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Noboru Iwata

Publications and source records attributed to Noboru Iwata.

16 recordsLinked to original sources

Lithium and dementia: a preliminary study.

Recent studies have shown that lithium may block the accumulation of amyloid-beta (Abeta) peptides and to inhibit the hyperphosphorylation of tau via the inhibition of GSK-3alpha in the brain of mice. The purpose of the present study is to examine whether lithium could potentially be effective for the prevention of Alzheimer's disease. We investigated the clinical records of 1,423 outpatients at a university psychiatric outpatient clinic and classified patients according to the following criteria: (a) absence of a diagnosis of dementia, (b) age 60 years or older, and (c) lithium had been prescribed and/or was currently prescribed. We compared these patients with randomly selected age and gender matched control group who had never been prescribed lithium. Despite no significant difference in MMSE scores between the lithium group, which consisted of patients receiving lithium treatment, and the control group, those who had previously received lithium and/or were currently prescribed lithium had significantly better MMSE scores than the control patients. The findings provide partial evidence to support the contention that lithium could offer hope as a preventive treatment for Alzheimer's disease. Further prospective studies with a large number of patients are warranted to investigate this potentially important effect.

Aged↗

Mental effect of cholesterol in males: protective effect?

BACKGROUND: While the benefits of low cholesterol for physical health are not in doubt, a potential negative aspect of low cholesterol for mental health is suggested by several studies. To examine the association between cholesterol and mental health, the authors performed an observational study. METHOD: From April 1995 to March 2002, a series of questionnaires pertaining to physical activity, food consumption, alcohol, coffee, smoking, and mental health (12 item-version of General Health Questionnaire: GHQ-12) were administered to 1972 employees in Japan. Subjects with less than 150 mg/dL of total cholesterol (very low cholesterol cohort) and other subjects (control cohort) were followed up for one to six years, and their mental health compared using GHQ caseness (GHQ-12 scores more than 3). RESULTS: Kaplan-Meier survival curves revealed that the very low cholesterol cohort had significantly greater GHQ caseness than the control cohort. Notably, this finding applied to males but not to females. After adjustment for general health, Cox's proportional hazards regression model confirmed this association in males only. The survival curves of control cohort were significantly different between males and females whereas those of very low cholesterol cohort were not. LIMITATIONS: GHQ caseness was regarded as "death" in the survival analysis. As such, it is not possible to differentiate between transient and persistent mental dysfunction and therefore may lead to overestimation of GHQ caseness over observational years. CONCLUSION: The present findings suggest that very low cholesterol may be associated with worse mental health in males and conversely and interestingly indicate that moderate (but not very low) cholesterol levels may protect mental health in males.

Adult↗

Twelve-month use of mental health services in four areas in Japan: findings from the World Mental Health Japan Survey 2002-2003.

The aim of the present study was to provide basic descriptive data regarding utilization of 12-month mental health services in the Japanese community population. Face-to-face household surveys were carried out in four areas (two urban cities and two rural municipalities), and a total of 1663 persons participated (overall response rate: 56.4%). For data collection, the structured psychiatric interview, World Mental Health version of the World Health Organization Composite International Diagnostic Interview (WMH-CIDI) was used, allowing DSM-IV diagnoses, severity, and service utilization. It was found that 7.3% of total respondents had received any service, either professional or non-professional, in the past 12 months, including 20.0% of those with 12-month DSM-IV disorders and 6.2% of those without. Thirty-three percent of those with any mood disorder used any service, and 26.8% of those used some type of health care. The probability of people with 13-15 years of education receiving mental health treatment was fourfold higher than those with >or=16 years of education. Gender, age, or income were not found to contribute to utilization of mental health services. The results confirm that the majority of people with a recent psychiatric disorder have not used mental health care or other support systems. The mental health care system in Japan has improved over the past decade, but not enough for people suffering from mental disturbances.

Adult↗

Social class inequalities in self-rated health and their gender and age group differences in Japan.

BACKGROUND: Few studies have examined social inequalities in self-rated health in Japan, and the issue of gender differences related to social inequalities in self-rated health remains inconclusive. METHODS: The data derived from interviews with 2987 randomly selected Japanese adults in four prefectures in Japan who completed the cross-national World Mental Health survey from 2002 through 2005. We calculated odds ratios (ORs) of having poor self-rated physical and mental health by two social class indicators independently with multivariate logistic regression models, adjusted for age, gender, marital status, and area. Stratified analyses by gender and age group were also conducted. RESULTS: The adjusted ORs of the lowest educational attainment category having poor self-rated physical and mental health were 1.42 (95% confidence interval [CI]: 1.15-1.76) and 1.37 (95% CI: 1.10-1.70), respectively. Among females, educational attainment had significant linear associations with self-rated physical and mental health. Adjusted household income was also significantly associated with self-rated physical health among female respondents. No associations were found among males. While educational attainment was associated with self-rated health among the young age group, adjusted household income was associated with self-rated physical health in the middle and old age group. CONCLUSION: These results indicated social inequalities in self-rated health and prominent social inequalities in self-rated health among females in Japan. Social inequalities in self-rated health seemed to exist across age groups. However, the mechanism of social inequalities in self-rated health could be different depending on the age group.

Adult↗

[Risk factors for suicide: a questionnaire survey by psychiatrists in Fukuoka Prefecture].

In our previous study, we demonstrated a preliminary questionnaire survey to psychiatrists from university hospitals, psychiatric hospitals, psychiatric clinics, and departments of psychiatry in general hospitals in Fukuoka Prefecture. In that study, 324 psychiatric patients who committed suicide between January 1, 1998 and December 31, 2001 were ascertained. In the present study, we have recruited matched control patients from the same clinics/hospitals and further demonstrated a secondary questionnaire survey to the psychiatrists in order to reveal the various risk factors for suicide suggested by the literature. Associations between completed suicide and possible risk factors were examined in 192 completed suicide psychiatric patients and 356 non-suicidal psychiatric patients (controls). Significant association was found for history of admission to psychiatric hospitals, history of suicide attempts, history of substance abuse, cluster B personality disorders, and hopelessness in our sample. In male samples, history of suicide attempts, cluster B personality disorders, recent loss, and hopelessness were significantly associated with suicide. In females, history of admission to psychiatric hospitals, history of suicide attempts, and hopelessness were significant.

Female↗

Twelve-month prevalence, severity, and treatment of common mental disorders in communities in Japan: preliminary finding from the World Mental Health Japan Survey 2002-2003.

To estimate the prevalence, severity, and treatment of Diagnostic and Statistical Manual of Mental Disorders (4th edn; DSM-IV) mental disorders in community populations in Japan, face-to-face household surveys were conducted in four community populations in Japan. A total of 1663 community adults responded (overall response rate, 56%). The DSM-IV disorders, severity, and treatment were assessed with the World Mental Health version of the World Health Organization (WHO) Composite International Diagnostic Interview (WMH-CIDI), a fully structured lay-administered psychiatric diagnostic interview. The prevalence of any WMH-CIDI/DSM-IV disorder in the prior year was 8.8%, of which 17% of cases were severe and 47% were moderate. Among specific disorders, major depression (2.9%), specific phobia (2.7%), and alcohol abuse/dependence (2.0%) were the most prevalent. Although disorder severity was correlated with probability of treatment, only 19% of the serious or moderate cases received medical treatment in the 12 months before the interview. Older and not currently married individuals had a greater risk of having more severe DSM-IV disorders if they had experienced any within the previous 12 months. Those who had completed high school or some college were more likely to seek medical treatment than those who had completed college. The study confirmed that the prevalence of DSM-IV mental disorders was equal to that observed in Asian countries but lower than that in Western countries. The percentage of those receiving medical treatment was low even for those who suffered severe or moderate disorders. Possible strategies are discussed.

Adult↗

[Development of a checklist for evaluation of mental health activities at the workplace].

"The Checklist for Evaluation of Mental Health Activities at the Workplace" was developed for workplace staff evaluating mental health activities in their own workplace. The validity and reliability of the checklist were examined and criteria for evaluation were developed for workplace/organization/companies with 50 or more employees in Japan. The checklist initially included 33 items covering seven major domains of occupational mental health, with a four-point response option, based on the Japanese Guideline for Worker Mental Health in the Workplace and a relevant literature review. A questionnaire was send to 60 members of the Occupational Mental Health Committee (OMHC) of the Japan Society for Occupational Health to ask their opinions on the checklist and on the minimum requirement for each item on the checklist; 30 (50%) responded. A random sample of 1,335 workplaces from a contractor list of workplaces for worker compensation insurance and a questionnaire was send to the personnel department to fill in the checklist; 412 (31.5%) responded and data from 335 of them with 50 or more employees were analyzed. Some OMHC members felt that one of the items (concerning the Total Health Promotion program) should be dropped; thus the checklist was revised to include 32 items, still covering the seven domains. Based on the workplace survey data, most domain scales showed internal consistency reliability at an acceptable level; explanatory factor analysis yielded a four-factor structure that was well concordant with the hypnotized seven-domain structure. Three levels of adequacy of mental health activities were set for each domain scale: "red" (inadequate), "yellow" (minimal), and "green" (adequate). One third of occupational health professionals from 49 workplaces rated the evaluation result based on the checklist as concordant with their view; 95% of them said the checklist would be useful in promoting occupational mental health activities. The study indicated that the checklist had reliability (based on internal consistency reliability) and content- and construct-validity (based on expert opinions, a factor-structure concordant with empirical data, and evaluation by workplace staff). The checklist seems useful in promoting occupational mental health activities.

Counseling↗

Symptomatological and cognitive predictors of insight in chronic schizophrenia.

Studies of schizophrenia show lack of agreement about the relationship of symptomatological and cognitive factors to insight. In this study, positive and negative symptomatology and cognitive function were assessed by the Positive and Negative Syndrome Scale (PANSS), the Wisconsin Card Sorting Test (WCST), and the Wechsler Adult Intelligence Scale Revised (WAIS-R) in male chronic schizophrenic patients in relation to level of insight measured with the Japanese version of the Schedule for the Assessment of Insight (SAI-J). Negative symptoms were significantly and negatively associated with overall insight, particularly with treatment compliance and recognition of mental illness. The present findings suggest that aspects of insight such as treatment compliance and recognition of mental illness are negatively associated with negative symptoms.

Adult↗

Lifetime and 6-month prevalence of DSM-III-R psychiatric disorders in an urban community in Japan.

We conducted a community-based interview survey of a random sample of residents aged 20 years or older in an urban community in Japan using the University of Michigan Version of the WHO Composite International Diagnostic Interview for selected mood and anxiety disorders and alcohol abuse/dependence according to DSM-III-R. The final sample consisted of 1029 respondents (response rate, 57%). The lifetime and 6-month prevalences of selected mood, anxiety and alcohol use disorders were low in general. Alcohol abuse/dependence was more prevalent in men than in women. Younger respondents had a greater risk of generalized anxiety disorder and alcohol dependence. A greater risk of mood, anxiety and alcohol use disorders was observed among a recent birth cohort. We confirmed a lower prevalence of mood and anxiety disorders and alcohol use disorders in a community population in Japan than in Western countries, observations that were similar to previous ones in East-Asian countries. The patterns of demographic correlates and comorbidity are similar to those of most other countries.

Adult↗

Suicide and occupation: further supportive evidence for their relevance.

In recent years, the relationship between occupation and suicide has been extensively investigated, but few definite conclusions regarding the nature of the relationship have been established. In the present study, this relationship was investigated by examining Japanese governmental statistics. First, correlations of suicide rate relative to industry categories were examined individually for primary industry (farmers, fishermen, and forest workers), secondary industry (construction workers, manufacture works, and miners), and tertiary industry (indoor workers) for all of the 47 prefectures of Japan. Second, in the industries that showed a significant correlation with suicide rate, the relationship to other factors was adjusted using possibly confounding factors. As a result, suicide rate was positively correlated with primary industry percentage, but not with secondary or tertiary industry percentages. Multiple regression analysis showed that suicide rate was positively associated with primary industry percentage with significant tendency while it was significantly and negatively associated with annual total sunshine. Limitations are that individual suicide rates according to occupational types were not available and direct correlations with the above variables could not be investigated. The present findings suggest a possibility that occupational factors associated with primary industry may be relevant to suicide, and that, additionally, annual total sunshine may affect suicide independently. Since workers with primary industry are likely to be exposed to sunshine than other workers, they may tend to be more affected by the decrease of annual total sunshine.

Adult↗

Aging and visual hallucinations in elderly psychiatric outpatients.

Estimates of the reported prevalence of visual hallucinations in the elderly vary from study to study. The aim of the present investigation was to re-evaluate the prevalence of visual hallucinations in elderly psychiatric outpatients and to examine pertinent risk factors. One hundred and twenty-two elderly (> or =60 years old) consecutive outpatients at our university hospital were investigated with a questionnaire regarding visual hallucinations and the Mini-Mental State Examination. Twelve of 122 (10%) patients suffered from visual hallucinations. Although advanced age, lower MMSE scores and dementia were significantly associated with the presence of visual hallucinations, logistic regression analysis revealed that only advanced age showed a tendency to predict the presence of visual hallucinations. In 53 patients with dementia examined separately, only advanced age was significantly associated with visual hallucinations. The present findings suggest that the prevalence of visual hallucinations in the elderly is about 10% and that aging is an important risk factor in the development of visual hallucinations in dementia. Further studies are required in order to investigate the contribution of age-related factors such as lowering visual acuity, bereavement and loneliness to the presence of visual hallucinations.

Aged↗

Predicting denial function of schizophrenic patients by the picture completion subtest of WAIS-R.

In the previous study, picture completion (PC) test scores of Wechsler Adult Intelligence Scale Revised (WAIS-R) were negatively associated with recognition of mental illness measured by Schedule for the Assessment of Insight (SAI). Therefore, it can be hypothesized that function measured by the PC test is positively associated with denial function. To investigate this hypothesis, we investigated the relationship between two picture tests (picture completion and picture arrangement) of the WAIS-R and denial function tests (lie scale, frequency scale and correction scale) of the Minnesota Multiphasic Personality Inventory (MMPI) in 26 schizophrenic patients. As a result, the lie scale score and the correction scale score were positively and significantly associated with picture completion whereas no scale score was significantly associated with picture arrangement. The present findings suggest that the positive association between function measured by the PC test and denial function measured by lie and correction scale scores. Further studies are warranted to investigate the usefulness of the PC test for the measurement of denial function in schizophrenia.

Adult↗

Race/ethnicity and depressive symptoms in community-dwelling young adults: a differential item functioning analysis.

To examine variations in the manifestation of depressive symptomatology across racial/ethnic groups, analyses of differential item functioning (DIF) on the Center for Epidemiologic Studies Depression Scale (CES-D) were separately conducted for representative samples of young adults in the following groups: African-Americans (n = 434), Hispanics born in the US (n = 493), and Hispanics born outside the US (n = 395). Non-Hispanic whites (n = 463) were employed as the reference group in all analyses. The effects of gender and age were controlled. DIF analyses indicated that: (1) about half of the CES-D items functioned differently among non-Hispanic whites compared to each of the other racial/ethnic groups; (2) the manifestation of symptoms seemed to be similar for both Hispanic groups, except for low positive affect; (3) African-Americans tended to favor somatic symptoms over affective (depressive) symptoms; (4) Immigrant Hispanics appeared to inhibit the expression of positive affect, and thus more high scorers on the total CES-D were observed within this subgroup. In contrast, no differences were observed when only negative items were considered. The use of positive affect items might artifactually induce spurious differences among people who were born outside the United States or North America.

Adult↗

Race/ethnicity and depressive symptoms: a cross-cultural/ethnic comparison among university students in East Asia, North and South America.

To examine manifestations of depressive symptomatology among undergraduate students in East Asia, North and South America, responses to the Center for Epidemiologic Studies Depression Scale (CES-D) were compared across Japanese (n = 310), Anglo-American (n = 377), Native American (n = 353), and Argentinean (n = 110) undergraduate students. Japanese reported a significantly higher level of low positive affect, leading to significantly higher total CES-D scores, whereas their negative symptoms score was comparable to scores of Anglo-Americans and Argentineans. Although Native Americans were more likely to endorse negative symptoms, their low positive affect score was comparable to those of Argentineans. Argentineans appear to suffer less from depressive symptoms. Results from a Differential Item Functioning analysis, using Anglo-Americans as the reference group, indicated that: (1) the manifestation of depressive symptoms seemed to be similar for Anglo-Americans and Argentineans, except for low positive affect; (2) Native Americans tended to favor somatic symptoms over affective (depressive) symptoms; (3) responses to positive affect questions could possibly be biased not only for Japanese but also for people in North America; i.e., the expression of positive affect might be enhanced in North American culture, while inhibited in Japanese culture.

Adolescent↗

Correlates of retrospective early life experience with personality in young Japanese women.

To examine the influence of early experiences on the development of personality. We used the Temperament and Character Inventory to assess 98 young women who had first entered a company. Different early experiences were linked, albeit weakly, to test scores. Both partial correlations and multiple regression analyses indicated that Self-directedness was higher if women reported more care of parents. Partial correlation, but not multiple regression analyses, showed that Cooperativeness was greater if women reported more care of parents and less frequent abuse. Reports of early parental loss or negative or positive early life events showed no correlation with scores on any of the Temperament and Character Inventory subscales.

Adult↗