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Abstract Background Although diabetes is one of the most common side effects of clozapine, a medication for the treatment of schizophrenia, to the best of our knowledge no study exists on clozapine‐induced glucose intolerance or hypoglycemia in patients with schizophrenia. Case Presentation We report a case of schizophrenia with repeated reactive hypoglycemia due to abnormal glucose tolerance during clozapine treatment. During clozapine administration in patients with schizophrenia, it is necessary to monitor physical and psychiatric symptoms due to reactive hypoglycemia and hyperglycemia. If abnormal glucose tolerance is a concern, it should be promptly detected using blood or oral glucose tolerance tests. Conclusion Early intervention for impaired glucose tolerance may prevent clozapine discontinuation due to diabetes or hyperglycemia.

Abstract Background A mass‐casualty incident occurred on July 26, 2016, at Tsukui Yamayuri‐en, which is a welfare facility for people with intellectual disabilities. Nineteen residents with intellectual disabilities were killed, and 26 other residents and staff members were injured. Kitasato University Hospital Emergency and Disaster Medical Center treated many patients in serious condition at the site and in the hospital. Aims The authors investigated the symptom severity and distributions of posttraumatic stress disorder (PTSD) among the emergency medical staff in charge. The subjects of this study were the staff members, mostly working at the Emergency and Disaster Medical Center, who treated the people injured in the incident. Methods We conducted a questionnaire survey using Impact of Event Scale‐Revised (IES‐R) on 104 staff members, and 79 responded. Results The IES‐R scores of nurses were significantly higher than those of doctors. There was no significant difference in the scores between male and female staff members, and there was no correlation between the score of each IES‐R subscale and age. Conclusion Results suggest that mental care should be provided to emergency medical staff, especially nurses who treat trauma patients involved in disasters and heinous crimes.

Aim: In Japan, the Orange Plan was formulated in 2013 to promote community-based integrated care systems, and in 2015, it was revised as the New Orange Plan. Since the introduction of these programmes, adequate research has not been carried out on how these measures affect regional dementia care. The aim of this study was to investigate the state of community-based dementia treatment through a survey of medical consultation pathways, including dementia diagnosis, at the Sagamihara Municipal Medical Center for Dementia. Methods: The participants included 1480 patients (585 men, 895 women) who presented for consultation at the Sagamihara Municipal Medical Center for Dementia for a differential diagnosis or treatment of dementia. The relationship between the path leading to medical consultation before pharmacotherapy and post-consultation diagnosis was investigated. Results: Significantly more participants who presented for consultation without a referral were not diagnosed with dementia than diagnosed. Furthermore, among participants referred from a non-psychiatric clinic, significantly more patients were diagnosed with dementia than not. A significant difference was observed in a comparison of facility types and the use or non-use of anti-dementia drugs. Notably, the rate of anti-dementia drug prescriptions was significantly higher in psychiatric hospitals and nonpsychiatric clinics. Furthermore, it is possible that approximately 30% of anti-dementia drugs prescribed at each facility were not covered by insurance. Conclusion: Community-based integrated care systems aim to promote collaboration within each region aimed. However, appropriate pharmacotherapy methods for dementia patients have not been adequately communicated to non-specialist physicians and local residents. For this reason, human resource solutions are needed to help medical staff deepen their understanding of dementia so that they can better provide dementia support to patients. [ABSTRACT FROM AUTHOR]