Search

Over the past two decades, computerized and Internet-based interventions for the treatment of various health problems, including substance abuse, have been developed and used to resolve treatment-related issues. The purpose of this study is to review selected studies that conducted computerized and Internet-based psychosocial interventions for people with drug-use problems.We used a PubMed search to identify relevant studies to our review based on the following inclusion criteria: 1) the study participants were drug users; 2) the Internet or computer technologies were used for the interventions; 3) the study used psychosocial interventions; and 4) meta-analysis and randomized controlled trial (RCT). In total, 12 studies (meta-analysis = 1, RCT = 11) were identified and included in this review. The RCTs extracted in this study were not included in the meta-analysis.The meta-analysis showed that studies targeting people with alcohol and/or drug-use disorders (n = 11) had a small effect size (d = 0.24). However, the effect size was considered heterogeneous. Most of the reviewed RCTs assessed either drug use or abstinence as primary outcome using such methods as self-report and urine test, and showed that intervention groups exhibited greater improvement in the drug use condition than the control groups. The effect sizes (d) ranged from 0.19 to 0.54. One study revealed that a computerized intervention was more cost effective if it was added to treatment as usual. Various interventions were designed to use behavioral therapy approaches, e.g., cognitive behavioral therapy, motivational interviewing, as well as face-to-face interventions. Treatment retention, adverse events, relationship with therapists and engagement in the treatment were assessed as secondary outcomes. These outcomes were equivalent or more effective for the intervention groups compared with the control groups.Computerized and Internet-based psychosocial interventions for drug users have a small to medium effect on the reduction of drug use but are highly cost effectiveness. These types of interventions can contribute to the improvement of treatment environments where treatment resources are very limited or where there is a stigma attached to drug users, as is often the case in Japan.

Most structured assessment tools for assessing risk of violence were developed in Western countries, and evidence for their effectiveness is not well established in Asian countries.Our aim was to examine the predictive accuracy of the Historical-Clinical-Risk Management-20 (HCR-20) for violence in forensic mental health inpatient units in Japan.A retrospective record study was conducted with a complete 2008-2013 cohort of forensic psychiatric inpatients at the National Center Hospital of Neurology and Psychiatry, Tokyo. Forensic psychiatrists were trained in use of the HCR-20 and asked to complete it as part of their admission assessment. The completed forms were then retained by the researchers and not used in clinical practice; for this, clinicians relied solely on national legally required guidelines. Violent outcomes were determined at 3 and 6 months after the assessment. Receiver operating characteristic analysis was used to calculate the predictive accuracy of the HCR-20 for violence.Area under the curve analyses suggested that the HCR-20 total score is a good predictor of violence in this cohort, with the clinical and risk sub-scales showing good predictive accuracy, but the historical sub-scale not doing so. Area under the curve figures were similar at 3 months and at 6 months.Our results are consistent with studies previously conducted in Western countries. This suggests that the HCR-20 is an effective tool for supporting risk of violence assessment in Japanese forensic psychiatric wards. Its widespread use in clinical practice could enhance safety and would certainly promote transparency in risk-related decision-making. Copyright © 2016 John WileySons, Ltd.

In this study, we compared the efficacy of a group relapse prevention program using the cognitive behavioral therapy-based workbook, Serigaya Methamphetamine Relapse Prevention Program (SMARPP), between patients abusing the so-called "dappou drugs" (designer drug in Japan, and those abusing methamphetamine (MAP). Both groups participated in the SMARPP at the Center Hospital, National Center of Neurology and Psychiatry. Results showed that, no significant differences were found in the rates of participation in the program or self-reported frequency of drug or alcohol use between the patients abusing "dappou drugs" or MAP. However, patients using "dappou drugs" reported no significant increase in their confidence in their ability to resist the temptation to use drugs on the self- report drug abuse scales after the SMARPP intervention, while patients abusing MAP reported a significant positive difference in their ability to resist temptation. In addition, insight into substance abuse problems and motivation to participate in further treatment slightly declined in those using "dappou drugs," while there was a significant increase reported by the patients using MAP. These results suggested that the SMARPP might not be as effective for patients abusing "dappou drugs" as for those abusing MAP. The development of a relapse prevention program specifically designed for patients abusing "dappou drugs" is required.

Therapeutic attitudes of health care professionals toward people with substance abuse are predictors of better health care. This quasi-experimental study aimed to examine changes in therapeutic attitudes of health care professionals who offered the Serigaya Methamphetamine Relapse Prevention Program (SMARPP). The SMARPP was developed based on the Matrix Model in Japan and is a new cognitive behavioral therapy for drug abusers.We compared therapeutic attitudes toward drug and alcohol abusers at baseline and a 6-month follow-up between health care professionals who provided the SMARPP to patients (the SMARPP group, n = 38) during the follow-up and professionals who did not (control group, n = 67). These health care professionals worked at the same workplace. Therapeutic attitudes were measured using scores of the Drug and Drug Problems Perception Questionnaire (DDPPQ) and the Alcohol and Alcohol Problems Perception Questionnaire (AAPPQ). We conducted repeated two-way analysis of covariance of the scores with group and time as factors. We calculated the effect sizes of mean differences between the groups at the follow-up survey.There was a significant interaction between group and time (p0.05). The average scores of the DDPPQ and the AAPPQ in the SMARPP group were significantly higher than those in the control group (p0.05). The effect sizes (Cohen's d) of the four subscales in the DDPPQ ranged from 0.37 to 0.55, and the effect size of the one subscale in the AAPPQ was 0.21.Therapeutic attitudes of staff who offer the SMARPP are improved, especially regarding attitudes toward people with drug abuse. Professionals who offer the SMARPP may acquire knowledge and skills to deal with drug problems and have increased satisfaction and confidence in their work.

The aim of this study was to clarify the clinical features of designer-drug-abusing patients through comparisons with methamphetamine-abusing patients and hypnotics/anxiolytics-abusing patients.Information on 126 designer-drug-abusing patients, 138 methamphetamine-abusing patients, and 87 hypnotics/anxiolytics-abusing patients was extracted from the 2012 database of 'The Nationwide Mental Hospital Survey on Drug-related Psychiatric Disorders' and the clinical variables of designer-drug-abusing patients compared with those of the other two groups.Multivariate analysis indicated the following significant differences between designer-drug-abusing patients and the other two types of patients: designer-drug-abusing patients were younger, included more men, had higher education and fewer relationships with antisocial groups, and included more patients meeting ICD-10 F1 sub-classification categories of 'Harmful use' and 'Psychotic disorders' than methamphetamine-abusing patients. Compared with hypnotics/anxiolytics-abusing patients, designer-drug-abusing patients were younger, included more men and more patients meeting criteria for 'Psychotic disorders', and more frequently cited 'peer pressure', 'unable to refuse', and 'seeking stimulation' as reasons for using the drug.The advent of designer drugs has created a new class of drug abuse, and abuse of designer drugs may carry a strong psychosis-inducing risk, exceeding that of methamphetamine.

本研究では, 景観体験を重視する上で, 囲続感に注目し, 従来の水平方向前方のみを計測する緑視率に加えて, 頭上垂直方向を計測する樹冠率を用い, 両者を合成することにより, 囲続感を重視した緑量感が計測できると考えた。この環境体験を踏まえた緑に対する視知覚環境情報を「緑視状況」と定義した。世田谷区内における代表住専街路を調査対象地とした, 冬期・夏期の実験を通じて, 主体 (街路歩行者) と, 街路樹を指標とした街路景観構成要素との相関を明らかにし, 街路樹が醸し出すイメ-ジと主体の周辺にある “もの” の空間分布を考察, 住居地域における「緑視状況」の有用性を立証した。また, その把握モデルも併せて提案する。