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Aims: Hikikomori is a common phenomenon reported in Japan and many other countries. However, the broad trends of the research publications on hikikomori are unclear. Therefore, this study examined the patterns of research on hikikomori using bibliometric analysis. Methods: Relevant publications were searched in Web of Science. Bibliometric analyses were performed with CiteSpace, R and VOSviewer. Results: In total, 297 publications on hikikomori met the eligibility criteria. The International Journal of Social Psychiatry (IF = 10.461) published the most papers (K = 17, or 5.7%) on hikikomori. Takahiro A. Kato from Kyushu University (41; 13.8%; H‐index = 18) was the most influential author, while Takahiro A. Kato (total link strength [TLS]: 235), Alan R. Teo (TLS: 157), and Masaru Tateno (TLS: 153) separately had the strongest research collaboration with other researchers. Of all countries that published on hikikomori, Japan had the highest number of publications (K = 91). The keywords "United States" and "psychiatric diagnosis" received the most attention between 2013 and 2015, whereas "health" and "autism spectrum disorder" received the most attention in 2021 and 2022. Conclusions: Peer‐reviewed research publications on hikikomori are growing rapidly and the research trends in this field are also changing. [ABSTRACT FROM AUTHOR]

Adverse childhood experiences (ACEs) have been shown to have long‐term effects on physical and mental health, not only in the US, but also other countries, including Japan. In this paper, measurement of assessment of ACEs has been discussed, that is, concept (what is ACEs), inquiry (how to ask about ACEs), scoring (how to count the number of ACEs), and prevalence (how many ACEs do we have). In addition, a possible mechanism on how ACEs affect health was summarized from a life‐course perspective, using the critical/sensitive period model, pathway model, and cumulative model with recent evidence on neurological findings. Intergenerational transmission, that is, maternal ACEs affecting the health of the offspring was also reviewed. Finally, future directions on how to prevent and remedy the impact of ACEs on health was discussed. [ABSTRACT FROM AUTHOR]

Aim In Japan, the Cabinet Office released the 'General Principles of Suicide Prevention Policy' in 2007 and suggested nine initiatives. In 2009, a national fund was launched to help prefectures (the administrative divisions of Japan) and local authorities implement five categories of suicide-prevention programs. This paper examines the impact of the national fund on the establishment of the systems for suicide prevention and the implementation of these initiatives among local authorities. Methods The present study included 1385 local authorities (79.5%) from all 47 prefectures that responded to the cross-sectional questionnaire survey. Results Improved suicide-prevention systems and the implementation of nine initiatives in April 2013 were observed among 265 local authorities (19.1%) that implemented 'Training of community service providers' and 'Public awareness campaigns'; 178 local authorities (12.9%) that implemented 'Face-to-face counseling', 'Training of community service providers' and 'Public awareness campaigns'; and 324 local authorities (23.4%) that implemented 'Trauma-informed policies and practices'. There was no significant difference in suicide-prevention systems and the implementation of nine initiatives between 203 local authorities (14.7%) that implemented only 'Public awareness campaigns' and 231 local authorities (16.7%) that did not implement any suicide-prevention programs. Conclusion The results of our study suggest that the national fund promoted the establishment of community systems for suicide prevention and helped implement initiatives among local authorities. The national suicide-prevention strategy in Japan should explore a standard package of programs to guide community suicide-prevention efforts with a sustained workforce among local authorities. [ABSTRACT FROM AUTHOR]

Aim: Assessing social competence is important for clinical and preventive interventions of depression. The aim of the present paper was to examine the factor structure of the Japanese Interpersonal Competence Scale (JICS). Methods: Exploratory and confirmatory factor analysis was performed on the survey responses of 730 participants. Simultaneous multigroup analyses were conducted to confirm factor stability across psychological health status and sex differences. Results: Two factors, which represent Perceptive Ability and Self-Restraint, were confirmed to show a moderate correlation. Perceptive Ability involves a more cognitive aspect of social competence, while Self-Restraint involves a more behavioral aspect, both of which are considered to reflect the emotion-based relating style specific to the Japanese people: indulgent dependence ( amae) and harmony ( wa). In addition, Self-Restraint may be linked to social functioning. Both constructs may confound a respondent's perceived confidence. Conclusion: Despite its shortcomings, the JICS is a unique measure of social competence in the Japanese cultural context. [ABSTRACT FROM AUTHOR]

Research on the merits of long-term group residences is inconclusive. The purpose of the present paper was to investigate the effects of supported group residence on the symptoms, social function, quality of life, general health quality, and the medical/psychiatric cost in Japan of a large number of psychiatric beds and long average length of stay. Patients were assessed every 6 months for 2 years using Positive and Negative Syndrome Scale, Katz Adjustment Scale, World Health Organization Quality of Life (WHO-QOL) and General Health Questionnaire 12-item version. Patients discharged to the supported group residence (SGR) significantly improved with regard to positive symptoms, the level of socially expected activities and free-time activities. The QOL physical domain of the inpatients was significantly more deteriorated compared to the SGR group. The total psychiatric/medical cost of the SGR group was approximately one-third that of the inpatient group, while the cost of the SGR to treat physical comorbidity was much higher. The present findings indicate that SGR has advantages for mental and social function but not for physical health. A major limitation of the present study was the high mean age (>60 years) of the subjects who had been hospitalized for a long period (mean, 24 years). [ABSTRACT FROM AUTHOR]

Although most Western studies have found a birth excess during winter or early spring among patients with schizophrenia, this has not been found in Japanese samples. The purpose of the present paper was to investigate this finding using a large Japanese sample. Distributions of monthly birth numbers of patients with schizophrenia were compared to those of the general population. Patients were from the governmental data, numbering 88 788. A significant birth excess during winter to early spring was found in male and female subjects with schizophrenia compared to the general population. There is a significant birth excess during winter to early spring for schizophrenia in Japan. The authors consider that the discrepancy between the current study and the previous Japanese studies was caused by small sample size and selection bias in the previous Japanese studies. [ABSTRACT FROM AUTHOR]

The purpose of the present paper was to evaluate the prevalence of restless legs syndrome (RLS) in a non-institutionalized Japanese elderly population. The subjects consisted of 8900 elderly people >65 years of age belonging to the Seniors Association in Izumo City in November 2000. The present study was conducted in two parts. The phase 1 investigation was a screening by mailed questionnaire and the phase 2 investigation was diagnosis by face-to-face interview. Subjects with possible cases of RLS in phase 1 proceeded to phase 2 and definite cases of RLS were then detected. In phase 1, a total of 3287 subjects completely answering all questionnaire items, were defined as the subjects of the present study. A total of 150 were classified as having ‘probable RLS’, resulting in a prevalence of 4.6%. These subjects with probable RLS in phase 1 were detected as the subjects of phase 2. By face-to-face interview and various clinical examinations, a total of 35 subjects (nine male, 26 female) were diagnosed as having definite RLS, resulting in a prevalence of 1.06%. Furthermore, seven subjects (two male, five female) with symptomatic RLS were detected and finally 28 subjects (seven male, 21 female) were diagnosed as having idiopathic RLS. It was significantly higher in women for both the total and idiopathic RLS groups (0.60% male vs 1.46% female; 0.46% male vs. 1.18% female, respectively). The prevalence of RLS may be lower in the Japanese elderly than that in Caucasian subjects. These results could enhance understanding of the differences in predisposition between the races. [ABSTRACT FROM AUTHOR]

The purpose of the present paper was to investigate the distribution of Zung Self-rating Depression Scale (SDS) scores in a general population and its factor structure. Questionnaires on SDS items were sent to 7136 randomly selected residents aged 20–79 years who lived in districts in Japan with high rates of suicide. Valid responses were received from 5547 residents (response rate: 77.7%). Factor analysis of the SDS scores was conducted. The SDS scores of the male subjects were significantly lower than those of the female subjects in all age groups. A reverse-J-shaped relationship was found between age groups and mean SDS scores for the male and female subjects. The highest mean score was in the age group of 20–39 years, and the lowest mean score was in the age group of 60–69 years for the male and female subjects. In factor analysis, two factors consisting of 12 items were extracted, and 10 of those 12 items covered six Diagnostic and Statistical Manual of Mental Disorders (4th edn; DSM-IV) criteria describing psychological disturbances of depression. The distribution of SDS scores differed depending on the age group. Major components of SDS in the subjects covered the DSM-IV criteria for psychological disturbances of depression. [ABSTRACT FROM AUTHOR]

Defense styles have a close relationship with ego development and psychopathology. The purpose of the present paper was to examine the reliability and validity of the Japanese edition of the Defense Style Questionnaire (DSQ-40; Andrews et al. 1993). Six hundred and six Japanese university students (348 female) completed the DSQ-40 and Maudsley Personality Inventory (MPI). The neurotic tendency had positive correlations with immature and neurotic defense styles and a negative correlation with the mature defense style. The extroversion tendency had positive correlations with the mature and neurotic defense styles and a negative correlation with the immature defense style. There was a significant test–retest correlation for all items of the DSQ-40 ( n = 284). The results show that the Japanese version of the DSQ-40 had concurrent validity with the MPI and a test–retest reliability of 2 months, although there was some doubt about the validity of the factor structure of the DSQ-40. Therefore, the DSQ-40 is a useful scale in Japan to measure ego development and ego function through defense styles. [ABSTRACT FROM AUTHOR]

Abstract The purpose of the present paper was to examine the reliability and validity of the Japanese version of the Social Adjustment Scale-Self Report (SAS-SR) and to present its normative data. The SAS-SR was administered to a random sample of all the employees of a large general hospital, together with the General Health Questionnaire (n = 363). It was also administered to a representative subset of first-visit patients at 33 psychiatric hospitals and clinics from all over Japan, along with the semistructured psychiatric interview to ascertain the patients’ diagnoses (n = 1581). For the internal consistency reliability of the subscales and the overall scale of the SAS-SR, Cronbach's α was between 0.61 and 0.73. The Pearson product-moment correlations between the subscale and overall scale scores with the GHQ score were mostly >0.3. The scores were statistically significantly and substantively different between the normal sample and the patient samples, and were also meaningful, differentiating between various diagnostic subgroups. The reference ranges of the SAS-SR scores for mentally healthy subjects were calculated as 95% prediction intervals; for example, 1.22–2.22 for the overall score. The Japanese version of the SAS-SR has good reliability and satisfactory validity. The present study provided reference ranges for its scores in order to increase their interpretability. With its ease of administration and its rich subscales, the scale promises to offer a psychometrically sound measure with which to assess social adjustment in people with various psychiatric disorders. [ABSTRACT FROM AUTHOR]

Presents abstracts of research papers discussed at the 17th Annual Meeting of Adolescent Psychiatry held on November 17, 1999 in Fukushima, Japan. 'Importance of image of father in the clinical course of an adolescent case,' by C. Fujita, S. Koyota, T. Ozaki, Y. Nakano and C. Yasutake; 'The turning point for a pair of twin girls,' by M. Nishikawa, K. Goto and R. Kaku.

AbstractThe objective of this study is to examine psychological/psychopathological characteristics of eating disorders and their subtypes through a combined administration of questionnaires and projective tests. Three questionnaires (Eating Disorder Inventory – 2, Social Adaptation Scale, Southern California University Eating Disorder Inventory – Revised) and two projective tests (the Tree Drawing Test [TDT, Baum Test], and the Sentence Completion Test [SCT]) were administered to 126 female patients between the ages of 15 and 30 years, with eating disorders according to DSM-IV criteria at our outpatient clinic, and to 54 sex- and age-matched control subjects. The purging subtypes of eating disorders (anorexia nervosa – binge-eating/purging type [ANBP] and bulimia nervosa – purging type [BNP]) were clearly differentiated from the controls, both by the questionnaires and the projective tests. Compared with the controls, ANBP/BNP showed more problematic profiles across the three questionnaires, drew smaller and poorer trees in TDT to a more left location on the drawing paper, and gave fewer positive, and more negative responses in SCT. In contrast, few significant differences were found between anorexia nervosa – restricting type (ANR) and the controls, and between ANBP and BNP. As a trend, however, ANR was consistently located between the controls and ANBP/BNP across the whole questionnaires and projective tests. [ABSTRACT FROM AUTHOR]

Reports on the proceedings of the annual meeting of the Japanese Society of Biological Psychiatry in Japan in April 2001. Issues in psychiatry and clinical neurosciences that were discussed during the meeting; Experts who presented research papers.

Abstract The Diagnostic and Statistical Manual of Mental Disorders, 3rd edition (DSM-III), a new standardized diagnostic system with multiaxial diagnosis, operational criteria and renewed definitions of mental disorders, was introduced in 1980 and prompted movements to reform conventions in Japanese psychiatry. This review overviews the initial response of Japanese clinicians to accept DSM-III, and its effects on the development of systematic research of psychiatric diagnosis. These new research activities include those on reliability of psychiatric diagnosis, application of various evaluation tools, discussion on the concept of mental disorders, relation of personality disorders with depressive disorders, and Taijin-kyofusho, or culturally distinctive phobia in Japan. A reference database search to survey the latest trend on psychiatric research indicated that the number of papers published by Japanese workers increased sharply after 1987, and DSM apparently greatly influenced their internationalization. Twenty years after the publication of DSM-III, a questionnaire on the use of DSM-IV was set out in 2000 to survey how widely DSM is utilized in clinical practice in Japan. Two hundred and twelve psychiatrists answered the questionnaire, and the results show that DSM has been accepted positively by the younger generation, while the older generation (over 40s) has still less interest in DSM, and DSM is used mainly for research purposes rather than in daily practice. [ABSTRACT FROM AUTHOR]

Highlights the papers presented at the 22nd annual meeting of the Japanese Society of Biological Psychiatry, held in March 30-April 1, 2000 in Tokyo, Japan. 'Hypocretin/orexin: A key role for narcolepsy,' by H. Kadotani and colleagues; 'Transcriptome analysis in pharmacogenomics and microarray,' by T. Tanaka and colleagues; 'The etiology and psychopathological symptoms of mental disorders,' by J. Suzuki.

Two hundred and seventy healthy university students were surveyed in December 1995 using Bond's Defense Style Questionnaire (DSQ) to measure the subjects' defense mechanisms. At the same time, a survey using Byrne's R-S Scale (Repression–Sensitization Scale) of the MMPI (Minnesota multiphasic personality inventory) and five psychiatric symptom indexes (anxiety, sense of inadequacy, sensitivity, depression and impulsive anger) selected from the CMI (Cornell Medical Index-Health Questionnaire) was conducted. Three factors were extracted from the DSQ through factor analysis: immature defenses, neurotic defenses, and mature defenses. The results of analysis of variance revealed the following: (i) for anxiety and anxiety related symptoms, both immature defenses and neurotic defenses indicated principal effect; (ii) for impulsive anger and depression, immature defenses presented principal effect; and (iii) for sensitivity and impulsive anger, interaction between a mature defense style and neurotic defense style was noted. The relationship between defense styles and psychiatric symptoms in healthy people is studied in this paper. [ABSTRACT FROM AUTHOR]

AbstractGrief reactions to the death of a close relative are not commonly treated in psychiatric out-patient clinics in Japan. However, recently our clinic has had a chance to see such cases. I analyzed 11 cases of grief reactions (7 females, 4 males). The first part of this paper focuses on the distinction between normal and abnormal grief reactions, and an attempt was made to classify grief reactions in the nosology. Following this, three factors were specified as enhancing vulnerability to bereavement: (1) sex (female), (2) age (middle-aged), and (3) cause of death (sudden death). The second part focuses on the dependency seen in the subjects, which was their most marked personality traits. Finally, vertical splitting as defined by Kohut and Kasahara was discussed as a defense mechanism in the crisis of bereavement. The bereaved person preserves a positive image of the deceased and his or herself by vertical splitting, thereby eliminating negative experiences and feelings (denial). This manifested itself in a strong feeling of solidarity with the deceased (identification). The treatment of the subjects followed a fairly good course, but five patients required more than 1 year. Four patients visited the clinic after the termination of their treatment because of a relapse of their depression. [ABSTRACT FROM AUTHOR]

The present study investigates elderly patients suffering from a pathological grief reaction to bereavement. The subjects were nine elderly inpatients with pathological grief reactions in the Department of Psychiatry in Fukuoka University Hospital between April 1991 and March 1995. Medical records of all patients were investigated retrospectively. The results were as follows: (i) all patients were female; (ii) the deceased were all husbands; (iii) most cases were sudden death; (iv) the period to onset was variable, from immediately after death to 10 years after death; (v) a delay of grief reactions was seen in many patients; (vi) the direct causes were often something other than bereavement, such as conflict with sisters, change of residence, bone fracture and daughter's malignant illness; (vii) although there was no significant difference, the ratio of those who began to live alone after bereavement was high; (viii) the number of children were insignificant; and (ix) many patients suffered the death of a parent in childhood. The paper presents observations on the results, and discusses the psychosocial factors of elderly patients with pathological grief reactions to bereavement. [ABSTRACT FROM AUTHOR]

Having a history of sexual abuse in one's childhood is not an exceptional case in Japanese society. In the present paper we describe a recent case of child sexual abuse actually treated by our clinic. [ABSTRACT FROM AUTHOR]

The purpose of the present paper was to investigate the efficacy of kamishoyosan (TJ-24), a traditional Japanese herbal formula ( kampo), for outpatients with premenstrual dysphoric disorder (PMDD) as an alternative treatment. Thirty patients with PMDD were treated with TJ-24 for six menstrual cycles. Nineteen patients (63.3%) had >50% improvement in the total score of the Hamilton Depression Rating Scale (HAM-D) Scale (17 items) in the late luteal phase. Fourteen patients (46.7%) went into remission (total HAM-D score <7). In the present study many patients with PMDD were successfully treated with TJ-24. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

This paper discusses the problems of Japanese under- and postgraduate education of psychiatry, and indicates several important points for psychiatric education. Most medical schools give lectures on psychiatry to fourth and fifth graders. Lecturing hours average 2.3% of the total lecture time for medical students. However, the hours have tended to decrease recently, and lectures by the Department of Psychiatry are spreading to the first and second graders. These lectures include behavioral science, psychology and science for human relationships. The following problems should be solved urgently: (i) undergraduate psychiatric education should focus on the majority of medical students who will not be psychiatrists; (ii) clarification should be made of the minimum required psychiatric knowledge for medical doctors; (iii) promotion of the use of efficient educational strategies; (iv) increases in practical training. The Department of Psychiatry has an important role to play in primary education of psychiatrists in most cases. Every university educates using different curriculums; however, the programs are mostly similar in their primary training. However, there is no standardized educational system and Board of Certification for psychiatrists in Japan. Minimum requirements and a certification system for psychiatrists are urgently needed. I will discuss the global review on the issues of under- and postgraduate psychiatric education in Japan, then highlight the problems that should be targeted in the future. [ABSTRACT FROM AUTHOR]

Ancestral longevity is sometimes thought to contribute to psychosocial well-being in late life. The present paper aims to examine if parental longevity is associated with mental health among the elderly. The age at death of the parents was compared between 68 patients with major depression who were aged 65 or over and 40 subjects of the same age range without any history of psychiatric disorder. Cox regression revealed that the fathers of the elderly men with unipolar depression died at a significantly younger age than those of the control group. Several hypotheses are advanced to explain this unexpected and intriguing association. [ABSTRACT FROM AUTHOR]

In a previous article, recent reports by Japanese researchers on non-Alzheimer-type degenerative dementias were reviewed. In the present article, recent Japanese reports on Alzheimer-type dementia (ATD) are reviewed. Alzheimer-type dementia has received great attention and has been studied from various viewpoints in Japan as well as in Europe and the Americas. In Japan, although it was believed that vascular dementia was the most frequent dementia in the elderly, ATD has recently been shown to be the most predominant type of dementia. Such a great number of papers on ATD have been reported in Japan that mainly the clinical, neuropathological, biochemical and molecular biological research papers alone are reviewed here. [ABSTRACT FROM AUTHOR]

Presents abstracts of papers on adolescent psychotherapy presented at the Japanese Association for Adolescent Psychotherapy's 19th annual conference on November 12, 2001, in Kobe, Japan.