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The benefit of biological therapies in rheumatoid arthritis (RA) treatment is well known, but their role in amyloid A (AA) amyloidosis secondary to RA is unclear. The aim of this study was to clarify the clinical benefit of etanercept in RA patients with AA amyloidosis. We treated 14 RA patients who had serum amyloid A protein (SAA) 1.3 allele, with biopsy-confirmed AA amyloidosis with etanercept and investigated the efficacy of etanercept treatment, focusing on renal function retrospectively. The AA amyloidosis improved and stabilized after 89.1 ± 27.2 weeks. Proteinuria decreased from 2.24 ± 0.81 to 0.57 ± 0.41 g/day (P < 0.01) and SAA fell from 250 ± 129 to 26 ± 15μg/ml (P < 0.01), respectively. Diarrhea secondary to gastrointestinal AA amyloidosis was less. Overall, the serum creatinine levels did not benefit with treatment, but in those with a creatinine values

Background: In order to further investigate the relationship of psychological wellbeing with depression and anxiety. Method: Students from five universities were solicited to participate in this study and 545 students with a mean age of 20.1 (SD = 2.2) years were finally accessed to analysis. Result: All six dimensions— autonomy (AU), environment mastery (EM), personal growth (PG), positive relationships with others (PR), purpose in life (PL), and self-acceptance (SA)—of the Scales of Psychological Well-being Inventory (SPWB) were moderately negatively correlated with depression and anxiety as measured by the Hospital Anxiety and Depression Scale (HADS). Furthermore, due to a good fit with the present data, the model of SPWB on depression and anxiety was consistent with the theory of psychological well-being and indicated that HADS depression was predicted by EM, PR, and SA, while HADS anxiety was predicted by AU, EM, PG, PR, and SA. Conclusion: SPWB is a reliable measure of well-being for Japanese young adults, and the negative affectivity such as depression and anxiety is to some extent determined by the lack of psychological well-being. Depression and Anxiety 26:E99–E105, 2009. & 2009 Wiley-Liss, Inc.

Nursing students face stressful situations during a clinical training. This two-wave (between June and December 2004) study explored the relationship between the coping styles and stressful life events in terms of the occurrence of depression and anxiety among 97 Japanese female nursing students before (Time 1) and after (Time 2) a clinical training. In a structural equation modelling, Time 2 depression was significantly predicted by Time 1 depression and stressful life events whereas Time 2 anxiety was predicted by Time 1 anxiety, stressful life events and emotion-oriented coping. Moreover, Time 1 depression predicted the impact of stressful life events and Time 1 anxiety predicted emotion-oriented coping.

The present study examines the effects of stressful life events, depression, and depressogenic cognitive patterns on suicidal ideation in 500 Japanese undergraduate students. The above factors were assessed at baseline (T1) and two weeks later (T3). At T1, structural equation modeling confirmed that (1) cognitive patterns and depression, but not stressful life events, influence suicidal ideation, and (2) cognitive patterns also influence suicidal ideation through depression. These findings were confirmed in a longitudinal analysis. The results suggest that the effects of stressful life events on suicidal ideation are indirect and are mediated by depressogenic cognitive styles and depressed mood.

This study explored the factorial structure of the Parental Bonding Instrument (PBI) in the Japanese population. Several differences between the structure model in the current study and Parker et al.'s original model were identified. We also examined the adaptability of the inventory to children currently being raised by parents. We also developed a structural equation model that takes into account the impacts of the respondents' generation and gender and the caregivers' gender. The cultural, developmental, generational, and gender influences on the factorial structure of the PBI as well as the implications for clinical settings were discussed.

The psychometric properties of the short form of the Scale of Egalitarian Sex Role Attitudes (SESRA-S) were studied among human service professionals. An exploratory factor analysis yielded two factors interpreted as reflecting women's rights (e.g. women at home and men at work [a reverse item]) and women's independence (e.g. working outside is equally important for women [a non-reverse item]), respectively. Confirmatory factor analysis showed a good fit. Impact of participant age, sex, residential area, and type of profession on sex role egalitarianism were examined by four-way layout anova. Men in rural areas had the lowest score in the women's rights subscale and psychiatrists in rural areas had the lowest score in the women's independence subscale.

Secondary amyloid A (AA) amyloidosis is an uncommon yet important complication of rheumatoid arthritis (RA). It is one of the most relentless of the extra-articular features of RA, and suitable treatments have not yet been found. We studied the efficacy of cyclophosphamide (CYC) combined with prednisolone (PSL) in amyloidotic patients who had serum amyloid A (SAA) 1.3 genotype, which is a risk factor for secondary amyloidosis in Japanese RA patients. Fifteen RA patients who were SAA1.3 homo- and heterozygotes with biopsy-confirmed AA amyloidosis were treated with a combination of CYC and PSL. Laboratory variables of C-reactive protein (CRP), rheumatoid factor (RF), erythrocyte sedimentation rate (ESR), serum albumin (Alb), serum creatinine (Cre) and Lansbury’s index were carried out by statistical analysis of changes between before and during the medication. According to the Mann–Whitney rank test, CRP, RF, ESR, Alb and Cre levels improved significantly with the combination treatment (p

The findings that free radicals play a causative role in the occurrence of tardive dyskinesia (TD) and that apolipoprotein E (ApoE) 4 has decreased anti-oxidant activity suggest a potential link between TD and ApoE alleles. We, therefore, examined ApoE allelic frequencies in schizophrenic subjects with TD and non-TD. Serum samples were obtained from 333 DSM IV-diagnosed schizophrenic patients and 191 controls in Japan. The presence of TD was evaluated by research diagnostic criteria for TD. ApoE phenotypes of the serum samples were determined by polyacrylamide gel isoelectricfocusing. A total of 62 TD subjects (31 males, 31 females) were identified among all patients examined. No significant differences in ApoE allelic frequency were found between TD and non-TD groups. ApoE epsilon4 allele frequency, however, was significantly lower in the female TD group than in the male TD group. These findings do not clearly demonstrate a certain association between TD and the epsilon4 allele, but may preliminarily reveal a difference in influence of this allele on the development of TD between males and females.

It is important to follow up on the health status of inhabitants living in the methyl mercury-polluted area surrounding Minamata City, paying particular attention to diseases not only of the central nervous system but also of other organs. We have been carrying out such concentric studies for more than 10 years. We have previously studied the cause-specific standard mortality ratios in Minamata disease patients and reported that the SMRs for liver disease and renal disease were significantly raised in male and female patients, respectively. It was also found that complications arising from diabetes could be due to the large number of old people among the autopsy cases. The next step was to clarify the actual prevalence and incidence of liver disease, renal disease, and diabetes mellitus epidemiologically among the population in this area. The aim of this study was to determine the actual prevalence of these diseases and complaints, and to investigate the contribution of various risk factors to these diseases in this area. The study was a population-based cross-sectional mass screening survey. A case-control study was designed to estimate the role of various risk factors including methyl mercury exposure for these diseases. A mass multiple health examination survey was performed in 1500 subjects aged 40 years and older in Tsunagi Town, neighboring Minamata City, every summer since 1984. Tsunagi Town is located in a methyl mercury-polluted area and there are 36.9 certified Minamata disease patients per 1000 population. Data concerning liver disease, renal disease, and diabetes mellitus were collected on the basis of urine, hematological, physical, and ultrasonographic examinations. Data on risk factors and subjective complaints were collected by interview and other measures. The prevalence of these diseases was not higher in this methyl mercury-polluted area compared with other areas in Japan, contrary to what was expected based on standard mortality ratios and pathological findings. There were no positive correlations between those diseases and methyl mercury exposure. On the other hand, the population in the polluted area had more and a greater variety of complaints than those in the nonpolluted area. It is possible that not only neurological subjective complaints but also nonspecific complaints of the population in the polluted area might be influenced by past methyl mercury exposure. This health surveillance in the population living in a methyl mercury-polluted area must be maintained in the future.

Recently farm mechanization has been widespread and developing rapidly, in particular riding farm machines are increasingly used in paddy fields in Japan. We have no information available on the actual situation regarding whole-body vibration on the seats of these farm machines from the standpoint of labour protection. Measurement and evaluation of whole-body vibration was performed on the seats of popular riding agricultural machineries. Whole-body vibration on the seats of combine harvesters and wheel tractors exceeded exposure limits and the fatigue-decreased proficiency boundary limit of 8 hr and also shortened the reduced comfort boundary limits of ISO 2631 (1985). Some combines, tractors and carieers had only less than one hour exposure duration as compared with the ISO 2631-1 standard (1997). On the other hand a questionnaire was also performed on the subject of agricultural machine operators. Any specific injury or other effects, i.e. low back injuries were not found among the group of operators as compared with those in non-operator farmers. It seems to be difficult to find out the health effects of whole-body vibration itself, because there may be a lot of causes, i.e. working posture, operating heavy materials, in farm working conditions.

To simultaneously examine the impact of childhood abuse history on borderline personality traits, negative life events, and depression, undergraduate students (N=243) were studied by questionnaire surveys with one week intervals. Neglect and emotional abuse as well as sexual maltreatment predicted borderline personality traits and baseline depression. Baseline depression as well as the impact of negative life events occurring the week prior predicted depression a week later. However, after considering the baseline depression level, child abuse history failed to predict the follow-up depression level. Borderline personality traits did not moderate these findings. Childhood emotional and sexual abuse history may influence depression and borderline personality traits.

To investigate the relationship among adult attachment style, life stress, and daily depression, a sample of 437 undergraduate students was prospectively studied. Insecure adult attachment and perceived life stress were related to their daily depressive mood. Further analyses using both multiple hierarchical regression and structural equation models (SEM) demonstrated that adult attachment style and perceived life stress independently predicted depression and had no interactive effects on daily depression. The impact of adult attachment on depression was not contingent upon the presence of life stress and securely attached participants were less impacted by depression than insecurely attached ones. These results suggest that adult attachment can play an important role in mental health intervention and may be helpful when it comes to preventing and treating depression.

A retrospective study of negative sexual experiences (NSEs) was conducted among 532 Japanese university women. More than one third of the respondents reported having experienced at least one NSE, and two thirds were victimized by strangers. When the woman knew the perpetrator well, the NSE was more likely to be repeated. One sixth of victims did not disclose the incident. Older children disclosed incidents more frequently than did younger children. Women in the total disclosure group disclosed the incidents more quickly than did those in the partial disclosure group. Women victimized by strangers were more likely to disclose the incident completely. Less than 10% of women were disappointed with the reaction of the first-disclosure receiver. Unlike results obtained in previous studies, the victims did not necessarily regard it negatively when the incident was viewed less seriously or they were criticized by first-disclosure receivers. On the other hand, instrumental support was not always supportive.

This study examined the relationship between health parameters and psychological distress among inhabitants of methylmercury-polluted areas in Japan. The subjects were 133 inhabitants over the age of 40 yr living in two methylmercury-polluted villages. Information on demographic factors, health status, and mental health was obtained using questionnaires, including the General Health Questionnaire (GHQ). The proportional odds model was used to estimate the adjusted odds ratios of factors associated with a higher GHQ score after adjustment for age, gender, and district. Very poor self-rated health status, a high number (5+) of subjective symptoms, having monthly outpatient visits and medical house calls, and receiving compensation for methylmercury poisoning were significantly associated with psychological distress. Poor physical condition may lead to the development of psychological distress.

At present, it is important to follow-up on the health condition of inhabitants living in a methylmercury-polluted area surrounding Minamata City, paying attention to subclinical disorders not only of the central nervous system, which have been concentrically studied for more than 40 years, but also to other health issues as well. We have performed annual follow-up multiple health examinations on about 1,500 persons of ages more than 40 years old in Tsunagi Town near Minamata City each summer from 1984 to 2004. Case-control studies were designed to estimate the role of risk factors for various health issues using geographical differences to compare the verified patients. The results of the study are summarized as follows: (1) There were no significant differences in the prevalence of diseases associated with Minamata disease (MD) (e.g., liver diseases, renal diseases). (2) Subjective complaints, which were related not only to neurological but also to general complaints were consistently much more common in the polluted area than in the control area. (3) Five percent of the inhabitants who were not certified as MD patients had a high predicting index of MD. They could be affected by methylmercury poisoning. It is important to make a differential diagnosis. (4) No significant differences with respect to ADL by residential area were observed. However, MD patients who stayed in their homes showed some impairments of instrumental ADL. (5) It is important to take into consideration mental distress not only from the physical effects but also from the secondary social damage experienced through MD in these area.

Objectives: Little attention has been paid to mental health of inhabitants of methylmercury-polluted areas. The objective of this study was to examine the factors relating to the conditions and characteristics of mental health of inhabitants residing in a methylmercury-polluted area.Methods: The eligible subjects of the study were inhabitants over the age of 40 years (n=301) living in two fishing village districts that were polluted by high concentrations of methylmercury. The study was conducted in two phases. In the first phase, a structured questionnaire was used to gather information on the current health condition and experience with Minamata disease of each subject through interviews. In the second phase, the General Health Questionnaire (GHQ)-30 was distributed to measure the psychological distress of the respondents.Results: There were 133 (44.2%) study subjects. Factor analysis of the data collected using the GHQ was carried out and five factors that accounted for 57.9% of the total variance were selected. The first factor was labeled “depression and anxiety”. Depression and anxiety were significantly associated with self-rated health status, the number of subjective symptoms, monthly outpatient visits and the receipt of compensation. Covariance structure analysis using the Amos 4.0 program demonstrated that depression and anxiety were significantly associated with the subjects' health condition, which in turn was influenced by experience with Minamata disease.Conclusion: Depression and anxiety of the inhabitants may be directly caused by the health condition. Further investigations with more precise and detailed measurements are needed to corroborate the causal relationship.

Little attention has been paid to the mental health of inhabitants of methylmercury-polluted areas in Japan. This study examined the relationship between one's experience with Minamata disease (MD) (such as compensation issues) and psychological distress. The subjects were 133 (44.2%) of the 301 inhabitants over the age of 40 years living in two fishing village districts along the coast of the Yatsushiro Sea which had been contaminated with methylmercury. Data on the inhabitants' experience with MD, social network factor, health condition and mental health were obtained using questionnaires including the General Health Questionnaire (GHQ)-30. The proportional odds model was used to estimate the adjusted odds ratios of factors associated with a higher GHQ score after adjustment for age, sex and village. MD status based on MD compensation, level of participation in MD patients' groups, and presence of certified MD patients in the family were significantly associated with psychological distress. Although these associations decreased after further adjustments were made taking health condition into consideration, MD status, participation in several sit-ins and the presence of certified MD patients in the family maintained marginally positive association with psychological distress. Further investigations with more precise and detailed measurements are needed to corroborate the relationship between inhabitants' experience with MD and mental health.

The association between apolipoprotein E (ApoE) alleles and schizophrenia has remained controversial. A recent report claiming that ApoE epsilon3 Taiwan Chinese carriers have an increased risk of schizophrenia prompted us to investigate the allele frequency in a large group of Japanese schizophrenic patients. Serum samples were obtained from 314 schizophrenic patients and 188 controls in Japan and examined using isoelectric focusing/immunoblotting. There were no significant differences in ApoE allele frequencies between schizophrenic patients and controls and in the odds ratios for schizophrenia among the epsilon2, epsilon3 and epsilon4 carriers. In contrast to the report from Taiwan, our findings and results of the majority of previous studies suggest no effects of ApoE alleles on the development of schizophrenia.

To explore the role of apolipoprotein E (ApoE) in schizophrenia, we investigated ApoE phenotypes in a group of patients with schizophrenia. Serum samples were obtained from 122 schizophrenic patients and 126 controls in Japan and were examined using isoelectric focusing/immunoblotting. This experiment showed a trend toward a decreased frequency of ApoE epsilon4 in schizophrenia and no link between ApoE epsilon4 and familial schizophrenia or early onset schizophrenia. On the other hand, a decreased frequency of ApoE epsilon2 in early onset schizophrenia was detected. These results suggest that ApoE epsilon2 protects against early onset schizophrenia, and that ApoE epsilon4 is not involved in the development of schizophrenia in Japanese.