Naoko Iida, Junko Ono, Yuki Mizuhara, Jin Narumoto
Abstract Aim Patients with anorexia nervosa (AN) sometimes undergo a chronic course, and they hardly maintain social participation. Work and social adjustment impairments are generally significantly associated with the clinical symptoms of eating disorders. Psychopathologies associated with the subjective social difficulties of patients with AN have been unclear. This study examined the association between AN psychopathologies and work and social adjustment impairments in adult female patients with AN. Methods This study included 36 Japanese adult female patients with AN who completed the Work and Social Adjustment Scale (WSAS) and the Eating Disorder Inventory‐2 (EDI‐2). Spearman's rank correlation coefficient was used to assess correlations between WSAS and EDI‐2 or demographic variables. Results The mean age was 31.8 years, the mean current body mass index was 13.4 kg/m 2 , and the median illness duration was 5 years. Patients demonstrated social difficulties, especially in social leisure activities. The total WSAS scores were significantly correlated with EDI‐2 “impulse regulation” and “asceticism.” WSAS “social leisure” was significantly correlated with EDI‐2 “bulimia,” “interoceptive awareness,” “impulse regulation,” and “asceticism.” Conclusion Psychopathologies, such as impulse regulation, asceticism, and interoceptive awareness, may be related factors to social difficulties. Emotion regulation, such as impulse regulation and emotional awareness, could be an important realm of treatment not only for psychopathology but also for social functioning in patients with AN.
{"title":"The subjective assessment of work and social adjustment impairments and associated psychopathologies in Japanese adult female patients with anorexia nervosa","authors":"Naoko Iida, Junko Ono, Yuki Mizuhara, Jin Narumoto","doi":"10.1002/pcn5.151","DOIUrl":"https://doi.org/10.1002/pcn5.151","url":null,"abstract":"Abstract Aim Patients with anorexia nervosa (AN) sometimes undergo a chronic course, and they hardly maintain social participation. Work and social adjustment impairments are generally significantly associated with the clinical symptoms of eating disorders. Psychopathologies associated with the subjective social difficulties of patients with AN have been unclear. This study examined the association between AN psychopathologies and work and social adjustment impairments in adult female patients with AN. Methods This study included 36 Japanese adult female patients with AN who completed the Work and Social Adjustment Scale (WSAS) and the Eating Disorder Inventory‐2 (EDI‐2). Spearman's rank correlation coefficient was used to assess correlations between WSAS and EDI‐2 or demographic variables. Results The mean age was 31.8 years, the mean current body mass index was 13.4 kg/m 2 , and the median illness duration was 5 years. Patients demonstrated social difficulties, especially in social leisure activities. The total WSAS scores were significantly correlated with EDI‐2 “impulse regulation” and “asceticism.” WSAS “social leisure” was significantly correlated with EDI‐2 “bulimia,” “interoceptive awareness,” “impulse regulation,” and “asceticism.” Conclusion Psychopathologies, such as impulse regulation, asceticism, and interoceptive awareness, may be related factors to social difficulties. Emotion regulation, such as impulse regulation and emotional awareness, could be an important realm of treatment not only for psychopathology but also for social functioning in patients with AN.","PeriodicalId":74405,"journal":{"name":"PCN reports : psychiatry and clinical neurosciences","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135634606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Bin Kimura (1931–2021), the Japanese anthropological psychopathologist and philosopher, attached importance to clinical impressions at psychiatric consultations in order to diagnose mental diseases precisely, and thus proposed his original theory of time structure. According to Kimura's theory of time structure, whether we live by giving weight to the past, the present, or the future can be called “time structure,” and is essentially related to the way we live with others and experience the world. We can obtain some signs for diagnosing mental diseases from the viewpoint of the time structure of each patient. “Ante‐festum” is the time structure in which one lives ahead to the future, and is typical of schizophrenic patients. “Post‐festum” is the time structure in which one is late for oneself, and is typical of patients with endogenous depression. “Intra‐festum” is the time structure in which one lives directly in the present, and is typical of patients with epilepsy or bipolar disorders. The anthropological diagnosis according to Kimura's theory of time structure could complement the operational diagnostic criteria, such as the Diagnostic and Statistical Manual of Mental Disorders and the International Classification of Diseases and Related Health Problems , in daily clinical practice. For example, Kimura's theory of time structure could exercise its ability to discriminate between endogenous and neurotic depression, and between schizophrenia and other delusional psychoses. The theory of time structure and anthropological diagnosis which Bin Kimura proposed in the late 20th century can give us many hints for assessing patients with mental diseases even today.
{"title":"The anthropological method for diagnosing mental diseases: On the theory of time structure of Bin Kimura","authors":"Shun'ichi Noma","doi":"10.1002/pcn5.150","DOIUrl":"https://doi.org/10.1002/pcn5.150","url":null,"abstract":"Abstract Bin Kimura (1931–2021), the Japanese anthropological psychopathologist and philosopher, attached importance to clinical impressions at psychiatric consultations in order to diagnose mental diseases precisely, and thus proposed his original theory of time structure. According to Kimura's theory of time structure, whether we live by giving weight to the past, the present, or the future can be called “time structure,” and is essentially related to the way we live with others and experience the world. We can obtain some signs for diagnosing mental diseases from the viewpoint of the time structure of each patient. “Ante‐festum” is the time structure in which one lives ahead to the future, and is typical of schizophrenic patients. “Post‐festum” is the time structure in which one is late for oneself, and is typical of patients with endogenous depression. “Intra‐festum” is the time structure in which one lives directly in the present, and is typical of patients with epilepsy or bipolar disorders. The anthropological diagnosis according to Kimura's theory of time structure could complement the operational diagnostic criteria, such as the Diagnostic and Statistical Manual of Mental Disorders and the International Classification of Diseases and Related Health Problems , in daily clinical practice. For example, Kimura's theory of time structure could exercise its ability to discriminate between endogenous and neurotic depression, and between schizophrenia and other delusional psychoses. The theory of time structure and anthropological diagnosis which Bin Kimura proposed in the late 20th century can give us many hints for assessing patients with mental diseases even today.","PeriodicalId":74405,"journal":{"name":"PCN reports : psychiatry and clinical neurosciences","volume":"44 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135635359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Aim Parents' emotions towards a child are extremely important. The Scale of Parent‐to‐Child Emotions (SPCE) consists of five basic and four self‐conscious emotion domains for assessment of parental emotional states. Abridgement of the SPCE is needed for research and clinical settings. Methods Our previous investigational data for SPCE development were used in this study. The sample of 2336 fathers and 2264 mothers, whose eldest child's age was up to 12 years old, was analyzed. Total information for each pair (form) of items corresponding to a latent trait ( θ ) was calculated. The form with the greatest amount of total information was selected as the best for each domain. In addition, relative efficiency for each form and correlations of raw sum scores in classical test theory (CTT) for short forms with factor scores in item response theory (IRT) were calculated. Results The SPCE was shortened to 18 items by selecting two items each for nine domains. Correlations of raw sum scores in CTT for short forms with factor scores in IRT were correlated strongly and significantly. Conclusion This abridged form of the scale, the SPCE‐18, may be applicable in a busy clinical setting or research works to investigate the trajectory of parent‐to‐child emotions across a long span of time.
{"title":"A Scale of Parent‐to‐Child Emotions (SPCE): Development and validation of a short form","authors":"Ayako Hada, Yukiko Ohashi, Yuriko Usui, Toshinori Kitamura","doi":"10.1002/pcn5.148","DOIUrl":"https://doi.org/10.1002/pcn5.148","url":null,"abstract":"Abstract Aim Parents' emotions towards a child are extremely important. The Scale of Parent‐to‐Child Emotions (SPCE) consists of five basic and four self‐conscious emotion domains for assessment of parental emotional states. Abridgement of the SPCE is needed for research and clinical settings. Methods Our previous investigational data for SPCE development were used in this study. The sample of 2336 fathers and 2264 mothers, whose eldest child's age was up to 12 years old, was analyzed. Total information for each pair (form) of items corresponding to a latent trait ( θ ) was calculated. The form with the greatest amount of total information was selected as the best for each domain. In addition, relative efficiency for each form and correlations of raw sum scores in classical test theory (CTT) for short forms with factor scores in item response theory (IRT) were calculated. Results The SPCE was shortened to 18 items by selecting two items each for nine domains. Correlations of raw sum scores in CTT for short forms with factor scores in IRT were correlated strongly and significantly. Conclusion This abridged form of the scale, the SPCE‐18, may be applicable in a busy clinical setting or research works to investigate the trajectory of parent‐to‐child emotions across a long span of time.","PeriodicalId":74405,"journal":{"name":"PCN reports : psychiatry and clinical neurosciences","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135644128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Simon G. D. Ruffell, Max Crosland‐Wood, Rob Palmer, Nige Netzband, WaiFung Tsang, Brandon Weiss, Sam Gandy, Tessa Cowley‐Court, Andreas Halman, Diana McHerron, Angelina Jong, Tom Kennedy, Eleanor White, Daniel Perkins, Devin B. Terhune, Jerome Sarris
Abstract Ayahuasca is a psychedelic plant brew originating from the Amazon rainforest. It is formed from two basic components, the Banisteriopsis caapi vine and a plant containing the potent psychedelic dimethyltryptamine (DMT), usually Psychotria viridis . Here we review the history of ayahuasca and describe recent work on its pharmacology, phenomenological responses, and clinical applications. There has been a significant increase in interest in ayahuasca since the turn of the millennium. Anecdotal evidence varies significantly, ranging from evangelical accounts to horror stories involving physical and psychological harm. The effects of the brew on personality and mental health outcomes are discussed in this review. Furthermore, phenomenological analyses of the ayahuasca experience are explored. Ayahuasca is a promising psychedelic agent that warrants greater empirical attention regarding its basic neurochemical mechanisms of action and potential therapeutic application.
{"title":"Ayahuasca: A review of historical, pharmacological, and therapeutic aspects","authors":"Simon G. D. Ruffell, Max Crosland‐Wood, Rob Palmer, Nige Netzband, WaiFung Tsang, Brandon Weiss, Sam Gandy, Tessa Cowley‐Court, Andreas Halman, Diana McHerron, Angelina Jong, Tom Kennedy, Eleanor White, Daniel Perkins, Devin B. Terhune, Jerome Sarris","doi":"10.1002/pcn5.146","DOIUrl":"https://doi.org/10.1002/pcn5.146","url":null,"abstract":"Abstract Ayahuasca is a psychedelic plant brew originating from the Amazon rainforest. It is formed from two basic components, the Banisteriopsis caapi vine and a plant containing the potent psychedelic dimethyltryptamine (DMT), usually Psychotria viridis . Here we review the history of ayahuasca and describe recent work on its pharmacology, phenomenological responses, and clinical applications. There has been a significant increase in interest in ayahuasca since the turn of the millennium. Anecdotal evidence varies significantly, ranging from evangelical accounts to horror stories involving physical and psychological harm. The effects of the brew on personality and mental health outcomes are discussed in this review. Furthermore, phenomenological analyses of the ayahuasca experience are explored. Ayahuasca is a promising psychedelic agent that warrants greater empirical attention regarding its basic neurochemical mechanisms of action and potential therapeutic application.","PeriodicalId":74405,"journal":{"name":"PCN reports : psychiatry and clinical neurosciences","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135835613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Aim Misophonia is a sound sensitivity disorder characterized by an unusually strong aversion to a specific class of sounds—often human bodily sounds (e.g., chewing). These sounds can cause intense negative emotions which can cause profound difficulties in everyday life. The condition is linked with higher rates of anxiety and depression, and here we ask whether it co‐occurs with elevated self‐harm and suicidal thinking. Methods We measured self‐harm and misophonia in the general population by examining a birth cohort sample from the Avon Longitudinal Study of Parents and Children (ALSPAC). We screened them for misophonia as adults, then analyzed their earlier data on well‐being, self‐harm, and suicidal thinking. Results Adults with misophonia had significantly higher rates of self‐harm and suicidal ideation, as well as poorer well‐being in a number of different measures at ages 16–17 and 23–24 years. Female misophonics were particularly at risk, from as early as their teenage years, though males, too, show elevated self‐harm at 24 years compared to nonmisophonic peers. Conclusion Our data provide evidence of elevated risks of self‐harm associated with misophonia and suggest the need for greater recognition and treatment pathways.
{"title":"Misophonia, self‐harm and suicidal ideation","authors":"Julia Simner, Louisa J. Rinaldi","doi":"10.1002/pcn5.142","DOIUrl":"https://doi.org/10.1002/pcn5.142","url":null,"abstract":"Abstract Aim Misophonia is a sound sensitivity disorder characterized by an unusually strong aversion to a specific class of sounds—often human bodily sounds (e.g., chewing). These sounds can cause intense negative emotions which can cause profound difficulties in everyday life. The condition is linked with higher rates of anxiety and depression, and here we ask whether it co‐occurs with elevated self‐harm and suicidal thinking. Methods We measured self‐harm and misophonia in the general population by examining a birth cohort sample from the Avon Longitudinal Study of Parents and Children (ALSPAC). We screened them for misophonia as adults, then analyzed their earlier data on well‐being, self‐harm, and suicidal thinking. Results Adults with misophonia had significantly higher rates of self‐harm and suicidal ideation, as well as poorer well‐being in a number of different measures at ages 16–17 and 23–24 years. Female misophonics were particularly at risk, from as early as their teenage years, though males, too, show elevated self‐harm at 24 years compared to nonmisophonic peers. Conclusion Our data provide evidence of elevated risks of self‐harm associated with misophonia and suggest the need for greater recognition and treatment pathways.","PeriodicalId":74405,"journal":{"name":"PCN reports : psychiatry and clinical neurosciences","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135458570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-05eCollection Date: 2023-09-01DOI: 10.1002/pcn5.138
Mai Iwanaga, Sosei Yamaguchi, Sayaka Sato, Kiyoaki Nakanishi, Erisa Nishiuchi, Michiyo Shimodaira, Yugan So, Kaori Usui, Chiyo Fujii
Aim: This study aimed to clarify the association between treatment status (untreated or treated) at the start of community mental health outreach services and service intensity.
Methods: This retrospective cohort study was conducted using the Tokorozawa City mental health outreach service users' data. Treatment status at the start of service (exposure variable) and the service intensity (outcome variables) were taken from clinical records. Poisson regression and linear regression analyses were conducted. The frequency of medical or social service use 12 months after service initiation was also calculated. This study was approved by the Research Ethics Committee at the National Center of Neurology and Psychiatry (No. A2020-081).
Results: Of 89 people, 37 (42%) were untreated. Family members in the untreated group were more likely to be targets or recipients of services than in the treated group (b = 0.707, p < 0.001, Bonferroni-adjusted p < 0.001). Compared to the treated group, the untreated group received fewer services themselves (b = -0.290, p = 0.005), and also fewer services by telephone (b = -0.252, p = 0.012); by contrast, they received more services at the health center (b = 0.478, p = 0.031) and for family support (b = 0.720, p = 0.024), but these significant differences disappeared after Bonferroni adjustment. At least 11% of people in the untreated group were hospitalized and 35% were outpatients 12 months after service initiation.
Conclusion: Family involvement may be a key service component for untreated people. The service intensity with and without treatment may vary by service location.
本研究旨在厘清社区心理健康外展服务开始时的治疗状况(未治疗或治疗)与服务强度之间的关系。本研究采用北小泽市心理健康外展服务使用者资料进行回顾性队列研究。服务开始时的治疗状态(暴露变量)和服务强度(结果变量)取自临床记录。进行泊松回归和线性回归分析。还计算了服务开始12个月后使用医疗或社会服务的频率。本研究已获国家神经病学和精神病学中心研究伦理委员会批准(编号:No。A2020 081)。89例患者中，37例(42%)未接受治疗。与治疗组相比，未治疗组的家庭成员更有可能成为服务的目标或接受者(b = 0.707, p < 0.001，经Bonferroni调整的p < 0.001)。与治疗组相比，未治疗组接受的服务较少(b = - 0.290, p = 0.005)，电话服务较少(b = - 0.252, p = 0.012);相比之下，他们在卫生中心获得的服务(b = 0.478, p = 0.031)和家庭支持(b = 0.720, p = 0.024)更多，但经Bonferroni调整后，这些显著差异消失。在服务开始12个月后，未治疗组中至少有11%的人住院，35%的人门诊。家庭参与可能是为未接受治疗的人提供服务的关键组成部分。使用和不使用处理的使用强度可能因使用地点而异。
{"title":"Service intensity of community mental health outreach among people with untreated mental health problems in Japan: A retrospective cohort study.","authors":"Mai Iwanaga, Sosei Yamaguchi, Sayaka Sato, Kiyoaki Nakanishi, Erisa Nishiuchi, Michiyo Shimodaira, Yugan So, Kaori Usui, Chiyo Fujii","doi":"10.1002/pcn5.138","DOIUrl":"10.1002/pcn5.138","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to clarify the association between treatment status (untreated or treated) at the start of community mental health outreach services and service intensity.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted using the Tokorozawa City mental health outreach service users' data. Treatment status at the start of service (exposure variable) and the service intensity (outcome variables) were taken from clinical records. Poisson regression and linear regression analyses were conducted. The frequency of medical or social service use 12 months after service initiation was also calculated. This study was approved by the Research Ethics Committee at the National Center of Neurology and Psychiatry (No. A2020-081).</p><p><strong>Results: </strong>Of 89 people, 37 (42%) were untreated. Family members in the untreated group were more likely to be targets or recipients of services than in the treated group (<i>b</i> = 0.707, <i>p</i> < 0.001, Bonferroni-adjusted <i>p</i> < 0.001). Compared to the treated group, the untreated group received fewer services themselves (<i>b</i> = -0.290, <i>p</i> = 0.005), and also fewer services by telephone (<i>b</i> = -0.252, <i>p</i> = 0.012); by contrast, they received more services at the health center (<i>b</i> = 0.478, <i>p</i> = 0.031) and for family support (<i>b</i> = 0.720, <i>p</i> = 0.024), but these significant differences disappeared after Bonferroni adjustment. At least 11% of people in the untreated group were hospitalized and 35% were outpatients 12 months after service initiation.</p><p><strong>Conclusion: </strong>Family involvement may be a key service component for untreated people. The service intensity with and without treatment may vary by service location.</p>","PeriodicalId":74405,"journal":{"name":"PCN reports : psychiatry and clinical neurosciences","volume":" ","pages":"e138"},"PeriodicalIF":0.0,"publicationDate":"2023-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11114434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45164942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dennis Bomansang Daliri, Agani Afaya, Richard Adongo Afaya, Nancy Abagye
Abstract Introduction This study examined postpartum depression (PPD) among mothers in the Bawku municipality of Ghana, aiming to assess its prevalence and associated risk factors. Methods A total of 242 women, 2–12 weeks postpartum, were randomly recruited for this cross‐sectional analytical study. The Edinburgh Postnatal Depression Scale was used for depression screening, and multivariate logistic regression analysis was employed to assess the factors associated with PPD. Results The study showed that 34.7% of the postpartum mothers were within the age range of 25–29, with a mean age of 27.9 (standard deviation [SD] ± 6.33). The prevalence of PPD was 50.4% (95% confidence interval [CI] 43.9–56.9). Several significant risk factors were identified, including inadequate prenatal visits (adjusted odds ratio [aOR] = 13.44, 95% CI 3.66–49.37, P < 0.001), obstetric complications (aOR = 3.39, 95% CI 1.23–11.19, P = 0.019), less than 3 weeks postpartum (aOR = 8.14, 95% CI 1.95, 33.94, P = 0.004), 6–8 weeks postpartum (aOR = 7.72, 95% CI 1.71–34.80, P = 0.008), and stressful life events (aOR = 3.30, 95% CI 1.23–8.89, P = 0.018). Conclusion The study concluded that the prevalence of PPD in the Bawku municipality is higher than previously reported in Ghana, emphasizing the need for early identification of pregnant women at risk for PPD.
摘要:本研究调查了加纳博库市母亲的产后抑郁症(PPD)，旨在评估其患病率和相关危险因素。方法随机招募242名产后2-12周的妇女进行横断面分析研究。采用爱丁堡产后抑郁量表进行抑郁筛查，并采用多因素logistic回归分析评估PPD相关因素。结果34.7%的产后母亲年龄在25 ~ 29岁之间，平均年龄27.9岁(标准差[SD]±6.33)。PPD患病率为50.4%(95%可信区间[CI] 43.9 ~ 56.9)。确定了几个重要的危险因素，包括产前检查不足(校正优势比[aOR] = 13.44, 95% CI 3.66-49.37, P <0.001)、产科并发症(aOR = 3.39, 95% CI 1.23-11.19, P = 0.019)、产后不到3周(aOR = 8.14, 95% CI 1.95, 33.94, P = 0.004)、产后6-8周(aOR = 7.72, 95% CI 1.71-34.80, P = 0.008)、生活压力事件(aOR = 3.30, 95% CI 1.23-8.89, P = 0.018)。
{"title":"Postpartum depression: The prevalence and associated factors among women attending postnatal clinics in the Bawku municipality, Upper East Region of Ghana","authors":"Dennis Bomansang Daliri, Agani Afaya, Richard Adongo Afaya, Nancy Abagye","doi":"10.1002/pcn5.143","DOIUrl":"https://doi.org/10.1002/pcn5.143","url":null,"abstract":"Abstract Introduction This study examined postpartum depression (PPD) among mothers in the Bawku municipality of Ghana, aiming to assess its prevalence and associated risk factors. Methods A total of 242 women, 2–12 weeks postpartum, were randomly recruited for this cross‐sectional analytical study. The Edinburgh Postnatal Depression Scale was used for depression screening, and multivariate logistic regression analysis was employed to assess the factors associated with PPD. Results The study showed that 34.7% of the postpartum mothers were within the age range of 25–29, with a mean age of 27.9 (standard deviation [SD] ± 6.33). The prevalence of PPD was 50.4% (95% confidence interval [CI] 43.9–56.9). Several significant risk factors were identified, including inadequate prenatal visits (adjusted odds ratio [aOR] = 13.44, 95% CI 3.66–49.37, P < 0.001), obstetric complications (aOR = 3.39, 95% CI 1.23–11.19, P = 0.019), less than 3 weeks postpartum (aOR = 8.14, 95% CI 1.95, 33.94, P = 0.004), 6–8 weeks postpartum (aOR = 7.72, 95% CI 1.71–34.80, P = 0.008), and stressful life events (aOR = 3.30, 95% CI 1.23–8.89, P = 0.018). Conclusion The study concluded that the prevalence of PPD in the Bawku municipality is higher than previously reported in Ghana, emphasizing the need for early identification of pregnant women at risk for PPD.","PeriodicalId":74405,"journal":{"name":"PCN reports : psychiatry and clinical neurosciences","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135304865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Background Delayed neuropsychiatric sequelae (DNS) occurs in 10%–30% of acute carbon monoxide poisoning cases. Patients with this condition present higher brain dysfunction. Hyperbaric oxygen (HBO) therapy was reportedly an effective treatment for DNS in the acute phase. Favorable predictive factors affecting the prognosis of patients with DNS after HBO therapy include younger age and longer interictal periods. However, the relationship between these factors and neuroimaging findings remains unclear. Case Presentation The patient was a 59‐year‐old man with DNS, who developed major depressive disorder and attempted suicide with charcoal briquettes. He was diagnosed with carbon monoxide poisoning and underwent acute HBO therapy. After a 1‐month lucid period, the patient developed intermittent carbon monoxide poisoning with cognitive dysfunction, following which HBO therapy was re‐initiated. Following treatment, the patient returned to work for 10 years. Frontal lobe hypoperfusion, measured by single‐photon emission computed tomography and cognitive impairment, improved with HBO therapy. However, magnetic resonance imaging revealed brain volume atrophy over time. Conclusion This study reported a case of DNS that completely resolved within a 10‐year follow‐up period. Cerebral blood flow reduction, mainly in the frontal lobe, improved along with cognitive recovery during HBO therapy. Despite gradually progressive brain atrophy over the past decade, no noted deficits in cerebral blood flow were observed in the frontal lobes. These findings suggest that improvement in cerebral blood flow during HBO therapy and its retention may be factors associated with a favorable prognosis in patients with DNS.
{"title":"Delayed neuropsychiatric sequelae with improvement of decreased cerebral bold flow by single‐photon emission computed tomography during hyperbaric oxygen therapy: A case report with a 10‐year follow‐up","authors":"Kosuke Hagiwara, Toshio Matsubara, Shin Nakagawa","doi":"10.1002/pcn5.139","DOIUrl":"https://doi.org/10.1002/pcn5.139","url":null,"abstract":"Abstract Background Delayed neuropsychiatric sequelae (DNS) occurs in 10%–30% of acute carbon monoxide poisoning cases. Patients with this condition present higher brain dysfunction. Hyperbaric oxygen (HBO) therapy was reportedly an effective treatment for DNS in the acute phase. Favorable predictive factors affecting the prognosis of patients with DNS after HBO therapy include younger age and longer interictal periods. However, the relationship between these factors and neuroimaging findings remains unclear. Case Presentation The patient was a 59‐year‐old man with DNS, who developed major depressive disorder and attempted suicide with charcoal briquettes. He was diagnosed with carbon monoxide poisoning and underwent acute HBO therapy. After a 1‐month lucid period, the patient developed intermittent carbon monoxide poisoning with cognitive dysfunction, following which HBO therapy was re‐initiated. Following treatment, the patient returned to work for 10 years. Frontal lobe hypoperfusion, measured by single‐photon emission computed tomography and cognitive impairment, improved with HBO therapy. However, magnetic resonance imaging revealed brain volume atrophy over time. Conclusion This study reported a case of DNS that completely resolved within a 10‐year follow‐up period. Cerebral blood flow reduction, mainly in the frontal lobe, improved along with cognitive recovery during HBO therapy. Despite gradually progressive brain atrophy over the past decade, no noted deficits in cerebral blood flow were observed in the frontal lobes. These findings suggest that improvement in cerebral blood flow during HBO therapy and its retention may be factors associated with a favorable prognosis in patients with DNS.","PeriodicalId":74405,"journal":{"name":"PCN reports : psychiatry and clinical neurosciences","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135298461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The use of psychotropic polypharmacy, defined as the use of medication from two or more psychotropic classes, is quite common in clinical practice despite limited evidence of efficacy and mounting safety concerns. Attention-deficit/hyperactivity disorder (ADHD) is one of the most disabling and common psychiatric disorders, persisting from childhood to adulthood. Individuals with ADHD are known to have many comorbid psychopathologies, making them candidates for psychotropic polypharmacy.1 In Japan, the approved psychotropic medications and the diagnosed disorders differ between pediatric and adult populations. Therefore, this study aimed to explore the utilization of multiple classes of psychotropics among patients undergoing ADHD pharmacotherapy, specifically targeting the adult population in Japan. A retrospective study was conducted using the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB), which covered 99.9% of public health insurance claims from hospitals, 97.9% from clinics, and 99.9% from pharmacies as of May 2015. The sampling data set of outpatients consisted of 1% of all claims data that were randomly extracted based on standard demographic characteristics in terms of age and sex in Japan, and included anonymized data on diagnoses, prescribed medications, examinations conducted, age group, and sex. Since the sensitivity of diagnoses in the database is generally low,2, 3 this study focused on pharmacotherapy. Data on individuals aged 20 years and over prescribed any of three ADHD medications as of October 2019 were retrieved from the NDB. The number of psychotropic medications prescribed concurrently with ADHD medications—atomoxetine, guanfacine, and the osmotic-controlled-release oral delivery system methylphenidate—was identified. The drug classification, including antipsychotics, antidepressants, anxiolytics/hypnotics, and mood stabilizers, is shown in Supporting Information: Table S1. DB Browser for SQLite Version 3.12.2 for macOS (https://sqlitebrowser.org) was used for analysis. Less than half of individuals in their 20s and nearly 20% of those over age 30 were prescribed ADHD medications alone. Among patients in their 20s, anxiolytics/hypnotics, antidepressants, and antipsychotics were prescribed at similar rates, while among those aged 30 and above, antidepressants and anxiolytics/hypnotics were more frequently prescribed (Table 1). Based on these observations, two potential scenarios emerge. The first one is that ADHD medications were prescribed to those who meet the diagnostic criteria for ADHD. In this case, adults with ADHD might exhibit multiple psychiatric symptoms to require polypharmacy of psychiatric medications. The second scenario is that pharmacotherapy for ADHD was being administered to individuals who might not fully meet the ADHD diagnostic criteria, but who are experiencing specific symptoms, such as issues with attention, impulsivity, and hyperactivity. The author and coll
多种精神药物的使用，定义为使用两种或两种以上精神药物类别的药物，在临床实践中相当普遍，尽管有效性证据有限，安全性担忧日益增加。注意缺陷/多动障碍(ADHD)是一种最致残和最常见的精神疾病，从童年持续到成年。众所周知，ADHD患者有许多共病精神病理，使他们成为精神药物的候选人在日本，批准的精神药物和诊断的疾病在儿童和成人人群中有所不同。因此，本研究旨在探讨在接受ADHD药物治疗的患者中，多类精神药物的使用情况，特别针对日本的成年人群。利用日本国家健康保险索赔和特定健康检查数据库(NDB)进行了一项回顾性研究，截至2015年5月，该数据库涵盖了来自医院的99.9%、诊所的97.9%和药店的99.9%的公共健康保险索赔。门诊患者的抽样数据集占所有索赔数据的1%，这些数据是根据日本年龄和性别的标准人口统计学特征随机抽取的，包括诊断、处方药物、进行的检查、年龄组和性别的匿名数据。由于数据库中诊断的敏感性通常较低，因此本研究侧重于药物治疗。截至2019年10月，从NDB中检索了年龄在20岁及以上的人的数据，这些人服用了三种ADHD药物中的任何一种。确定了与ADHD药物同时开具的精神药物的数量——阿托西汀、胍法辛和渗透控释口服给药系统哌甲酯。药物分类，包括抗精神病药、抗抑郁药、抗焦虑药/催眠药和情绪稳定药，见辅助信息:表S1。使用DB Browser for SQLite Version 3.12.2 for macOS (https://sqlitebrowser.org)进行分析。不到一半的20多岁的人和近20%的30岁以上的人单独服用了ADHD药物。在20多岁的患者中，抗焦虑药/催眠药、抗抑郁药和抗精神病药的处方率相似，而在30岁及以上的患者中，抗抑郁药和抗焦虑药/催眠药的处方率更高(表1)。基于这些观察，出现了两种可能的情况。第一个是ADHD药物是给那些符合ADHD诊断标准的人开的。在这种情况下，患有多动症的成年人可能表现出多种精神症状，需要多种精神药物治疗。第二种情况是，ADHD的药物治疗是针对那些可能不完全符合ADHD诊断标准，但有特定症状的人进行的，比如注意力不集中、冲动和多动。作者及其同事发现，成年患者自我感知ADHD特征的水平与抑郁症状的严重程度显著相关，4表明仅通过自我管理问卷诊断ADHD可能高估了其患病率，特别是当抑郁状态变得严重时。在考虑开ADHD药物之前，对患者的核心精神问题进行评估是必不可少的，以避免不必要的多重用药。在任何情况下，只要由训练有素的提供者开出处方，使用精神药物组合可能是合理的根据NDB的一项调查，大约40%的ADHD患者是在19岁以后才被诊断出来的考虑到超过70%的日本精神药物患者接受单药或双药处方7，尽管日本在2012年至2018年期间四次降低医疗费用报销，以促进精神药物的合理使用，但抗焦虑药/催眠药的处方率仍然很高8，需要进一步研究涉及ADHD的成人需要多种药物治疗的危险因素并探索预防干预措施药物和其他精神药物。本研究有几个局限性。首先，这项横断面研究可能高估了多药作用，因为它没有考虑到药物转换导致的意外多药作用。其次，关于药物依从性的信息在这个数据集中是不可用的。如果患者没有按照医生的指示服用处方药物，由于症状改善不足，可能会增加额外的药物。第三，NDB没有考虑到整个人口，它只占所有索赔数据的1%。然而，本研究为日本精神类药物与ADHD药物的处方模式提供了有代表性的证据。
{"title":"Prescription patterns of psychotropics for adults treated with ADHD medications: Analysis of the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) of 2019","authors":"Kanako Ishizuka","doi":"10.1002/pcn5.147","DOIUrl":"https://doi.org/10.1002/pcn5.147","url":null,"abstract":"The use of psychotropic polypharmacy, defined as the use of medication from two or more psychotropic classes, is quite common in clinical practice despite limited evidence of efficacy and mounting safety concerns. Attention-deficit/hyperactivity disorder (ADHD) is one of the most disabling and common psychiatric disorders, persisting from childhood to adulthood. Individuals with ADHD are known to have many comorbid psychopathologies, making them candidates for psychotropic polypharmacy.1 In Japan, the approved psychotropic medications and the diagnosed disorders differ between pediatric and adult populations. Therefore, this study aimed to explore the utilization of multiple classes of psychotropics among patients undergoing ADHD pharmacotherapy, specifically targeting the adult population in Japan. A retrospective study was conducted using the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB), which covered 99.9% of public health insurance claims from hospitals, 97.9% from clinics, and 99.9% from pharmacies as of May 2015. The sampling data set of outpatients consisted of 1% of all claims data that were randomly extracted based on standard demographic characteristics in terms of age and sex in Japan, and included anonymized data on diagnoses, prescribed medications, examinations conducted, age group, and sex. Since the sensitivity of diagnoses in the database is generally low,2, 3 this study focused on pharmacotherapy. Data on individuals aged 20 years and over prescribed any of three ADHD medications as of October 2019 were retrieved from the NDB. The number of psychotropic medications prescribed concurrently with ADHD medications—atomoxetine, guanfacine, and the osmotic-controlled-release oral delivery system methylphenidate—was identified. The drug classification, including antipsychotics, antidepressants, anxiolytics/hypnotics, and mood stabilizers, is shown in Supporting Information: Table S1. DB Browser for SQLite Version 3.12.2 for macOS (https://sqlitebrowser.org) was used for analysis. Less than half of individuals in their 20s and nearly 20% of those over age 30 were prescribed ADHD medications alone. Among patients in their 20s, anxiolytics/hypnotics, antidepressants, and antipsychotics were prescribed at similar rates, while among those aged 30 and above, antidepressants and anxiolytics/hypnotics were more frequently prescribed (Table 1). Based on these observations, two potential scenarios emerge. The first one is that ADHD medications were prescribed to those who meet the diagnostic criteria for ADHD. In this case, adults with ADHD might exhibit multiple psychiatric symptoms to require polypharmacy of psychiatric medications. The second scenario is that pharmacotherapy for ADHD was being administered to individuals who might not fully meet the ADHD diagnostic criteria, but who are experiencing specific symptoms, such as issues with attention, impulsivity, and hyperactivity. The author and coll","PeriodicalId":74405,"journal":{"name":"PCN reports : psychiatry and clinical neurosciences","volume":"169 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134961545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Bin Kimura, the most internationally renowned Japanese psychopathologist, developed a unique life‐theoretical position in his later years. The concept of “ aida ” or “betweenness,” which was in the social dimension in his earlier thought, came to be called “horizontal betweenness,” and the “vertical betweenness” in the vital dimension came to be emphasized. In relation to his time theory, the “intra festum,” which signifies the tendency to immerse oneself in the present, has come to be highlighted as a direct contact with life. He used many coupled concepts, such as “ mizukara / onozukara ” and “reality/actuality,” to contrast his life‐theoretical position with the scientific‐epistemological one. He was also heavily influenced by the ideas of Viktor von Weizsäcker, and superimposed his concept of “vertical betweenness” over Weizsäcker's concept of “ground relationship” by interpreting it as expressing the dependence of individual life ( bios ) on life in general ( zoé ). However, the strongest influences on his life theory were the ideas of Kitaro Nishida, the leading philosopher of the Kyoto School, with whom he had been familiar since his youth. In his last years, Kimura, under Nishida's influence, came to equate life in general with generalized death. Kimura's life philosophy might provide the foundation of psychotherapy by deepening subjective and empathetic understanding of psychiatric patients.
{"title":"Life philosophy of Bin Kimura","authors":"Kenjiro Fukao","doi":"10.1002/pcn5.145","DOIUrl":"https://doi.org/10.1002/pcn5.145","url":null,"abstract":"Abstract Bin Kimura, the most internationally renowned Japanese psychopathologist, developed a unique life‐theoretical position in his later years. The concept of “ aida ” or “betweenness,” which was in the social dimension in his earlier thought, came to be called “horizontal betweenness,” and the “vertical betweenness” in the vital dimension came to be emphasized. In relation to his time theory, the “intra festum,” which signifies the tendency to immerse oneself in the present, has come to be highlighted as a direct contact with life. He used many coupled concepts, such as “ mizukara / onozukara ” and “reality/actuality,” to contrast his life‐theoretical position with the scientific‐epistemological one. He was also heavily influenced by the ideas of Viktor von Weizsäcker, and superimposed his concept of “vertical betweenness” over Weizsäcker's concept of “ground relationship” by interpreting it as expressing the dependence of individual life ( bios ) on life in general ( zoé ). However, the strongest influences on his life theory were the ideas of Kitaro Nishida, the leading philosopher of the Kyoto School, with whom he had been familiar since his youth. In his last years, Kimura, under Nishida's influence, came to equate life in general with generalized death. Kimura's life philosophy might provide the foundation of psychotherapy by deepening subjective and empathetic understanding of psychiatric patients.","PeriodicalId":74405,"journal":{"name":"PCN reports : psychiatry and clinical neurosciences","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135484333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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