[Activities of the rehabilitation committee and a survey on group workshops].
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Adult↗
Biomedical subjects
Y Kawamuro
Publications and source records attributed to Y Kawamuro.
[Possibility of discharge and need for rehabilitation of psychiatric patients hospitalized for one year or more in Japan: a preliminary report. Committee on Rehabilitation Affairs, Subcommittee of Survey on Rehabilitation Need].
A total of 19,342 psychiatric patients staying in a total of 143 hospitals in Japan for one year or more entered in this study in order to determine the possibility of discharge (POD) and the need for rehabilitation. Those who were assessed by the psychiatrist in charge to have POD provided community support was assured accounted for 32.5%. As for the levels of daily life functions measured with the GAF score, those assessed to have POD showed the maximum frequency between scores 51 and 60, while the others, who were not considered suitable for discharge, showed the maximum frequency between scores 21 and 30. On the other hand, the control group, consisting of subjects with psychiatric disabilities and living in the community while using day care or rehabilitation facilities, showed the maximum frequency of GAF scores between 51 and 60. Two-thirds of the study subjects were older than fifty, while in the control group those aged between 30 and 49 accounted for 49.0%, thus indicating that the residents of mental hospitals tend to be older. More than 60% of the study subjects had been staying in hospital for five years or more. Those without their own home accounted for about 60%.
Adult↗
Quantitative electro-oculography and electroencephalography as indices of alertness.
Even though both electro-oculography (EOG) and EEG have been widely used for assessing alertness, the relationship between these two measures has not yet been clarified at various alertness levels. We estimated the frequencies of eye movements faster than 15 degrees/s (NoEM15) and EEG power at every 0.5 Hz step frequency point, quantitatively as well as continuously from alert to very light sleep (Stage 1) in 14 healthy adults. We devised a new EOG derivation for a computerized analysis, because conventional EOG recordings suffer from EEG contamination and have been analyzed manually. EOG electrodes were attached to the left orbitale in this study. The eye movements were detected as peaks in differentiated EOG signals. Significant correlations were found between NoEM15 and EEG powers at several frequency points, mainly in the alpha and beta bands. Though fluctuating EEG components in close correspondence to the frequency of the eye movements varied depending on the individual, EEG power at the peak frequency of the awake state was most closely associated with the eye movements. A broad band power that centers at the peak frequency may be a better measure for alertness assessment than powers in fixed bands.
Adolescent↗
Problems with team treatment in Japan.
Although it has been a while since psychiatric team treatment was first advocated as being necessary in Japan, the application of team treatment in practice remains underused. In order to solve the five problems highlighted by the Nurse and Co-medical Project of the Japanese Association of Psychiatric Hospitals and to put psychiatric team treatment into practice, it is important that professionals in the field of psychiatry have a common understanding of the end concepts and functions of psychiatric team treatment and that they take an involved interest in the compatibility and functional roles of the work done by each profession. It is then important that good psychiatric treatment be constructed around a full complement of competent staff.
Hospitals, Psychiatric↗
[Evaluation of regional examples of the mental health and welfare system with emphasis on local municipal areas].
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Community Mental Health Services↗
[A research on the importance of the clinical certificate to the medical practitioners outside the field of psychiatry. Committee on graduate education sub-committee on Feasibility of Implementing Specialty Board Certification in the Japanese Society of Psychiatry and Neurology].
OBJECTIVES AND METHODS: The main objectives of the research was to identify the merits and demerits of the specialty board certification system, that had been implemented in the other medical societies than the society of psychiatry in Japan. As a measure of the research, we conducted a survey by distributing questionnaires to medical institutions. The subjects of this survey included medical practitioners, other than the psychiatrists, who belong to general hospital, university hospital and the Japan Medical Association. FINDINGS: We received 228 responses out of the subjects. The findings were that 86% of the subjects have acquired the specialty board certificate, and that half of them have more than two kinds of qualifications on the average. Thus, the report suggests that the specialty board certification system have been long pervaded throughout the medical fields outside psychiatry. In addition, the subjects pointed out as the merits of the specialty board certification system that it helps to achieve the higher level of technique, and to organize and sophisticate as well as widen the knowledge of their specialty. They also reported that it contributes to instigate the life-long education and to earn identification and recognition of their specialty from other fields of medicine than their own. Fifty-three percent of the subjects acknowledged the necessity of the specialty board certification system while 13% regarded it unnecessary. This result proves that, despite higher percentage of the doctors with qualifications, the system itself is not approved of with full acknowledgement in the medical world. This rather negative attitudes toward the system is originated in the fact that acquiring and maintaining the certificate, i.e., renewal fees, are considerably high. In fact, as many as 62% of the subjects felt these points as disadvantages of the system. The medical practitioners outside the fields of psychiatry did not show any particular concern about the lack of the specialty board certification system in our field that is distinct as a field of medicine. Only 18% of the subjects expressed that urgent actualization of the system is desirable in our fields. In addition, securing the cites required for learning the technique and giving the exam to the applicants is the most important matter to be concerned. On the contrary, in other fields of medicine, the matter does not need to be discussed. Therefore, this is a problem unique to the fields of psychiatry. CONCLUSION: Although there are disadvantage of the specialty board certification system pointed out as shown above, we believe that it is necessary to introduce the system in the field of psychiatry. These disadvantage are mainly the matter of individual income. We need to consider the introduction of the system from the perspective of sophisticating the quality of psychiatry as a field of medicine in our country. We, the Subcommittee on feasibility of implementing specialty board certification in the Japanese Society of Psychiatry and Neurology have been contemplating over the system up to this moment. The progress has been made to the point of presenting, Discussion of the Specialty Board Certification System in Psychiatry, Yamauchi, May, 1994.
Certification↗
Horizontal component of electro-oculogram as a parameter of arousal in dementia: relationship between intellectual improvement and increasing arousal under pharmacotherapy.
Although nootropics and metabolically active compounds sometimes attenuate intellectual deficits of dementia patients, this mechanism has not been discussed or investigated. The authors hypothesized that these compounds act to enhance attention and/or concentration by increasing the arousal level, and then improve intellectual functions. Based on this hypothesis, the authors investigated the arousal level and the improvement of intellectual functions in ten patients with Alzheimer type dementia and ten patients with multi-infarct dementia before and after 3 months pharmacotherapy using bifemelane hydrochloride. They then analyzed whether the increases in arousal level involves or relates to the improvement of intellectual functions. On the 20 patients, psychological tests were carried out, and the arousal level was evaluated using the frequency of rapid eye movements in the electro-oculogram (EOG) before and after 3 months administration of bifemelane hydrochloride. As a result, a significant positive correlation was observed between the improvement on the Hasegawa's dementia scale and the rate of increase in rapid eye movements in the EOG. The EOG monitoring can be a great help in establishing an objective evaluation method on drug efficacy.
Aged↗
Responders and non-responders to bifemelane hydrochloride in Alzheimer-type and multi-infarct dementia.
Although metabolically active compounds sometime attenuate cognitive deficits of dementia patients, this mechanism has not been discussed or investigated. We hypothesized that these compounds improve cognitive disorders not by directly acting on this cognitive function, but by increasing the arousal level. Based on this hypothesis, we investigated the change of arousal levels and the improvement of intellectual functions in 10 patients with Alzheimer-type dementia (ATD) and 10 patients with multi-infarct dementia (MID) before and 3 months after pharmacotherapy using bifemelane hydrochloride. For each patient, a psychological test battery was carried out and the arousal level was evaluated using the frequency of rapid eye movements in the electro-oculogram (EOG) and the frequency analysis of electroencephalogram (EEG) before and after the treatment. Evaluation of the cognitive improvement was made and eight out of the 20 patients were regarded as responders to the treatment. The frequency of small rapid eye movements (SREM) in the EOG increased significantly only in responders and the rate of change in SREM appearance in responders was significantly different from that in non-responders. This finding suggests that a part of the intellectual improvement in ATD and MID results from the increased level of arousal.
Aged↗
[The correlation between changes in EEG and eye movement (EOG) accompanied by lowered arousal level].
We investigated the correlation between the components of spontaneous eye movement (EOG) and EEG in six healthy individuals. The study was conducted in three periods; from the resting to drowsy stage, from the drowsy to spontaneous awakening stage, and in the forced waking stage. EEG, as registered from bipolar electrodes attached between the left parietal region (P3) and the left occipital region (O1), was monitored continuously by the FFT method with a segment of 12.8 seconds. Rapid eye movement and slow eye movement were observed simultaneously. In conclusion, even when the arousal level varies considerably, there is a close correlation between frequency of rapid eye movement and EEG patterns of 10.16 integral of 10.94 Hz & 17.97 integral of 19.53 Hz (simple correlation p < 0.01). Additionally, during the forced waking period (after stage 2), delta and theta bands increased in cases along with sleepiness. Even if the depth of sleep was the same, one's mood upon awakening was determined by the frequency of slow waves before awakening.
Adult↗