Prevalence and Comorbidity of Anxiety and Depressive Disorders in Studies of PRIME-MD and PHQ (Patient Health Questionnaire) in Japan

We examine two studies on the prevalence and comorbidity of anxiety and depressive disorders in Japanese patients in primary care settings. The PRIME-MD study (Primary Care Evaluation of Mental Disorders) in Japan was conducted in seven primary care sites. The sample group included 601 adult patients (249 males, 352 females, mean age = 58.9 years, SD = 16.5). Of the 12.5% of patients diagnosed with mood disorders, 5.0% (n = 29) were major depressive disorder, and 6.7% (n = 40) were minor depressive disorder. The odds ratio for co-occurrence of major depressive disorder with generalized anxiety disorders and major depressive disorder with anxiety disorders (NOS) was 11.5 (95% CI: 2.17–18.45) and 8.00 (95% CI: 3.19–20.07), respectively. The PHQ (Patient Health Questionnaire) study in Japan was conducted in eleven primary care sites. A total of 1409 adult patients (611 males, 797 females; mean age: 56.2 years, SD: ±20.4) completed the PHQ in full. The prevalence of diagnosis of any mood disorder or any anxiety disorder was 25.0%. Of the 15.8% of patients diagnosed with mood disorders, 5.3% were for major depression and 8.4% for other depressive disorders. The odds ratio for co-occurrence of major depressive disorder with other anxiety disorders was 30.4 (95% CI: 13.19–70.28)

A randomized controlled multicenter trial of post-suicide attempt case management for the prevention of further attempts in Japan (ACTION-J)

<p>Abstract</p> <p>Background</p> <p>A previous suicide attempt is a potent risk factor for suicide later on. Crisis intervention, psychiatric and psychosocial evaluation at emergency medical facilities, and follow-up care for suicide attempters are considered important components for suicide prevention. The Japanese Multimodal Intervention Trials for Suicide Prevention (J-MISP) includes a randomized, controlled, multicenter trial of post-suicide attempt case management for the prevention of further attempts (ACTION-J) to address the continuing increase in suicides in Japan. The primary aim of ACTION-J is to examine the effectiveness of an extensive intervention for suicide attempters in prevention of recurrent suicidal behavior, as compared with standard intervention. This paper describes the rationale and protocol of the ACTION-J trial.</p> <p>Methods/Design</p> <p>In this clinical trial, case management intervention will be provided at 19 emergency medical facilities in Japan. After crisis intervention including psychiatric evaluation, psychosocial assessment, and psychological education, subjects will be randomly assigned to either a group receiving continuous case management or a control group receiving standard care. Suicidal ideation, depressive symptoms, and general health condition will be evaluated as secondary measures. The intervention was initiated in July 2006. By December, 2009, 842 subjects will be randomized. Subject follow-up will continue for 1.5 to 5 years.</p> <p>Discussion</p> <p>Suicide is a complex phenomenon that encompasses multiple factors. Case management by multi-sector collaboration is needed. ACTION-J may provide valuable information on suicide attempters and may develop effective case management to reduce future risk for suicide attempters.</p> <p>Trial registration</p> <p>UMIN Clinical Trials Registry number, UMIN000000444. ClinicalTrials.gov number, NCT00736918.</p

A Single Amino Acid Mutation in SNAP-25 Induces Anxiety-Related Behavior in Mouse

Synaptosomal-associated protein of 25 kDa (SNAP-25) is a presynaptic protein essential for neurotransmitter release. Previously, we demonstrate that protein kinase C (PKC) phosphorylates Ser187 of SNAP-25, and enhances neurotransmitter release by recruiting secretory vesicles near to the plasma membrane. As PKC is abundant in the brain and SNAP-25 is essential for synaptic transmission, SNAP-25 phosphorylation is likely to play a crucial role in the central nervous system. We therefore generated a mutant mouse, substituting Ser187 of SNAP-25 with Ala using “knock-in” technology. The most striking effect of the mutation was observed in their behavior. The homozygous mutant mice froze readily in response to environmental change, and showed strong anxiety-related behavior in general activity and light and dark preference tests. In addition, the mutant mice sometimes exhibited spontaneously occurring convulsive seizures. Microdialysis measurements revealed that serotonin and dopamine release were markedly reduced in amygdala. These results clearly indicate that PKC-dependent SNAP-25 phosphorylation plays a critical role in the regulation of emotional behavior as well as the suppression of epileptic seizures, and the lack of enhancement of monoamine release is one of the possible mechanisms underlying these defects

Activation on Ammonia Absorbing Reaction for Magnesium Chloride

Hexa-ammine complex (Mg­(NH₃)₆Cl₂) is directly formed at room temperature by the reaction between magnesium chloride (MgCl₂) and ammonia (NH₃) without formation of mono- and diammine complexes (Mg­(NH₃)­Cl₂ and Mg­(NH₃)₂Cl₂) even though these are more stable phases. The high kinetic barrier exists for the formation of low coordinated ammine complexes. The activation by using heat treatment and ball milling is carried out, and then the NH₃ absorption properties are investigated to understand kinetic properties of the ammine complexes formation of MgCl₂. At 373 K, the formation of Mg­(NH₃)₂Cl₂ is realized. Furthermore, it is found that a higher temperature than 573 K is required to form Mg­(NH₃)­Cl₂. Interestingly, the ball milled MgCl₂ can transform into low coordinated ammine complexes even at room temperature, indicating that the structural disorder state generated by the ball milling induces the formation of the above phases with low activation energy. Therefore, it is expected that the kinetic barrier to form ammine complexes of MgCl₂ is strongly related to the process on the structural change