The Development of a Self-rating Questionnaire for Screening Dementia

Few self-rating questionnaires have been developed for use in screening for dementia due to technical difficulties. We were required to develop a self-rating questionnaire for dementia for the first-stage screening of a 1995 dementia prevalence study in the Nagasaki Prefecture. In our pilot study, we drafted a questionnaire of 43 items and applied it to 399 subjects in attendance at educational programs for senior citizens, and residing in institutions for senior citizens and in nursing homes for the aged. 185 subjects (71 males, 114 females ; average age, 77.3 years) successfully completed the questionnaire, including 39 subjects with medically diagnosed dementia. We conducted a discriminant analysis on these subjects\u27 responses to the original 43 items, and extracted 13 items which most contributed to discrimination of dementia. The sensitivity of discrimination by the final questionnaire was 0.82, and the specificity was 0.89. In the prevalence study of dementia in Nagasaki Prefecture, we could re-examine the validity of the questionnaire. The high sensitivity and moderate level of specificity of the questionnaire was considered reasonable for use in screening dementia

Nagasaki Schizophrenia Study : Outcome of a 15-year Follow-up of an Incident Cohort

The Nagasaki World Health Organization (WHO) Collaborating Center for Research and Training in Mental Health conducted the WHO Coordinated Multi-Center Study of the Long-term Course and Outcome of Schizophrenia as a part of the International Study on Schizophrenia (ISoS). The study used 107 patients who were initially diagnosed as having ICD-9 schizophrenia for the WHO Collaborative Study on the Determinants of Outcome of Severe Mental Disorders (DOSMeD). Subjects were first collected in 1979-1980 for an incidence study of schizophrenia in Nagasaki. In this 15-yearfollow- up study, 7 subjects died, 43 subjects were lost to follow-up and 57 were successfully traced. Among the 7 death cases, 4 suicides were confirmed and 1 was suspected. During the 15-year period, 25 (44%) of the 57 living subjects displayed continuous psychotic course type schizophrenia. During the last 2 years, 14 (25%) were not psychotic ; 31 (54%) were continuously psychotic. Global Assessment of Functioning Scale for Symptomatology (GAF-S) indicated symptomatological outcomes : 16 (28%) had severe symptoms (GAF-S70). Social outcome was evaluated using the Global Assessment of Functioning Scale for Disability (GAF-D): 28 (49%) showed poor adjustment (GAF-D70). The overall time trend was almost evenly divided in thirds : 20 (35%) were getting better, 18 (32%) were the same and 19 (33%) were worse. The present study showed that the outcome of schizophrenia is not always poor, although some patients display a continuous course and poor outcome

Glucagon-like peptide-1 receptor agonists as an effective therapeutic agent for diabetes mellitus and obesity in patients with schizophrenia under treatment with second-generation antipsychotics

Objectives: Cases of schizophrenia are commonly complicated with obesity and diabetes mellitus partially caused by excessive eating associated with the use of second-generation antipsychotics (SGAs). We aimed to study the efficacy of glucagon-like peptide-1 in patients with schizophrenia under treatment with SGAs. Methods: Diabetic patients with schizophrenia were included if their HbA1c levels increased more than 1% and/or their weight increased more than 3 kg after treatment with SGAs. Patients who developed diabetes after treatment with SGAs were also included. The participants were treated with GLP-1 receptor agonists for one year, and their changes in weight and HbA1c and any adverse events were evaluated. Results: Seven patients were treated with GLP-1 receptor agonists; their mean age was 46.1 yrs old (range; 26 to 59), mean body weight was 85.3 kg (65.5 to 96.8), and mean BMI was 33.8 (27 to 38.7). Five of them showed improvement in their HbA1c levels of 1.2% (0.1 to 3.4, p=0.089) with a weight loss of 3.7 kg (-9.6 to +3.5, p=0.14) on average. The adverse effects observed were all gastrointestinal, but were not severe enough to cause termination of the GLP-1 receptor agonist treatment. The GLP-1 receptor agonist was not effective in one patient, and another patient terminated the treatment in a few months. Conclusions: Although the number of patients studied was small, GLP-1 receptor agonists seem to be effective for treating diabetes and bringing about weight loss in patients with schizophrenia under treatment with SGAs