Biomedical subjects

T Someya

Publications and source records attributed to T Someya.

At least 37 records · Page 2Linked to original sources

PubMed1999

Schizophrenia: is it time to replace the term?

The attitudes of Japanese psychiatrists toward their patients who suffer from schizophrenia were investigated. We were concerned specifically with whether the psychiatrists inform their patients of the suspected diagnosis. We discuss how the term 'schizophrenia' may influence a psychiatrist's decision to inform his patients of the diagnosis. A self-reported questionnaire was distributed to 150 executive board members of the Japanese Society of Psychiatry and Neurology and analysis of the data obtained from 110 respondents was carried out. The results showed that the concepts that psychiatrists use when they give a diagnosis of schizophrenia vary considerably. Fifty-nine per cent of the respondents informed their patients of a diagnosis of schizophrenia on a case-by-case basis, while 37% informed only the patients' families. A tree analysis showed that the most important predictors for informing the patients of the diagnosis were assumptions about the public image of schizophrenia and a negative impression of the term schizophrenia, translated as 'Seishin Bunretsu Byou' in Japanese. The results revealed that the Japanese term for schizophrenia influences a psychiatrist's decision to inform patients of the diagnosis and that, by changing the term to a less stigmatized one, the disclosure of information about schizophrenia to patients would be promoted.

Attitude of Health Personnel↗

PubMed1999

Reliability of the 5-min speech sample for assessing expressed emotion in Japanese patients.

Expressed emotion (EE) has been shown in various countries to be a good predictor of the clinical course of a patient's mental illness. Because the traditional EE interview requires considerable time and effort, this study examined the reliability of a method called the five-minute speech sample (FMSS) for assessing EE. The samples of 65 subjects were rated by the FMSS-EE coding system, and the interrater reliability among four authorized raters was investigated. Of these 65 samples, 10 (15%) were rated as high-EE (high critical, 6%; high emotional over-involvement (EOI), 9%), and 19 (29%) were rated as borderline (b-)-high-EE (b-critical, 15%; b-EOI, 14%). The intraclass correlation coefficient (ICC) was 0.91 for the overall category, 0.74 for criticism, 0.85 for EOI, 0.63 for b-critical and 0.54 for b-EOI. The FMSS was shown to be reliable for the assessment of EE, even outside of Western countries. However, the lower agreement in the subcategories of EOI and b-critical has to be considered as a limitation of this brief method.

Adult↗

PubMed1999

The effect of cytochrome P450 2D6 genotypes on haloperidol metabolism: a preliminary study in a psychiatric population.

We investigated the effect of cytochrome P450 (CYP2D6) genotypes on plasma levels of haloperidol (HAL) and reduced haloperidol (RHAL) in 47 Japanese male schizophrenic inpatients being treated with HAL. Mutation-specific polymerase chain reaction (PCR) analysis was used to detect CYP2D6*10 as the C188C1T mutation in exon 1. A long-PCR analysis method was used to detect CYP2D6*5. Allele frequencies of CYP2D6*5 and CYP2D6*10 were 4.3% and 34.0%, respectively. Plasma concentrations of HAL and RHAL were measured using high-performance liquid chromatography. The ranges of the plasma concentration of HAL and RHAL corrected to the dose were 0.28-1.60 (mean +/- SD, 0.66+/-0.25, n = 47) ng/mL/mg and 0.03-3.00 (mean+/-SD, 0.36+/-0.46, n = 47) ng/mL, respectively. Plasma RHAL/HAL ratios (R/H ratios) ranged from 0.06 to 1.88 (mean +/- SD, 0.48+/-0.32, n = 47). The analysis was performed among the four genotype groups: CYP2D6*1/CYP2D6*1 (n = 11), CYP2D6*1/CYP2D6*10 (n = 11), CYP2D6*10/CYP2D6*10 (n = 6) and those who have CYP2D6*5 allele (CYP2D6*1/ CYP2D6*5 or CYP2D6*5/CYP2D6*10 (n = 4). We observed significant tendency in effects of CYP2D6 genotypes on plasma concentration of HAL and significant effects on plasma concentration of RHAL, and R/H ratio. These results we obtained suggested that the plasma concentration of HAL and RHAL were determined partly by CYP2D6 polymorphic activity.

Adult↗

PubMed1999

Cultural difference in recognition of facial emotional expression: contrast between Japanese and American raters.

Using the Japanese and Caucasian Facial Expressions of Emotion (JACFEE) photo set, the relationship between recognition and intensity ratings of universal facial expressions of emotions in 123 Japanese undergraduate students was examined and compared with data reported by American raters. In Japanese raters, although the intensity was rated as high for some of the poses, their correctness scores were poor, suggesting a serious misjudgment of the intended emotions as defined in the JACFEE photo set. Only in Japanese raters were significant relationships between the intensity scores and the percentage correctness scores for sadness detected (r = 0.97, P < 0.0001), but no significant relationship was observed for other emotions. The robust correlation suggests the possibility that Japanese raters might be more responsive to certain emotional expressions when they are fully or intensely expressed. It is proposed that the facial emotional expression paradigm cannot be applied to the psychiatric setting without first refining for cultural differences.

Adult↗

PubMed1999

Interindividual variation of plasma haloperidol concentrations and the impact of concomitant medications: the analysis of therapeutic drug monitoring data.

We analyzed therapeutic drug monitoring (TDM) data from 231 schizophrenic inpatients (137 men, 94 women) and investigated interindividual differences of plasma haloperidol (HAL) concentrations and drug/drug interactions between HAL and various concomitant drugs. Plasma HAL concentrations were determined by an enzyme immunoassay (EIA) method. Plasma HAL concentrations per daily dose of HAL per body weight (HAL C/D ratio) demonstrated an approximately 11-fold interindividual variation. The patient subjects who received carbamazepine (CBZ) concomitantly had a mean HAL C/D ratio that was 37% lower than that of the patient subjects without CBZ. The patient subjects treated with concomitant phenobarbital (PB) also showed a mean HAL C/D ratio that was 22% lower than those without PB. We concluded that careful evaluation of HAL TDM data and consideration of the impact of concomitant medication such as CBZ or PB that might influence the metabolism of HAL is necessary in daily clinical settings to avoid insufficient clinical response because of lowered concentrations of HAL or adverse effects because of high concentrations of HAL.

Aged↗

PubMed1999

Lower plasma levels of haloperidol in smoking than in nonsmoking schizophrenic patients.

The impact of smoking on plasma haloperidol (HAL) concentrations was investigated in 66 Japanese male schizophrenic inpatients treated orally with HAL. The subjects consisted of 22 nonsmokers and 44 smokers each smoking ten cigarettes per day. Plasma concentrations of HAL were determined by an enzyme immunoassay method. There were significant positive correlations between the plasma HAL concentration and the daily dose of HAL per kg body weight (Y = 58.1X-0.01 (r = 0.86)). Smokers had significantly lower HAL concentrations per daily dose of HAL/kg body weight than nonsmokers (smokers vs. nonsmokers = 54.3+/-16.6 vs. 70.6+/-23.2 ng/mL/mg/kg). In doses less than 0.2 mg/kg of HAL, smokers showed significantly lower HAL concentrations per daily dose of HAL/kg body weight than nonsmokers (smokers vs. nonsmokers = 55.1+/-14.4 vs. 79.5+/-27.1 ng/mL/mg/kg), whereas no significant difference in HAL concentrations per daily dose of HAL/kg body weight was observed between smokers and nonsmokers when treated with more than 0.2 mg/kg (smokers vs. nonsmokers = 52.9+/-20.7 vs. 60.0+/-11.1 ng/mL/mg/kg). Our results indicate that smoking may induce the enzyme(s) metabolizing HAL, which results in lower plasma HAL concentrations in smokers than in nonsmokers, particularly at low doses of HAL.

Administration, Oral↗

PubMed1999

Factor analysis of the EMBU scale in a large sample of Japanese volunteers.

OBJECTIVE: The EMBU (Egna Minnen av Barndoms Uppfostran; (one's memories of upbringing') is a convenient and reliable instrument for the assessment of parental attitudes. The aim of the present study was to investigate the extent to which the factor structure of the EMBU, obtained in previous investigations, could be retrieved in a large Japanese sample. METHOD: The EMBU scale was administered to 1320 healthy Japanese volunteers. Both exploratory and confirmatory factor analyses were performed. RESULTS: The first factor in the analysis, accounting for 9.9% (father) and 10.6% (mother) of the variance, consisted of rejection items. The second factor, accounting for 9.1% (father) and 8.6% (mother) of the variance, contained items relating to emotional warmth. The third factor appeared to represent overprotection, and accounted for 7.8% (father) and 7.8% (mother) of the variance. The fourth factor, which accounted for 3.7% (father) and 3.7% (mother) of the variance, included items classified under favouring subjects. Confirmatory factor analysis revealed that this four-factor structure fitted our data very well for both the father and the mother. The results of factor analysis for four subscales showed three major factors for the EMBU. CONCLUSION: The results of this study confirmed that the EMBU yielded a factor structure in Japan similar to that found in European countries. The EMBU is useful for comparison of parenting attitudes in different societies or countries.

Adult↗

PubMed1999

Characteristics of perceived parenting styles in Japan using the EMBU scale.

OBJECTIVE: The EMBU (Egna Minnen av Barndoms Uppfostran) is a self-report questionnaire for the assessment of one's memory of parental rearing experiences. We are interested in using this scale to determine the characteristics of perceived parenting styles in Japan. METHOD: The study subjects consisted of 1320 healthy Japanese volunteers, comprising 687 males (52%) and 633 females (48%). We investigated the relationship between demographics and the EMBU scale. RESULTS: ANCOVA revealed that the subject's gender had a significant effect on paternal rejection scores (male > female), and both gender and birth-order position had significant effects on emotional warmth scores for both parents (female > male, and only-child > middle or last-born child). Birth-order position had significant effects on maternal over-protection, with the highest score being that of only children, and on the aspect of favouritism (favouring subjects), scores for both parents were highest from the last-born children. Rejection scores for the mother were significantly higher than those for the father from female subjects. Among both male and female subjects, emotional warmth scores and overprotection scores for the mother were significantly higher than those for the father. Among male subjects, scores for the mother on favouritism of the subject were significantly higher than those for the father. On the other hand, among female subjects, scores for the father on favouritism of the subject were higher than scores for the mother. CONCLUSION: Our results suggest that parenting styles have significant interrelationships with the gender and birth-order position of the subject.

Adult↗

PubMed1999

Relationship between stress coping and personality in patients with major depressive disorder.

BACKGROUND: Stress coping is defined as a behavioral or cognitive response of an individual to uncomfortable or difficult situations. It has been suggested that coping, like personality, is related to the pathology and course of mental disorders. Accordingly, we here used a clinical sample to investigate the relationships between coping strategies and personality traits. METHODS: Subjects were 60 outpatients who were in remission from major depressive disorder and who completed the Coping Inventory for Stressful Situations (CISS) and the Munich Personality Test (MPT). RESULTS: Task-oriented coping showed a positive correlation with extraversion and frustration tolerance. Emotion-oriented coping was closely associated with neuroticism, esoteric tendencies and isolation tendency. Avoidance-oriented coping was related to extraversion. Principal component analysis indicated three corresponding factors between coping and personality; one was related to psychopathology (loading from the neuroticism, esoteric tendencies and isolation tendency scales of the MPT, and from the emotion-oriented coping scale of the CISS), a second was a social-adaptive ability component (loading from the frustration tolerance and extraversion scales of the MPT, and from the task-oriented coping and avoidance-oriented coping scales of the CISS), and a third was a passive-avoidance coping component (loaded from the emotion-oriented coping and avoidance-oriented coping scales of the CISS only). CONCLUSION: Some personality traits such as extraversion and frustration tolerance are significantly related to task-oriented coping, and psychopathological personality traits such as neuroticism are associated with emotional-oriented coping in major depressive disorder.

Adaptation, Psychological↗

PubMed1999

A pharmacotherapy algorithm for the treatment of dysthymia in Japan.

Based on randomized controlled trials conducted in western countries, we proposed a pharmacotherapy algorithm for DSM-IV dysthymia in Japan. The main strategy of the algorithm are: firstly, one of the antidepressants is selected for an initial agent, and secondly, efficacy of the selected antidepressant is evaluated at 8 to 12 weeks. The agent with sufficient efficacy is continued for at least 6 months, while ineffective agent is replaced to another antidepressant. The algorithm is preliminary mainly because of the lack of data from Japanese samples and the unavailability of some useful agents in Japan, for instance, selective serotonin reuptake inhibitors and monoamine oxidase inhibitors.

Algorithms↗

PubMed1998

Parental Bonding Instrument and the Inventory to Diagnose Depression Lifetime version in a volunteer sample of Japanese workers.

This study replicated the factor structure of the Parental Bonding Instrument (PBI), and explored the relationships of PBI scores to demographic variables. We investigated the association between parental bonding in the parents measured by the PBI, and lifetime history of depression in their children assessed by the Inventory to Diagnose Depression Lifetime version (IDDL) in a volunteer sample of 239 Japanese workers. In factor analyses with varimax rotation (two-factor solution), the PBI items for both parents showed clear bimodality, and the total variance explained by the two factors was similar to that found in previous Western studies. Subjects with a lifetime history of depression reported a significantly lower score on maternal care than did those without a lifetime history of depression. Without requiring 2 weeks symptom duration on the IDDL, low maternal care was also related to a history of depression. The relationships between PBI scores and age, education, sex of respondent, and sex of parent differed in part from those in Western subjects. These results suggested the following: (1) child-rearing behaviors in non-Western cultures can be, similarly to those in Western cultures, described with the PBI; (2) parental styles, as measured by the PBI, may be associated with depression in non-Western subjects; and (3) sociodemographic influences on PBI scores may be different in subjects with different cultural backgrounds.

Child↗

PubMed1998

Plasma concentrations of timiperone and its reduced metabolite in the patients on timiperone.

Plasma levels of timiperone (TIM) and reduced timiperone (RTIM) were determined in 10 schizophrenic patients who were treated with TIM. Activities of ketone reductase in red blood cells (RBC) were assayed using TIM and haloperidol (HAL) as substrates. Plasma levels of TIM and RTIM ranged from 3.2 ng/mL to 9.5 ng/mL and from 1.7 ng/mL to 7.6 ng/mL, respectively, and approximately four-fold inter-individual variations in RTIM/TIM (0.37-1.43, 0.67 +/- 0.25) were observed. There were significant and positive correlations between plasma levels of TIM or RTIM with the daily doses of TIM (mg/kg body weight); TIM (ng/mL)= 19.5 x daily dose of TIM (mg/kg) + 1.3, r = 0.79, n = 18, P < 0.01; RTIM (ng/mL) = 13.1 x daily dose of TIM (mg/kg) + 0.7, r = 0.73, n = 18, P < 0.001). Given 0.3 mg/kg of TIM, a plasma level of TIM as 7.15 ng/mL was predicted, which is approximately 60% that of HAL. The activity of TIM reductase in RBC was determined as approximately 70% of HAL reductase in RBC, although the correlation between the activities of TIM reductase and HAL reductase in RBC was high (r = 0.98, n = 10, P < 0.001).

Adolescent↗

PubMed1998

Frequency distribution of serum cholesterol levels in patients with panic disorder: comparison with normal controls.

We compared the frequency distribution of total cholesterol (TC) levels in 103 patients with panic disorder (PD) with that in 173 gender- and age-matched normal controls (NC). There was no significant difference in the mean TC level between the PD and the NC groups. The distribution of TC levels in the PD group was similar to that in the NC group. As a whole distribution pattern, there is no association between high serum cholesterol levels and panic disorder. However, four male PD patients had very high TC levels of more than 260 mg/dL, and two of them had obviously deviated values from the frequency distribution of TC levels in the NC group. Our findings are supportive of the view that male PD patients with high TC levels have excess mortality due to cardiovascular diseases.

Adult↗

PubMed1998

Carbonyl reduction of timiperone in human liver cytosol.

This in vitro study using human liver enzymes was undertaken in order to compare the mechanism of metabolic reduction of timiperone, a potent butyrophenone neuroleptic, with that of haloperidol. Conversion of timiperone to reduced timiperone in liver cytosol was confirmed. The carbonyl reductase inhibitors (menadione IC50 5-18 microM; ethacrynic acid IC50 26-51 microM) potently inhibited both timiperone reductase and haloperidol reductase activity, while 4-methylpyrazole (alcohol dehydrogenase inhibitor) had no effect and phenobarbital (aldehyde reductase inhibitor) had a weak inhibitory effect. The formation of reduced timiperone was highly correlated with the formation of reduced haloperidol(r = 0.87, n = 6, P < 0.02). Timiperone reductase activity was approximately 40% lower than haloperidol reductase activity (at a substrate concentration of 100 microM, two-tailed t-test, P < 0.05). The Michaelis-Menten constant (Km) and maximum velocity (Vmax) of reduced timiperone formation were much lower than reduced haloperidol formation (K(m) values: 29.7 +/- 15.1 versus 381.3 +/- 1.1 microM, n = 3, P < 0.01; Vmax: 0.81 +/- 0.19 versus 6.00 +/- 1.47 nmol/mg/min; n = 3, P < 0.05). However, the ratio Vmax/K(m) (clearance) for timiperone was 1.3-2.4 times higher than for haloperidol, indicating that metabolic clearance of timiperone by carbonyl reductase may be similar to or slightly higher than for haloperidol.

Alcohol Oxidoreductases↗

PubMed1997

Multiple regression analysis of relationship between frontal lobe phosphorus metabolism and clinical symptoms in patients with schizophrenia.

We investigated the differences among diagnostic types of 36 schizophrenic patients in the brain phosphorus metabolism in the frontal lobe. We performed phosphorus-31 magnetic resonance spectroscopy (31P-MRS) in the frontal region in patients with schizophrenia of the catatonic (n = 4), disorganized (n = 8), paranoid (n = 10) and undifferentiated (n = 14) types. In the disorganized type, the PME level was significantly decreased compared to those in the other three types, while the phosphodiester (PDE) level tended to be higher, although not significantly, than those in the other types. Using multiple regression analysis, we investigated whether or not the clinical symptoms were correlated with the brain phosphorus metabolism. An increased motor retardation factor score was significantly correlated with decreased PME level, whereas more severe emotional withdrawal and blunted affect were associated with increased PDE level. These results suggest that altered membrane phospholipid metabolism in the frontal region may be associated with negative symptoms and that schizophrenia of the disorganized type is associated with more severe negative symptoms and may present more severe brain abnormalities compared to the other types.

Adolescent↗

PubMed1997

Cell-transforming activity and genotoxicity of phenolphthalein in cultured Syrian hamster embryo cells.

Phenolphthalein is a cathartic agent widely used in non-prescription laxatives. For the simultaneous assessment of in vitro carcinogenicity and mutagenicity of phenolphthalein, the ability of this chemical to induce cell transformation and genetic effects was examined using the Syrian hamster embryo (SHE) cell model. Cell growth was reduced by treatment with phenolphthalein at 10-40 microM in a dose-related manner. Treatment with phenolphthalein for 48 hr induced a dose-dependent increase in morphological transformation of SHE cells. Over the dose range that resulted in cell transformation ( 10-40 microM), treatment of SHE cells with phenolphthalein induced gene mutations at the hprt locus but not at the Na+/K+ ATPase locus. A statistically significant level of chromosomal aberrations was elicited in SHE cells treated with phenolphthalein at the highest dose (40 microM). Meanwhile, neither numerical chromosomal changes nor DNA adduct formation, analyzed by the nuclease P1 enhancement version of 32P-post-labeling, were induced by treatment with phenolphthalein at any concentrations examined. We thus report cell-transforming activity and mutagenicity of phenolphthalein assessed with the same mammalian cells in culture. Our results provide evidence that phenolphthalein has cell-transforming and genotoxic activity in cultured mammalian cells. The mutagenic and clastogenic activities of phenolphthalein could be a causal mechanism for carcinogenicity in rodents.

Animals↗

PubMed1997

Significance of monitoring plasma levels of amitriptyline, and its hydroxylated and desmethylated metabolites in prediction of the clinical outcome of depressive state.

The clinical significance of monitoring the plasma levels of amitriptyline and its metabolites in prediction of the clinical outcome of depressive episode was investigated in 49 inpatients. Discriminant analysis of drug concentrations (at two weeks after initiation of drug treatment) and clinical outcome revealed that increasing the plasma levels of amitriptyline, cis-isomers of hydroxylated metabolites (Z-10-hydroxyamitriptyline and Z-10-hydroxynortriptyline) predicted a better clinical outcome, while increasing of plasma levels of nortriptyline and trans-isomers of hydroxylated metabolites (E-10-hydroxyamitriptyline and E-10-hydroxynortriptyline) were shown to predict a poor clinical outcome in the depressive episode of the subjects, and that clinical outcome of approximately 73% of the subjects could be correctly predicted.

Adult↗

PubMed1997

Differences in symptom structure between panic attack and limited symptom panic attack: a study using cluster analysis.

We had investigated the clinical characteristics of panic disorder (PD) in a Japanese outpatient population comprised of more than 250 patients diagnosed as having PD during a 13-year study period and observed that some PD patients had both panic attacks (PA) and limited symptom panic attacks (LPA). In the criteria for PD based on the Diagnostic and Statistics Manual of Mental Disorders, third edition-revised (DSM-III-R), episodes involving four or more symptoms are classified as PA, while those involving fewer than four symptoms are described as LPA. Therefore, LPA is identified as part of an episode of PA, since the difference between the two episodes is only in the number of symptoms. However, some recent research suggests that there is a distinct subgroup of individuals who suffer LPA. Using cluster analysis, we investigated the differences between PA and LPA groups in terms of the structures of several panic symptoms, which included anticipatory anxiety, agoraphobia and 13 clinical symptoms based on the DSM-III-R at the time of panic attacks, in 247 patients with PD. Cluster analysis revealed clusters of three and four panic symptoms in the PA group and LPA group, respectively, and there were also differences in symptom structure between the two groups. These results suggest that there may be a subgroup of individuals who show LPA among PD patients.

Adult↗