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This study aimed to investigate the interaction between sarcopenic obesity and locomotive and nonlocomotive physical activity (PA) on the risk of depressive symptoms in community-dwelling older Japanese women. Participants were 143 community-dwelling older women aged 64–94 years. PA was measured using a three-axis accelerometer. Participants were classified according to two levels of total, locomotive, and nonlocomotive PA. Depressive symptoms were assessed by a self-administered survey consisting of the 15-item Japanese version of the Geriatric Depression Scale (GDS-15-J). The interaction between sarcopenic obesity groups and total or locomotive PA did not affect GDS-15-J scores. However, the interaction between sarcopenic obesity groups and nonlocomotive PA significantly affected GDS-15-J scores (p <.05). Moreover, sarcopenic obesity in the low PA group had significantly higher GDS-15-J scores compared with sarcopenic obesity in the high PA group (p <.05). We concluded that sarcopenic obesity combined with low nonlocomotive PA may exacerbate depressive symptoms in older women. [ABSTRACT FROM AUTHOR]

Objective: Although it has been suggested that a decline in oral function is one of the potential risk factors affecting mild cognitive impairment (MCI), evidence is insufficient to draw clear conclusions. This Japanese cross‐sectional study examined the association between tongue pressure (TP) and MCI in middle‐aged and older adults aged 36–84 years. Methods: Study participants were 1019 (368 men and 651 women). TP was evaluated using a TP measurement device. The maximum value of three measurements was used for analysis. MCI was defined as being present if a participant had a Japanese version of the Montreal Cognitive Assessment score of <26. Adjustment was made for age, smoking status, alcohol consumption, leisure‐time physical activity, body mass index, hypertension, dyslipidemia, diabetes mellitus, history of depression, number of teeth, employment, education, and household income. Results: The prevalence of MCI was 45.3%. Among women, compared with the lowest tertile of TP, the second and highest tertiles were significantly associated with a lower prevalence of MCI with a clear dose–response relationship; the adjusted odds ratio (95% confidence intervals) in the second and highest tertiles of TP were 0.54 (0.36–0.83) and 0.55 (0.36–0.84), respectively (p for trend = 0.005). In contrast, no statistically significant association was observed between TP and the prevalence of MCI among men. Conclusions: Our findings suggest that higher TP might be inversely associated with the prevalence of MCI in middle‐aged and older Japanese women. [ABSTRACT FROM AUTHOR]

Diet has been repeatedly shown to affect mental and sleep health outcomes. However, it is well known that there are cross‐cultural differences in dietary practices as well as the prevalence of mental and sleep health outcomes. Given that the dietary inflammatory potential of diets has been linked to mental and sleep health outcomes, in the current study we sought to assess the inflammatory status of habitual diets and examine its relationship with mental and sleep health outcomes in both the United Kingdom and Japan. Our aim was to determine if the associations between the dietary inflammation index (DII) score and these health outcomes could elucidate any potential cross‐cultural differences in health. Online survey data was collected from 602 participants (aged 18–40 years) in the United Kingdom (n = 288) and Japan (n = 314). Participants self‐reported their dietary intakes, as well as current mental health and sleep patterns. The DII score was calculated (score range − 2.79 to 3.49) We found that although participants in the United Kingdom reported better overall mental wellbeing, participants in Japan reported less severe depression, anxiety and stress and better subjective sleep quality, less sleep disturbances and daytime dysfunction, despite sleeping shorter, and a better adherence to an anti‐inflammatory diet. Moreover, across the United Kingdom and Japan, adherence to more anti‐inflammatory diets predicted higher levels of subjective sleep quality, fewer sleep disturbances, less use of sleep medicine and less daytime dysfunction. In conclusion, there are several differences between mental and sleep health outcomes in the United Kingdom and Japan, which could be attributable to the inflammatory potential of respective regional diets. Future studies are warranted to examine the mental and sleep health benefits of adhering to anti‐inflammatory traditional Japanese diets in clinical and subclinical cohorts. [ABSTRACT FROM AUTHOR]

In Japan, many pregnant women and mothers suffer from anxiety, depression, and other postnatal issues that can be exacerbated by their birth experiences. While benefiting from advanced medical care, these women's mental and psychological health may be disregarded in their maternity care. Midwives have the potential to play a significant role in improving women's birth experiences. Hence, this study aimed to explore the meaning of the woman–midwife relationship, with a specific focus on sensing peace of mind and trust to improve women's birth experiences. Using a hermeneutic phenomenological approach, 14 Japanese women were interviewed. Sensing peace of mind and trust was one of the significant meanings of the woman–midwife relationship and is articulated across five themes: (1) attuning to the world, (2) different kinds of safety and trust, (3) relying on and entrusting midwives, (4) making a mother, and (5) an emotional bridge. The positive relationship with midwives enhanced the women's mental well-being through allowing the women to attune to the peaceful mind which directed their future perspectives and sustained them in motherhood. They became confident mothers by trusting their midwives. The maternity care system in Japan needs to shift to more relationship-based care to ensure continuity of midwifery care that will improve women's birth experiences and their long-term well-being. [ABSTRACT FROM AUTHOR]

Purpose: It was reported that maternal-infant bonding failure predicts abusive parenting. Maternal-infant bonding is important to prevent child abuse. This study aimed to investigate the association between prenatal depressive symptoms, anxiety, cortisol, and oxytocin levels, and postnatal maternal–infant bonding. Methods: The participants completed a self-report prenatal questionnaire that included the Edinburgh Postnatal Depression Scale (EPDS) and State-Trait Anxiety Inventory (STAI) in the second trimester. Blood and saliva were collected in the second trimester. Cortisol levels were measured in plasma, while oxytocin levels were measured in saliva. Postnatal questionnaires, including the Mother-to-Infant Bonding Scale (MIBS), were administered at 2–5 days, 1 month, and 3 months postpartum. Multiple linear regression and generalized estimating equation (GEE) were conducted for analysis. Results: Sixty-six primiparas participated in the study. Prenatal depressive symptoms (EPDS ≥ 9) and anxiety (STAI-S ≥ 42) were observed in 21.2% and 28.8% of the participants, respectively. The median cortisol and oxytocin levels were 21.0 µg/dL and 30.4 pg/mL, respectively. Multivariate linear regression showed that postnatal social support, prenatal depressive symptoms, anxiety, and salivary oxytocin levels predicted MIBS scores at 2–5 days postpartum. At 1 month postpartum, household income, history of miscarriage, postnatal social support, and prenatal anxiety predicted MIBS scores. At 3 months postpartum, only postnatal social support predicted MIBS scores. The results of GEE showed that prenatal anxiety, oxytocin levels, postpartum period, household income, and postpartum social support were associated with MIBS scores. Conclusion: Prenatal depressive symptoms, anxiety, and lower salivary oxytocin levels were predicted to worsen maternal–infant bonding at 2–5 days postpartum. Prenatal anxiety was predicted to cause the same 1 month postpartum. Measuring prenatal depressive symptoms, anxiety, and salivary oxytocin levels may render the assessment of the risk of maternal–infant bonding failure during the early postpartum period and intervene during pregnancy possible. [ABSTRACT FROM AUTHOR]

Sleep health is known to be multidimensional, and there is increasing clinical interest in composite sleep health scores that capture the number of adverse sleep characteristics. We investigated whether a composite sleep health score was associated with depressive symptoms in patients with obstructive sleep apnea (OSA) treated with continuous positive airway pressure (CPAP). Participants were OSA patients using CPAP (n = 1768, (92.1 % men, age 52.7 ± 10.7 years) attending sleep clinics in Japan. A cross-sectional survey conducted in 2020 assessed self-reported sleep and depressive symptoms. Sleep health was categorized as "good' or "poor' on five dimensions: satisfaction, daytime sleepiness, mid-sleep time, efficiency, and duration. A composite sleep health score was calculated by summing the "poor' dimensions. Depressive symptoms were assessed using two items from the Patient Health Questionnaire (PHQ-2). Associations between sleep health and depressive symptoms were assessed using multivariable logistic regression analysis. Individual sleep health symptoms of poor satisfaction and efficiency were significantly associated with depressed mood; poor satisfaction, daytime sleepiness, and duration were significantly associated with loss of interest; and poor satisfaction, efficiency, and duration were significantly associated with depressive symptoms. Composite sleep health scores were associated with greater odds of depressive symptoms in a graded manner. Individual and composite sleep health scores were associated with depressive symptoms. Measures of multidimensional sleep health may provide a better understanding of the association between poor sleep and depressive symptoms among patients with OSA using CPAP, accounting for CPAP adherence, leading to improved intervention strategies. • Sleep health is multidimensional and needs a composite measure of sleep health. • We studied sleep health and depressive symptoms in OSA patients using CPAP. • Both individual and composite sleep health were associated with depressive symptoms. • Multidimensional sleep health enhances understanding of depressive symptoms of OSA. [ABSTRACT FROM AUTHOR]

Background: Having no or few confidants is found to be associated with more severe mental health problems and a higher prevalence of depression in adults, but research examining this association in adolescents is scarce. Social relationships may be particularly critical during adolescence, as it is an important developmental period during which vulnerability to mental health problems increases. The present study examined the relationship between having no or few confidants and anxiety/depressive symptoms in adolescents. Methods: Cross-sectional self-report survey targeting 7–12th grade students (age range: 12–18) was conducted in public junior and senior high schools in Mie and Kochi, Japan. Data from 17,829 students (49.7% boys) were analyzed. Associations between anxiety/depressive symptoms (12-item General Health Questionnaire; score range: 0–12) and the number of confidants (None, 1–3, or ≥ 4) were examined using multilevel regression analyses. The analyses were stratified by gender and school level (junior/senior high), and adjusted for experiences of being physically abused and bullied and the interactions of these experiences with the number of confidants. Results: Having no or 1–3 confidants was associated with more anxiety/depressive symptoms, compared to having ≥ 4 confidants (p < 0.001) in all stratified groups. Having no confidants was associated with more anxiety/depressive symptoms than having 1–3 confidants (p < 0.001); in senior high boys, no difference was observed between having no confidants and having 1–3 confidants. In addition, in senior high boys, victims of bullying who have confidants reported significantly less anxiety/depressive symptoms than the victims who have no confidants (p < 0.01). Conclusions: Adolescents who had no or few confidants had more anxiety/depressive symptoms. Attention needs to be paid to better identify these adolescents, and avenues to support them need to be established. [ABSTRACT FROM AUTHOR]

Aim: This study examined the oral status and the presence of teeth requiring treatment among older adults receiving home medical care. Methods: This cross‐sectional study was conducted at a Japanese dental clinic specializing in geriatric treatment. We recruited older adults receiving home medical care in the community who had begun to receive domiciliary dental care. The Japanese version of the Oral Health Assessment Tool (OHAT‐J), as well as the presence of teeth requiring extraction and the need for assistance in maintaining oral hygiene were used to evaluate the participants' oral health and its association with other items. Results: Ninety‐three participants (44 male and 49 female, median age: 87.0 years) were surveyed. The median OHAT‐J score was 6. The duration since the previous dental visit was 23 months. Sixty‐two (73.8%) of 84 participants with ≥1 natural tooth had severe caries or teeth with severe mobility that required extraction. Logistic analysis revealed that requiring assistance in maintaining oral hygiene, mild dementia, severe dementia, and depression were significantly associated with an OHAT score of ≥6. Conclusions: Older adults receiving home medical care had poor oral health, with approximately 70% of them requiring tooth extraction. The need for assistance in maintaining oral hygiene and poor mental status contribute to poor oral health. Geriatr Gerontol Int 2024; 24: 706–714. [ABSTRACT FROM AUTHOR]

Summary: This 5-year longitudinal study investigated the relationship between depressive symptoms and fracture risk in a large Japanese cohort. Depressive symptoms were a significant risk factor for hip fractures in women. Purpose: A relationship between depressive symptoms and fractures has not been clearly demonstrated. We aimed to investigate the relationship between depressive symptoms and 5-year fracture risk in the Japan Public Health Center-based Prospective Study for the Next Generation. Methods: From 2011 to 2016, 114,092 participants were enrolled, and a follow-up survey was conducted 5 years later. We analyzed 30,552 men and 38,063 women aged 40–74 years who had no past fractures at baseline. Presence of depressive symptoms was defined as a modified 11-item Center for Epidemiological Studies Depression Scale score of 8 or higher, a history of depression, or use of antidepressants. Subjects were asked to report vertebral, upper limb, and/or hip fractures, except for traffic or work accidents, that occurred during the follow-up period. The adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for fracture were analyzed via logistic regression analysis to evaluate the relationship between depressive symptoms and fracture. Results: Women with depressive symptoms demonstrated a high AOR for hip fractures (AOR: 2.78, 95% CI: 1.30 – 5.92); this result was consistent in post menopause women. In men, this association was not found for any age group or any type of fracture. Conclusions: Depressive symptoms in women may increase the risk of hip fractures. Further studies are required to explore this relationship in more detail. [ABSTRACT FROM AUTHOR]

Major depressive disorder is a prevalent psychiatric illness characterized by mood disturbances and influenced by various environmental and genetic factors, yet its etiology remains largely unknown. We profiled a self-reported depressive population in Japan with a focus on sociodemographic background, lifestyle, comorbidities, and genetic background, using data from two cohorts, a population-based cohort and a three-generation cohort, recruited by the Tohoku Medical Megabank Organization until December 2021. Our findings revealed that depression in the Japanese population is strongly associated with certain sociocultural features prevalent in Japan, such as social isolation, neuroticism, and introversion, as well as with well-known risk factors that include age and gender. Environmental factors related to the Great East Japan Earthquake, considered as cohort characteristics, were also strongly associated with the onset of depression. Moreover, using GWAS analysis of whole-genome sequencing data, we identified novel candidate genetic risk variants located on chromosomes 21 and 22 that are associated with depression in Japanese individuals; further validation of these risk variants is warranted. Our study has limitations, including uncertain clinical relevance resulting from the use of self-reported questionnaires for depression assessment. Additionally, the cohort exhibited a population bias, with greater representation of women than men. Our results provide holistic insights into depression risk factors in Japanese adults, although their associations with depression are correlations. This supports the idea that targeted interventions and individualized approaches are important for addressing depression in the Japanese population. • Self-reported depression in Japanese adults was profiled from multiple perspectives. • Sociocultural factors that contribute to depression in Japan were identified. • Novel genetic risk variant candidates related to depression in Japan were discovered. • Our study provides fundamental knowledge about depression in Japan. [ABSTRACT FROM AUTHOR]

Objective: To assess the prevalence and impact of neck pain during headache among respondents with migraine in the multicountry Chronic Migraine Epidemiology and Outcomes – International (CaMEO‐I) Study. Background: Neck pain among individuals with migraine is highly prevalent and contributes to disability. Methods: The CaMEO‐I was a prospective, cross‐sectional, web‐based study conducted in Canada, France, Germany, Japan, United Kingdom, and the United States. A demographically representative sample of participants from each country completed a screening survey to evaluate headache characteristics. Respondents with headache were identified as having migraine or non‐migraine headache based on modified International Classification of Headache Disorders, third edition, criteria; those with migraine completed a detailed survey with migraine‐specific assessments. Results were stratified by the presence or absence of neck pain with headache (NPWH). For these analyses, data were pooled across the six countries. Results: Of 51,969 respondents who reported headache within the past 12 months, 14,492 (27.9%) were classified as having migraine; the remaining 37,477 (72.1%) had non‐migraine headache. Overall, 9896/14,492 (68.3%) of respondents with migraine headache reported NPWH, which was significantly higher (p < 0.001) than the proportion of respondents with non‐migraine headache who reported NPWH (13,536/37,477 [36.1%]). Among respondents with migraine, moderate‐to‐severe disability was significantly more prevalent for those with NPWH versus without (47.7% [4718/9896] vs. 28.9%, p < 0.001). Respondents with NPWH versus without also had significantly greater work productivity losses, at a median (interquartile range [IQR]) of 50.0 (20.0, 71.3) vs. 30.0 (0.0, 60.0) (p < 0.001), lower quality of life (Migraine‐Specific Quality of Life questionnaire version 2.1, median [IQR] Role Function–Restrictive domain score 60.0 [42.9, 74.3] vs. 68.6 [54.3, 82.9], p < 0.001), higher prevalence of depression and anxiety symptoms (depression, 40.2% [3982/9896] vs. 28.2% [1296/4596], p < 0.001); anxiety, 41.2% [4082/9896] vs. 29.2% [1343/4596], p < 0.001), higher prevalence of cutaneous allodynia during headache (54.0% [5345/9896] vs. 36.6% [1681/4596], p < 0.001), and higher prevalence of poor acute treatment optimization (61.1% [5582/9129] vs. 53.3% [2197/4122], p < 0.001). Conclusions: Nearly 70% of respondents with migraine reported NPWH. Individuals with migraine with neck pain during their headaches had greater disability, depression, anxiety, and cutaneous allodynia (during headache) than those without neck pain during their headaches. They also had diminished quality of life and work productivity, and poorer response to acute treatment compared with those without neck pain. Plain Language Summary: We looked at data from a web‐based study of over 51,000 people across Canada, France, Germany, Japan, United Kingdom, and the United States to understand how neck pain affects people with migraine. We found that neck pain is common in people with migraine, and that those who have neck pain during their headaches have more disability, worse symptoms, more anxiety and depression, and poorer quality of life than those without neck pain. Our results show that neck pain is a serious problem for people with migraine, and it can worsen the negative impacts of migraine. [ABSTRACT FROM AUTHOR]

The present review aimed to synthesize the empirical evidence regarding the association between problematic pornography use (PPU) and mental health. A comprehensive literature search using keywords and subject headings was performed with three electronic databases, resulting in 20 studies that met the inclusion criteria. The patterns of association between PPU and mental health were examined, and the limitations of these studies were discussed. The overall findings suggest the relationship between PPU and mental health outcomes is not clear-cut, and it is often mediated by other factors such as loneliness, anxiety, and self-esteem. Further studies are required to evaluate the prevalence of PPU and both risk and protective factors which are associated with exposure to online pornography. Most studies relied on homogenous samples which have limited the generalizability of findings. The use of representative samples, including both males and females with different sexual orientations and from diverse cultural and ethnic backgrounds, would strengthen our understanding of PPU and go further to expound on its controversies. Clinical recommendations and future directions are also discussed. [ABSTRACT FROM AUTHOR]

Objective: The present study examined the moderating effect of coping flexibility on the association between the coping waiting patiently for interpersonal stressors and depression. Coping flexibility refers to devising and implementing suitable coping strategies according to the situation, coping was defined in this study as holding oneself back and not acting prematurely to address a stressful relationship. Participants: A total of 481 Japanese college students. Methods: Participants completed questionnaires to measure coping, coping flexibility, perceived stress, and depression using a longitudinal design. Results: Multiple regression analysis showed that an interaction between coping and coping flexibility was associated with depression. This result indicated that higher levels of coping was associated with lower depression 16 weeks later when coping flexibility was higher, but the association was not observed when coping flexibility was lower. Conclusions: Our findings contribute to elucidating the condition or process whereby the strategy of waiting patiently as a coping mechanism for interpersonal stressor reduces depression. [ABSTRACT FROM AUTHOR]

The cognitive distortion scale (CDS) is a self-rated measure to assess the degree of cognitive distortion which is 10 thinking errors commonly seen in depression. However, there is no scale to measure 10 types cognitive distortions specific to depression in Japan. Therefore, this study translated the CDS into Japanese (CDS-J), and examined its factor structure, validity, and reliability in a Japanese population. A total of 237 healthy individuals and 39 individuals with depression participated in this study. Confirmatory factor analysis indicated the appropriateness of the CDS-J's 10-factor structure. Regarding convergent validity, CDS-J was significantly correlated with dysfunctional attitudes, negative automatic thoughts, and depression. Regarding discriminant validity, the CDS-J showed no significant correlation with positive automatic thoughts. The total CDS-J scores of the healthy participants and of those with major depression were compared. The results showed significant differences between groups. Finally, the CDS-J was found to have a high test--retest reliability. Therefore, the CDS-J is a valid and reliable tool for assessing cognitive distortions in Japan. [ABSTRACT FROM AUTHOR]

Introduction: The clinical efficacy of repetitive transcranial magnetic stimulation (rTMS) for treatment-resistant depression (TRD) in Japan has not been adequately investigated. Furthermore, the relationship between stimulation-site pain and the antidepressant effects of rTMS has not been thoroughly examined. Therefore, this study aimed to clarify (1) the real-world efficacy and safety of rTMS for TRD in Japan and (2) the relationship between stimulation-site pain and clinical improvement of depressive symptoms. Methods: We conducted a retrospective observational study involving 50 right-handed patients with TRD. All patients received high-frequency rTMS for up to 6 weeks. Depressive symptoms were assessed using the Montgomery-Åsberg depression rating scale (MADRS). Pain at the stimulation site was reported by the patients using a visual analog scale (VAS) after each session. Remission and response rates at 3 and 6 weeks were calculated based on the MADRS scores. The correlation between changes in the MADRS and VAS scores was examined. Results: Remission and response rates were 36% and 46%, respectively, at the end of 3 weeks, and 60% and 70%, respectively, at 6 weeks. At the end of the treatment, there was significant correlation between the reduction of MADRS and VAS scores (r = 0.42, p = 0.003). Conclusion: This study demonstrates the clinical efficacy of rTMS in Japan and the correlation between its antidepressant effects and stimulation-site pain. [ABSTRACT FROM AUTHOR]

Rumination, defined as "repetitive thinking about the symptoms, causes, circumstances, meanings, and consequences of negative mood" (Watkins & Roberts, 2020), is a cognitive vulnerability factor that leads to multiple mental disorders transdiagnostically. Rumination-focused cognitive-behavioral therapy (RFCBT) is a novel approach of CBT that directly addresses rumination. The effectiveness of RFCBT in the treatment and prevention of depression has been demonstrated through multiple randomized controlled trials, all of which are conducted within Western cultures. Nevertheless, previous studies indicate that the consequences of rumination may differ across cultures. Therefore, cultural adaptation is a key in introducing RFCBT to the Eastern culture. The present article focuses on the endeavors undertaken thus far to introduce RFCBT to Japan, with specific focus on intervention studies and dissemination work. Future directions are discussed to build the evidence-base and promote dissemination within Japan and the Eastern countries. [ABSTRACT FROM AUTHOR]

Purpose: The COVID-19 pandemic has intensified feelings of loneliness, especially among postpartum women. This nationwide Japanese longitudinal study assessed the impact of such feelings on depressive symptoms and mother-to-infant bonding difficulties (MIBD), two pivotal determinants of maternal and infant well-being. Methods: Starting with a baseline survey conducted between July and August 2021, we tracked 1254 postpartum Japanese women who initially reported minimal depressive symptoms (i.e., Edinburgh Postnatal Depression Scale < 9) and MIBD (i.e., Mother-to-Infant Bonding Scale < 5), over a follow-up period of approximately 6 months. Baseline loneliness was evaluated with the UCLA Loneliness Scale Short-Form (UCLA-LS3-SF3). Results: Forty-nine percent of the sample reported the presence of baseline feelings of loneliness. After propensity score matching on sociodemographics and various pregnancy, childbirth, and COVID-19–related aspects, baseline loneliness was associated with increased risks of later depressive symptoms but not MIBD. Using restricted cubic spline logistic regression and considering loneliness as a continuous variable, we found a positive increasing quadratic relationship with depressive symptoms. As loneliness increased, so did the risk of later depressive symptoms. However, there was no significant association between loneliness and MIBD. These results were confirmed through a sensitivity analysis using inverse probability weighting to address attrition bias. Conclusion: Feelings of postpartum loneliness are associated with future risks of depressive symptoms. The data suggests that addressing loneliness in postpartum women early is crucial to safeguarding their well-being and that of their infants. [ABSTRACT FROM AUTHOR]

The relationship between chronic pain and the occurrence of falls in healthy older adults has been clarified in previous studies, but its relationship in older adults with disabilities has not. This study aimed to determine whether chronic pain is related to the occurrence of falls in older adults with disabilities. The participants were 101 older adults above 65 years old who used long-term care insurance services in Japan. Of these, 30 were fallers and 71 were non-fallers. Chronic pain, defined as pain lasting more than three months, was assessed using questionnaires, and the falls' occurrence was followed up for six months using a fall calendar. Logistic regression analysis was used to analyze the data, with falls as the dependent variable, chronic pain as the independent variable, and age, sex, body mass index, number of drugs, sleep disorders, and depression as covariates. After adjusting for covariates, chronic pain significantly influenced the occurrence of falls (odds ratio: 3.168, 95% confidence interval: 1.057–9.495, p =.04). Chronic pain was related to the occurrence of falls in older adults with disabilities. There is a need to focus on chronic pain presence in falls' prevention among older adults with disabilities. [ABSTRACT FROM AUTHOR]

Pachinko and pachislot are popular types of gambling activities in Japan. Prior studies in Japan have reported a concerning prevalence of problem gambling among adult players. While these studies have identified various gambling-related harms, Japanese research on harm-minimization strategies is scarce. Therefore, the present study aimed to compare differences of gambling-related harms among normal-, half-, and quarter-pachi players to the usefulness of low-investment pachinko and pachislot as a harm-reduction strategy. We considered gamblers who played games that cost the typical amount of money to be "normal-pachi players." Those who played low-investment games were categorized as "half-pachi players" and "quarter-pachi players," reflecting those who played games at half or one quarter the cost of a typical machine, respectively. To assess the harm-reduction effect, a one-way ANCOVA was conducted to compare the impact of the groups (normal-pachi players [n = 101], half-pachi players [n = 104], and quarter-pachi players [n = 100]) on dependent variables, namely the number of days players had gambled during the prior month; total time and amount of money spent on gambling; debts caused by gambling; gambling severity; cognitive distortion; depressive symptoms; and problems in work, family, and social life. We demonstrated that the amount of money spent by quarter-pachi players on gambling during the past month was lower than that of normal-pachi players. However, we did not find significant differences with respect to any other gambling-related harms among normal-, half-, and quarter-pachi players. Low-investment pachinko and pachislot players spends less the amount of money spent on gambling. Low-investment pachinko and pachislot would thus partly act as a harm-minimization strategy. Moreover, the results of the present study indicate that the problems at work affect various outcomes for gamblers. Given that 90% of the participants in this study were employed, the results of this study may have important implications for employed gamblers. [ABSTRACT FROM AUTHOR]

Aims: To determine the prevalence and impact of emotional blunting (EB) in patients with major depressive disorder (MDD) in Japan, and identify treatment needs for EB using patients' perceptions and attitudes. Methods: Eligible patients in Japan (aged 18–59 years) who reported a diagnosis of MDD and antidepressant medication use for >3 months were eligible to complete an online survey. The primary outcome was the prevalence of EB, self‐reported using a validated screening question. Secondary outcomes included the correlation between EB symptoms (measured by the Oxford Depression Questionnaire [ODQ]) and scores on the Patient Health Questionnaire 9‐item (PHQ‐9), Generalized Anxiety Disorder 7‐item (GAD‐7), Work and Social Adjustment Scale (WSAS), and the EuroQol 5‐Dimension 5‐Levels questionnaire (EQ‐5D‐5L). Descriptive questions were used to explore patients' perceptions and attitudes toward EB. Results: In total, 3376 patients were included in the analysis (56% male; 48% aged 50–59 years). Overall, 67.1% of patients self‐reported symptoms of EB, with 10% rating these as severe. The mean (SD) ODQ total score was 78.2 (21.5), which increased with worsening EB symptoms. There were correlations between ODQ total scores and the PHQ‐9, GAD‐7, WSAS, and EQ‐5D‐5L scores (correlation coefficients: 0.67, 0.55, 0.56, −0.51, respectively; all p < 0.0001). Descriptive analyses showed that one‐third of patients reporting EB symptoms did not tell their physician, with two‐thirds finding these symptoms distressing and likely to affect recovery. Conclusion: EB is an important clinical issue in Japan that needs to be considered alongside functional recovery when managing treatment of patients with MDD. [ABSTRACT FROM AUTHOR]

In Japan, physical activity duration in junior high schools is substantially higher than that in elementary schools. Using longitudinal data, this study examined the association between changes in physical activity duration and depressive symptoms in 1225 adolescents without depressive symptoms at baseline (51.2% female) from a rural city in Japan. Adolescents in the group that changed from "Active" (physical activity duration ≥7 h /week) in the fifth-grade of elementary school (age 11 years) to "Inactive" in the second-grade of junior high school (age 14 years) had a higher odds ratio of being rated as having depressive tendencies at age 14 years than adolescents in the Active–Active group. Additionally, the results of the cross-lagged effects model analysis suggested that depressive symptoms may be a factor in the reduced physical activity duration. [ABSTRACT FROM AUTHOR]

Background: To examine whether the "Effectiveness of Guideline for Dissemination and Education in psychiatric treatment (EGIUDE)" project affects the rate of prescriptions of hypnotic medication and the type of hypnotic medications prescribed among psychiatrists, for schizophrenia and major depressive disorder in Japan. Methods: The EGUIDE project is a nationwide prospective study of evidence-based clinical guidelines for schizophrenia and major depressive disorder in Japan. From 2016 to 2021, clinical and prescribing data from patients discharged from hospitals participating in the EGUIDE project were used to examine hypnotic medication prescriptions The prescribing rate of hypnotics and the prescribing rate of each type of hypnotic (benzodiazepine receptor agonist, nonbenzodiazepine receptor agonist, melatonin receptor agonist, and orexin receptor antagonist) were compared among patients who had been prescribed medication by psychiatrists participating in the EGUIDE project and patients who had been prescribed medication by nonparticipating psychiatrists. Multivariate logistic regression analysis was performed to examine the effect of the EGUIDE project on the prescription of hypnotic medications. Results: A total of 12,161 patients with schizophrenia and 6,167 patients with major depressive disorder were included. Psychiatrists participating in the EGUIDE project significantly reduced the rate of prescribing hypnotic medication and benzodiazepine receptor agonists for both schizophrenia (P < 0.001) and major depressive disorder (P < 0.001) patients. Conclusion: This is the first study to investigate the educational effects of guidelines for the treatment of psychiatric disorders on psychiatrists in terms of prescribing hypnotic medications to patients. The EGUIDE project may play an important role in reducing hypnotic medication prescription rates, particularly with respect to benzodiazepine receptor agonists. The results suggest that the EGUIDE project may result in improved therapeutic behavior. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to investigate the impact of memory function and social capital on depressive symptoms during the COVID‐19 pandemic among older adults in rural Japan. Methods: A retrospective study with longitudinal data was conducted during COVID‐19 from May 2021 to November 2021 (T2) in Kurogawa, Japan. The candidate population for this study was 145 with the following requirements: (1) older individuals aged 65 years or above who were registered in the Kurogawa study, and (2) those with previous data (from November 2016 to February 2020; T1 as pre‐pandemic). Memory function was assessed using the Wechsler Memory Scale‐Revised Logical Memory II delayed recall part A (LM II‐DR). Depressive symptoms were assessed using the Japanese version of the 15‐item Geriatric Depression Scale (GDS‐15). Social capital was evaluated through civic participation, social cohesion, and reciprocity. Fear of the COVID‐19 infection (FCV‐19S) was evaluated. Results: The final analysis included 96 participants (mean age = 81.0 years, SD = 4.8) Multivariate analysis for GDS‐15 score by Mixed Model Repeated Measures (MMRM) revealed significant associations between LM II‐DR (β = −0.13, 95% CI: −0.21–0.05, p = 0.002) and FCV‐19S during COVID‐19 (β = 0.08, 95% CI: 0.01–0.15, p = 0.02) with GDS‐15 score. However, civic participation, social cohesion and reciprocity were not associated with GDS‐15 score. Conclusions: Among older adults in rural Japan, memory function and fear of the COVID‐19 infection were significantly associated with depressive symptoms in MMRM analysis. However, social capital was not associated with depressive symptoms. This highlights the need to address memory function and fear of the COVID‐19 infection in interventions for older adults during crises like the COVID‐19 pandemic. Key points: This study examined the impact of memory function and social capital on depressive symptoms during the COVID‐19 pandemic among older adults in rural Japan.LM II‐DR and FCV‐19S were significantly associated with GDS‐15 scores, under considering within‐individual correlation and time points (before and during COVID‐19) in Mixed Model Repeated Measures (MMRM) analysis.However, civic participation, social cohesion and reciprocity were not associated with depressive symptoms in MMRM analysis.This highlights the need to address memory function and fear of the COVID‐19 infection in interventions for older adults during crises such as the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

For patients with chronic pain and persistent physical symptoms, understanding the mechanism of central sensitisation may help in understanding how symptoms persist. This cross-sectional study investigated the association of central sensitisation with depression, anxiety, and somatic symptoms. Four hundred and fifteen adults attending an outpatient psychosomatic clinic were evaluated. Participants completed the Hospital Anxiety and Depression Scale, Somatic Symptom Scale 8, and the Central Sensitisation Inventory. The relationships between these factors were examined using descriptive statistics and multiple logistic regression analyses. The mean age was 42.3 years, and 59% were female. The disorders included adjustment disorders (n = 70), anxiety disorders (n = 63), depressive disorders (n = 103), feeding and eating disorders (n = 30), sleep–wake disorders (n = 37), somatic symptoms and related disorders (n = 84), and others (n = 28). In multiple logistic regression analyses, higher central sensitisation was associated with more severe anxiety, depression, and somatic symptoms after controlling for potential confounders. In the disease-specific analysis, somatic symptoms correlated more positively with central sensitisation than with depression or anxiety. Central sensitisation and depression, anxiety, and somatic symptoms were associated with patients attending an outpatient clinic. These findings highlight the importance of evaluating depression, anxiety, and somatic symptoms when assessing central sensitisation. [ABSTRACT FROM AUTHOR]

Aim: To explore the prevalence of social isolation among Japanese community‐dwelling older adults before and during the COVID‐19 pandemic as well as determine how family and friend connections before and during the pandemic affected frail older adults during the pandemic. Design: A cross‐sectional study. Methods: A total of 852 community‐dwelling older adults in Hokkaido and Tokyo, Japan were surveyed conducted between April and November 2021 using convenience sampling. The Lubben social network scale‐6, frailty screening index, and geriatric depression scale were used to assess social isolation, frailty and depression, respectively. A path analysis was conducted to evaluate the effect of social isolation on frailty. Results: Participants had a mean age of 76.8 ± 6.6 years. Overall, 46% and 59% of participants were socially isolated before and during the COVID‐19 pandemic, respectively. Frailty was found in 19% of participants during the pandemic. Friends and family connectedness before the pandemic had no direct relationship with frailty; only friend connectedness affected frailty indirectly via depression. Family connectedness during the pandemic had a significant, negative and direct relationship with frailty. Conclusion: The findings show that connectedness with family and friends is critical for older people's physical and mental health. Impact: Nurses in the community should consider these findings to reduce mental health problems and physical decline among older adults. It is important to identify older adults who are socially isolated from their families or friends and provide resources to help them build relationships within their communities. Patient or Public Contribution: Community centre staff and community volunteers assisted in data collection. The public was not involved in data analysis, interpretation or manuscript preparation. [ABSTRACT FROM AUTHOR]

Purpose: Providing support for older adults after spousal bereavement is crucial for psychological recovery through the grieving process and for promoting a healthy and happy remainder of life. The current study aimed to understand factors influencing well-being among Japanese community-dwelling older adults who experienced spousal bereavement by evaluating how their roles and activities affected their psychological well-being following the loss. Method: We conducted a cross-sectional, anonymous, self-administered questionnaire survey of 332 older adults who had experienced death of a spouse in later adulthood. Results: Identified factors that affected well-being after spousal loss were sex, ability to go out without assistance from others, long duration since spousal loss, having a hobby, and adopting a life-oriented approach to cope with bereavement. Well-being following spousal loss was influenced by participants' activities and roles. Conclusion: Findings of the current study provide potentially valuable suggestions for surviving spouses and their supporters when coping with grief following spousal loss. [Research in Gerontological Nursing, 17(3), 121–130.] [ABSTRACT FROM AUTHOR]

Objective: We explored whether a patient’s psychosocial background before allogeneic hematopoietic stem cell transplantation (allo-HSCT) could predict the occurrence of psychiatric symptoms during treatment and after hospital discharge. Method: Logistic regression analysis was performed using INTERMED, a scale that comprehensively evaluates psychological factors such as psychiatric history, current mental status, and coping skills, and social factors such as social participation status, relationships with others, and living environment, which were used as independent variables. The Center for Epidemiologic Studies Depression Scale was used to measure depression, while the Profile of Mood States was used to measure anxiety and other symptoms. Both measures were used as dependent variables and were administered upon clean room admission, during clean room stay, at clean room discharge, and at 3, 6, and 12 months after hospital discharge. Results: Participants included 70 patients (45 males and 25 females, mean age 53.3 ± 12.3 years). Thirty-eight patients participated in the program for the entire period, up to 12 months after hospital discharge. The total score on the Japanese version of the INTERMED and psychological factor scores assessed at baseline were significant predictors of depressed mood on discharge; however, there were no significant predictors of scores on the Profile of Mood States. Conclusions: A comprehensive pretransplant evaluation of psychosocial background can help predict the appearance of psychiatric symptoms after allo-HSCT. In patients who are expected to develop psychiatric symptoms after allo-HSCT, it is important to consider early intervention by a specialist and close monitoring by a medical team. [ABSTRACT FROM AUTHOR]

This study compared the effects of academic year, college department, and undergraduate or graduate status on Japanese students' mental health during the COVID-19 pandemic. From 2021–2023, an online survey was conducted using the Counseling Center Assessment of Psychological Systems-Japanese (CCAPS-Japanese) to evaluate students' mental health; 9395 undergraduate students (4623 female, 4772 male) and 1169 graduate students (380 female, 789 male) responded. Undergraduate students in medicine had lower levels of depression, generalized anxiety, and social anxiety than those in other departments. Engineering students exhibited the highest level of academic distress. First-year students had the highest levels of generalized and social anxiety but the lowest level of academic distress. Second-year students had the lowest level of depression, and third-year students had the highest level of academic distress. Among graduate students, first-year students had higher levels of depression, generalized anxiety, social anxiety, academic distress, and hostility than second-year students. Undergraduates had poorer mental health than graduate students. Females had higher levels of eating concerns than males among undergraduate students. This study revealed that the mental health of university students was affected by various factors. These findings demonstrate the characteristics of university students requiring early support. [ABSTRACT FROM AUTHOR]

Background: Little information is available on the association between gender nonconformity during adolescence and subsequent mental health. While the distress related to gender nonconformity may be socially produced rather than attributed to individual-level factors, further research is needed to better understand the role of psychosocial factors in this context. Method: We analyzed data from the Tokyo Teen Cohort, obtained through random sampling of adolescents born between 2002 and 2004. We used inverse probability weighting to examine the association of gender nonconformity at ages 12 and 14 as a time-varying variable with subsequent mental health at age 16, while accounting for time-fixed and time-varying confounders. Furthermore, we used a weighting approach to investigate the mediating role of modifiable psychosocial factors in this association, addressing exposure-mediator and mediator–mediator interactions. Results: A total of 3171 participants were analyzed. Persistent gender nonconforming behavior at ages 12 and 14 was associated with subsequent depression (β = 2.02, 95% confidence interval [CI] 0.85 to 3.19) and psychotic experiences (β = 0.33, 95% CI 0.14 to 0.52) at age 16. The results remained robust in sensitivity analyses. Approximately 30% of the association between gender nonconformity and depression was consistently mediated by a set of psychosocial factors, namely loneliness, bullying victimization, and relationships with mother, father, and friends. Conclusions: Persistent gender nonconformity during adolescence is associated with subsequent mental health. Psychosocial factors play a vital mediating role in this association, highlighting the essential need for social intervention and change to reduce stigmatization and ameliorate mental health challenges. [ABSTRACT FROM AUTHOR]

This study evaluated the effect of perceived discrimination and racism on the mental health state of Korean residents in Japan, with a particular focus on the risk of post-traumatic stress disorder (PTSD), depression, and psychological distress. Surveys were sent to Korean residents in Japan and a total of 240 valid responses were received. The valid response rate was 27.1%. The participants answered several questionnaire items, including demographic information and questions pertaining to their experiences of perceived discrimination, along with three self-reported measures of mental health, i.e., the Japanese version of Impact of Event Scale-Revised, the Zung Self-rating Depression Scale (SDS), and the 12-item General Health Questionnaire (GHQ-12). The results indicated that Korean residents in Japan experience hate speech and discrimination with a markedly high frequency (92.9% and 100%, respectively), and that factors such as employment discrimination and exposure to hate speech via social networking services were significant predictors of probable PTSD and psychological distress. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to clarify the relationship between depressive symptoms and infection prevention measures and daily lifestyle habits during the coronavirus disease 2019 pandemic among community‐dwelling Japanese older adults. Methods: This cross‐sectional study was conducted on older residents (age ≥65 years) living in the Tama area of Tokyo and Sapporo, Hokkaido, in 2021. A self‐administered questionnaire survey was conducted to collect data on demographics, the impact of the pandemic on physical condition, and depressive symptoms, infection prevention measures, and daily lifestyle habits during the pandemic. The Geriatric Depression Scale was used to assess depressive symptoms. Results: In total, 554 respondents were included in the analysis. The results of multiple logistic regression analyses revealed that refraining from going out and visiting medical institutions were associated with depressive symptoms. Furthermore, those who went out almost every day were less likely to have depressive symptoms than the others, those who exercised almost every day were less likely to have depressive symptoms than were those who almost never exercised, and those who slept 6–7 h were less likely to have depressive symptoms than were those who slept ≤5 h. Conclusions: The findings of the present study suggest the necessity of having a place where older adults with physical and lifestyle concerns can consult with healthcare providers in a location other than a medical institution, even during infectious disease outbreaks. In addition, increasing the frequencies of going out and independent exercise and sleeping 6–7 h may help prevent depression among older adults. [ABSTRACT FROM AUTHOR]

Background/objectives: In addition to the potential effects of nutrients on mood, eating behaviors have been suggested to be associated with depressive symptoms. We investigated the prospective association between the accumulation of unhealthy eating behaviors and depressive symptoms in a Japanese working population. Methods: Participants were 914 workers (aged 19–68 years) who did not have depressive symptoms at baseline (April 2012 and May 2013) and attended a 3-year follow-up survey (April 2015 and May 2016). Unhealthy eating behaviors (skipping breakfast, eating dinner just before bedtime, and snacking after dinner) were assessed at baseline. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES-D) scale at follow-up. Multiple logistic regression was used to estimate the odds ratio of depressive symptoms (CES-D score ≥16) at follow-up according to the number of unhealthy eating behaviors. Results: In a model with adjustment of background factors, participants having 2–3 unhealthy eating behaviors at baseline had significantly higher risk of developing depressive symptoms (OR, 2.02; 95% CI, 1.21–3.38) compared with those having no such behaviors. After adjustment for occupational and lifestyle factors, the association was slightly attenuated but remained significant (OR, 1.87; 95% CI, 1.10–3.21). This association was further attenuated and became statistically non-significant after additional adjustment for nutritional factors (OR, 1.67; 95% CI, 0.96–2.90). Conclusions: Our results suggest that the accumulation of unhealthy eating behaviors is associated with an increased risk of depressive symptoms and that this association may be partly ascribed to a lower intake of nutrients with mood-improving effects. [ABSTRACT FROM AUTHOR]

Aim: This study examined the associations between geriatric factors and decreased opportunities for conversation among older adults amid a period of self‐restraint during the COVID‐19 pandemic. Methods: A cross‐sectional questionnaire‐based survey was carried out in October 2020. The participants were 204 residents aged ≥65 years staying at a private care home in Kyoto city, Japan. Logistic regression analysis was carried out with the reduction of conversation opportunities as the dependent variable, and geriatric factors as independent variables after adjusting for age and sex. We compared the decreased frequency of opportunities between residents in the assisted living wing and in the nursing care wing of the private care home. Results: The percentages of respondents who reported a decrease in the opportunities for conversation among themselves were 43.9% for residents in the assisted living wing and 19.7% for those in the nursing care wing. After adjusting for age and sex, the opportunities for conversation was significantly associated with the basic activities of daily living (OR 1.07, 95% CI 1.01–1.12), instrumental self‐maintenance (OR 1.25, 95% CI 1.08–1.46), intellectual activity (OR 1.35, 95% CI 1.09–1.66), depression (OR 1.13, 95% CI 1.04–1.23), depressive mood (OR 3.83, 95% CI 1.98–7.42), decreased motivation (OR 3.11, 95% CI 1.58–6.12), appetite loss (OR 4.32, 95% CI 1.54–12.07), swallowing function (OR 1.05, 95% CI 1.00–1.10), chewing difficulty (OR 2.50, 95% CI 1.31–4.75) and eating alone (OR 2.5, 95% CI 1.35–4.62). Conclusion: Decreased opportunities for conversation was more perceived among older adults with higher daily functioning, suggesting that it is associated with depressed mood, oral function and solitary eating. Geriatr Gerontol Int 2024; 24: 385–391. [ABSTRACT FROM AUTHOR]

Japanese psychiatrists have proposed a new type of depression characterized by passing blame and irritability, which worsens on working days. This new type of depression is assumed to be closely associated with two personality traits: Interpersonal sensitivity, which reflects the tendency to be excessively concerned about or overreact to others' negative evaluations, and privileged self, which reflects the tendency to pursue own pleasures at the expense of maintaining harmony with others. Although a previous longitudinal study showed that these traits can lead to interpersonal stress generation among university students, it did not control for the influence of baseline negative events, nor use a scale that separately assessed negative dependent events caused by the participants' behaviors and negative independent events occurring outside the participants' control. The current study addressed these limitations and investigated whether interpersonal sensitivity and privileged self led to stress generation and increased depressive symptoms. Undergraduate and graduate students in Japan (N = 265) responded to self-report measures twice at an interval of four weeks. The results indicated that privileged self was related to an increase in subsequent experiences of negative dependent and independent events after controlling for either category of events experienced at the baseline. These findings suggest that privileged self can lead to stress generation or the perception that surrounding circumstances are worse than they are. Furthermore, privileged self was associated with an increase in subsequent depressive symptoms via experiences of negative interpersonal dependent events. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic exposed older adults to high risk of sarcopenia. This study aimed to investigate the prevalence of sarcopenia and its risk factors among Japanese community-dwelling older adults during the COVID-19 pandemic. We collected data through questionnaires and physical measurements among 242 older adults. Sarcopenia was assessed using the Asian Working Group for Sarcopenia 2019 criteria. The results revealed that 14.5% had sarcopenia, which was significantly associated with age, nutritional status, number of prescription medications, body mass index, and self-rated health. On multivariate analysis, the risk of malnutrition was independently significantly associated with sarcopenia. Approximately 70% of participants reported decreased social interaction and going outside, but with no significant association with sarcopenia. In addition, approximately 65% of the participants had an exercise habit and went outside at least once a week, thus maintaining a good level of activity. These findings suggest that prevention of sarcopenia during the pandemic required provision of opportunities for older adults to remain active and positive assessment of nutritional status and well-being. [ABSTRACT FROM AUTHOR]

Previous studies have highlighted that the balance between social support individuals receive and that they provide plays a crucial role in their well‐being. However, these studies predominantly focused on the balance without distinguishing situations where individuals receive and provide abundant support from situations where they receive and provide limited support. The present research emphasizes the importance of concurrently considering the amount and balance of social support. With this goal, we compared models focusing solely on balance to those considering both amount and balance, utilizing data from older Japanese adults (n = 1,324). The models focusing solely on balance yielded mixed findings: positive relationships between balance and subjective well‐being emerged only when variables indicating balance were created in a particular manner. In contrast, the models examining both amount and balance provided more reliable and comprehensive insights. First, the amount of support received and provided independently had a positive relationship with subjective well‐being. Second, balance was not related to subjective well‐being: individuals receiving or providing abundant support (i.e., unbalanced) reported similar levels of well‐being to those receiving and providing abundant support (i.e., balanced). Furthermore, they reported higher levels of well‐being than those receiving and providing limited support (i.e., balanced). [ABSTRACT FROM AUTHOR]

Aim: To update the major depressive disorder (MDD) treatment guidelines of the Japanese Society of Mood Disorders, we conducted a systematic review and pairwise meta‐analysis of double‐blind, randomized, placebo‐controlled trials of available antidepressants in Japan for older adults with MDD. Methods: Outcome measures included response rate (primary), improvement in depressive symptom scale score, remission rate, all‐cause discontinuation, discontinuation due to adverse events, and at least one adverse event. A random‐effects model was used to calculate the risk ratio (RR) and standardized mean difference (SMD) with a 95% confidence interval (95% CI). Results: Nine double‐blind, randomized, placebo‐controlled trials (n = 2145) were identified. No study has been conducted in Japan. Our meta‐analysis included the following antidepressants: duloxetine, escitalopram, imipramine, sertraline, venlafaxine, and vortioxetine. Antidepressants have significantly higher response rates than placebo (RR [95% CI] = 1.38 [1.04, 1.83], p = 0.02). Antidepressants outperformed placebo in terms of improving depressive symptom scale score (SMD [95% CI] = −0.62 [−0.92, −0.33], p < 0.0001). However, antidepressants were associated with a higher discontinuation rate due to adverse events (RR [95% CI] = 1.94 [1.30, 2.88], p = 0.001) and a higher incidence of at least one adverse event (RR [95% CI] = 1.11 [1.02, 1.21], p = 0.02) compared to placebo. The groups did not differ significantly in terms of remission rate or all‐cause discontinuation. Conclusions: Our meta‐analysis concluded that treatment with antidepressants available in Japan is only weakly recommended for moderate to severe MDD in older adults. [ABSTRACT FROM AUTHOR]

Aim: This systematic review and frequentist network meta‐analysis used random‐effects models is conducted to determine whether there are differences in the efficacy, acceptability, tolerability, and safety profiles of brexpiprazole (BRE) and aripiprazole (ARI) for Japanese with major depressive disorder (MDD) who were inadequately responsive to antidepressants. Methods: Outcome measures were scores on the Montgomery Åsberg Depression Rating Scale (primary), the Clinical Global Impression severity scale, and social functioning scale; the non‐response rate; the non‐remission rate; all‐cause discontinuation; discontinuation due to adverse events (DAE); at least one adverse event (1AE); serious adverse event, akathisia; tremor; weight gain. Results: A literature search identified three double‐blind, randomized, placebo‐controlled trials. These comprised one BRE study (with a 1 mg/day [BRE1] and a 2 mg/day [BRE2]) and two ARI studies (with a 3 mg/day arm and a flexible‐dose arm[within the dosage range approved in Japan]) (n = 1736). Both BRE and ARI demonstrated better efficacy than the placebo. BRE but not ARI had a higher DAE than the placebo. ARI but not BRE had a higher 1AE than the placebo. BRE and ARI had a higher risk of akathisia and weight gain than the placebo. There were no significant differences between BRE and ARI for any of the outcomes. Although BRE1 had good efficacy, it carried risk of weight gain. Although BRE2 also had efficacy, it carried risks of DAE, akathisia, and weight gain. However, the risk of akathisia in BRE2 was reduced by an initial dose of 0.5 mg/day rather than 1.0 mg/day. Conclusions: Overall BRE showed similar utility to ARI and a good risk–benefit balance. [ABSTRACT FROM AUTHOR]

Aim: Interview quality is an important factor in the success of clinical trials for major depressive disorder (MDD). There is a substantial need to establish a reliable, remote clinical assessment interview system that can replace traditional in‐person interviews. Methods: We conducted a multicenter, randomized, unblinded, prospective, cross‐sectional study to assess the reliability of remote interviews in patients with MDD (UMIN000041839). Eligible patients with MDD underwent remote and in‐person sessions of the Montgomery‐Åsberg Depression Rating Scale (MADRS) assessment performed by different raters within 28 days of providing consent. Patients were randomized to a group first assessed using in‐person interviews and secondarily using remote interviews (in‐person‐first group) or a group first assessed by remote interviews and secondarily using in‐person interviews (remote‐first group). Nineteen trained people (15 clinical psychologists, 3 nurses, and 1 clinical laboratory technologist) performed interviews. Results: Of 59 patients (in‐person‐first group, n = 32; remote‐first group, n = 27) who completed both remote and in‐person interviews, 51% (n = 30) were women; the mean age was 41.6 years (range, 21–64 years). There was a strong association between remote and in‐person MADRS scores (r = 0.891, kappa = 0.901). An overall intraclass correlation coefficient (ICC) of 0.886 (95% confidence interval, 0.877–0.952) indicated good consistency between MADRS scores in remote and in‐person interviews. The ICC decreased as the severity of depression increased. Conclusion: Our results suggest remote interviews are a feasible alternative option to in‐person interviews in assessing symptom severity in MDD patients and could promote clinical trials in Japan. [ABSTRACT FROM AUTHOR]

Introduction: The question remains to be elucidated: "Is treatment with antidepressants at doses approved in Japan effective for Japanese patients with MDD?" It is crucial to confirm this in order to provide appropriate treatments for Japanese patients with major depressive disorder (MDD). Therefore, we conducted a systematic review and random‐effects pairwise meta‐analysis including these nine double‐blind, randomized, placebo‐controlled trials. Methods: We calculated the standardized mean difference (SMD) and risk ratio (RR) with a 95% confidence interval (95% CI). Results: Pooled newer antidepressants outperformed placebo regarding improvement of depressive symptom scale scores [SMD (95% CI) = −0.20 (−0.27, −0.12), p < 0.00001], response to treatment [RR (95% CI) = 1.23 (1.13, 1.32), p < 0.00001], and remission rate [RR (95% CI) = 1.30 (1.16, 1.45), p < 0.00001]. Although all‐cause discontinuation was not significantly different between the treatment groups, the pooled antidepressant group showed a higher discontinuation rate due to adverse event [RR (95% CI) = 1.60 (1.13, 2.26), p = 0.007] and a higher incidence of at least one adverse event than the placebo group [RR (95% CI) = 1.13 (1.08, 1.18), p < 0.00001]. Discussion: We concluded that newer antidepressants are effective for Japanese adults with MDD although the clinicians must monitor the health conditions of these individuals. [ABSTRACT FROM AUTHOR]

No study has shown the relationship between alanine-glyoxylate aminotransferase 2 (AGXT2) single nucleotide polymorphisms (SNPs) and depressive symptoms. The present case–control study examined this relationship in Japanese adults. Cases and control participants were selected from those who participated in the baseline survey of the Aidai Cohort Study, which is an ongoing cohort study. Cases comprised 280 participants with depressive symptoms based on a Center for Epidemiologic Studies Depression Scale (CES-D) score ≥ 16. Control participants comprised 2034 participants without depressive symptoms based on the CES-D who had not been diagnosed by a physician as having depression or who had not been currently taking medication for depression. Adjustment was made for age, sex, smoking status, alcohol consumption, leisure time physical activity, education, body mass index, hypertension, dyslipidemia, and diabetes mellitus. Compared with the GG genotype of rs180749, both the GA and AA genotypes were significantly positively associated with the risk of depressive symptoms assessed by the CES-D: the adjusted odds ratios for the GA and AA genotypes were 2.83 (95% confidence interval [CI] 1.23–8.24) and 3.10 (95% CI 1.37–8.92), respectively. The TGC haplotype of rs37370, rs180749, and rs16899974 was significantly inversely related to depressive symptoms (crude OR 0.67; 95% CI 0.49–0.90), whereas the TAC haplotype was significantly positively associated with depressive symptoms (crude OR 1.24; 95% CI 1.01–1.52). This is the first study to show significant associations between AGXT2 SNP rs180749, the TGC haplotype, and the TAC haplotype and depressive symptoms. [ABSTRACT FROM AUTHOR]

Objectives: Hoarding in older adults can have a detrimental effect on daily life. Repetitive negative thinking (RNT) could result in a greater avoidance of discarding and increased saving behaviors; yet, the unique role of RNT on hoarding in older adults remains understudied. This study aimed to investigate whether the intensity of RNT contributes to hoarding in older adults. Methods: Two hundred and sixty-four older adults in Japan (ages 65–86 years, 132 males and 132 females) participated in an online survey. Hierarchical regression analyses were conducted to examine whether RNT could significantly explain the variance of hoarding after controlling for age, sex, years of education, self-reported cognitive impairment, and depression. Results: As we expected, RNT was significantly associated with greater hoarding behaviors, such as excessive acquisition (β =.27, p =.005) and difficulty in discarding (β =.27, p =.003). On the other hand, reflection, repetitive thinking without negative emotional valence, was significantly associated with higher scores on clutter (β =.36 p <.001). Conclusion: Our findings highlight the importance of addressing RNT in the prevention and treatment of hoarding symptoms among older adults, potentially leading to more effective interventions and improved outcomes in managing hoarding behaviors in this population. [ABSTRACT FROM AUTHOR]

BACKGROUND: Return-to-work (RTW) programs are provided as rehabilitation for people who have taken sick leave from work because of mental health problems. However, methods to present this information to workplaces objectively remain limited. OBJECTIVE: This study aimed to conduct an exploratory investigation of the relationship between duration of sick leave and time variation of words used in RTW programs for depression from textual data collected from electronic medical records as a new evaluation indicator. METHODS: The study subjects were those who had taken sick leave because of major depressive or adjustment disorder and had participated in an RTW program. The study data comprised demographic characteristics and texts. Textual data were collected from electronic medical records and classified based on the SOAP note. Thereafter, the textual data were quantified into category scores based on a standard text analysis dictionary. A generalized linear mixed model was used for the statistical analysis, with the score for each category (emotional, social, cognitive, perceptual, biological, motivational, relativity, and informal) as the dependent variable and the duration of sick leave, time, and interaction between the duration of sick leave and time as the independent variables. The level of statistical significance was set at 0.05. RESULTS: In total, 42 participants were included in the analysis. The results revealed a significant interaction between the social (p = 0.001) and emotional (p = 0.002) categories. CONCLUSION: The findings suggest a relationship between word changes in electronic medical records and the duration of sick leave. [ABSTRACT FROM AUTHOR]

Cultural bridging may alleviate and catalyze the therapeutic process and help to match therapeutic interventions and patient preferences. In this article, we propose to enhance Western-originated prevention and treatment of depression (behavioral activation) with an Eastern-originated cultural concept of the purpose of living (ikigai). Behavioral activation (BA) is an effective standard method (within cognitive-behavior therapy) to treat depression, whereas ikigai is a Japanese life philosophy attitude. Both approaches share the fundamental idea that the reflection of personal values guides the individual's everyday decisions. In the present narrative review, we try to explain and systematically compare both approaches to explore the possibilities of their meaningful integration. While the literature underscored the striking similarity between the fundamental ideas of both concepts, the main difference is that ikigai, as a traditional, non-psychotherapeutic approach, refers more to intuition and metaphorical heuristics. We introduce when and how the practice of ikigai could enhance behavioral activation interventions in psychotherapy and its transfer into everyday life. [ABSTRACT FROM AUTHOR]

Background: Previous studies have suggested that response-style strategies (rumination, problem-solving, and distraction) can be risk or protective factors for the development of abnormal eating behaviors/attitudes (AEB) during adolescence. However, due to limited empirical data regarding the prospective effects of these strategies on AEB, further research is needed to clarify their role in developing AEB in adolescence. Methods: This study investigated the one-year lagged effects of response-style strategies on AEB in 24,883 fourth- to eighth-grade students in Japan between 2015 and 2019 using a cross-lagged panel model. Depressive symptoms and body mass index (BMI), which are reported to relate to AEB, were also included in the analytic model. The students self-reported their levels of response-style strategies, AEB, and depressive symptoms. We also evaluated BMI based on teachers' reports. Results: We found that greater rumination significantly predicted more severe AEB in the following year among students from all grades, with small to moderate effect sizes. In addition, distraction significantly predicted more severe binge eating/purging behaviors, but with very weak small effect sizes. Problem-solving did not predict any level of AEB. Furthermore, we observed significant reciprocal relationships between response-style strategies, AEB, and depressive symptoms. Positive reciprocal associations between BMI and AEB were also found except for some intervals. Conclusions: We concluded that a decrease in rumination is critical to alleviating mental health problems, such as AEB and depressive symptoms, during adolescence. This suggests that interventions to reduce the level of rumination should be conducted in the early stages of adolescence. Trial Registration Number: Not Applicable. Plain English summary: This study examines the effects of three response styles when faced with distress—rumination, problem-solving, and distraction—on unhealthy eating behaviors. In this study, we looked at how these coping strategies are linked to unhealthy eating behaviors in 24,883 students in grades four to eight in Japan between 2015 and 2019. We checked again at year-long intervals to see if the coping strategies had any effect on the students' unhealthy eating behaviors. In addition, we considered depressive symptoms and body mass index in our analysis because these variables might also be related to unhealthy eating behaviors. We found that more rumination (i.e., a repetitive negative thinking pattern) predicted the severity of unhealthy eating behaviors and depressive symptoms in the following year across all the grades. In addition, greater depressive symptoms also contributed to an increase in unhealthy eating behaviors in the following year. Therefore, we suggest that rumination is a key factor that influences mental health during adolescence. [ABSTRACT FROM AUTHOR]

Introduction: Cerebral white matter hyperintensities (WMHs) are commonly found in the aging brain and have been implicated in the initiation and severity of many central nervous system diseases. Furthermore, an increased WMH volume indicates reduced brain health in older adults. This study investigated the association between WMH volume and physical activity in older adults with depressive symptoms (DS) and mild memory impairment (MMI). Factors associated with the WMH volume were also investigated. Methods: A total of 57 individuals aged over 65 years with DS and MMI were included in this study. The participants underwent magnetic resonance imaging to quantify WMH volumes. After WMH volume was accumulated, normalized to the total intracranial volume (TIV), the percentage of WMH volume was calculated. In addition, all participants wore a triaxial accelerometer for 2 weeks, and the average daily physical activity and number of steps were measured. The levels of blood biomarkers including cortisol, interleukin-6 (IL-6), brain-derived insulin-like growth factor-1, and brainderived neurotrophic factor were measured. Motor and cognitive functions were also assessed. Results: Faster maximum walking speed and longer time spent engaged in moderate physical activity were associated with a smaller percent of WMH volume, whereas higher serum IL-6 levels were associated with a larger percent of WMH volume. The number of steps per day, time spent engaged in low levels of physical activity, cognitive function, and all other measured biomarkers were not significantly associated with percent of WMH volume. Discussion: Higher blood inflammatory cytokine levels, shorter duration of moderate physical activity, and lower maximum walking speed were associated with a higher percent of WMH volume. Our results provide useful information for maintaining brain health in older adults at a high risk of developing dementia and may contribute to the development of preventive medicine for brain health. [ABSTRACT FROM AUTHOR]

Objectives: The association between socioeconomic status (SES) and the onset of depressive symptoms has attracted considerable attention. However, few studies have simultaneously examined the association of multiple SES indicators, including "assets," with the onset of depressive symptoms. Therefore, this study examined the association of four SES indicators in old age ('years of education' 'equivalent income,' 'equivalent assets,' and 'the longest‐held job') with new‐onset depressive symptoms in a large Japanese dataset. Methods: This longitudinal study used panel data of cognitively and physically independent older adults from the Japan Gerontological Evaluation Study (JAGES) conducted in 2013 and 2016. Multivariate logistic regression analysis was conducted to examine the association of each SES indicator with new‐onset depressive symptoms, and odds ratios and 95% confidence intervals (CIs) were calculated. Results: We analyzed the data of 40,257 older adults, with a mean age (± standard deviation) of 72.9 (±5.5) years. In the follow‐up survey, 4292 older adults had new‐onset depression symptoms (10.7%). 39.3% had 10–12 years of education. 36.9% had an equivalent income of up to JPY 1.99 million. 24.4% had equivalent assets of JPY 4–17.99 million. Most had a clerical job for the long time. Furthermore, fewer years of education (males: OR = 1.42, 95% CI = 1.22–1.64, p‐value <0.001/females: 1.26, [1.09–1.47], p = 0.002), lower income (males: 1.64, [1.34–2.01], p < 0.001/females: 1.82, [1.49–2.22], p < 0.001), and fewer assets (males: 1.40, [1.16–1.68], p < 0.001/females: 1.21, [1.02–1.42], p = 0.025) resulted in higher odds of having new‐onset depressive symptoms, even when other SES indicators were entered simultaneously. Conclusions: All four SES indicators have an independent association with the development of new‐onset depressive symptoms among older adults, reflecting different aspects of SES. The association between the "longest‐held job" and new‐onset depressive symptoms can be largely explained by other SES indicators. A multifaceted and lifetime approach is required to prevent the onset of depressive symptoms in old age. Key points: Fewer years of education and lower income and assets result in higher chances of developing depressive symptoms for Japanese older adults, even after adjusting SES indicators of different life stages for each other.Fewer assets are significantly associated with the development of depressive symptoms, independent of income.A multifaceted and lifetime approach is required for each SES indicator to prevent the onset of depressive symptoms. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the association between child-specific and household material deprivation with depression among elementary and middle school students in Japan. Methods: We used cross-sectional data from 10,505 and 10,008 students for fifth-grade elementary school students (G5) and second-grade middle school students (G8), respectively, and their caregivers. The data were collected from August to September 2016 in 4 municipalities of Tokyo and from July to November 2017 in 23 municipalities of Hiroshima prefecture. Caregivers completed questionnaires including household income and material deprivation, and children completed child-specific material deprivation and depression status using the Japanese version of the Birleson depression self-rating scale for children (DSRS-C). To explore the associations, logistic regression was used after conducting multiple imputation for the missing data. Results: 14.2% of G5 students and 23.6% of G8 students had DSRS-C scores of more than or equal to 16, denoting the risk of depression. We found that household equivalent income was not associated with childhood depression in both G5 and G8 students when adjusted for material deprivations. While at least one item of household material deprivation was significantly associated with depression in G8 students (OR = 1.19, CI = 1.00, 1.41), but not in G5 children. Child-specific material deprivation of more than 5 items was significantly associated with depression in both age groups (G5: OR = 1.53, CI = 1.25, 1.88; G8: OR = 1.45, CI = 1.22, 1.73). Conclusion: Future research on child mental health needs to consider children's perspectives, especially material deprivation in young children. [ABSTRACT FROM AUTHOR]

Background: Social activity has long been recognized as an essential component of active aging. How- ever, an overlooked dimension is cross-national comparison within Asia on social activity and its relationship to the functional decline. This study examined functional decline among older Thai and Japanese adults over a two-year period and compared associated social and other factors. Methods: We collected data from two waves of a longitudinal cohort survey administered in Nakhon Pathom, Thailand and the city of Tosa, Japan, covering community-dwelling adults aged ≤ 65. The data cover basic activities of daily living (ADL), sociodemographic traits, health status, depression, and social activities. A total of 338 Thai and 869 Japanese participants with no functional limitations participated at baseline, and 216 Thai and 480 Japanese participants completed the follow-up study after two years. Results: At follow-up, Thai participants reported a higher percentage of functional decline than Japanese participants (22.2% vs. 13.5%). Risk factors associated with functional decline in Thai participants were increased age, female gender, low economic satisfaction, and low social activity levels. Functional decline among Japanese participants was associated with increased age, low social activity levels, and arthropathy. Low social activity was a strong predictor of decline in ADL, and the association was significant even after adjusting for related factors in Thai and Japanese individuals. Conclusion: Although there were differences in the variables associated with ADL decline between Thai and Japanese participants, our results support the promotion of social activities for older adults to preserve a healthy functional status. [ABSTRACT FROM AUTHOR]

Previous studies have suggested that an extremely strong desire for happiness might ironically reduce a person's well-being, particularly among Western people. According to the goal progress theory and the theory of valuing happiness, rumination might explain the relationship between valuing happiness and well-being. Based on these theoretical rationales, this study examined the following hypotheses: (1) valuing happiness is significantly associated with rumination, (2) people who experience low life stress have a stronger association between valuing happiness and rumination, and (3) people with more interdependent self-construal have a weaker association between valuing happiness and rumination. University students in Japan participated in a cross-sectional study (N = 350; Study 1) and a 4-weeks longitudinal study (N = 329; Study 2). They responded to a packet of questionnaires assessing valuing happiness, trait rumination, depressive symptoms, negative events, and interdependent self-construal. Consistent with our hypothesis, valuing happiness was concurrently and longitudinally associated with increased rumination after controlling for depressive symptoms. However, negative events did not moderate the association between valuing happiness and rumination. Furthermore, Study 1, but not Study 2, indicated that the association between valuing happiness and rumination was stronger among students with highly interdependent self-construal than those with less interdependent self-construal. The preset findings indicated that valuing happiness might be a factor that perpetuates rumination. More sophisticated evidence on the influence of valuing happiness on rumination can lead to effective psychotherapies for decreasing rumination and depression. [ABSTRACT FROM AUTHOR]