精神分裂病患者のデイケア活動中における行動特性-着席行動を指標にして-

精神分裂病患者の行動特性を分析して，精神科デイ・ケア（DC）における精神分裂病患者への関わり方を検討した．対象はDCに通所中の精神分裂病患者15名で，DC通所期間が2年未満の短期通所群と2年以上の長期通所群に区分して検討した．行動特性の指標は，座席占有度と作業療法士（OTR）からの距離を用いた．そして，社会生活能力は精神障害者社会生活評価尺度を用い評価した．その結果，DC長期通所群は短期通所群に比べ，ナワバリは広いが生活能力は劣り，OTRへの対人的な親和性も弱いことが示唆された．このことから，DCの活動は対人関係技能の訓練に焦点をおくだけでなく，治療構造，及び治療契約の定期的な見直しも必要であると考えられた．We examined how to deal with schizophrenic patients in a psychiatric day care program (DO) by analyzing some features of their behavior. The subjects of the study were 15 schizophrenic patients who were attending the DC, and we divided the subjects into two groups: patients who had been attending the DC for less than two years (a short-term attending group) and those attending for more than two years (a long-term attending group). As indexes of behavioral features, we used seat occupation assessment and distance from occupational therapists. Social life ability was evaluated according to the Life Assessment Scale for the Mentally III. The results were that the patients in the long-term attending group had larger territoriality, but lower social life ability and weaker affinity to the occupational therapist compared to those in the shortterm attending group. These findings suggested that in DC activities we should not only focus on interpersonal skills training, but also review the treatment structure and treatment contract regularly

Sensory processing, autonomic nervous function, and social participation in people with mental illnesses

Introduction: This study investigated the relationship between sensory processing, respiratory sinus arrhythmia, and social participation in people with psychiatric disorders. Method: This study recruited 30 participants, primarily women, from a psychiatric university hospital with a mental health diagnosis listed in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (mean age: 37.7 ± 16.0 years). Sensory processing, autonomic nervous function, and social participation were measured using the Adolescent/Adult Sensory Profile®, respiratory sinus arrhythmia, and World Health Organization Disability Assessment Schedule, respectively. Through mediation analysis, a model wherein sensory processing mediated the relationship between respiratory sinus arrhythmia and social participation was developed. Results: Social participation was moderately to highly correlated with Adolescent/Adult Sensory Profile® quadrants (excluding sensory seeking) and respiratory sinus arrhythmia. Furthermore, the mediation analysis revealed that sensory avoiding mediated the relationship between respiratory sinus arrhythmia and social participation, consequently counteracting the direct relationship. Conclusion: A mediation model was constructed, which indicated that individuals with psychiatric disorders and low parasympathetic nervous system activity expressed higher sensory processing quadrant of sensory avoiding. Ultimately, this was associated with reduced social participation

Mothers\u27 Perceptions of the Sexual Development and Behavior of their Children and Persons with Autism in General

In order to ascertain and evaluate mothers\u27 perceptions of the sexual development and behavior of their children with autism, we conducted a questionnaire survey on participants in meetings held in Nagasaki. From among 172 persons who consented to participate in the survey and responded to the self-administered questionnaire, we selected 71 mothers of sons with autism (aged 6 years or over) as the study subjects. The questionnaire included items on children\u27s sexual behaviors, the appearance of secondary sexual characters/sexual development, the mothers\u27 perceptions of the children\u27s sexual development and behavior, and assessments of their own child and persons with autism in general with respect to masturbation, romantic relationships, and marriage. According to the severity of the children\u27s autism, subjects were classified into severe and non-severe groups and the above-mentioned items were compared between the two groups. No significant difference was observed between the two groups in terms of the age at first appearance of secondary sex characters; however, the age at which interest in the opposite sex was first shown was significantly earlier in the non-severe group (p = 0.031). Among 58 children aged 120 months or over, 29 (50.0%) were masturbating and the proportion of such children was significantly larger in the severe group (p = 0.014). Regarding problem sexual behavior, no significant difference was observed in the frequency of worried mothers between the two groups (p = 0.80), while "talking about sex in public" was more frequent in the non-severe group (p = 0.018). Approximately 80% of the mothers in both groups had positive views about masturbation both for their own child and for persons with autism in general; however, the proportion of mothers showing positive views about romantic relationships or marriage was significantly smaller in the severe group (p<0.0001). The present study demonstrated that mothers\u27 perceptions of sexual development and behavior in their children with autism vary according to the disease severity. This finding indicates the necessity for healthcare professionals to actively concern themselves with the mothers

Intraoperative hand strength as an indicator of consciousness during awake craniotomy: a prospective, observational study

握力が覚醒下開頭手術中の覚醒度の指標となる. 京都大学プレスリリース. 2022-01-11.Awake craniotomy enables mapping and monitoring of brain functions. For successful procedures, rapid awakening and the precise evaluation of consciousness are required. A prospective, observational study conducted to test whether intraoperative hand strength could be a sensitive indicator of consciousness during the awake phase of awake craniotomy. Twenty-three patients who underwent awake craniotomy were included. Subtle changes of the level of consciousness were assessed by the Japan Coma Scale (JCS). The associations of hand strength on the unaffected side with the predicted plasma concentration (Cp) of propofol, the bispectral index (BIS), and the JCS were analyzed. Hand strength relative to the preoperative maximum hand strength on the unaffected side showed significant correlations with the Cp of propofol (ρ =  − 0.219, p = 0.007), the BIS (ρ = 0.259, p = 0.002), and the JCS (τ =  − 0.508, p = 0.001). Receiver operating characteristic curve analysis for discriminating JCS 0–1 and JCS ≥ 2 demonstrated that the area under the curve was 0.76 for hand strength, 0.78 for Cp of propofol, and 0.66 for BIS. With a cutoff value of 75% for hand strength, the sensitivity was 0.76, and the specificity was 0.67. These data demonstrated that hand strength is a useful indicator for assessing the intraoperative level of consciousness during awake craniotomy

精神分裂病患者のデイケア活動中における行動特性-着席行動を指標にして-

精神分裂病患者の行動特性を分析して，精神科デイ・ケア（DC）における精神分裂病患者への関わり方を検討した．対象はDCに通所中の精神分裂病患者15名で，DC通所期間が2年未満の短期通所群と2年以上の長期通所群に区分して検討した．行動特性の指標は，座席占有度と作業療法士（OTR）からの距離を用いた．そして，社会生活能力は精神障害者社会生活評価尺度を用い評価した．その結果，DC長期通所群は短期通所群に比べ，ナワバリは広いが生活能力は劣り，OTRへの対人的な親和性も弱いことが示唆された．このことから，DCの活動は対人関係技能の訓練に焦点をおくだけでなく，治療構造，及び治療契約の定期的な見直しも必要であると考えられた．We examined how to deal with schizophrenic patients in a psychiatric day care program (DO) by analyzing some features of their behavior. The subjects of the study were 15 schizophrenic patients who were attending the DC, and we divided the subjects into two groups: patients who had been attending the DC for less than two years (a short-term attending group) and those attending for more than two years (a long-term attending group). As indexes of behavioral features, we used seat occupation assessment and distance from occupational therapists. Social life ability was evaluated according to the Life Assessment Scale for the Mentally III. The results were that the patients in the long-term attending group had larger territoriality, but lower social life ability and weaker affinity to the occupational therapist compared to those in the shortterm attending group. These findings suggested that in DC activities we should not only focus on interpersonal skills training, but also review the treatment structure and treatment contract regularly

Ability of Procedural Learning and Gestalt Cognition in Patients with Schizophrenia Assessed by Push-Button Task and Tree-Drawing Test

We assessed the ability of procedural learning and gestalt cognition in patients with schizophrenia by push-button task and tree-drawing test, respectively. The study subjects were 30 patients with schizophrenia and 35 healthy individuals. The patients fulfilled the diagnostic criteria specified in the International Classification of Diseases, Tenth Revision and healthy individuals were all employees of private psychiatric institutions. We used a scale for measuring work ability and classified the patients into two groups of the same size on the basis of the measurements, and called them high-autonomy group and low-autonomy group. In the push-button task, we used an apparatus with 18 buttons whose lighting was controlled by computer, and the lighting order was determined to make the path of lighting form two types of gestalt. Complete push of 18 buttons defined a trial, and we assessed the ability of procedural learning by reduction in reaction time with trial. In the tree-drawing test, we classified the drawing into 3 types, i.e., positive, negative and normal, on the basis of the gestalt of the tree drawn. In each of the two types of gestalt and their combination, the reaction time at respective trials significantly (p0.14). The frequency of positive drawing was highest in low-autonomy group and monotonically decreased in high-autonomy group and healthy group, while the reverse order held in the frequency of normal drawing, and the frequency of negative drawing was highest in high-autonomy group. The correlation between the group and the tree-drawing type was significant (p<0.0001). The present study suggests the usefulness of push-button task and tree-drawing test for assessing recovery process in schizophrenia