Quality of life and its predictors in people with schizophrenia

The author reviewed measurement of quality of life (QOL) of schizophrenia patients and the clinical factors related to their QOL. As schizophrenia patients were thought to be unable to assess their own QOL because of their cognitive impairment, objective QOL measures had been frequently used. However, nowadays, there is general agreement that symptomatically stabilized patients could assess their QOL by themselves. Therefore, researchers gradually have become interested in subjective QOL measure. Although most researchers often evaluate schizophrenia patients’ QOL using only subjective or objective QOL measure, considering the fact that there is a discrepancy between the two types of measures, it is recommended to use both of them as complementary measures. As for clinical factors related to lowered QOL, several studies reported that depressive symptom was most associated with lowered subjective QOL, negative symptom was strongly related to lowered objective one and poor life skill was associated with both. Moreover, several studies found that cognitive dysfunctions in some cognitive domains were related to lowered objective QOL but the effects of them were much smaller than those of negative symptoms. It is suggested that improving depressive and negative symptoms and life skills may contribute to enhancement of QOL of schizophrenia patients

Quality of Life ノ コウジョウ オ メザシタ トウゴウ シッチョウショウ チリョウ

The author reviewed studies on quality of life （QOL） of schizophrenia patients and discussed treatment strategy for improving their QOL. Although schizophrenia patients have been thought to be unable to assess their own QOL because of their cognitive impairment and objective QOL measures have been often used, nowadays, there is general agreement that stabilized patients could evaluate their QOL by themselves and then researchers gradually have become interested in use of subjective QOL measures. As most researchers still tend to assess schizophrenia patients’ QOL with only one type of the measures in spite of recent finding that there is a discrepancy between the two types, it would be recommended to use both of them as complementary measures. As for clinical factors related to lowered QOL, it is reported that depressive symptom is associated with lowered subjective QOL and negative symptom with lowered objective one. Moreover, poor life skill is found to be associated with lowered subjective and objective QOL, and several studies report that cognitive dysfunction in some cognitive domains may lead to lowered objective QOL. Generally, it is suggested that reducing depressive and negative symptoms and improving life skill could contribute to enhancement of QOL of schizophrenia patients

セッショク ショウガイ ノ シンダン ト チリョウ

Eating disorders are common especially in young women nowadays and sometimes can devastate their social functions. In diagnosis of eating disorders, clinicians have to pay attention to cooccurrence of them and other psychiatric disorders such as mood disorder, anxiety disorder, and developmental disorder. To evaluate patients’ psychological trait and state precisely, clinicians must have a good knowledge of the effects of starvation on psychological aspects. The author also highlights that in the treatment of eating disorders, adequate somatic risk assessment and psychological intervention including motivational enhancement approach and cognitive behavioral approach are essential

Personality profiles in patients with eating disorders

The present review focused on the personality profiles of patients with eating disorders. Studies using the Structured Clinical Interview for DSM-III-R Personality Disorder showed high rates of diagnostic co-occurrence between eating disorders and personality disorders. The most commonly observed were histrionic, obsessive-compulsive, avoidant, dependent and borderline personality disorders. Studies using the Cloninger’s personality theory suggested that high Harm Avoidance might be relevant to the pathology of anorexia nervosa and high Novelty Seeking and Harm Avoidance to bulimia nervosa. Moreover, high Self-Directedness was suggested to be associated with favorable outcome in bulimia nervosa. The assessment of personality in a cross-sectional study, however, might be influenced by the various states of the illness. Therefore, a sophisticated longitudinal study will be required to advance this area of research

On quality of life of anorexia nervosa

Quality of life (QOL) is important as an indicator of recovery of patients with anorexia nervosa (AN). Recently, AN patients' QOL has been investigated from different perspective such as influencing factors. In the present article, using PubMed, the authors performed a search for the research articles that were published between January 1,2000 and December 31,2016 and selected the articles focusing on QOL of patients with AN to review them. As a result of that, it was revealed that AN patients had lower QOL even after recovery than healthy controls and those who still had partial symptoms of eating disorder or had psychiatric comorbidity reported lowered QOL. From the content of QOL subscale, it was revealed that AN patients expressed higher level of dissatisfaction with family environment than patients with other type of eating disorder. Moreover, recently, it has been pointed out that patients with AN might not be able to evaluate their own QOL precisely because of low body weight that could negatively affect their cognitive function and denial of clinical condition. Summing up these findings, the authors suggested that although evaluating QOL is clinically important, we should be careful about the interpretation of the results

Changes of depression and QOL in adolescents

Aims : The purpose of the present study was to evaluate the changes of levels of depression and quality of life in adolescent students after receiving short-term cognitive behavioral educational program in health class for stress management. Methods : Subjects were 176 middle school students aged 12 to 14 years. They completed the Depression Self-Rating Scale for Children (DSRS-C) and the Revised Children Quality of Life Questionnaire (Kiddo-KINDLR) before, after and 6-months after the program. The three-session program consisted of psychoeducation and learning skills of cognitive restructuring and problem solving. Results : The total scores of the DSRS-C and the Kiddo-KINDLR in all subjects did not significantly change after the completion of program. However, as for the high risk group (score of the DSRS-C≧16), significant improvement in the two scales was found after the program. Especially, depression level in the high risk group significantly decreased and the improvement was maintained 6-months later. Conclusion : These results suggest that this type of approach may be effective for adolescents with high risk of depression in terms of improving not only depressive symptom but also quality of life

Psychiatric nurses’ observation techniques

The purpose of this study was to clarify characteristics of psychiatric nurses’ observation techniques for psychopathological symptoms. The subjects were 21 psychiatric nurses and 20 nursing students who had finished their practicum in psychiatric nursing. Using a non-contact eye-tracking analysis system, we compared quantitatively their radial motion while they were observing psychopathological symptoms of a schizophrenia simulation patient. The radial motion of them was recorded while they were observing a video of a simulated patient presenting psychopathological symptoms, and the recording was analyzed by the eye-tracking system. The investigator set the important observation areas and determined the sum of the fixation time and the number of fixations in the areas. Differences between psychiatric nurses and nursing students were tested using the Mann-Whitney U-test. The results revealed a significant difference in observation of the upper limbs area with a median of 7147.90 msec for nurses group and a median of 2447.54 msec for students group (U = 98.00, p = 0.01). The finding suggests that nurses tend to pay more attention to patient’s upper limbs to be cautious about possible violence and to find agitation caused by psychopathological symptoms, extrapyramidal adverse effects, and scars caused by self-mutilation

交代制勤務年数における男性更年期症状とその背景としての生活習慣

Background: There are various health problems in rotating shift workers. There have been few studies on the associations of male climacteric symptoms with duration of working and lifestyle. Objective: The aim of this study was to determine the differences in male climacteric symptoms depending on the number of working years and to determine whether lifestyle habits differ depending on the number of working years in rotating shift workers. Methods: We collected participant’s data from the manufacturing companies in Japan during the period from March to May in 2017. We conducted a self-administered questionnaire survey in 1561 male rotating night shift workers. Male climacteric symptoms were evaluated by using the Aging Males’ Symptoms (AMS) rating scale. We analyzed 636 rotating shift workers aged over 40 years old whose all AMS data was collected. Results: A significant difference in psychological AMS score was found between men who had worked for 10 - 19 years (9.4 ± 3.9) and men who had worked for more than 40 years (7.6 ± 3.0) (p = 0.011). Sexual functional AMS score significantly differed depending on the number of working years (less than 10 years: 8.1 ± 3.9, 10 - 19 years: 9.8 ± 4.1, 20 - 29 years: 7.9 ± 3.3, 30 - 39 years: 9.3 ± 3.5, more than 40 years: 9.3 ± 3.5) (p < 0.001). The proportion of workers with a balanced meal intake was significantly lower in men who had worked for less than 10 years and the proportions of such workers were significantly higher in men who had worked for 10 - 19 years and for more than 40 years. The proportions of men who did not drink alcohol were high in men who had worked for less than 10 years and 20 - 29 years and low in men who had worked more than 30 years. Conclusion: Psychological AMS score and sexual functional AMS score are significantly different among the 5 groups according to the number of working years on rotating shift. In addition, well-balanced diet on day shift and reduction of alcohol drinking is a related-factor for long-term rotating night shift workers

Cognitive behavioral approaches to the patients suffering from depression due to maladjustment in the work place: two case reports

The authors report two cases of depression in which Beck's cognitive therapy was effective. Case 1was a 32-year-old man who had been troubled with the recurrent depression for about eight years in spite of regular medication. Case 2was a 30-year-old man who had been chronically depressed for one year. Maladjustment in the work place was involved in the development of their depressive symptoms. Through the psycho-therapeutic sessions, they were encouraged to identify their cognitive distortions such as emotional reasoning, all-or-nothing thinking and disqualifying the positive, and assisted to modify their cognitive distortions by means of cognitive behavioral techniques. Gradu-ally gaining self-efficacy, they became able to cope well with their present problems. Both of them finally recovered from depression and, especially in case1, he could overcome recurrence. The active ingredients in successful cognitive therapy were discussed. It was also stressed that the capacity to be sufficiently introspective to identify negative automatic thoughts and to be sufficiently logical to understand how the thoughts are distorted was requisite for this therapy

A Study on Relationship between Psychological Well-being and Menstrual-Associated Symptoms in Female University Students

Female-specific menstrual-associated symptoms are regarded as a factor to lower psychological well-being. The purpose of the current study was to clarify the relationship between psychologocal well-being and menstrual-associated symptoms. We conducted an anonymous survey using self-report questionnaires, in which the MOS 36-Item Short-Form Health Survey version1.2 （SF-36） and the Menstrual Distress Questionnaire （MDQ） were administered to 382 female university students in order to evaluate health-related quality of life and menstrual-associated symptoms respectively. Data from 311 subjects were analyzed to investigate the relationship between the two scales before, during and after menstruation and in strong and weak menstrual-associated symptoms groups. There were significant negative correlations between the SF-36 subscale ‘vitality’ and the MDQ subscale ‘negative affect’ before and during menstruation. In the strong menstrual-associated symptoms group, significant negative correlations were found between subscales of the SF-36 and the MDQ before, during and after menstruation, suggesting that psychological symptoms of menstrual-associated symptoms might influence their physical and psychological quality of life. We concludes that to examine coping methods in order to reduce psychological symptoms and to provide individualized education are necessary