九州大学-研究者情報 [安野広三 (助教) 九州大学病院心療内科]

安野広三（あんのこうぞう）

データ更新日：2023.06.22

助教　／　九州大学病院心療内科

原著論文

1.	Takafumi Saito, Mao Shibata, Naoki Hirabayashi, Takanori Honda, Yukiko Morisaki, Kozo Anno, Nobuyuki Sudo, Masako Hosoi, Toshiharu Ninomiya, Family dysfunction is associated with chronic pain in a community-dwelling Japanese population: The Hisayama study, EUROPEAN JOURNAL OF PAIN, 10.1002/ejp.2076, 27, 4, 518-529, 2023.04, Background: Poor family functioning has been reported to be associated with the severity of chronic pain in outpatients, but the association has not been fully addressed in general populations. The present study aimed to examine the association between family dysfunction levels and the presence of chronic pain in a community-dwelling Japanese population. Methods: A total of 2598 participants aged ≥40 years were classified as having healthy, borderline or unhealthy family functioning. Chronic pain was defined as subjective pain for three months or longer, and further classified by pain intensity, the number of chronic pain sites, pain duration and the extent of pain spread. A logistic regression model was used to compute the odds ratios (ORs) for chronic pain outcomes. Results: The prevalence of chronic pain was 49%. The age-and sex-adjusted prevalence of total and severe chronic pain were increased significantly with increasing family dysfunction levels (all p for trend Conclusions: The family dysfunction level was positively associated with the presence as well as the severity of chronic pain in a community-dwelling population. Significance: A biopsychosocial burden due to family relationships could worsen the clinical presentation of pain. Social support or family therapy for dysfunctional families would be a potential initiative for the prevention or management of chronic pain..
2.	安野広三，岩城理恵，村上匡史，藤本晃嗣，田中佑，早木千絵，須藤信行，細井昌子, Chronic Pain Acceptance Questionnaire 日本語版（CPAQ-J）の作成と信頼性・妥当性の検討, 慢性疼痛, 41, 1, 83-90, 2022.12, 【背景】「慢性疼痛のアクセプタンス」は慢性疼痛の理解や治療のための重要な概念とされている。その測定にはChronic Pain Acceptance Questionnaire が最も使用されている。本研究の目的はCPAQ日本語版（CPAQ-J）の作成，その妥当性の検討であった。【方法】慢性疼痛患者243 人を対象とし，CPAQ-J および痛みの強度，機能障害，不安，抑うつ，痛みの破局化，生活の質，生活満足度につき回答してもらった。【結果】CPAQ-J はスクリープロット，主因子法により英語原版と同様の2 因子構造を示し，十分な内的整合性（Cronbach α係数0.83）と再検査信頼性（級内相関係数0.88）が示された。また，痛みの強度，機能障害，不安，抑うつ，痛みの破局化，生活の質，生活満足度と有意な関連を認めた。【結論】本研究でCPAQ-J は我が国の慢性疼痛患者において，十分な信頼性と妥当性が示された。.
3.	＠Tomioka M, ＠Hosoi M, ＠Okuzawa T, ＠Anno K, ＠Iwaki R, ＠Kawata H, ＠Kubo C, ＠Sudo N, The effectiveness of Pictorial Representation of Illness and Self Measure (PRISM) for the assessment of the suffering and quality of interpersonal relationships of patients with chronic pain (vol 15, 22, 2021), BIOPSYCHOSOCIAL MEDICINE, 10.1186/s13030-021-00230-1, 16, 1, 2021 Nov 20;15(1):22, 2022.01, Background: Pictorial Representation of Illness and Self Measure (PRISM) is a tool that can be used to visualize and evaluate the burden of suffering caused by an illness. The aim of this study was to identify which aspects of the burden of chronic pain patients are associated with Self/illness separation (SIS), an indicator of the magnitude of suffering. We also examined the effectiveness of PRISM for evaluating changes in the relationships between patients and their medical care and significant others due to our inpatient treatment. Methods: Seventy-two patients with chronic pain who were outpatients or admitted to the Department of Psychosomatic Medicine completed PRISM, depression and anxiety scales, and three types of pain-related self-assessment questionnaires (Brief Pain Inventory, Short-form McGill Pain Questionnaire, and Pain Catastrophizing Scale). Outpatients were queried at the time of outpatient visits and inpatients at the time of admission. In addition to PRISM disks related to illness, we asked each patient to place disks related to things important to them and their medical care. Of the inpatients, 31 did PRISM at the time of discharge. Among the reported important factors, which significant other was placed at the time of admission and discharge was evaluated. The distances of self/medical care separation (SMcS) and self/significant others separation (SSoS) were measured. Results: Of the 21 scales measured, 10 showed a significant correlation with SIS. Factor analysis of these 10 scales extracted three factors, Life interferences, Negative affects, and Pain intensity. The SMcS and SSoS distances were shorter at discharge than at admission. Conclusions: PRISM for patients with chronic pain is an integrated evaluation method that reflects three aspects of pain. By adding medical care and significant others to the usual method of placing only illness on the sheet it became possible to assess changes in the quality of interpersonal relationships..
4.	Shinji Kimura, Masako Hosoi, Naofumi Otsuru, Madoka Iwasaki, Takako Matsubara, Yasuyuki Mizuno, Makoto Nishihara, Takanori Murakami, Ryo Yamazaki, Hajime Ijiro, Kozo Anno, Kei Watanabe, Takuya Kitamura, Shouhei Yamada, A Novel Exercise Facilitation Method in Combination with Cognitive Behavioral Therapy Using the Ikiiki Rehabilitation Notebook for Intractable Chronic Pain: Technical Report and 22 Cases, Healthcare, 10.3390/healthcare9091209, 9, 9, 1209, 9(9):1209, 2021.09, Recent clinical practice guidelines for chronic pain indicate, with a high evidence level, that the combination of exercise and cognitive behavioral therapy (CBT) is effective. The purpose of this study was to evaluate the effectiveness of an exercise facilitation method in combination with CBT using the "Ikiiki Rehabilitation Notebook" for patients with intractable chronic pain. "Ikiiki" means active in Japanese. A total of 22 cases with chronic low back (n = 13), lower extremity (n = 8), or neck (n = 1) pain were treated using this notebook. Two cases dropped out, leaving 22 cases. Each case was evaluated in terms of the numerical rating scale (NRS) of the pain, activities of daily living (ADL), pain catastrophizing scale (PCS), and quality of life (QOL) at pretreatment and post-treatment. The endpoint of the method was to achieve the long-term goals set by the patients. The mean treatment period was 11.2 months. The outcomes were as follows: improvement of presenteeism: nine cases; enhanced participation in hobbies: seven cases; improved school attendance: two cases; return to work: one case; improvement of self-care and/or self-efficacy: three cases. The NRS, ADL, PCS, and QOL were significantly improved after the treatment. This method is possibly valuable for educating patients about the cause and treatment of chronic pain and actively facilitating exercise and social participation. Further studies are needed to investigate the effectiveness of using this notebook for the patient with intractable chronic pain..
5.	Mao Shibata, Tomoyuki Ohara, Masako Hosoi, Jun Hata, Daigo Yoshida, Naoki Hirabayashi, Yukiko Morisaki, Taro Nakazawa, Akane Mihara, Takuya Nagata, Emi Oishi, Kozo Anno, Nobuyuki Sudo, Toshiharu Ninomiya, Emotional Loneliness Is Associated With a Risk of Dementia in a General Japanese Older Population: The Hisayama Study, The journals of gerontology. Series B, Psychological sciences and social sciences, 10.1093/geronb/gbaa196, 76, 9, 1756-1766, 76(9):1756-1766, 2020.10, Objectives: To investigate the association of loneliness and its component subscales with the risk of dementia in a generalJapanese older population. Method: A total of 1,141 community-dwelling Japanese residents aged ≥65 years without dementia were prospectively followed up for a median 5.0 years. We evaluated any loneliness and its component subscales—namely, social and emotional loneliness—by using the 6-item de Jong Gierveld Loneliness Scale. Cox proportional hazards models were used to estimate hazard ratios (HRs) of each loneliness type on the risk of dementia controlling for demographic factors, lifestyle factors, physical factors, social isolation factors, and depression. Results: During the follow-up, 114 participants developed dementia. The age- and sex-adjusted incidence rate of dementia was significantly greater in participants with any loneliness and emotional loneliness than those without. The multivariableadjusted HRs (95% confidence intervals) of participants with any loneliness and emotional loneliness on incident dementia were 1.61 (1.08–2.40) and 1.65 (1.07–2.54), respectively, as compared to those without. However, there was no significant association between social loneliness and dementia risk. In subgroup analyses of social isolation factors, excess risks of dementia associated with emotional loneliness were observed in participants who had a partner, lived with someone, or rarely communicated with relatives or friends, but such association was not significant in participants who had no partner, lived alone, or frequently communicated with friends or relatives. Discussion: The present study suggested that loneliness, especially emotional loneliness, was a significant risk factor for the development of dementia in the general older population in Japan..
6.	Mao Shibata, Toshiharu Ninomiya, Kozo Anno, Hiroshi Kawata, Rie Iwaki, Ryoko Sawamoto, Chiharu Kubo, Yutaka Kiyohara, Nobuyuki Sudo, Masako Hosoi, Parenting style during childhood is associated with the development of chronic pain and a patient's need for psychosomatic treatment in adulthood A case-control study, Medicine, 10.1097/MD.0000000000021230, 99, 29, e21230, 2020.07, [URL], The aim of this study is to investigate the relation between parenting style and chronic pain and the patients' need for psychosomatic treatment in adulthood.We compared 4 combinations of 2 parenting style subscales, high and low care and overprotection, among the following 4 age- and sex-matched groups: community-dwelling subjects without chronic pain (n = 100), community-dwelling subjects with chronic pain (n = 100), outpatients with chronic pain (n = 50), and inpatients with chronic pain (n = 50). Parenting style was assessed for both the mother and father by use of the Parental Bonding Instrument questionnaire. The parenting style associated with the worst outcome was defined as both low care and high overprotection, as reported in previous studies.The frequency of reported adverse parenting style was significantly higher among chronic pain patients than community-dwelling subjects without chronic pain (all P
7.	＠田中佑，＠安野広三，＠早木千絵，＠西原智恵，＠柴田舞欧，＠岩城理恵，＠須藤信行，＠細井昌子, 慢性疼痛患者への心身医学的介入の効果：初診時における「過去の医療不信」が痛みの破局化の改善に関連する, 慢性疼痛, 38, 1, 104-110, 2019.12, 背景】慢性疼痛の治療では痛みの破局化の軽減が重要な目標となるが，その改善の予測因子は十分検討されていない。我々は心療内科外来治療で破局化の大きな軽減が見られた患者群の初診時の心理社会的因子の特徴を後方視的に検討した。【方法】当科外来で治療した慢性疼痛患者96 名中，初診時のPain Catastrophizing Scale（PCS）が平均値以上の46 名を“高値群”とし，6 カ月後に初診時の1SD 以上改善した“著明改善群”とその他の“低改善群”に分け，初診時の痛み関連，情動関連，対人関連変数について比較した。【結果】“高値群”はいずれの変数でも“低値群”より望ましくない結果だった。“高値群”でも治療で破局化が有意に改善した。“著明改善群”は“低改善群”より初診時の「医療への信頼感」が有意に低かった。【考察】医療不信が強く破局化をきたしている患者ほど，治療初期の関係構築で破局化が改善する可能性がある.
8.	Mao Shibata, Nakamura K, Ukawa S, Okada E, Hirata M, Nagai A, Yamagata Z, Ninomiya T, Muto K, Kiyohara Y, Matsuda K, Kamatani Y, Kubo M, Nakamura Y; BioBank Japan Cooperative Hospital Group., Tamakoshi A, Kozo Anno, Kawata Hiroshi, Rie Iwaki, Ryoko Sawamoto, Chiharu Kubo, Yutaka Kiyohara, Nobuyuki SUDO, Hosoi M, Perceived inadequate care and excessive overprotection during childhood are associated with greater risk of sleep disturbance in adulthood: the Hisayama Study, BMC PSYCHIATRY, 10.1186/s12888-016-0926-2, 16, 2016.07, Background: Sleep disturbance and poor sleep quality are major health problems worldwide. One potential risk factor for the development and maintenance of sleep disturbance is the parenting style experienced during childhood. However, its role in sleep disturbance in adulthood has not yet been estimated. This Japanese population study was done to clarify the relation between the parenting styles “care” and “overprotection” during childhood and sleep disturbance in adulthood. Methods: A total of 702 community-dwelling Japanese residents aged ≥ 40 years were assessed in 2011 for their perceptions of the parenting style of their parents by use of the Parental Bonding Instrument (PBI) and for sleep disturbance by use of the Pittsburgh Sleep Quality Index (PSQI). The odds ratio (OR) for sleep disturbance (a global PSQI score > 5) was calculated using a logistic regression model. Results: The prevalence of sleep disturbance was 29 %. After adjusting for sociodemographic, lifestyle, and physical factors in a comparison with the optimal parenting styles (high care and low overprotection), the ORs for sleep disturbance by men were significantly higher for low paternal care, by 2.49 times (95 % confidence interval [CI]: 1.21–5.09), and for high overprotection, by 2.40 times (95 % CI: 1.19–4.85), while the ORs were not significant for low maternal care and high overprotection. For women the only significant factor was high maternal overprotection, by 1.62 times (95 % CI: 1.05–2.52), while the ORs were not significant for low maternal care, low paternal care and high paternal overprotection. The association remained significant for high paternal overprotection for men after additionally controlling for depression. Conclusions: This study suggests that parenting style, especially inadequate care and excessive overprotection during childhood, is related to sleep disturbance in adulthood and that the association is much more significant for parents of the same sex as the child..
9.	Chie Hayaki, Kozo Anno, Mao Shibata, Rie Iwaki, Kawata Hiroshi, Nobuyuki SUDO, Hosoi M, Family dysfunction A comparison of chronic widespread pain and chronic localized pain, MEDICINE, 10.1097/MD.0000000000005495, 95, 49, 2016.12, Previous studies have shown differences in the psychosocial factors related to chronic localized pain (CLP) and chronic widespread pain (CWP). However, no studies have done an evaluation of differences between CLP and CWP from the viewpoint of family functioning. We did a cross-sectional study in a tertiary care setting to investigate possible differences in the relation of CWP and CLP to family functioning. Patients with CLP (N=126) or CWP (N=75) were assessed for family functioning by the Family Assessment Device (FAD) and a comparison was done. Logistic regression analysis was used to estimate associations of family functioning subscales with pain status (CWP vs CLP), controlling for demographic variables, pain variables; pain duration, pain ratings, pain disability, and psychological factors; depression, anxiety, and catastrophizing. The odds ratios (ORs) for the presence of CWP were calculated. Compared to patients with CLP, patients with CWP showed a lower functional status for Roles and Affective Involvement. The ORs for CWP were significantly higher in lower functioning Roles (OR: 2.38, 95% CI: 1.21–4.65) and Affective Involvement (OR: 2.86, 95% CI: 1.56–5.24) after adjusting for demographic variables. The significant association of CWP to Roles and Affective Involvement remained after controlling for the pain variables and psychological factors. This study shows that the families of patients with CWP have poorer family functioning than those with CLP. Our findings suggest that early identification and interventions for the family dysfunction of chronic pain patients are important to the treatment and prevention of CWP..
10.	細井昌子, 安野広三, 早木千絵, 富岡光直, 木下貴廣, 藤井悠子, 足立友理, 荒木登茂子, 須藤信行, 線維筋痛症の心身相関と全人的アプローチのための病態メカニズムの理解, Japanese Journal of Psychosomatic Medicine, 10.15064/jjpm.56.5_445, 56, 5, 445-452, 2016.05, [URL], Although fibromyalgia is not well known on the pathology, recent researches have proved that patients with fibromyalgia have unique psychological characteristics, abnormalities in immunology, brain function, and autonomic nervous system function from multimodal aspects. Here we present that fibromyalgia patients have displayed abnormal pacing, passive self-image induced by background and over-adaptation and hyperactivity, and abnormal resting state brain connectivity to enable readers to understand the psychosomatic relationship and holistic approach for the disease. The default mode network (DMN) showed greater connectivity to the insula cortex and secondary somatosensory cortex (S2) in fibromyalgia patients. The DMN change as a centralized pain and the abnormalities in musculoskeletal system and autonomic nervous system as peripheral pains constitute complicated psychosomatic pathologies. It is desirable that holistic approach in normalizing the pacing and increasing in accessibility among consciousness, preconsciousness and unconsciousness should be developed in the clinical psychosomatic practice for fibromyalgia patients..
11.	Kozo Anno, Mao　Shibata, Toshiharu Ninomiya, Rie Iwaki, Hiroshi Kawata, Ryoko Sawamoto, Chiharu Kubo, Yutaka Kiyohara, Nobuyuki SUDO, Masako Hosoi, Paternal and maternal bonding styles in childhood are associated with the prevalence of chronic pain in a general adult population: the Hisayama Study, BMC PSYCHIATRY, 10.1186/s12888-015-0574-y, 15, 181, 2015.07, Background: Previous research has suggested that extraordinary adverse experiences during childhood, such as abuse, are possible risk factors for the development of chronic pain. However, the relationship between the perceived parental bonding style during childhood and chronic pain has been much less studied. Methods: In this cross-sectional study, 760 community-dwelling Japanese adults were asked if they had pain that had been present for six months or more. They completed the Parental Bonding Instrument (PBI), a selfadministrated questionnaire designed to assess perceived parental bonding, and the Patient Health Questionnaire-9 to assess current depressive symptoms. The PBI consists of care and overprotection subscales that are analyzed by assigning the parental bonding style to one of four quadrants: Optimal bonding (high care/low overprotection), neglectful parenting (low care/low overprotection), affectionate constraint (high care/high overprotection), and affectionless control (low care/high overprotection). Logistic regression analysis was done to estimate the contribution of the parental bonding style to the risk of chronic pain, controlling for demographic variables. Results: Compared to the optimal bonding group, the odds ratios (ORs) for having chronic pain were significantly higher in the affectionless control group for paternal bonding (OR: 2.21, 95 % CI: 1.50-3.27) and for maternal bonding (OR: 1.60, 95 % CI: 1.09-2.36). After adjusting for depression, significance remained only for paternal bonding. Conclusion: The results demonstrate that the parental bonding style during childhood is associated with the prevalence of chronic pain in adults in the general population and that the association is more robust for paternal bonding than for maternal bonding..
12.	Mao Shibata, Toshiharu Ninomiya, Mark P. Jensen, Kozo Anno, Koji Yonemoto, Seiko Makino, Rie Iwaki, Koji Yamashiro, Toshiyuki Yoshida, Yuko Imada, Chiharu Kubo, Yutaka Kiyohara, Nobuyuki Sudo, Masako Hosoi, Alexithymia is associated with greater risk of chronic pain and negative affect and with lower life satisfaction in a general population The Hisayama study, PloS one, 10.1371/journal.pone.0090984, 9, 3, 2014.03, [URL], Introduction: Chronic pain is a significant health problem worldwide, with a prevalence in the general population of approximately 40%. Alexithymia - the personality trait of having difficulties with emotional awareness and self-regulation - has been reported to contribute to an increased risk of several chronic diseases and health conditions, and limited research indicates a potential role for alexithymia in the development and maintenance of chronic pain. However, no study has yet examined the associations between alexithymia and chronic pain in the general population. Methods: We administered measures assessing alexithymia, pain, disability, anxiety, depression, and life satisfaction to 927 adults in Hisayama, Japan. We classified the participants into four groups (low-normal alexithymia, middle-normal alexithymia, high-normal alexithymia, and alexithymic) based on their responses to the alexithymia measure. We calculated the risk estimates for the criterion measures by a logistic regression analysis. Results: Controlling for demographic variables, the odds ratio (OR) for having chronic pain was significantly higher in the high-normal (OR: 1.49, 95% CI: 1.07-2.09) and alexithymic groups (OR: 2.56, 95% CI: 1.47-4.45) compared to the low-normal group. Approximately 40% of the participants belonged to these two high-risk groups. In the subanalyses of the 439 participants with chronic pain, the levels of pain intensity, disability, depression, and anxiety were significantly increased and the degree of life satisfaction was decreased with elevating alexithymia categories. Conclusions: The findings demonstrate that, in the general population, higher levels of alexithymia are associated with a higher risk of having chronic pain. The early identification and treatment of alexithymia and negative affect may be beneficial in preventing chronic pain and reducing the clinical and economic burdens of chronic pain. Further research is needed to determine if this association is due to a causal effect of alexithymia on the prevalence and severity of chronic pain..
13.	Seiko Makino, Mark P. Jensen, Tatsuyuki Arimura, Tetsuji Obata, Kozo Anno, Rie Iwaki, Chiharu Kubo, Nobuyuki Sudo, Masako Hosoi, Alexithymia and chronic pain The role of negative affectivity, Clinical Journal of Pain, 10.1097/AJP.0b013e3182579c63, 29, 4, 354-361, 2013.04, [URL], OBJECTIVES:: Alexithymia has been shown to be associated with key pain-related variables in persons with chronic pain from western countries, but the generalizability of these findings across cultures has not been examined adequately. Also, there remain questions regarding the importance of alexithymia to patient functioning over and above the effects of the general negative affectivity. METHODS:: Alexithymia, pain intensity, pain interference, depression, anxiety, and pain catastrophizing were measured in 128 Japanese patients with chronic pain. Because of the low internal consistency coefficients for 2 of the alexithymia scales (measuring difficulty describing feelings and externally oriented feelings) in our sample, we limited our analyses to a scale assessing difficulty identifying feelings and the total alexithymia scale score. RESULTS:: Although the 20-item Toronto Alexithymia Scale total and the Difficulty Identifying Feelings scale scores were not significantly associated with pain intensity, these scales were associated with pain interference, catastrophizing, and negative affectivity in our sample. However, these associations became nonsignificant when measures of negative affectivity were controlled. DISCUSSION:: The findings support the cross-cultural generalizability of significant associations between alexithymia and both pain interference and catastrophizing. However, whether (1) alexithymia influences patient functioning indirectly by its effects on negative affect or (2) the univariate associations found between alexithymia and measures of patient functioning are a byproduct of both being influenced by negative affect needs to be tested using longitudinal and experimental research..

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