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

Traits of irrational beliefs related to eating problems in Japanese college women

This study focused on the relation of irrational beliefs and Body Mass Index(BMI) to inappropriate eating attitudes in Japanese college women. A total of 110 nonclinical subjects completed the Japanese Irrational Belief Test (JIBT) and the Japanese version of the Eating Attitudes Test (EAT). The JIBT subscale of ‘self expectation’ had significant positive correlations with the EAT total score and the subscales of ‘obsession with eating’,‘dieting’ and ‘obese-phobia’. The JIBT subscale of ‘dependence’ had a significant positive correlation with the EAT subscale of ‘obsession with eating’. BMI score showed significant positive correlations with the EAT total score and the subscales of ‘dieting’ and ‘obesephobia’.The present results suggest that characteristic irrational beliefs are associated with inappropriate eating attitudes, suggesting that clarifying and then modifying their rationality may be a useful method of preventive intervention in nonclinical young women with eating problems

The differences in AEP (Auditory Evoked Potentials) and SEP (Somatosensory Evoked Potentials) between epileptics and normal subjects

152 epileptics (male: 92, female: 60) and 200 normal subjects (100 of each sexes) were compared on AEP (Auditory Evoked Potential) and SEP (Somatosensory Evoked Potential), which were recorded through monopolar and bipolar derivations. The latencies and interpeak amplitudes of AEPs and VEPs were tested statistically by ANCOV A excluding the influence of age and drugs had been administered. The following results were obtained. 1. In AEPs, the latencies in epileptics were significantly longer compared with healthy subjects. These tendencies were more marked in short and middle latency components in males, but more marked in late components in females. 2. Interpeak amplitudes of AEP were relatively smaller in epileptics compared with healthy subjects. 3. In SEPs, the latencies were significantly longer in epileptics compared with healthy subjects. These tendencies were more marked in females. 4. There was no consistent tendency in interpeak amplitudes of SEP between epileptics and normal subjects in both sexes, but the interpeak amplitudes between predominant components were smaller in epileptics than normal subjects. 5. In epileptics, between the subjects had been administered the drug (each of CBZ, PB, VPA or PHT) or not, significant differences in latencies and interpeak amplitudes were not confirmed with the components significantly different in latencies and amplitudes between epileptics and healthy subjects were found. We verified the significant differences in AEP and SEP between epileptics and healthy subjects excluding the influences of age and drugs, even not considering the seizure types nor epileptic focus sites. It was supposed the disturbance in auditory and somatosensory pathway up to cortex in the central nervous system in epileptics

Auditory Evoked Potential (AEP) in schizophrenia

This AEP study aims to investigate the characteristics of cerebral responsiveness in a large number of 181 schizophrenics compared with 200 normal controls. AEPs evoked by binaural click stimuli were recorded with 1024 msec of analysis time through the two derivations (3 CH: Cz→A1+2, 6 CH: Cz→T5). The differences between the two groups of each sex in latency and interpeak amplitude were estimated statistically. The statistically significant (P<0.01 or 0.05) results were obtained as follows. 1. The schizophrenic group of both sexes showed a significant latency prolongation, middle latency components, P 2, P 3, long latency components, especially for the most prominent negative peak N 4 and prominent positive peak P 5. 2. The schizophrenic group of both sexes showed a significant interpeak amplitude reduction including the most prominent negative peak N 4 and prominent positive peak P 5, but augmentation for N 2-P 3. 3. There were no significant differences in latency and amplitude of N 4, P 5 between unmedicated and medicated schizophrenics. A few components with significant differences in latencies and amplitudes between the subjects taking antipsychotics more than 600 mg, in chlorpromazine equivalent values, or not, coincides with those also between the epileptics and healthy subjects. Theses differences in the middle and long latency components confirmed regardless of schizphrenic subtypes, suggests the dysfunction in the primary and secondary cortex in schizphrenics

AEPおよび脳波へのinsulin低血糖の影響

The effects of insulin-induced hypoglycemia on the central nervous system were studied by auditory evoked potential (AEP), with 8 schizophrenic patients (31~47 y.o.), during the 'kleine Insulinbehandlung'. In the three experimental session on different days, human regular insulin was injected subcutaneously to each patient, whose consciousness level was lowered to the stage of somnolence and recovered by intake of a glucose solution (100 g). EEG containig AEPs evoked by click simuli was derived from the two derivations (3rd ch : Cz→A1+2, 6th ch : Cz→T5). In the experimental session, EEG containing AEPs was recorded before and 20, 40, 60, 80, 100 and 120 min after the injection of insulin, and 20 min after intake of glucose. Consecutive changes of group mean AEP were studied. Individual AEPs were subjected to the component analysis, and to the statistical assessment together with EEG power %. As a result, the middle latency components of AEP significantly reduced in latency and significantly increased in amplitude in the early stage after the injection of insulin, but significantly prolonged in latency in the latter stage. On the other hand, the long latency components of AEP significantly prolonged in latency and significantly decreased in amplitude throughout hypoglycemia. EEG power % significantly decreased in δ power% in the early stage, but significantly increased in δ and θ power % and significantly decreased in α and β power % in the latter stage. These results were attributed to the inhibitory effects of insulin-induced hypoglycemia on the cerebral cortex, and to the activation of the noradrenergic neurons responding to the hypoglycemia in the early stage. The results also indicate that the activated noradrenergic neurons are gradually declined during prolonged hypoglycemia

健常成人の対側,同側および両側眼への閃光刺激によるVEPの差異

Differences among VEPs evoked by left and right monocular, and binocular flash stimuli were studied with 40 healthy male subjects (21-33 y.o.). VEPs were evoked by LED flash stimuli and derived from the six derivations and recorded with 1024 msec of analysis time. The following results were obtained. 1) In all of six derivations, the contours of the group mean VEPs were roughly similar in both ipsilateral left monocular and contralateral right monocular stimuli. These findings demonstrate that response characteristics and receptive field properties of the two eyes are well coincided with each other. 2) In details, the latencies of the short and middle latency components of the third (O 1→T 5) and the forth derivation (O 1→Cz) in contralateral right monocular VEPs were significantly shorter than those in ipsilateral left monocular VEPs. In all derivations, the peak to peak amplitudes in contralateral right monocular VEPs were significantly larger than those in ipsilateral left monocular VEPs. These findings verified the hemispheric dominant laterality of the contralateral eye, even with latencies, besides with amplitudes. 3) As compared with left monocular VEPs, the latencies of the short and middle latency components in binocular VEPs were significantly short and the peak to peak amplitudes in binocular VEPs were significantly large. These findings might suggest the existence of "binocular depth cells" of the monkey, which respond when the two eyes stimulated simultaneously, even in man. 4) In details, the latencies of the long latency components in binocular and contralateral right monocular VEPs were significantly longer than those in ipsilateral left monocular VEPs. This finding suggests the delay of the alpha regeneration as a photic after discharge following VEPs, because binocular and contralateral right monocular stimuli are stronger than ipsilateral left monocular stimuli

Visual Evoked Potential (VEP) in Manic Depressive Illness (MDI)

The differences between MDI patients and healthy subjects in Visual Evoked Potential (VEP) were studied with 45 MDI subjects (22 males and 23 females) and 60 healthy subjects (30 males and 30 females). VEPs were recorded through the two derivations (2 ch : O1→A1+2, 5 ch : O1→Cz), averaging 100 responses, with 1024 msec of analysis time. Individual VEPs were subjected to the component analysis, and to the statistical assessment. The following results were obtained. 1. The peak latencies of MDI patients were significantly longer in short latency components (mainly P 3, N 3), and interpeak amplitudes significantly larger in short and middle latency components than healthy subjects, but little significant differences in long latency components. These results suggest that MDI patients had some dysfunction in the optic pathway after lateral geniculate body up to the primary visual cortex. 2. Furthermore, between VEPs recorded in manic and depressive states, there were no significant differences in the peak latencies and the interpeak amplitudes. There were little significant differences in VEP between the patients treated regularly with lithium carbonate or carbamazepine and not, and between who had the clinical history more than 2 years and not. 3. These results indicate the single pathophysiological basis underlaying manic-depressive patients, regardless of the contrasting clinical figure between the manic and depressive state

An application of wavelet analysis to the human cerebral evoked potential

Adopting Wavelet analysis for the analysis of the waveform of EP (Evoked Potential), it was intended to confirm possibility of the subjective diagnosis for schizophrenia, epilepsy and healthy subject. 1. Each waveform of EPs (SEP, VEP and AEP) of 100 healthy male subjects (25.4±3.1 y.o.), 100 male schizophrenics (31.6± 10.4 y.o.) and 99 male epileptics (35.9± 13.1 y.o.) were subjected to the Wavelet analysis and the multiresolution analysis. As a result, the difference of Wavelet values among these subject groups were verified significantly. The Wavelet values was defined as the square means of each wavelet coefficients at each scale of multiresolution analysis. 2. The waveform of EPs of each subject were discriminated by use of discriminant method derived from Wavelet Function, in order to judge to which subject group the subject belongs, according to the wavelet values. Analyzing the waveform of EP, between 15~600msec of latency, the highest value of sensitivity, 89%, 87% and 88% was obtained for normal subject, schizophrenics and epileptics, respectively. As the conclusion, the possibility of the subjective diagnosis for schizophrenia, epilepsy, and normal subjects, by Wavelet analysis of EP waveform, were verified possible

AEPおよび脳波に対するcaffeineの効果

We studied the effects of caffeine on the central nervous system by auditory evoked potentials (AEP) with 25 healthy male subjects (T-group: 24-44 y.o., mean caffeine consumption: 251.4 mg/day). According to the DSM-IV criteria for caffeine intoxication, T-group were devided into the light (L-group: 11 subjects, ≦250 mg/ day) and heavy consumer group (H-group: 14 subjects, >250 mg/ day), and into caffeine (CAF-group) and placebo administration group (PLA-group) according to a double-blind cross-over design. EEG containing AEP was recorded through the two deviations (monopolar : Cz→A1+2, bipolar : Cz→T5); before and 30, 60 and 90 min after the oral administration of caffeine or placebo (3 mg/kg of B.W.). Consecutive changes of the latencies and amplitudes in group mean AEP were studied. Those of individual AEP were subjected to the component analysis, and to the statistical assessment with reference to the EEG power % changes. 1. After the administration of caffeine, CAF-group had a significant decrease in N 4 (= N 1, latency : 95-125 msec) and P 5 (=P 2, latency : 160-200 msec) latencies of long latency components, followed by a decrease in N 4-P 5 amplitudes of AEP, which indicated that there was a post-exciting inhibitory effect in CAF(H)-group. In EEG, α power % significantly increased, whereas δ, θ and β power % significantly decreased. These findings indicated that caffeine might have a sedative effect as well as the exciting effects on the primary and secondary auditory cortex. 2. CAF(H)-group had significant changes in latencies of AEP and EEG only 30 min after the administration of caffeine, whereas CAF(L)-group had these changes over 60 min after that, suggesting the hypersensitivity to caffeine by the interruption of caffeine consumption. 3. These changes seemed to be assciated with the effects of caffeine as an adenosine A1 receptor antagonist in the cerebral cortex, although further investigation on the neurotransmitters related to caffeine should be expected