A review of recent case reports of cenesthopathy in Japan

Idiopathic abnormal bodily sensations, or cenesthesic symptoms, are exhibited in a wide variety of mental illnesses. In Japan, patients with abnormal bodily sensations are often diagnosed with cenesthopathy. This study reviewed recent case reports of cenesthopathy. Of the 100 identified cases, young patients were more commonly men with predominant bodily cenesthesic symptoms, while older patients (40 years) were more commonly women with cenesthesic symptoms restricted to the oral cavity (oral cenesthopathy).ArticlePSYCHOGERIATRICS. 13(3):196-198 (2013)journal articl

Cavum Septum Pellucidum and Cavum Vergae With Late-Onset Catatonia

Associations between large cavum septum pellucidum and functional psychosis disorders, especially schizophrenia, have been reported. We report a case of late-onset catatonia associated with enlarged CSP and cavum vergae. A 66-year-old woman was presented with altered mental status and stereotypic movement. She was initially treated with aripiprazole and lorazepam. After 4 weeks, she was treated with electroconvulsive therapy. By 10 treatments, echolalia vanished, and catatonic behavior was alleviated. Developmental anomalies in the midline structure may increase susceptibility to psychosis, even in the elderly.ArticleJOURNAL OF ECT. 29(3):E45-E46 (2013)journal articl

Neuroanatomical correlates of attention-deficit-hyperactivity disorder accounting for comorbid oppositional defiant disorder and conduct disorder

Aim: An increasing number of neuroimaging studies have been conducted to uncover the pathophysiology of attention-deficit-hyperactivity disorder (ADHD). The findings are inconsistent, however, at least partially due to methodological differences. In the present study voxel-based morphometry (VBM) was used to evaluate brain morphology in ADHD subjects after taking into account the confounding effect of oppositional defiant disorder (ODD) and conduct disorder (CD) comorbidity. Methods: Eighteen children with ADHD and 17 age-and gender-matched typically developing subjects underwent high-spatial resolution magnetic resonance imaging. The regional gray matter volume differences between the children with ADHD and controls were examined with and without accounting for comorbid ODD and CD in a voxel-by-voxel manner throughout the entire brain. Results: The VBM indicated significantly smaller regional gray matter volume in regions including the bilateral temporal polar and occipital cortices and the left amygdala in subjects with ADHD compared with controls. Significantly smaller regional gray matter volumes were demonstrated in more extensive regions including the bilateral temporal polar cortices, bilateral amygdala, right occipital cortex, right superior temporal sulcus, and left middle frontal gyrus after controlling for the confounding effect of comorbid ODD and CD. Conclusion: Morphological abnormalities in ADHD were seen not only in the regions associated with executive functioning but also in the regions associated with social cognition. When the effect of comorbid CD and ODD was taken into account, there were more extensive regions with significantly smaller volume in ADHD compared to controls.ArticlePSYCHIATRY AND CLINICAL NEUROSCIENCES. 64(4):394-402 (2010)journal articl

Impact of behavioral/developmental disorders comorbid with conduct disorder

Aims: The aim of the present study was to verify the comorbidity of conduct disorder (CD) and behavioral/developmental disorders in children and adolescents, and to examine the traits of CD comorbid with them. Methods: Subjects were 64 children (60 boys, four girls) who were resident at three institutions for delinquent children or who were conduct-disordered outpatients of a university hospital aged under 18 years. A diagnostic interview was carried out by experienced child psychiatrists and the intelligence score and the Adverse Childhood Experiences score were measured by a licensed psychologist. Results: A total of 57 children were diagnosed as having CD, of whom 26 (45.6%) were diagnosed with comorbid attention-deficit-hyperactivity disorder (ADHD), 12 were diagnosed with comorbid pervasive developmental disorder (PDD, 21,1%), and 19 (33.3%) had no comorbidity of either disorder. Six children (18.8% of CD comorbid with ADHD) met the criteria for both ADHD and PDD. The group with comorbid PDD was significantly younger at onset (F = 6.51, P = 0.003) and included unsocialized type more frequently (KH2 = 6.66, P = 0.036) compared with the other two groups. Conclusions: Clinicians should be aware that not only ADHD but also PDD may be comorbid with CD. Establishment of the correct diagnosis is important because recognizing the presence of PDD will enable us to provide appropriate treatment and guidance, which may improve prognosis.ArticlePSYCHIATRY AND CLINICAL NEUROSCIENCES. 63(6):762-768 (2009)journal articl

Cavum Septum Pellucidum and Cavum Vergae With Late-Onset Catatonia

Associations between large cavum septum pellucidum and functional psychosis disorders, especially schizophrenia, have been reported. We report a case of late-onset catatonia associated with enlarged CSP and cavum vergae. A 66-year-old woman was presented with altered mental status and stereotypic movement. She was initially treated with aripiprazole and lorazepam. After 4 weeks, she was treated with electroconvulsive therapy. By 10 treatments, echolalia vanished, and catatonic behavior was alleviated. Developmental anomalies in the midline structure may increase susceptibility to psychosis, even in the elderly.ArticleJOURNAL OF ECT. 29(3):E45-E46 (2013)journal articl

Comparison of diagnostic names of mental illnesses in medical documents before and after the adoption of a new Japanese translation of 'schizophrenia'

Aim: The name of a disease entered in medical documents often differs from the true diagnosis in psychiatric practice. We examined the effects of different translations of 'schizophrenia' into Japanese on the usage of disease names in documents. Methods: We conducted a retrospective survey of the names of diseases used in the medical documents of 250 outpatients with schizophrenia or depression. These patients had attended our department of psychiatry between 1998 and 2000. We also investigated the names of the diseases of 226 outpatients who had first visited our department between 2003 and 2007. We defined the diagnosis (based on ICD-10) as the 'ICD-10 disease name' and the name of the disease written in medical documents as the 'disease name in documents'. We classified the documents that were used to apply for national psychiatric care and welfare services as 'official documents' and those submitted to others as 'private documents'. Results: Prior to 2000, the term 'seishin-bunretsu-byo' ('split-mind disease'; old translation of 'schizophrenia') was used in 72.3% of official documents and 3.6% of private documents. In 2003 and later, the term 'togo-shitcho-sho' ('integration disorder'; new translation of 'schizophrenia') was used in 98.0% of official documents and 21.7% of private documents. Conclusion: The use of 'togo-shitcho-sho' in official documents has become established. On the other hand, terms such as 'nervous breakdown' and 'depressive state' are still commonly used in private documents after the adoption of the new Japanese translation of schizophrenia.ArticlePSYCHIATRY AND CLINICAL NEUROSCIENCES. 65(1):89-94 (2011)journal articl

Novel oestrogen receptor beta-selective ligand reduces obesity and depressive-like behaviour in ovariectomized mice

Hormonal changes due to menopause can cause various health problems including weight gain and depressive symptoms. Multiple lines of evidence indicate that oestrogen receptors (ERs) play a major role in postmenopausal obesity and depression. However, little is known regarding the ER subtype-specific effects on obesity and depressive symptoms. To delineate potential effects of ER beta activation in postmenopausal women, we investigated the effects of a novel oestrogen receptor beta-selective ligand (C-1) in ovariectomized mice. Uterine weight, depressive behaviour, and weight gain were examined in sham-operated control mice and ovariectomized mice administered placebo, C-1, or 17 beta-oestradiol (E2). Administration of C-1 or E2 reduced body weight gain and depressive-like behaviour in ovariectomized mice, as assessed by the forced swim test. In addition, administration of E2 to ovariectomized mice increased uterine weight, but administration of C-1 did not result in a significant increase in uterine weight. These results suggest that the selective activation of ERa in ovariectomized mice may have protective effects against obesity and depressive-like behaviour without causing an increase in uterine weight. The present findings raise the possibility of the application of ER beta-ligands such as C-1 as a novel treatment for obesity and depression in postmenopausal women.ArticleSCIENTIFIC REPORTS. 7:4663 (2017)journal articl

Comparison of alterations in cerebral hemoglobin oxygenation in late life depression ans Alzheimer's disease as assessed by near-infrared spectroscopy

BACKGROUND: Patients with Alzheimer's disease (AD) often present with apathy symptoms resembling the decreased motivation observed in depressed patients. Therefore, differentiating the initial phase of AD from late life depression may be difficult in some cases. Near-infrared spectroscopy (NIRS) is a functional neuroimaging modality that uses near-infrared light to measure changes in hemoglobin concentration on the cortical surface during activation tasks. The objective of this study was to investigate differences in brain activation associated with late life depression and with AD by means of NIRS. METHODS: NIRS was performed in 30 patients with depression, 28 patients with AD, and 33 healthy controls, all aged 60 years or older. During two tasks, a verbal fluency task and a visuospatial task, changes in oxygenated hemoglobin concentration in the frontal and parietal cortices were investigated. RESULTS: In the visuospatial task, cortical activation was lower in the depressed group than in the AD group, and significant differences were observed in the parietal cortex. CONCLUSIONS: NIRS can detect differences in brain activation between patients with late life depression and those with AD. NIRS is a promising tool for the differential diagnosis of late life depression and AD.ArticleBEHAVIORAL AND BRAIN FUNCTIONS. 10:8 (2014)journal articl

混沌とする世界における国際機関の強化 : ヒロシマの果たす役割は

巻頭言...4 第Ⅰ部　戦後国際関係に果した国際機関の役割 　The Future of Multilateralism:Governing the World in a Post-Hegemonic Era...G.John Ikenberry...6 　『ジュネーヴ軍縮会議』の取り組み : その成果と現状...天野万利...12 　War Occurrence and Multilateral Institutions...Takashi Inogushi...17 第Ⅱ部　混沌とする世界における国際機関の強化 　Gridlock: Why Global Cooperation is Failing When We Need it Most...David Held...20 　Post-2015 Development Agenda and the Role of the United Nations...Akiko Yuge...27 　混沌とする世界と国際機関の強化...西田恒夫...32 基調講演 　日本と世界の当面するチャレンジ...明石康...37 第Ⅲ部　ヒロシマは何ができるのか？ 　MULTILATERALISM IN A GLOBALIZED WORLD : Meeting Grand Global Challenges...Brian D. Finlay...43 　被爆地からの訴えは核軍縮を促したか...水本和実...49 　北東アジア非核兵器地帯の実現に向けた広島の役割...山本武彦...55 　ヒロシマの思想、そして今後のヒロシマの役割...川野徳幸...59 巻末言...73 資料1　シンポジウム・ポスター...75 資料2　キーワード集...77 資料3　参加者アンケート結果...82広島大学平和科学研究センター／新潟県立大学共催国際シンポジウ

Japanese Lung Cancer Society Guidelines for Stage IV NSCLC With EGFR Mutations

Patients with NSCLC in East Asia, including Japan, frequently contain EGFR mutations. In 2018, we published the latest full clinical practice guidelines on the basis of those provided by the Japanese Lung Cancer Society Guidelines Committee. The purpose of this study was to update those recommendations, especially for the treatment of metastatic or recurrent EGFR-mutated NSCLC. We conducted a literature search of systematic reviews of randomized controlled and nonrandomized trials published between 2018 and 2019 that multiple physicians had reviewed independently. On the basis of those studies and the advice from the Japanese Society of Lung Cancer Expert Panel, we developed updated guidelines according to the Grading of Recommendations, Assessment, Development, and Evaluation system. We also evaluated the benefits of overall and progression-free survival, end points, toxicities, and patients’ reported outcomes. For patients with NSCLC harboring EGFR-activating mutations, the use of EGFR tyrosine kinase inhibitors (EGFR TKIs), especially osimertinib, had the best recommendation as to first-line treatment. We also recommended the combination of EGFR TKI with other agents (platinum-based chemotherapy or antiangiogenic agents); however, it can lead to toxicity. In the presence of EGFR uncommon mutations, except for an exon 20 insertion, we also recommended the EGFR TKI treatment. However, we could not provide recommendations for the treatment of EGFR mutations with immune checkpoint inhibitors, including monotherapy, and its combination with cytotoxic chemotherapy, because of the limited evidence present in the literature. The 2020 Japanese Lung Cancer Society Guidelines can help community-based physicians to determine the most appropriate treatments and adequately provide medical care to their patients