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Biomedical subjects

Toshiki Shioiri

Publications and source records attributed to Toshiki Shioiri.

15 recordsLinked to original sources
PubMed2006

Impaired psychological recovery in the elderly after the Niigata-Chuetsu Earthquake in Japan:a population-based study.

BACKGROUND: An earthquake measuring 6.8 on the Richter scale struck the Niigata-Chuetsu region of Japan at 5.56 P.M. on the 23rd of October, 2004. The earthquake was followed by sustained occurrence of numerous aftershocks, which delayed reconstruction of community lifelines. Even one year after the earthquake, 9,160 people were living in temporary housing. Such a devastating earthquake and life after the earthquake in an unfamiliar environment should cause psychological distress, especially among the elderly. METHODS: Psychological distress was measured using the 12-item General Health Questionnaire (GHQ-12) in 2,083 subjects (69% response rate) who were living in transient housing five months after the earthquake. GHQ-12 was scored using the original method, Likert scoring and corrected method. The subjects were asked to assess their psychological status before the earthquake, their psychological status at the most stressful time after the earthquake and their psychological status at five months after the earthquake. Exploratory and confirmatory factor analysis was used to reveal the factor structure of GHQ12. Multiple regression analysis was performed to analyze the relationship between various background factors and GHQ-12 score and its subscale. RESULTS: GHQ-12 scores were significantly elevated at the most stressful time and they were significantly high even at five months after the earthquake. Factor analysis revealed that a model consisting of two factors (social dysfunction and dysphoria) using corrected GHQ scoring showed a high level of goodness-of-fit. Multiple regression analysis revealed that age of subjects affected GHQ-12 scores. GHQ-12 score as well as its factor 'social dysfunction' scale were increased with increasing age of subjects at five months after the earthquake. CONCLUSION: Impaired psychological recovery was observed even at five months after the Niigata-Chuetsu Earthquake in the elderly. The elderly were more affected by matters relating to coping with daily problems.

Adult↗
PubMed2006

Lack of a relationship between the pupillary light reflex response and state/trait anxiety in remitted patients with panic disorder.

OBJECTIVE: Recently, some studies have indicated that pupillary function only correlates with state/trait anxiety in healthy subjects. In the present study, we examined whether or not there were relationships between the PLR functions and state/trait anxiety in remitted (the absence of panic attack (PA) symptoms for at least 6 months) PD patients compared to normal control (NC) subjects. METHODS: Before and after audiovisual stimulation (AS) that induced mental stress through exposure to video images of high stress experiences, such as driving motor vehicles, the pupillary light reflex (PLR) was measured with an infrared pupillometer in 30 remitted PD patients and 30 age- and gender-matched NC subjects. In order to examine the relationships between the 8 PLR parameters (initial pupillary diameter in darkness, pupillary diameter at maximum constriction, constriction ratio, latency of the reflex, time to reach maximum constriction and time constant of redilation) and state/trait anxiety, we used the State-Trait Anxiety Inventory (STAI) and stepwise multiple regression analysis. RESULTS: There was no significant group difference in the STAI-T score and STAI-S scores before and after AS. We confirmed the significant relationships between pupillary function and state/trait anxiety in NC subjects, but not in PD patients. CONCLUSIONS: These findings suggest that in contrast to NCs, even remitted PD patients may have dysfunctional PLR regulation with mental loading, such as AS. Moreover, it is possible that the abnormalities of ANS exist extensively in PD, since almost all panic symptoms, including PA, are involved in cardiovascular symptoms, but not pupillary ones.

Acoustic Stimulation↗
PubMed2006

Differences in characteristics between suicide victims who left notes or not.

BACKGROUND: Suicide notes (SN) are one of markers of the severity of a suicide attempt and are said to provide a valuable insight into the thinking of suicide victims before the fatal act [Shah, A., De, T., 1998. Suicide and the elderly. Int. J. Psychiat. Clin Pract. 2, 3-18]. To examine whether suicide victims who wrote notes (note writers: NW) differ from those who did not, we investigated the characteristics of a sample of more than 5000 Japanese suicides using multiple logistic regression analysis. METHODS: For all suicide victims (5161 cases), we examined the following information: gender, age, suicide method, reason for suicide, marital status, residential status, history of psychiatric disorders, previous suicidal behavior, physical disease, and content of suicide notes. RESULTS: Mean incidence of NW was 30.1% (male: 29.7%, female: 30.8%). NW in Japan had the following characteristics; higher proportion in female and living alone, suicide by more lethal methods such as carbon monoxide, hanging or sharp instruments. On the other hand, non-NW had tendencies to commit suicide for reasons of physical illness and psychiatric disorder, and/or history of previous psychiatric disorders. LIMITATIONS: This study is observational and discusses only completed, not attempted, suicide. Medical and psychiatric comorbidity are judged only by the history of diagnosis and the information about the problems in relationships is based not on valid criteria for inclusion. CONCLUSIONS: Although these findings show ethnic differences, it is possible that SN may be considered an indicator of a serious suicide attempt. Further studies of SN are needed to confirm this.

Adult↗
PubMed2006

Clinical features and treatment outcome in Japanese patients with social anxiety disorder: chart review study.

The lifetime prevalence of social anxiety disorder (SAD) is high at 3-13%, but there have been only limited reports investigating the clinical features of this disorder in a large number of Japanese patients. The authors have conducted a retrospective, chart review study of 52 patients with SAD and obtained the following results. (i) The proportion of SAD in first visit outpatients at the Department of Psychiatry, Niigata University Medical and Dental Hospital, Niigata, Japan, was 1.04%. The male : female ratio was 1:0.73, so male patients appeared to be more common in the sample. (ii) With regard to subtype, generalized type (73% of the patients) was more common than non-generalized type (27%). (iii) The mean age of onset was 18.6 +/- 7.8 years, and there was a trend towards onset of disease at a younger age in the generalized type compared to the non-generalized type. (iv) The most common chief complaint was anxiety and tension in front of others (40.4%). (v) Pharmacotherapy resulted in improvement in 63.5% of the patients. Treatment by fluvoxamine and alprazolam resulted in high response rates of more than 70%.

Adult↗
PubMed2006

Routine use of operational diagnostic criteria affects the pharmacotherapy of dysthymia: national questionnaire survey of experienced psychiatrists in Japan.

The purpose of the present paper was to evaluate, with the use of a questionnaire, how Japanese psychiatrists diagnose and treat a typical adult dysthymia case. Clinicians who routinely use operational diagnostic criteria (ODC) had more correct diagnoses than those who did not. Approximately 70% of psychiatrists who routinely use ODC chose selective serotonin re-uptake inhibitors (SSRI) as the first choice of treatment, while of those psychiatrists who do not use these criteria, only half prescribed SSRI. This difference was statistically significant (P = 0.01). The results of the present study suggest that psychiatrists who are familiar with ODC tend to treat dysthymia according to evidence-based pharmacotherapy.

Adult↗
PubMed2005

Dysfunctional baroreflex regulation of sympathetic nerve activity in remitted patients with panic disorder. A new methodological approach.

BACKGROUND: Many researchers have studied the abnormalities of autonomic nervous system (ANS) such as decreased heart rate variability, which is a risk factor for sudden cardiac death, in patients with panic disorder (PD). However, no consistent abnormality has been uncovered to date. One of the reasons for this controversy may be due to the fact that most of these conventional studies have analyzed each physiological variable independent of other indices. We examined the ANS in PD patients using a new method which can more directly investigate the function of the baroreflex by examining the relation between the blood pressure (BP) and heart rate (HR). METHODS: During rest and audiovisual stimulation (AS) as mental stress such as being exposed to video imaginary of experiences such as driving motor vehicles, cardiovascular parameters, HR and BP were consecutively measured in 13 remitted PD patients and twenty aged and gender-matched normal controls (NC). In this study, to assess the cardiovascular ANS function (baroreflex) in PD we used the power spectrum analysis as usual and the mean of lag time (tau) between the Mayer wave components, which was closely related to sympathetic nerve activity of vasomotor, of HR and BP variability as a new trial. RESULTS: The PD patients and NC did not differ with regard to the power spectrum analysis of the heart rate. We found that tau in the PD group was significantly shorter than that in the NC both before and after AS, especially before. CONCLUSIONS: These findings suggest that remitted PD patients may have a dysfunctional baroreflex regulation of sympathetic nerve activity.

Acoustic Stimulation↗
PubMed2005

Diffusion tensor analysis in chronic schizophrenia. A preliminary study on a high-field (3.0T) system.

The objective of this study was to delineate further the nature of diffusion anisotropy abnormalities in frontal white matter previously observed in schizophrenic patients using a high-field magnetic resonance imaging (MRI) system. Six schizophrenia patients and six healthy control subjects were examined using a highfield MRI (3.0T) system. In order to confirm previously reported abnormalities in anisotropy, data were first analyzed to determine fractional anisotropy (FA), a frequently utilized general index of anisotropy. Subsequently, the identical data set was subjected to lambda chart analysis (LCA), a newly developed algorithm for diffusion tensor analysis (DTA) that more effectively provides eigenvalue information. Frontal white matter FA was found to be significantly reduced in schizophrenic patients compared to control subjects, confirming previously reported findings. LCA revealed that the decline in FA was due to a disproportionate increase in small eigenvalue components, and not due to a decline in principal eigenvalue components.

Adult↗
PubMed2005

Incidence of note-leaving remains constant despite increasing suicide rates.

Suicide notes (SN) are potentially valuable sources of information about the psychological states of the suicidal person. It was hypothesized that there was a significant relation between suicide rate and note-leaving rate and that the incidence of note-leaving was increased during prolonged economic recession. During 21 years (1981-2001) in Kobe, of a total of 18 558 violent deaths, 5161 were due to suicide (27.8%), with 3417 male cases (66.2%) and 1754 female cases (33.8%). For each year the annual suicide rates and note-leaving rates were calculated, and this represents the percentage of committed suicides in which SN were left, among all suicide victims. In spite of the prolonged economic slump, the note-leaving rate remained almost constant (23.4-36.2%). Pearson's correlation coefficient showed no significant correlation between suicide rate and note-leaving rates (r = 0.27, P = 0.23). The finding that the incidence of note-leaving remains constant despite increasing suicide rates may suggest that the reasons for suicide do not affect note-leaving. There are cross-cultural, ethnic, and racial variations in suicidal behaviors. Although this finding may be specific in Japan, further studies of SN are needed to help clarify the suicidal states of mind.

Communication↗
PubMed2004

Momentary changes in the cardiovascular autonomic system during mental loading in patients with panic disorder: a new physiological index "rho(max)".

BACKGROUND: Although panic disorder (PD) is suggestive of autonomic nervous system dysfunction, especially in the cardiovascular autonomic system (CAS), the results in many previous studies are still controversial. Using a new physiological index which could well reflect emotional reaction to visual stimuli (Yoshizawa, M., Sugita, N., Tanaka, A., Abe, K., Yambe, T., Nitta, S., 2001. Quantiatative Physioligical Evaluation of Three Dimensional Images. The Seventh International Conference on Virtual Systems and Multumedia, 25-27.), we studied momentary changes in the CAS in patients with PD during audiovisual stimulation (AS) as mental loading. METHODS: During AS, exposed to a video of imaginary experiences such as driving a motor vehicle or diving into the sea, blood pressure (BP) and heart rate (HR) were measured in 12 remitted patients with PD and 19 age- and sex-matched normal controls (NC). We used the maximum cross-correlation coefficient (rho(max)) from the BP to the HR, whose frequency components were limited to around 0.1 Hz. RESULTS: The rho(max) was an available index which could detect the momentary changes in the CAS during AS in both groups. The two-way ANOVA disclosed significant group and time effects on the rho(max). The momentary response to emotional stimuli in the PD patients was slower than that in the NC subjects. LIMITATIONS: Antidepressants have a potential impact on the autonomic variables in this study. CONCLUSIONS: These findings suggest that there may be a dysfunction of the CAS in remitted PD patients and that the dysfunction may be one of the trait markers of PD. To confirm these findings, however, further studies with a large sample size are required.

Acoustic Stimulation↗
PubMed2004

Pupillary light reflex in panic disorder. A trial using audiovisual stimulation.

BACKGROUND: Although many previous studies reported abnormalities of autonomic function in patients with panic disorder (PD), almost all targets in those studies primarily focused on cardiovascular autonomic functions. In the present study, we determined whether PD patients exhibited abnormalities in the pupillary autonomic nervous system (ANS). METHODS: Before and after audiovisual stimulation (AS), which induced mental stress through exposure to video images of high stress experiences, such as driving motor vehicles, the pupillary light reflex (PLR) was measured by infrared pupillometer in 13 remitted PD patients and twenty age- and gender-matched normal controls (NC). RESULTS: Before and after AS, there were no significant differences in initial pupillary diameters in dark conditions (D1), pupillary diameters at maximum constriction (D2) or constriction ratios (CR: (D1-D2)/D1) between PD and NC subjects. However, the CR ratio (CR before/CR after) was significantly higher in the PD group than in the NC. CONCLUSIONS: These findings suggest that even remitted PD patients may have a dysfunctional PLR regulation with experimental stressors such as AS.

Adult↗
PubMed2004

Effects of concomitant fluvoxamine on the plasma concentration of etizolam in Japanese psychiatric patients: wide interindividual variation in the drug interaction.

Administration of fluvoxamine with concomitant benzodiazepines is common in clinical situations. This study investigated the effects of the coadministration of fluvoxamine on plasma concentrations of etizolam and evaluated the effects of various fluvoxamine doses on drug interactions with etizolam. Subjects were 18 Japanese outpatients concomitantly treated with fluvoxamine before or after monotherapy with etizolam. Plasma concentrations of etizolam were measured using a column-switching high-performance liquid chromatographic method with ultraviolet detection. In 17 subjects treated concomitantly with fluvoxamine at 25 mg or 50 mg, the ranges of plasma concentrations of etizolam corrected for the dose increased from 2.0-13.3 (mean 6.3 +/- 3.6, n = 17) in monotherapy to 2.7-18.2 (mean 9.6 +/- 5.1, n = 17) ng/mL/mg in concomitant doses. Wide variations were observed in the drug interactions; however, coadministration with fluvoxamine produced significant changes in the plasma concentrations of etizolam (P < 0.0001) with a median of 42.9% (range 0.0 to 235.0%). Although the sleepiness of the subjects was evaluated using the Stanford Sleepiness Scale, no changes in sleepiness were found between the etizolam-monotherapy and the fluvoxamine-concomitant states. Of the 12 subjects treated concomitantly with fluvoxamine at 25 mg, 2 subjects received fluvoxamine at a dose increased up to 150 mg, and another received fluvoxamine at a dose increased up to 200 mg. They showed an increase in the plasma concentrations of etizolam in a fluvoxamine dose-dependent manner; more particularly, the increased dose of fluvoxamine (150 mg and 200 mg) resulted in about a twofold variation in plasma concentrations of etizolam.

Adult↗
PubMed2004

Economic slump and suicide method: preliminary study in Kobe.

During the recent half decade, Japan's suicide rate at approximately 25 deaths per 100 000 people has been one of the highest rates in the world. From the perspective of suicide prevention by restricting access to suicidal means, the aim of the present study was to examine what kind of suicidal method increased during prolonged economic slump. During 21 years (1981-2001), for all suicide victims (5161 cases) the gender, age, and suicide methods were investigated. The yearly full unemployment rate was also used as a representative socioeconomic factor during the same periods in Japan using government statistics, and the relationship between methods of suicide and full unemployment rate was investigated. Pearson's correlation suggested that there was a significant correlation only for hanging rate (r = 0.736, P < 0.001), but not for the percentages of other methods of suicide. This finding that unemployed persons may have a susceptibility towards certain suicide methods could help in the prevention of suicides. Mental health in Japan should be given more attention, especially for the working population, and social programs offering help should be considered widely.

Adolescent↗
PubMed2003

Effects of concomitant fluvoxamine on the metabolism of alprazolam in Japanese psychiatric patients: interaction with CYP2C19 mutated alleles.

OBJECTIVES: Administration of fluvoxamine (FLV) with concomitant benzodiazepines is common in clinical situations. We studied the effects of the coadministration of FLV on plasma concentrations of alprazolam (ALP). We also studied the effects of CYP2C19(*)2 or CYP2C19(*)3 on these drug interactions. METHODS: The subjects were 23 Japanese outpatients all concomitantly treated with FLV either before or after monotherapy with ALP. We measured the plasma concentrations of ALP and FLV using a column-switching, high-performance liquid chromatographic method with ultraviolet detection. The CYP2C19(*)2 or CYP2C19(*)3 alleles were identified using a polymerase chain reaction analysis. RESULTS: Coadministration with FLV produced significant, on average 58%, increases in the plasma concentrations of ALP ( P<0.001). There were, however, wide variations in the interactive effects of the coadministration of FLV on the plasma concentrations of ALP. While there were some subjects who had greater increases in plasma ALP concentrations, more than 100%, in response to the coadministration of FLV among the subjects with no mutated or one mutated allele, there are no subjects who had increases in plasma ALP concentrations of more than 50% among the subjects with two mutated alleles. The differences of these variances among the three genotype groups reached a level of significance ( P<0.05). CONCLUSION: Coadministration of FLV significantly increased the plasma concentrations of ALP compared with ALP monotherapy. Wide variations were observed in the drug interactions, with the CYP2C19 genotype possibly being related to these interactions.

Adult↗
PubMed2002

Blink rate variability in patients with panic disorder: new trial using audiovisual stimulation.

Several lines of evidence have implicated central dopaminergic pathways in the modulation of spontaneous blink rate (BR). Furthermore, previous studies have indicated a relationship between spontaneous BR and anxiety and/or depression. However, to our knowledge, there is no report on the examination of BR in a group of patients with panic disorder (PD). During the conditions of rest and with audiovisual stimulation, exposed to a video of imaginary experiences, such as driving a motor vehicle or diving into the sea, BR was examined in 11 male patients with PD and compared with the BR of 16 age-matched normal controls. The BR was significantly higher in PD patients relative to normal controls under both conditions. In particular, the PD group had a higher BR score during the sea scene as relaxation compared with the normal controls. In conclusion, although the sample size was small the present preliminary study, these findings suggest that BR may have potential for application in the assessment of anxiety state, which is consistent with previous studies.

Adult↗