Post-disaster mental health and psychosocial support in the areas affected by the Great East Japan Earthquake: a qualitative study

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Pervasive Developmental Disorders and Autism Spectrum Disorders: Are These Disorders One and the Same?

The concept of pervasive developmental disorders (PDD) and autism spectrum disorders (ASD) closely resemble each other. Both ICD-10 and DSM-IV use the term PDD. The authors surveyed the perception of PDD/ASD and attitudes toward terminology. The subjects of this study were 205 medical/social-welfare professionals working in fields relating to developmental disorders. Questionnaires were mailed to site investigators at the collaborating institutes. With regard to what the scope of ASD and PDD encompasses, the answers were almost equally divided among three views: ASD and PDD are the same, PDD is wider in scope and ASD is wider. The terms PDD and autism were used in slightly different ways depended upon the situation. Our results demonstrate that the parameters of PDD and ASD are unclear and that the terms related to PDD/ASD are often used differently. Further studies are required to develop more clear and reliable diagnostic criteria for PDD

Suicidal ideation and burnout among psychiatric trainees in Japan

AIM: Burnout is a psychological condition that may occur in all workers after being exposed to excessive work-related stresses. We investigated suicidal ideation and burnout among Japanese psychiatric trainees as a part of the Burnout Syndrome Study (BoSS) International.  METHODS: In the Japanese branch, 91 trainees fully completed suicide ideation and behaviour questionnaire (SIBQ) and Maslach Burnout Inventory-General Survey (MBI-GS).  RESULTS: Passive suicidal ideation was reported by 38.5% of Japanese trainees and 22.0% of them had experienced active suicidal ideation. The burnout rate among Japanese subjects was 40.0%. These results were worse compared to the all 1980 trainees who fully completed the main outcome measure in BoSS International, 25.9%, 20.4% and 36.7%, respectively.  CONCLUSIONS: Our results suggest a higher risk of suicide among Japanese residents. Japan has a higher suicide rate than other countries. Early detection of, and appropriate intervention for, suicidal ideation is important in preventing suicide in psychiatry residents

The practice of child and adolescent psychiatry: a survey of early-career psychiatrists in Japan

<p>Abstract</p> <p>Background</p> <p>Child and adolescent psychiatry (CAP), a subspecialty of psychiatry in Japan, is facing a serious workforce shortage. To resolve this situation, the Japanese government has organized a task force and has been working to increase psychiatrists' clinical skills to improve care for children and adolescents with mental health problems. Using an online questionnaire system, the authors have conducted a survey to investigate the perceptions, experiences, and interests of early-career psychiatrists in CAP.</p> <p>Methods</p> <p>The subjects of this study were 182 psychiatrists in Japan whose individual clinical experiences did not exceed 15 years. The authors of this study created an online questionnaire system and e-mailed the URL and login password to all subjects. Respondents anonymously answered the questions. Most questions required an answer indicating a level of agreement scored on a nine-point scale. Responding to the questionnaire was considered to constitute consent, and all respondents' privacy was carefully protected.</p> <p>Results</p> <p>The mean age and clinical psychiatric experience of the subjects were found to be 33.1 ± 4.5 years and 5.43 ± 3.5 years, respectively. On a nine-point scale (with nine being the highest), experience and interest in CAP measured 3.05 ± 1.9 and 5.34 ± 2.5, respectively; further, these two factors showed significant correlation (r = 0.437, p < 0.0001). The mean score for the early-career psychiatrists' confidence in their ability to diagnose and appropriately treat was notably low, at 3.13 ± 1.9.</p> <p>Conclusion</p> <p>Our results demonstrated that early-career psychiatrists self-evaluated their CAP clinical experience as insufficient, and these clinicians' CAP experiences and interests correlated significantly. Therefore, in order to improve child and adolescent medical care, we need to expose young psychiatrists to sufficient CAP cases and explore the factors that could attract them to this field.</p

Variant isoforms of CD44 involves acquisition of chemoresistance to cisplatin and has potential as a novel indicator for identifying a cisplatin-resistant population in urothelial cancer

Abstract Background Cisplatin is the most commonly used chemotherapeutic agent in the treatment of patients with metastatic and/or recurrent urothelial cancer. However, the effectiveness of these treatments is severely limited due to the development of cisplatin resistance. Cancer stem cells have been documented as one of the key hypotheses involved in chemoresistance. CD44v8–10 has been identified as one of the new cancer stem cells markers and was recently shown to enhance the antioxidant system by interaction with xCT, a subunit of the cystine transporter modulating intracellular glutathione synthesis. The aim of the present study was to investigate the clinical role of CD44v8–10 and the molecular mechanism underlying the acquisition of cisplatin resistance through CD44v8–10 in urothelial cancer. Methods We analyzed the clinical significance of the immunohistochemical CD44v9 expression, which detects the immunogen of human CD44v8–10, in 77 urothelial cancer patients treated with cisplatin-based systemic chemotherapy for recurrence and/or metastasis. We then evaluated the biological role of CD44v8–10 in the acquisition of cisplatin resistance using the urothelial cancer cell lines, T24 and T24PR, which were generated to acquire resistance to cisplatin. Results The 5-year cancer-specific survival rate was significantly lower in the CD44v9-positive group than in the CD44v9-negative group (P = 0.008). Multivariate analyses revealed that CD44v9 positivity was an independent risk factor of cancer-specific survival (P = 0.024, hazard ratio = 5.16) in urothelial cancer patients who had recurrence and/or metastasis and received cisplatin-based chemotherapy. The expression of CD44v8–10 and xCT was stronger in T24PR cells than in T24 cells. The amount of intracellular glutathione was significantly higher in T24PR cells than in T24 cells (p < 0.001), and intracellular reactive oxygen species production by cisplatin was lower in T24PR cells than in T24 cells. Furthermore, the knockdown of CD44v8–10 by siRNA led to the recovery of cisplatin sensitivity in T24PR cells. Conclusions CD44v9 in tumor specimens has potential as a novel indicator for identifying a cisplatin-chemoresistant population among urothelial cancer patients. CD44v8–10 contributes to reactive oxygen species defenses, which are involved in chemoresistance, by promoting the function of xCT, which adjusts the synthesis of glutathione

Nationwide survey of work environment, work-life balance and burnout among psychiatrists in Japan.

BACKGROUND: Psychiatry has been consistently shown to be a profession characterised by 'high-burnout'; however, no nationwide surveys on this topic have been conducted in Japan. AIMS: The objective of this study was to estimate the prevalence of burnout and to ascertain the relationship between work environment satisfaction, work-life balance satisfaction and burnout among psychiatrists working in medical schools in Japan. METHOD: We mailed anonymous questionnaires to all 80 psychiatry departments in medical schools throughout Japan. Work-life satisfaction, work-environment satisfaction and social support assessments, as well as the Maslach Burnout Inventory (MBI), were used. RESULTS: Sixty psychiatric departments (75.0%) responded, and 704 psychiatrists provided answers to the assessments and MBI. Half of the respondents (n = 311, 46.0%) experienced difficulty with their work-life balance. Based on the responses to the MBI, 21.0% of the respondents had a high level of emotional exhaustion, 12.0% had a high level of depersonalisation, and 72.0% had a low level of personal accomplishment. Receiving little support, experiencing difficulty with work-life balance, and having less work-environment satisfaction were significantly associated with higher emotional exhaustion. A higher number of nights worked per month was significantly associated with higher depersonalisation. CONCLUSIONS: A low level of personal accomplishment was quite prevalent among Japanese psychiatrists compared with the results of previous studies. Poor work-life balance was related to burnout, and social support was noted to mitigate the impact of burnout

Post-disaster mental health and psychosocial support in the areas affected by the Great East Japan Earthquake: a qualitative study

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Means MBI scores and burnout rates.

<p>a Chi-squared test; the results of three burnout subsets were compared.</p

Factors associated with burnout and stress: multivariate linear regression analysis (n = 704).

<p>β: standardised regression coefficient.</p><p>VIF: variance inflation factor.</p>a<p>Coded as: 0 =  Male; 1 =  Female.</p>b<p>Coded as: 1 =  Professor or Associate Professor; 2 =  Assistant Professor; 3 =  Psychiatric Resident; 4 =  Postgraduate Student.</p>c<p>Coded as: 0 =  Married; 1 =  Not married.</p>d<p>Coded as: 0 =  Have children; 1 =  Do not have children.</p>e<p>Coded as: 1 =  Less than 40 hours; 2 = 40 to less than 50 hours; 3 = 50 hours or more.</p>f<p>Coded as: 1 =  None; 2 =  Less than 4 times; 3 = 5 to 9 times; 4 = 10 times or more.</p>g<p>Possible range: 1–5. Higher scores indicate higher satisfaction levels.</p>*<p>Statistically significant variables.</p