain activity reveal the heterogeneity of OCD. Several correlative analyses have shown distinct neural correlations associated with specific OCD symptom dimensions such as aggression/checking, contamination/cleaning, and hoarding. Overlapping of these neural disturbances will cause treatment-refractory OCD. Another reason for a treatment-refractory state may be comorbid disorders such as major depression and tic disorders. Comorbid depression will aggravate metabolic impairments in the hippocampus and thalamus and cause more severe disturbance of neuro-circuits in OCD. Obsessive-compulsive symptom with Tourette syndrome or pervasive developmental disorders will become refractory because of fixation caused by developmental factors and a perceptual element called "just right feeling". There should be a close relationship between neuro-circuit disturbance and a treatment-refractory state. The pathophysiology becomes more complicated due to the symptom subtype and comorbidity. Further investigations are needed to develop effective treatment strategies based on biological evidence.

Language：English   Publishing type：Research paper (scientific journal)  

Obsessive-compulsive disorder (OCD) is clinically heterogeneous. The aim of this study was to investigate differential neural responses to a symptom provocation task in drug-free patients who have predominantly aggression/checking symptoms (Checkers) and patients with contamination/washing symptoms (Washers). We compared the Checkers (n = 10) and the Washers (n = 12) separately to normal controls during the symptom provocation tasks using fMRI (functional magnetic resonance imaging). Moreover, we performed correlative analysis in each OCD group between brain activation and symptom severity. The Checkers showed hypoactivation in the left caudate and left anterior cingulate cortex (ACC) compared to the normal controls and a positive correlation between activated brain areas and symptom severity in the left ACC. The Washers showed hyperactivation in several bilateral cortico-cerebellar regions and a positive correlation between symptom severity and the bilateral fronto-temporal gyrus. We suggest that the caudate and ACC are associated with checking rituals and that large cortical brain regions are related to washing rituals.

DOI： 10.1016/j.pnpbp.2012.09.002

Language：English   Publishing type：Research paper (scientific journal)  

Context: Functional magnetic resonance imaging studies in attention-deficit/hyperactivity disorder (ADHD) revealed fronto-striato-parietal dysfunctions during tasks of inhibition and attention. However, it is unclear whether task-dissociated dysfunctions exist and to what extent they may be influenced by age and by long-term stimulant medication use. Objective: To conduct a meta-analysis of functional magnetic resonance imaging studies in ADHD during inhibition and attention tasks, exploring age and long-term stimulant medication use effects. Data Sources: Pub-Med, Science-Direct, Web of Knowledge, Google Scholar, and Scopus databases were searched up to May 2012 for meta-analyses. Meta-regression methods explored age and long-term stimulant medication use effects. Study Selection: Twenty-one data sets were included for inhibition (287 patients with ADHD and 320 control subjects), and 13 data sets were included for attention (171 patients with ADHD and 178 control subjects). Data Extraction: Peak coordinates of clusters of significant group differences, as well as demographic, clinical, and methodological variables, were extracted for each study or were obtained from the authors. Data Synthesis: Patients with ADHD relative to controls showed reduced activation for inhibition in the right inferior frontal cortex, supplementary motor area, and anterior cingulate cortex, as well as striato-thalamic areas, and showed reduced activation for attention in the right dorsolateral prefrontal cortex, posterior basal ganglia, and thalamic and parietal regions. Furthermore, the meta-regression analysis for the attention domain showed that long-term stimulant medication use was associated with more similar right caudate activation relative to controls. Age effects could be analyzed only for the inhibition meta-analysis, showing that the supplementary motor area and basal ganglia were underactivated solely in children with ADHD relative to controls, while the inferior frontal cortex and thalamus were underactivated solely in adults with ADHD relative to controls. Conclusions: Patients with ADHD have consistent functional abnormalities in 2 distinct domain-dissociated right hemispheric fronto-basal ganglia networks, including the inferior frontal cortex, supplementary motor area, and anterior cingulate cortex for inhibition and dorsolateral prefrontal cortex, parietal, and cerebellar areas for attention. Furthermore, preliminary evidence suggests that long-term stimulant medication use may be associated with more normal activation in right caudate during the attention domain.

DOI： 10.1001/jamapsychiatry.2013.277

Language：English   Publishing type：Research paper (scientific journal)  

Language：English   Publishing type：Research paper (scientific journal)  

Responsible for pages：強迫性障害の薬物療法（p204-227）   Language：Japanese   Book type：Scholarly book

Responsible for pages：OCDに対する行動療法の神経科学的基盤（p103-117）   Language：Japanese   Book type：Scholarly book

Responsible for pages：強迫性障害の外来治療．外来治療の進め方の基本（p85-113）   Language：Japanese   Book type：Scholarly book

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Responsible for pages：p567   Language：Japanese   Book type：General book, introductory book for general audience

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Responsible for pages：pp103-117   Book type：General book, introductory book for general audience

Responsible for pages：pp204-227   Book type：General book, introductory book for general audience

Presentation type：Oral presentation (general)  

Venue：名古屋   Country：Japan  

Duration effect of OCD on cognitive function: a functional MRI study.

Presentation type：Symposium, workshop panel (public)  

Venue：福岡   Country：Japan  

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Venue：名古屋   Country：Japan  

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Venue：神戸   Country：Japan  

Brain changes in patients with OCD brought by BT and SSRI: a cognitive and symptom provocation fMRI study

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Event date： 2024.6

Venue：イスタンブール   Country：Turkey  

Event date： 2021.5

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Event date： 2019.10 - 2020.6

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Event date： 2019.9 - 2019.6

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Event date： 2017.6

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Venue：福岡   Country：Japan  

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Venue：大分   Country：Japan  

Event date： 2008.9

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Venue：飯塚   Country：Japan  

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Venue：岡山   Country：Japan  

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Language：English   Publisher：(国研)国立国際医療研究センター  

Language：Japanese   Publisher：(株)金剛出版  

＜文献概要＞今回はデカルト(1596～1650)の「機械論」「心身二元論」を検討するが,まずは啓蒙思想に関するロバートソンの文章(Robertson, 2015)を引用しよう。思想史研究の大家による解説に触れる経験が,今回のキーワード「啓蒙思想,科学革命,デカルト,知性と感覚の関係にまつわる認識」についての知識を整理するのに役立つのではないか,と期待してのことです。

Language：Japanese   Publisher：(公財)メンタルヘルス岡本記念財団  

Language：Japanese   Publisher：(株)星和書店  

不安症群は,過剰な恐怖および不安と関連する行動の障害特徴をもち,社交不安症,パニック症,全般性不安症を代表とする疾患群である。強迫症は,繰り返し生じ持続する思考・衝動・イメージである強迫観念と,それによる苦痛を中和する目的で行われる強迫行為を特徴とする疾患である。薬物療法としては選択的セロトニン再取り込み阻害薬(SSRI)と一部のセロトニン・ノルアドレナリン再取り込み阻害薬(SNRI)の有効性が示されている。本稿では,サイエンスの側面から国内のガイドラインおよび2023年にアップデートされたWorld Federation of Societies of Biological Psychiatry(WFSBP)ガイドラインを中心にそれぞれの薬剤の位置づけを概説し,さらにアートの側面として,薬物療法と相補的な機能をもつ精神療法,特に認知行動療法を活用した日常臨床における工夫について紹介する。(著者抄録)

Language：Japanese   Publisher：(公社)日本精神神経学会  

COVID-19罹患後症状は,急性期の症状が収束した後も持続または新たに現れるものを指す.その定義や呼称は一貫しておらず,コロナ後遺症やlong COVIDなどのさまざまな名称が使用される.これらの症状は多岐にわたり,その異質性から症状群として認識されることが一般的である.本稿では特に,罹患後症状における精神神経症状に焦点をあて,その臨床的特徴や分類,リスク因子や保護因子,流行と変異株ごとの特徴,現状の課題を整理する.さらに,国内における疫学研究や患者レジストリ研究からの最新の知見にも注目し,病態と治療に関する国内外の研究動向を概観する.ポストコロナと称される時代において,罹患後症状を長期的な視点で捉え,再考する意義を提唱する.(著者抄録)

Language：Japanese   Publisher：(株)金剛出版  

Language：Japanese   Publisher：(株)世論時報社  

Language：English   Publisher：John Wiley & Sons Australia, Ltd  

Language：Japanese   Publisher：日本循環制御医学会  

精神疾患を有する患者においては、心臓突然死が多いことが知られている。特に統合失調症、うつ病と不安障害に焦点を当て、虚血性心疾患と致死的不整脈に関する研究をまとめた。これらの疾患は、循環障害の発症に関わる機序を持ち、さらに治療に用いる向精神薬も発症のリスクを高める可能性があることが知られている。精神疾患に特徴的な遺伝的要因、自律神経障害、炎症反応、ストレス反応、不健康な生活習慣等が関与している。また、向精神薬によるモノアミンへの影響やナトリウムチャネル、カリウムチャネルの遮断作用も発症に関連している。定期的な心電図検査と予防対策を実施し、精神疾患を有する患者の身体的健康管理を行うことが重要である。(著者抄録)

Language：Japanese   Publisher：(株)金剛出版  

Language：Japanese   Publisher：(株)星和書店  

精神病様症状体験(Psychotic-like experiences)は一般人口においても一定の割合でみられ,強迫症においても報告されている。さらにPLEsの水準に留まらない精神病症状が強迫症と併存し,難治化することもある。本稿では,精神病様症状を有する強迫症の症例の治療経過を提示し,強迫症において幻覚・妄想状態の兆しが生じた場合の見立てと治療について考察する。強迫症状と精神病様症状が併存している場合,どちらの病態が主体であるのかの見立てが重要になる。幻覚・妄想状態の兆しを有する強迫症に対しても認知行動療法を援用したアプローチは有用である可能性がある。一方,薬物療法に関する知見は十分ではなく今後の臨床研究の蓄積が望まれる。(著者抄録)

Language：Japanese   Publisher：(株)金剛出版  

Language：Japanese   Publisher：(株)星和書店  

日本専門医機構による新専門医制度は,専門医の質を高め,良質な医療が提供されることを目的として始まった制度である。その到達目標としては専門知識や専門技能,学問的姿勢,医師としての倫理性などが挙げられ,経験目標として,経験すべき疾患や病態,診察,治療などが設定されている。専攻医プログラムはこの目的に沿って運用され,大学や総合病院精神科,公的・私的精神科病院をローテートしながら精神科医としての臨床能力を育んでいけるようにプログラムが組まれている。筆者が統括する九州大学精神科プログラムでは,すべての専攻医が,1)バランスの取れた研修を経験できること,2)個々の希望や資質に応じた専門性を身につけていくこと,そして3)精神科医に必要とされる基本的な精神療法の技術を習得すること,の3点を心がけている。(著者抄録)

Language：Japanese   Publisher：(公社)日本精神神経学会  

摂食障害(摂食症),特に神経性やせ症は慢性化しやすく,追跡期間10年以上の研究をまとめると平均73.2%が寛解,8.5%が改善していた一方で,13.7%が慢性化し,9.4%が死亡していた.神経性やせ症の標準化死亡比は代表的な精神疾患より高い.慢性化した結果,重症遷延性神経性やせ症(SE-AN)となり,特定機能病院の精神科に対して入院治療要請がなされて,困難な状況に直面することも多い.その現実的な解決は,身体的合併症の治療的負担から忌避するのではなく,反対に早期発見,早期介入から慢性期までのすべての局面における精神科的治療に積極的に取り組むことである.現在の入院中心,身体面中心の治療には限界があり,地域包括,長期的視点からの治療が求められている.また,早期であっても,すでに先行する神経発達症,不安症,パーソナリティ症などの併存症を有している場合,予後不良となる可能性があるが,それらの併存症は現在,精神科医が主となって治療に取り組んでいる疾患ばかりである.そこで,まず,神経性やせ症は精神疾患のなかで最も顕著な脳のボリューム低下,精神のみならず体重のコントロールの困難さという素因の関与など,従来の精神疾患と同様の文脈で理解できる生物学的基盤を有していることを認識することである.そして,支持的精神療法をはじめとする,一般的な治療として定着している精神科医療を最大限動員することで,十分に回復させることが可能であり,精神科医が率先して取り組むべきである.(著者抄録)

Language：Japanese   Publisher：(公社)日本精神神経学会  

著者は大学病院の精神科に勤務し,研究や教育を行うとともに臨床業務として外来診療を実施し,入院診療全体の管理と専攻医の指導を行っている.外来診療患者は,強迫症を中心とした不安障害領域の患者が最も多く,次いで気分障害や発達障害の患者の割合が多い.再来に関しては系統的な介入を行う一部の患者を除いて,専門外来枠は設けず,ほとんどの患者を同じ再来枠のなかで診ている.診療スタイルの基本にあるのは認知行動療法であるが,全例にかっちりとした系統的精神療法を実施することは時間的に不可能であり,いかにそのエッセンスをちりばめられるかを意識しながら診療を行っている.それによって,たとえ短時間の診療であってもその有効性を高められると考える.また,丹念な聴き取りとその理解に基づいた面接は,治療者とともに患者自身の症状理解をもたらし,患者と治療者の信頼関係構築にもつながると感じている.本稿では,短時間の外来診療への認知行動療法の活かし方について,主に強迫症の診療場面を呈示しながら具体的な説明を行いたい.(著者抄録)

Language：Japanese   Publisher：(株)アークメディア  

Language：Japanese   Publisher：(株)日本医事新報社  

Language：English   Publisher：John Wiley & Sons Australia, Ltd  

Language：Japanese   Publisher：(株)医学書院  

＜文献概要＞はじめに　強迫症(obsessive compulsive disorder:OCD)は特定の事柄に対して繰り返し生じる思考(強迫観念)と,それを打ち消すための繰り返しの行動(強迫行為)を特徴とする疾患である。強迫観念や強迫行為は長時間を浪費し,日常生活に強い悪影響を生じさせる。従来は不安障害(ICD-10では神経症性障害)を代表する疾患の1つであったが,病態,臨床像の違いから2013年刊行のDSM-5では,不安症群から独立し,衝動やこだわりを特徴とする「強迫症および関連症群」の中核疾患と定義付けられている。OCDの診断や重症度の把握,治療効果判定の場面において最も広く用いられている評価尺度がYale-Brown obsessive compulsive scale(Y-BOCS)である。Y-BOCSは強迫症状の評価方法として信頼性と妥当性が担保されており,臨床から研究まで世界標準の検査方法として幅広く用いられている。本稿では,このY-BOCSを中心に,OCDの症状評価の方法について解説する。

Language：Japanese   Publisher：大道学館出版部  

Authorship：Last author   Language：Japanese   Publisher：(公財)メンタルヘルス岡本記念財団  

Language：Japanese   Publisher：(株)診断と治療社  

＜文献概要＞1.強迫症は10～20歳代で発症し,専門医療機関に受診するまでに10年以上経過していることが多い.2.強迫症は未治療期間が長いほど,薬物療法への反応が乏しくなる.3.身体科には過剰な手洗いによる「手荒れ」で受診することがある.4.思春期～壮年期の「手荒れ」が主訴の患者は,強迫症の可能性を考え,その情報を提供することで精神科への早期受診を図ることが重要である.

Language：Japanese   Publisher：日本認知療法・認知行動療法学会  

Language：English   Publisher：John Wiley & Sons Australia, Ltd  

Language：Japanese   Publisher：(株)金剛出版  

Language：Japanese   Publisher：(株)医学書院  

＜文献概要＞強迫症(OCD)は,強迫観念と強迫行為を主症状とする疾患である。10代前半と20歳前後に二峰性の発症のピークがあり,生涯有病率は約2%と精神疾患としては頻度が高く,慢性化による生活機能障害を来しやすい。男性では10代早期に発症のピークがあり,遺伝負因・家族歴が濃厚で,チックや自閉スペクトラム症を併存しやすい。一方,女性の発症のピークは20歳前後と男性より遅い。成人発症例は進学や就職,転居,結婚,出産といったライフイベントに伴うストレスと環境変化が症状の成立に関与することが多く,うつ病や不安症の併発も多い。発症から受診までに比較的長期間を要するのも特徴である。適切な治療が行われなければ長期慢性化し,難治化するリスクが高い。早期に症状に気づき,早めに受診し,薬物療法や精神療法による適切な治療介入を行うことで症状と生活機能の速やかな回復を目指し,長期的な回復の維持につなげることが大事である。

Language：Japanese   Publisher：(株)先端医学社  

Language：Japanese   Publisher：(株)日本臨床社  

Language：Japanese   Publisher：(株)アークメディア  

Language：Japanese   Publisher：(株)星和書店  

Language：English   Publisher：John Wiley & Sons Australia, Ltd  

Language：Japanese   Publisher：(株)星和書店  

ためこみの症状は,一般的には価値のないモノの過剰な収集と,それら収集物を整理することなくためこんでしまい,捨てることができない状態のことである。近年話題となることの多いゴミ屋敷問題との関連も示唆されているが,その因果関係についてはよく分かっていない。ためこみ症は,2013年に刊行されたDSM-5(精神疾患の診断・統計マニュアル第5版)で新たに定義された精神疾患であり,2022年に発効されたICD-11でも,「強迫症または関連症群」のカテゴリーにやはり「ためこみ症」として収載されている。ためこみ症は,典型的には10代で発症し慢性的な経過をたどりながら増悪していく疾患であり,早期からの介入が望まれるが疾患に対する認知度は高くなく精神科医療につながるケースは少ない。治療に関しては,明確なガイドラインは存在しないものの認知行動療法が第一選択となる。本稿ではためこみ症について概説し,認知行動療法的アプローチを行った症例を提示する。(著者抄録)

Language：Japanese   Publisher：九州精神神経学会  

Language：Japanese   Publisher：(株)医学書院  

＜文献概要＞新型コロナウイルス感染症(COVID-19)による罹患後症状は,罹患後に発生するさまざまな心身の不調である。罹患後症状には,疲労感や倦怠感,関節痛,筋肉痛,咳や息切れといったものがよくみられるが,不安やうつの出現も報告されている。海外の調査結果から,不安,抑うつといった精神症状の出現頻度はCOVID-19罹患後に高まることが示唆された。一方で長期フォローの結果は,他の呼吸器疾患と同レベルに収束することを示しており,罹患後の精神症状は,感染による心理的側面の要因が強い可能性もある。本邦では精神症状に焦点をあてた罹患後症状の大規模調査の結果はまだ報告されていないが,筆者らが行ったCOVID-19の入院患者の精神症状調査の結果からは,感染期から不安,うつ,不眠,混乱といった症状の出現頻度が増えていることが明らかになった。罹患後症状としての精神症状がウイルスの直接的な影響なのか,心理的要因が大きいかについては,今後の疫学研究や生物学的研究の蓄積が待たれる。

Language：English   Publisher：John Wiley & Sons Australia, Ltd  

Language：Japanese   Publisher：(株)星和書店  

ためこみ症はためこみを主症状として,所有物の価値とは関係なく廃棄が困難となり,過剰な収集や整理不能による散らかりが持続する状態を指す。ためこみ症は有用性・感傷的価値・審美的価値といった《所有物への信念》が介在した肯定的な感情反応によって廃棄が負の弱化,収集が正の強化を受け,自尊心・責任感・記憶に関する《自己への信念》が介在した否定的な感情によって廃棄が正の弱化,収集が負の強化を受けることで,ためこみが強固に維持される。《所有物への信念》はこだわり,《自己への信念》はとらわれに繋がっており,ためこみ症は「もの」へのとらわれとこだわりの両側面が影響することが特徴的である。ためこみ症はいまだ認知度が低く,多くの患者は疾患だと認識しておらず,周囲からも否定的な評価を受けている。ためこみ症への病態理解を深めることは治療関係の構築にも繋がり,その後の治療を後押しする。(著者抄録)

Language：Japanese   Publisher：(株)先端医学社  

1 強迫症の症状としては通常見られないものを選べ.a 対称性へのこだわり b 洗浄行為 c 被害的な思考 d 性的な思考 e 心のなかで行う確認行為 2 強迫症の診断に該当しないものを選べ.a 強迫観念か強迫行為のいずれかのみ存在する b 洞察が欠如している c チック障害の併存がある d 器質性疾患が存在する e 汚染恐怖のため,ものをためこんでいる(著者抄録)

Language：Japanese   Publisher：(有)科学評論社  

Language：Japanese   Publisher：(株)金剛出版  

Authorship：Last author   Language：Japanese   Publisher：(株)ワールドプランニング  

軽度認知障害(MCI)の調査は対象集団の選定により結果が大きく異なる.本邦8地域に在住する地域高齢住民を対象としたコホート研究の成績によると,2016～2018年におけるMCI(non-amnestic含む)の粗有病率は17.0%であった.地域住民の追跡調査におけるMCIから正常へのreversion率や認知症へのprogression率はそれぞれ10～44%,4～38%であり,MCIと診断されても生活習慣病の管理に加えて余暇時の運動や社会活動への参加など,健康的なライフスタイルが認知機能低下のリスク低減につながることが示唆された.(著者抄録)

Language：Japanese   Publisher：(株)ライフメディコム  

不安症はパニック症、広場恐怖症、社交不安症といった、不安を主症状とした疾患群の総称であり、不安を中心とする情動反応の高まりを症状の主体としている。精神疾患のなかでも有病率が高く、一般診療においてもわれわれが高頻度で接する疾患であるといえる。強迫症は、強迫観念と強迫行為を特徴とする疾患であり、従来は不安症のひとつとして定義されていたが、2013年刊行のDSM-5や、間もなく発刊されるICD-11では、強迫関連症群という、ひとつのカテゴリーを形成する中核的疾患として独立することとなった。本稿では、不安症に含まれるパニック症、広場恐怖症、社交不安症、全般性不安症、限局性恐怖症、そして現在は強迫関連症群へと独立したが元々は神経症の中核疾患であった強迫症と新たに強迫関連症として定義されたためこみ症について、それぞれの診断のポイントと標準的な治療法について概略を示す。(著者抄録)

Language：Japanese   Publisher：(公社)日本医師会  

Language：Japanese   Publisher：(株)星和書店  

Language：Japanese   Publisher：(株)金剛出版  

Language：Japanese   Publisher：(株)星和書店  

強迫症(OCD)は、不安の対象に対して繰り返し生じる思考(強迫観念)と反復的な行動(強迫行為)を特徴とする疾患である。10代での若年発症が多い一方、初診までに要する期間が長く、長期の罹病によって学業や就労など社会機能に多大な影響が生じやすい。OCDは抗うつ薬による薬物療法の有効性が見出されているものの反応不十分な治療抵抗例、重症例の比率が他の不安障害に比しても高く、これまで数々の非薬物療法も含めた治療ガイドラインが提案、策定されてきた。その一方で、OCDの多様性を鑑みるとそれらのガイドラインに沿って治療を行ってもなかなか改善が得られないケースがあるのもまた現実である。本稿ではOCDの治療ガイドラインについて解説するとともに、OCDの重症度や併存症、不合理感の有無によって生じる多様な病態に応じた治療の進め方について筆者の私見を述べる。(著者抄録)

Language：Japanese   Publisher：大道学館出版部  

Language：Japanese   Publisher：(株)医学書院  

＜文献概要＞ピットフォール　・強迫症に苦手意識を持ってしまう・自閉スペクトラム症やうつ病の併存についての注意不足・強迫症の認知行動療法(CBT)=曝露反応妨害法(ERP)と考えてしまう・不合理感が少ない(ない)場合は治療ができないと考えてしまう・見かけの治療抵抗性にだまされてしまう・COVID-19に関連したマスメディアの情報に流されてしまう

Language：Japanese   Publisher：大道学館出版部  

Language：Japanese   Publisher：(株)アークメディア  

Language：Japanese   Publisher：日本認知療法・認知行動療法学会  

Language：Japanese   Publisher：大道学館出版部  

Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (scientific journal)  

Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (scientific journal)  

Repository Public URL： http://hdl.handle.net/2324/4479044

Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (scientific journal)  

Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (scientific journal)  

Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (scientific journal)  

Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (scientific journal)  

Publishing type：Article, review, commentary, editorial, etc. (scientific journal)  

Publishing type：Article, review, commentary, editorial, etc. (scientific journal)  

Type：Competition, symposium, etc. 

Type：Competition, symposium, etc. 

Type：Competition, symposium, etc. 

Number of participants：5,000

女性の医学最前線「強迫性障害」

医療と健康面「パニック障害」