Neuropsychopharmacology Reports最新文献

Objective: To examine the characteristics associated with happiness in Japanese individuals with schizophrenia.

Methods: A self-reported online survey was conducted in 2022 among individuals aged 20-75 years, including 223 and 1776 individuals with and without schizophrenia, respectively. We used a modified Poisson regression to assess the factors associated with happiness by calculating the age- and sex-adjusted prevalence ratios (PRs). We examined within-schizophrenia group differences by age and sex strata, and compared these stratified PRs between groups with and without schizophrenia.

Results: Among participants with schizophrenia, happiness was significantly associated with self-rated health status (PR = 1.75), Ikigai (PR = 5.02), depressive symptoms (PR = 0.43), perceived stress (PR = 0.52), cognitive social capital (PR = 2.07), structural social capital (PR = 1.70), social support (PR = 2.40), close friends (PR = 1.88), close relatives (PR = 2.34), and a cohabiting partner (PR = 1.57). Within the schizophrenia group, sex differences were significant for cognitive social capital (men: PR = 3.45; women: PR = 1.43) and cohabiting partners (men: PR = 2.26; women: PR = 1.25), whereas no significant age differences were found. Factors demonstrating a stronger association in participants with schizophrenia than in those without schizophrenia included: Ikigai (with, PR = 5.02; without, PR = 2.91), cognitive social capital (with, PR = 2.07; without, PR = 1.49), and structural social capital (with, PR = 1.70; without, PR = 1.24).

Conclusion: Happiness in individuals with schizophrenia is associated with physical, mental, and social factors, with social factors exhibiting sex-related differences.

Background: Anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis, a type of autoimmune encephalitis, characterized by acute onset neuropsychiatric symptoms, predominantly affects young females and is often associated with ovarian teratomas. Although small cell lung cancer (SCLC) is a known cause of paraneoplastic encephalitis, its association with anti-NMDAR encephalitis is rare and often carries a poor prognosis due to limited response to immunotherapy.

Case presentation: An 80-year-old male with no psychiatric history presented with flu-like symptoms, followed by the acute onset of neuropsychiatric symptoms, including pressured speech, agitation, memory impairment, and abnormal behavior. Autoimmune encephalitis was suspected due to mildly elevated cerebrospinal fluid (CSF) white cell count and a mass in the right upper lung detected by whole-body computed tomography (CT) on the first day of hospitalization. High-dose intravenous corticosteroids were administered on Day 1, resulting in prompt and sustained improvement in symptoms. CSF was later confirmed positive for anti-NMDAR antibodies, and a bronchoscopy biopsy of the pulmonary mass diagnosed SCLC. The patient recovered without neurological deficits and was discharged in stable condition on hospital Day 30.

Conclusion: This was a rare case of anti-NMDAR encephalitis associated with SCLC in an elderly male patient. Diagnosis in elderly individuals is often challenging because of the atypical presentations and lower tumor association. Nevertheless, timely intervention initiation may lead to favorable outcomes. Clinicians should consider autoimmune encephalitis, including anti-NMDAR encephalitis, when evaluating acute onset neuropsychiatric symptoms in elderly individuals and initiate early immunotherapy alongside tumor screening.

Background: Since research on the pathophysiology of psychiatric disorders diagnosed by symptoms has not succeeded, a data-driven analysis incorporating biological and cross-disease perspectives has been proposed. We have reported a new subgroup of psychiatric disorders by a data-driven analysis of subcortical volumes of brain MRI in 5602 subjects, including patients with psychiatric disorders and controls. This subgroup of patients is characterized by enlarged ventricle and cognitive impairment (EVCI) with a high proportion of schizophrenia, electroencephalography abnormalities, and rare pathological copy number variations.

Case presentation: Of the nine patients with EVCI, eight patients had schizophrenia, and one patient had autism spectrum disorder. Early onset of age was observed in eight patients with schizophrenia. Treatment responses were poor in seven patients with schizophrenia, and two of three treatment-resistant schizophrenia patients responded to clozapine. Four patients showed ischemic changes in cerebral white matter. In electroencephalography, abnormal findings were observed in five patients, borderline findings in two patients, and normal findings in two patients. Rare pathogenic copy number variations were found in three patients (22q11.21 deletion, 7q11.23 duplication, and 7q36.2 deletion).

Conclusions: The results of this case series showed additional clinical features of treatment response and ischemic changes in cerebral white matter, which could be a clue to the treatment and diagnosis of EVCI. This case series might help elucidate the pathophysiology of EVCI.

Purpose: This study aims to identify the characteristics of patients with cannabis use disorder and to determine whether the challenges in treating cannabis use disorder stem from the pharmacological properties of cannabis as an abused substance or from other contributing factors.

Methods: The subjects of this study were the 208 male cases of methamphetamine-related mental disorders (MAP group) and 82 male cases of cannabis-related mental disorders (CAN group), which drawn from the "2024 Nationwide Survey on the Actual Conditions of Drug-Related Mental Disorders in Psychiatric Hospitals in Japan." Clinical variables were compared between the two groups, and logistic regression analyses were conducted to examine the use of medical and nonmedical resources.

Results: The CAN group was found to be younger, to have fewer histories of drug-related criminal offenses, incarceration in correctional facilities, or comorbid psychiatric disorders, compared to the MAP group, and to exhibit less severe forms of substance use disorder and have less experience participating in self-help groups or utilizing private recovery support facilities. Logistic regression analyses of the use of self-help groups and private recovery support facilities indicated that the utilization of these nonmedical resources was more strongly associated with older age and greater severity of substance use disorder than with the specific type of substance abused.

Conclusion: Recently, an increasing number of young patients in Japan have been arrested for cannabis-related offenses and seek addiction treatment. There is growing concern that current nonmedical support resources may not adequately address the specific needs of these individuals.

Reduced physical activities, social support, old age, and increased exposure to regular stressful life events are crucial factors for poor mental health. Although several medicines are available to support mental health-related symptoms, due to more side effects and non-compliance for long-term use, these conventional medicines are not appropriate to tackle these symptoms. In this context, the study aimed to determine whether spiritual energy therapy with an experienced spiritual energy practitioner could manage adults' psychological and mental health-related symptoms. A single-blind, active-controlled, randomized trial was performed. Enrolled participants (n = 80) exhibited at least one psychological symptom. Spiritual energy therapy was given to subjects at two time points (Days 0 and 90) in physical presence. Psychological scores and physiological biomarkers were assessed. Treatment group subjects were reported to have a significant (p ≤ 0.0001) improvement in psychological scores related to stress, depression, mental restlessness, emotional trauma, hopelessness, etc., compared to the control group subjects. Additionally, subjects in the treatment group also showed significant improvement in biological markers compared to those in the control group. No treatment-related adverse effects were observed. The current study data unveiled a significant effect of spiritual energy therapy on improving adults' mental health conditions and symptoms, and significantly decreased elevated proinflammatory and oxidative stress biomarker levels in the treatment group.

This image visualizes the weighing of commercial incentives against research integrity, highlighting the challenge of maintaining transparency in CBD-related studies.

Benzodiazepine and non-benzodiazepine hypnotics (Z-drugs) are known risk factors for adverse events, including delirium and falls. Although formularies are intended to promote appropriate prescribing, few comprehensive studies have assessed their clinical impact in the context of sleep medications. This study aimed to evaluate changes in hypnotic prescribing patterns and associated clinical outcomes following the implementation of a sleep medication formulary. A psychiatric liaison team developed and implemented a formulary in April 2024, recommending lemborexant as the first-line treatment and eszopiclone as the second-line option. This single-center, retrospective study compared patients admitted and discharged during the 12 months before (April 2023 to March 2024; n = 12 633) and after (April 2024 to March 2025; n = 12 931) implementation. Outcome measures included monthly prescription volumes, diazepam equivalents, use in clinical pathways and prescription sets, delirium incidence, nighttime falls, and length of hospital stay. Statistical analyses were performed using the Mann-Whitney U-test and Fisher's exact test. Following implementation, prescription volumes of lemborexant and eszopiclone increased significantly, whereas diazepam equivalents decreased from 10 682 mg to 4117 mg. All 104 clinical pathways and prescription sets previously using benzodiazepine hypnotics or Z-drugs were converted to lemborexant. Monthly delirium cases declined from 12.5 to 8.0, and the proportion of nighttime falls among patients receiving benzodiazepine hypnotics or Z-drugs decreased from 24.0% to 11.5%. The median hospital stay also decreased from 8 to 7 days. These findings suggest that formulary implementation effectively optimized hypnotic prescribing and contributed to improved clinical outcomes and patient safety in an acute care setting.

First- and second-generation antipsychotics (FGAs and SGAs, respectively) with dopamine-antagonizing properties may cause involuntary movement-related adverse drug reactions (ADRs). However, the risk in the Japanese population is not well characterized. In this study, we analyzed spontaneous ADR reports from the Japanese Adverse Drug Event Report (JADER) database and evaluated the reporting odds ratios (RORs) of tardive dyskinesia (TD) and other extrapyramidal symptoms (EPS) associated with antipsychotics. SGAs were evaluated both as a whole class and as subgroups based on their primary pharmacological mode of action. From 1 April 2011 to 31 March 2020, 1 197 065 ADRs, including 760 TD and 6059 EPS cases, were identified for this study. By calculating RORs, risk signals were detected with both FGAs and SGAs for TD and EPS compared with non-antipsychotics, with an ROR (95% confidence interval (CI)) of 153.9 (125.64-188.34) with FGAs for TD and 95.3 (80.61-112.65) with SGAs total for TD. No risk signals were detected for SGAs total data or any SGA subgroups versus FGAs. The ROR (95% CI) with SGAs total versus FGAs for TD was 0.62 (0.51-0.75), for dyskinesia: 0.55 (0.42-0.72), and for parkinsonism: 0.43 (0.35-0.52), showing that SGAs were associated with lower reporting frequency versus FGAs, but not for akathisia and dystonia. In conclusion, both FGAs and SGAs were associated with risks for TD and EPS compared with non-antipsychotics in the Japanese population, and SGAs total or all SGA subgroups showed no risk signals compared with FGAs.

Aim: This study aimed to evaluate the efficacy and safety of steroid therapy in patients with Fukuyama congenital muscular dystrophy (FCMD).

Methods: This is a noncontrolled, nonblinded, multicenter collaborative phase 2 trial in patients with a definite diagnosis of 3-kb insertion mutation homozygous or compound heterozygous FCMD based on genetic testing. The first part of the study evaluates efficacy; patients with homozygous FCMD were given oral prednisolone at a dose of 1 mg/kg on alternate days (0.5 mg/kg/day) for 24 weeks. The second part of the study evaluates safety; patients with homozygous and heterozygous FCMD were given oral prednisolone at a dose of 1 mg/kg on alternate days (0.5 mg/kg/day) for 48 weeks. Homozygous patients will be evaluated in the first part of the study for up to 24 weeks after prednisolone administration, after which they will continue receiving prednisolone in the second part for an additional 24 weeks. The primary endpoints were the changes in motor function evaluated using the gross motor function measure after treatment with prednisolone in the first part and the safety profiles based on the results of physical examination, vital signs, 12-lead electrocardiography (ECG), echocardiography, ophthalmic testing, SpO₂, laboratory tests, immunological tests, and adverse events in the second part.

Discussion: Based on previous clinical research, prednisolone shows great potential as a therapeutic drug in patients with FCMD. To achieve this goal, we planned an investigator-initiated trial to confirm the effectiveness and safety of prednisolone.