Neuropsychopharmacology Reports最新文献

Background: Alcohol use disorder (AUD) is characterized by severe dependence on alcohol, poor impulse control, and heightened attention to alcohol-related cues. Attention bias modification (ABM) retrains individuals to distract attention from alcohol-related cues. This study investigates the effect of combining ABM with cognitive behavioral therapy (CBT) to reduce relapse risk and cravings in male patients with AUD.

Methods: A quasi-randomized controlled trial was conducted among male inpatients diagnosed with AUD. Participants were divided into an intervention group receiving ABM in addition to CBT and a control group receiving CBT with a placebo intervention. The primary outcomes-risk of relapse and craving levels-were measured using the Alcohol Relapse Risk Scale (ARRS) and a visual analog scale (VAS), respectively. Participants underwent weekly sessions over 6 weeks, and outcomes were analyzed using generalized linear models (GLMs).

Results: The analysis did not reveal significant interactions between the intervention group and time for ARRS scores and craving levels. Both groups experienced a reduction in relapse risk and cravings. However, there was no significant difference between the ABM + CBT and CBT-only groups.

Conclusions: Although the combined ABM and CBT intervention did not result in statistically significant reductions in relapse risk and cravings compared to CBT alone, the overall reduction in these outcomes in both groups highlights the effectiveness of CBT in treating AUD. Future studies should use naturalistic settings and tailor the intervention to individual cognitive profiles.

Background: Laxative use has recently been indicated as a risk factor for hospitalization in patients with schizophrenia. Oral antipsychotic therapy for patients with schizophrenia treated with laxatives may be problematic due to gastrointestinal dysfunction, which affects absorption. Therefore, transdermal patches of antipsychotics may be a suitable alternative. We herein compared the efficacies of a blonanserin (BNS) patch and BNS oral formulation in patients with schizophrenia treated with laxatives.

Methods: A retrospective cohort study was performed using a claims database in Japan provided by DeSC Healthcare Inc. Subjects were BNS patch- or BNS oral formulation-prescribed patients with schizophrenia. The primary outcome was hospitalization to psychiatric wards. The hazard ratio (HR) for hospitalization was estimated using Cox proportional hazards model and adjusted by propensity scores.

Results: Among the 3896 patients identified, 1407 were prescribed laxatives (BNS patch group: n = 538, BNS oral group: n = 869). Mean ages in the BNS patch and BNS oral groups were 74 and 58 years, respectively. The adjusted HR for hospitalization (BNS patch group vs. BNS oral group) was 1.31 (95% confidence interval; 0.88, 1.94), with no significant difference.

Conclusions: No significant difference was observed in the risk of hospitalization for patients with schizophrenia treated with laxatives between the BNS patch and BNS oral groups. The effectiveness of antipsychotic patches in these patients warrants further research that considers factors such as patch preference in the elderly.

Aim: Suvorexant is an orexin receptor antagonist (ORA) for the treatment of insomnia. The antagonistic action of suvorexant on orexin receptors is associated with an increase in rapid eye movement (REM) sleep, which can potentially lead to nightmares depending on the patient's condition. However, the precise risk factors for nightmares among patients taking ORAs, such as suvorexant, have yet to be identified. In this retrospective study, we aimed to identify the risk factors for the development of nightmares in patients treated with suvorexant.

Methods: The risk factors were determined by comparing parameters between the nightmare group and the nonnightmare group. This study included 440 patients who received suvorexant at the University of Miyazaki Hospital from April 2014 to January 2021.

Results: We found that 9.1% (n = 40) of the patients experienced suvorexant-induced nightmares. There was a significant difference in the median age, which was lower in the nightmare group than in the nonnightmare group (p < 0.01). Furthermore, both multiple logistic regression analysis and Cox proportional hazards regression analysis revealed increased odds ratios for nightmares for individuals aged 20-39 years.

Conclusions: This study revealed that elderly patients taking suvorexant had fewer nightmares than nonelderly patients did.

Aim: The Internet Gaming Disorder Scale is a 9-item screening instrument developed based on the diagnostic criteria for Internet Gaming Disorder (IGD) in the DSM-5. This study aimed to examine the reliability and validity of the Internet Gaming Disorder Scale for children (IGDS-C) in Japanese clinical and nonclinical populations.

Methods: The study included clinical outpatients aged 9-29 with problematic game use and nonclinical adolescents aged 12-18 who played online games at least once a week. Reliability was examined by calculating internal consistency and test-retest reliability. Validity was assessed using Spearman's correlation and Confirmatory Factor Analysis (CFA).

Results: A total of 746 participants (93 clinical, 653 nonclinical) were eligible for statistical analysis. Reliability results revealed acceptable internal consistency (Cronbach's α = 0.87) and test-retest reliability (intraclass correlation coefficient = 0.62). CFA results (Comparative Fit Index = 0.92, Tucker-Lewis Index = 0.90, root mean square error of approximation = 0.10, standardized root mean square residual = 0.05, factor loadings = 0.59-0.71) and significant correlations with the GAMES test, psychological distress, and gaming hours verified the validity of the IGDS-C.

Conclusion: The study verified the reliability and validity of the IGDS-C in Japanese clinical and nonclinical participants, suggesting that it generally reflects the severity of IGD well.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder. Some children with ASD show enhanced cortisol response to stress. BTBR T⁺ Itpr3^tf/J (BTBR) mice, an ASD model, display behavior consistent with the three diagnostic categories of ASD and exhibit an exaggerated response to stress in adulthood. However, it remains unclear how basal corticosterone levels change and how the hypothalamic-pituitary-adrenal axis responds to stress during the early life stages in BTBR mice. In this study, we found that basal corticosterone levels showed characteristic changes, peaking at weaning during postnatal development in both BTBR and control C57BL/6J (B6J) mice. Furthermore, we observed higher corticosterone and corticotropin-releasing hormone levels in BTBR mice than in B6J mice following acute stress exposure during weaning; however, adrenocorticotropic hormone levels were lower in BTBR mice. Glucocorticoid receptor mRNA expression levels in the hippocampus and lateral septum after stress were higher in BTBR mice than in B6J mice. This study documented changes in corticosterone levels at baseline during postnatal development in mice and showed that BTBR mice exhibited disrupted stress responses at weaning.

Aim: Selective serotonin reuptake inhibitors are thought to exert a clinical effect through various mechanisms, including through alteration in synaptic plasticity. Repetitive transcranial magnetic stimulation can induce temporary changes in synaptic excitability in cerebral cortex that resemble long-term potentiation and long-term depression that serve as a measure of synaptic plasticity in vivo. A version of repetitive transcranial magnetic stimulation called continuous theta burst stimulation can induce inhibition of cortical excitability that can be measured through a motor evoked potential. Previous work has suggested that this response can be modulated by administration of selective serotonin reuptake inhibitors.

Method: Thirty-one healthy volunteers received both fluoxetine 20 mg and placebo in randomly ordered sessions, followed by spaced continuous theta burst stimulation to motor cortex. Changes in Motor Evoked Potentials were then recorded over 60 min.

Results: The response to spaced continuous theta burst stimulation did not differ significantly between fluoxetine and placebo sessions. Spaced continuous theta burst stimulation produced a paradoxical excitatory response in an unexpected number of participants.

Conclusion: A single dose of fluoxetine 20 mg does not influence the response to continuous theta burst stimulation. Previous results suggesting an effect of selective serotonin reuptake inhibitors on inhibitory non-invasive brain stimulation protocols may be due to insufficiently large sample sizes.

Aim: This study aimed to elucidate the effects of repetitive transcranial magnetic stimulation (rTMS) on weight, body mass index (BMI), and lipid metabolism in patients with treatment-resistant depression (TRD).

Methods: This retrospective observational study included patients with TRD who received rTMS treatment at the Jikei University Hospital from September 2018 to August 2021. The patients were diagnosed based on the DSM-5 and ICD-10 criteria and treated using the NeuroStar TMS System. For 3-6 weeks, 10-Hz rTMS was administered to the left dorsolateral prefrontal cortex at 120% motor threshold. The primary outcomes were changes in weight and BMI, whereas the secondary outcomes included changes in total, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) cholesterol levels, thyroid function indicators, as well as HAMD-17, HAMD-24, and Montgomery-Åsberg Depression Rating Scale (MADRS) scores. Statistical analysis was conducted using paired t-tests and repeated measures ANOVA.

Results: Among the 34 patients (20 men and 14 women) included, no significant changes were observed in weight or BMI after rTMS treatment (average weight reduction: -0.50 kg, 95% CI: -0.14 to 0.56, p = 0.24; average BMI reduction: -0.21, 95% CI: -0.10 to 0.61, p = 0.15). However, significant reductions in total, HDL, and LDL cholesterol levels and FT4 were observed. Furthermore, the HAMD-17, HAMD-24, and MADRS scores significantly increased post-treatment.

Conclusion: rTMS treatment did not affect weight or BMI in patients with TRD but is believed to improve lipid metabolism.

Schizophrenia causes cognitive dysfunction. The assessment of cognitive function is important in the treatment of schizophrenia. The Wechsler Adult Intelligence Scale (WAIS) is used to assess cognitive function in patients with psychiatric disorders. For clinical use, a short form of the WAIS-III was developed in Japan specifically for patients with schizophrenia, allowing the estimation of IQ using the Similarities and Symbol Search. In the present study, we examined whether the same tasks could be used on the short form of the WAIS-IV. The subjects were 110 patients with schizophrenia. Using methods consistent with those employed in developing the WAIS-III short form, exploratory factor analysis was conducted to confirm the factor structure of intelligence in patients with schizophrenia. Regression analysis demonstrated that the Similarities and Symbol Search had sufficient explanatory power for estimating full-scale IQ. Additionally, correlation analysis revealed a positive relationship between estimated IQ, and social functioning. These findings indicate that the short form of the WAIS-IV, consisting of the Similarities and Symbol Search, meets the necessary criteria for practical use. This short form provides an efficient alternative for estimating cognitive function in patients with schizophrenia while maintaining enough validity.

Aim: There are limited reports regarding psychotropic prescriptions in first-visit patients with major depressive disorder (MDD). The objective of this study is to clarify the prescription patterns of psychotropics and their association with symptoms among first-visit patients with MDD in Japan.

Methods: In this cross-sectional analysis, we examined 376 first-visit patients diagnosed with MDD. Depressive symptoms were evaluated using the Quick Inventory of Depressive Symptomatology Japanese version (QIDS-J). To assess personality traits, we administered the Japanese version of the Ten Item Personality Inventory (TIPI-J), and psychotic symptoms were evaluated using the PRIME Screen-Revised (PS-J).

Results: Among the first-visit patients with MDD, 31.4% (118/376) were prescribed antidepressants, and 18.1% (68/376) received benzodiazepines. Overall, 40.2% (151/376) of the patients were prescribed at least one psychotropic medication. In a multivariate logistic regression model using the forced entry method, missing data on educational attainment and the view of myself domain of the QIDS-J were negatively associated, while the concentration/decision-making domain of the QIDS-J was positively associated with antidepressant prescription.

Conclusion: More than half of the first-visit patients did not receive any psychotropic medication. Psychiatrists appear to consider specific symptoms and personality traits when deciding whether to prescribe medications, which may also be influenced by patient preferences. Further studies, including longitudinal analyses, are needed to explore these associations in more detail.

Although methamphetamine (METH) and other addictive substance use disorders are a major social problem worldwide, appropriate pharmacotherapies have not yet been discovered. Subtype-nonselective opioid receptor antagonists, such as naltrexone (NTX), have been reported to suppress METH addiction, but unclear are the opioid receptor subtypes that are involved in this beneficial effect. To clarify the role of μ-opioid receptors (MOPs), we examined effects of the novel nonpeptidic MOP-selective antagonist UD-030 on the acquisition and expression of METH-induced conditioned place preference (CPP) using behavioral tests in C57BL/6J mice. UD-030 was found to inhibit both the acquisition and expression of METH-induced CPP in a dose-dependent manner, with effects comparable to those observed with NTX. These findings suggest that UD-030 has the potential to mitigate METH-related reward mechanisms and may serve as a promising candidate for MOP-selective pharmacotherapy targeting METH addiction.