A Pilot Study of Barriers to Psychiatric Treatment among Japanese Healthcare Workers

Background: The medical service industry has the highest number of industry-classified workers’ compensation claims related to mental disorders. They are a group of people who particularly need mental health care.Aims: To investigate the barriers to seeking psychiatric treatment among healthcare workers. Methods: This cross-sectional survey was conducted for healthcare workers. We assessed the relationship between barriers to psychiatric treatment, stress perception, coping methods, and demographic variables.Results: There were 91 respondents in the final analysis (participants’ mean age was 34.73±11.41). Factor analysis identified three factors that affect resistance to seeking treatment (?=0.83): 1) anxiety toward psychiatric medicine, 2) resistance to psychiatric visits, and 3) lack of belief in the effectiveness of psychiatric treatment. Correlation analysis indicated that resistance to psychiatric treatment increased with age (r=0.21, p<0.05). In addition, women scored significantly higher than men concerning resistance toward psychiatric visits, and doctors scored lower than those in other occupations on this measure. Conclusion: These results indicated that a main component of resistance was related to resistance toward the word “psychiatric”. It may be useful to avoid using the word “psychiatric” with individuals belonging to groups with high resistance to psychiatric treatment when suggesting that they consult a psychiatrist

Fluvoxamine alleviates paclitaxel-induced neurotoxicity

Paclitaxel (Px) is an effective chemotherapeutic agent for the treatment of various cancers. However, it is often associated with neurological side effects, including chemotherapy-associated cognitive impairment (CACI), such as “chemobrain”. Previously, we reported that endoplasmic reticulum (ER) stress is involved in Px-induced neurotoxicity, and immunoglobulin heavy chain binding protein (BiP) inducer X (BIX) alleviates Px-induced neurotoxicity. However, BIX has not been used in clinical practice yet. We recently reported that fluvoxamine (Flv) alleviates ER stress via induction of sigma-1 receptor (Sig-1R). The purpose of this study was to investigate whether Flv could alleviate Px-induced neurotoxicity in vitro. SK-N-SH cells were pre-treated for 12 h with or without 10 μg/ml Flv followed by treatment with 1 μM Px with or without co-existence of 10 μg/ml Flv for 24 h. To investigate the involvement of Sig-1R in alleviation effect on Px-induced neurotoxicity, 1 μM NE100, an antagonist of Sig-1R, was added for 24 h. Neurotoxicity was assessed using the MTS viability assay and ER stress-mediated neurotoxicity was assessed by evaluating the expression of C/EBP homologous protein (CHOP), cleaved caspase 4, and cleaved caspase 3.　Pre-treatment with Flv significantly alleviated the induction of CHOP, cleaved caspase 4, and cleaved caspase 3 in SK-N-SH cells. At the same time, pre-treatment with Flv significantly induced Sig-1R in SK-N-SH cells. In addition, viability was significantly higher in Flv-treated cells than in untreated cells, which was reversed by treatment with NE100.　Our results suggest that Flv alleviates Px-induced neurotoxicity in part through the induction of Sig-1R. Our findings should contribute to one of the novel approaches for the alleviation of Px-induced neurotoxicity, including chemobrain

Comparison and Analysis of Delirium Induced by Histamine H2 Receptor Antagonists and Proton Pump Inhibitors in Cancer Patients

Objective: H2 blockers have been reported to be responsible for drug-induced delirium. We compared the incidence of delirium between two groups of patients who were treated with H2 blockers (H2 group) or proton pump inhibitors (PPI group) for anastomotic ulcer prevention following surgical treatment of esophageal cancer. Method: The incidence and severity of delirium were retrospectively compared in patients of the H2 group (30 cases; age, 65.2 ± 8.1 years) and the PPI group (30 cases; 65.2 ± 6.5 years). The diagnosis of delirium was based on the Diagnostic and Statistical Manual of Mental Disorders-IV-Text Revision. Delirium severity was rated on the Delirium Rating Scale (DRS). Results: The incidence of delirium was significantly lower in the PPI group than in the H2 group (p = 0.047). In the 11 patients from the H2 group who developed delirium, discontinuation of H2 blockers resulted in a significant reduction in the DRS score (p = 0.009). In three patients for whom H2 blockers were discontinued, DRS scores decreased by 50% or more three days after discontinuation compared to the prediscontinuation score. Conclusions: These results suggested that switching antiulcer drugs from H2 blockers to PPIs reduced delirium and thus provided an appropriate coping method for drug-induced delirium from antiulcer drugs

Psychological Effects of Hands-On Training Using Public Transportation among Inpatients with Physical Disabilities: Analysis of the Self-Efficacy and Perception of Occupational Enablement Using a Multimethod Design

Introduction. This study is aimed at understanding how practicing the use of public transportation can affect the self-efficacy and perceptions of occupational enablement among patients with physical disabilities in a recovery rehabilitation hospital. Method. We recruited 21 inpatients with physical disabilities caused by stroke or orthopedic diseases from a recovery rehabilitation hospital in Japan and used a multimethod design including an intervention study and a follow-up survey. The intervention study utilized a before-after trial and provided hands-on training in the use of public transportation as the intervention. How self-efficacy and perceptions of occupational enablement changed before and after the intervention was measured using the visual analog scale (VAS). The follow-up survey was conducted to investigate whether patients used public transportation postdischarge. Results. Only differences in the VAS scores regarding self-efficacy were significant between before and after the hands-on training in the use of public transportation, whereas differences regarding the perceptions of occupation enablement were not. Self-efficacy after the intervention was higher than that before the intervention. In the follow-up survey, both VAS scores of the psychological factors were significantly higher in the group that used public transportation postdischarge than in the group that did not. Conclusion. Providing hands-on training in the use of public transportation for inpatients with physical disabilities increased their self-efficacy, indicating that psychological factors should be evaluated to predict their occupational skill improvement and to verify the outcomes of an occupational therapeutic intervention

Apathy correlates with prefrontal amyloid beta deposition in Alzheimer’s Disease

11th World Congress of Biological Psychiatr

Impact of cognitive function-focused mental health promotion campaign for psychiatric help-seeking behavior in Japanese university students

Purpose: We developed a mental health promotion campaign program to promote psychiatric help-seeking behavior among university students by adopting a social marketing approach and nudge theory from behavioral economics. The purpose of this study was to examine the effectiveness of the campaign. The campaign focused on the illustration of cognitive function- related symptoms and was called the “Fatigue of Brain” campaign. Methods: This study retrospectively compared the duration until psychiatric consultation at health care centers in a Japanese university between data obtained from our previous study (2016- 2018) with data from our newly developed mental health campaign (2018-2020). The campaign program included a small leaflet, given to all students during their physical examinations, which directed them to a special website. Results: The results of logistic regression analysis using data that met the eligibility and inclusion/exclusion criteria showed that the proportion of students (40.3%) who visited psychiatric consultations within two weeks of the campaign’s onset was significantly higher than the proportion of students visiting before the campaign (37.6%; OR = .578, 95% CI = .343 - .972, p = .039). Multivariate analysis revealed that the proportion of students with depressive symptoms (31.6%) was significantly higher during the campaign than before the campaign (17.3%; OR = .444, 95%CI = .234–.843, p = .013). Conclusions: The results suggest that our cognitive function-focused mental health campaign promotes earlier psychiatric consultation

Impact of cognitive function-focused mental health promotion campaign for psychiatric help-seeking behavior in Japanese university students

Purpose: We developed a mental health promotion campaign program to promote psychiatric help-seeking behavior among university students by adopting a social marketing approach and nudge theory from behavioral economics. The purpose of this study was to examine the effectiveness of the campaign. The campaign focused on the illustration of cognitive function-related symptoms and was called the “Fatigue of Brain” campaign. Methods: This study retrospectively compared the duration until psychiatric consultation at health care centers in a Japanese university between data obtained from our previous study (2016-2018) with data from our newly developed mental health campaign (2018-2020). The campaign program included a small leaflet, given to all students during their physical examinations, which directed them to a special website. Results: The results of logistic regression analysis using data that met the eligibility and inclusion/exclusion criteria showed that the proportion of students (40.3%) who visited psychiatric consultations within two weeks of the campaign’s onset was significantly higher than the proportion of students visiting before the campaign (37.6%; OR = .578, 95% CI = .343 - .972, p = .039). Multivariate analysis revealed that the proportion of students with depressive symptoms (31.6%) was significantly higher during the campaign than before the campaign (17.3%; OR = .444, 95%CI = .234–.843, p = .013). Conclusions: The results suggest that our cognitive function-focused mental health campaign promotes earlier psychiatric consultation