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Erratum in: Fukushima J Med Sci. 2019;65(2):68-69., The present adjunct study of the Japan Environment and Children's Study (JECS) aimed to determine the occurrence of developmental disorders in Fukushima Prefecture, which was exposed to low-dose radiation. At two medical institutions in Fukushima City, we enrolled 339 pregnant women from September 2013 through May 31, 2014, who delivered 335 neonates (174 male, including one set of twins) between November 4, 2013 and November 11, 2014. The parents of four neonates declined to participate in the present study and one neonate died. Therefore, 334 families agreed to participate in additional surveys until March 2017. Child Behavior Checklists (CBCL) were mailed to all 334 families during the month of their infant's second birthday and we received 236 responses (response rate, 70%). All responses were below the 69th percentile in the CBCL, and no responses indicated significant problem behaviors. Boys tended to have higher values for items associated with developmental problems, but symptoms of autism were not evident. The mental health of the mothers indicated in the previous study might not have influenced the children. Autism spectrum disorder (ASD) is not obvious by the age of three years and thus it might become apparent as the children grow older.

Many studies have consistently reported the bidirectional relationship between problem drinking and psychological distress following a disaster, but the risk factors of problem drinking following a disaster remain unclear. In this study, we therefore aimed to explore the risk factors associated with the incidence of problem drinking among evacuees after the Great East Japan Earthquake of March 11, 2011. We used the data for evacuees of the Fukushima Daiichi nuclear power plant accident, obtained from the Mental Health and Lifestyle Survey. A total of 12,490 individuals from 13 municipalities, which included the evacuation order areas after the accident, completed surveys between 2012 and 2013. The CAGE (Cutting down, Annoyed by criticism, Guilty feeling, and Eye-opener) questionnaire was used to screen the participants for alcohol dependence, and a score ≥ 2 indicated problem drinking. Logistic regression models were applied to investigate the possible predictors of problem drinking. The results showed that insufficient sleep and heavy drinking (≥ 4 drinks per day) were significant risk factors for the incidence of problem drinking in both men and women. Additional risk factors included family financial issues due to the disaster and trauma symptoms among men and a diagnosed history of mental illness among women. Other remaining variables were not significantly associated with problem drinking. The present study is the first to identify the risk factors for problem drinking following a compound disaster. Our findings could be used to develop a primary intervention program to improve evacuees' health and lives following a disaster.

Perineuronal nets comprise chondroitin sulfate moieties and their core proteins, and their neuropathological alterations have been implicated in schizophrenia. To explore the molecular mechanism of the perineuronal net impairments in schizophrenia, we measured the immunoreactivity of chondroitin sulfate moieties, major components of perineuronal nets, in three brain regions (postmortem dorsolateral prefrontal cortex, caudate nucleus, and hippocampus) of schizophrenia patients and control subjects. Immunoblotting for chondroitin 4-sulfate and chondroitin 6-sulfate moieties revealed a significant increase in intensity of a 180 kD band of chondroitin 4-sulfate immunoreactivity in the hippocampus of patients, although we detected no significant alteration in their immunoreactivities with any other molecular sizes or in other brain regions. The levels of immunoreactivity were not correlated with postmortem interval, age, or storage time. We failed to find such an increase in a similar molecular range of the chondroitin 4-sulfate immunoreactivity in the hippocampus of the rats chronically treated with haloperidol. These results suggest that the level alteration of the chondroitin 4-sulfate moiety might contribute to the perineuronal net abnormality found in patients with schizophrenia.

Mismatch negativity (MMN) is a component of auditory event-related potentials that reflects automatic change detection in the brain, showing qualities of endophenotypes in schizophrenia. MMN deficiency is one of the robust findings in patients, and it reflects both cognitive and functional decline. Catechol-o-methyltransferase (COMT) is a key enzyme involved in regulating dopamine transmission within the prefrontal cortex. A preliminary study suggested that the COMTVal108/158Met genotype (rs4680) is related to cognitive function in schizophrenia. Both the COMTVal108/158Met genotype and MMN are related to cognitive function, but no studies have reported on the relationship between MMN and the COMTVal108/158Met genotype in schizophrenia. This study therefore examined the relationship between COMTVal108/158Met genotype and MMN. The duration of MMN was measured, and the COMTVal108/158Met polymorphism was detected by polymerase chain reaction-restriction fragment length polymorphism in 49 Japanese schizophrenia patients (Val/Val, n = 21; Met carriers, n = 28). Amplitude and latency of MMN were compared between Val/Val and Met carriers.

Background: To elucidate the possibility of using the Minnesota Multifaceted Personality Inventory (MMPI) to predict the prognosis of somatoform disorders, which are often treatment-resistant, we investigated the prognosis of somatoform disorders predicted using the MMPI. Methods: During the period from January 1, 2013, to December 31, 2017, 125 cases of somatoform disorder were diagnosed in the psychiatric department of Fukushima Medical University Hospital, among which, 67 were consultation-liaison psychiatry cases and 58 cases were only psychiatric cases. Clinical information, MMPI scores, and prognosis information were collected from medical records in each case, and then statistical analysis was performed.Results: The results showed that the unchanged group had significantly higher scores than the improved group on only the Hy scale. Receiver operating characteristic analysis of the Hy scale scores of the improved and unchanged group was then conducted to calculated a cutoff value. The cutoff point was 73.5 with a sensitivity of 0.557 and a specificity of 0.717. Conclusion: For patients diagnosed with somatoform disorder who had an MMPI Hy scale score higher than the cutoff value, improvement with conventional supportive psychotherapy or drug therapy was predicted to be difficult. Therefore, the cutoff point identified in this study appears to be an important index for selecting treatment for somatoform disorders.

To investigate associations between dietary patterns and the risk of impaired kidney function, we analyzed data from 14,732 participants (40&ndash, 89 years) who completed the baseline diet questionnaire of The Fukushima Health Management Survey in 2011. The incidence of chronic kidney disease (CKD) (estimated glomerular filtration rate (eGFR) &lt, 60 mL/min/1.73 m2 or proteinuria (&ge, 1+ by dipstick test)) and annual changes in eGFR were assessed from 2012 to 2015. Three major dietary patterns were identified. The adjusted cumulative incidence ratio of the highest vs. lowest tertile of a vegetable diet scores was 0.90 (95% confidence interval (CI): 0.82, 1.00) for eGFR &lt, 60 mL/min/1.73 m2, 0.68 (95% CI: 0.52, 0.90) for proteinuria, and 0.88 (95% CI: 0.80, 0.97) for CKD (P for trend = 0.031, 0.007, and 0.005, respectively). The incident risk of CKD in the highest tertile of juice diet scores was 18% higher than the lowest tertile. The odds ratio of the highest vs. lowest tertile of vegetable diet scores was 0.85 (95% CI: 0.75, 0.98) in the rapidly decreasing eGFR group (P for trend = 0.009). We did not observe significant associations for the meat dietary pattern. A Japanese vegetable diet could reduce the risk of developing impaired kidney function and CKD.

Auditory neurophysiological responses, such as steady-state responses, event-related potential P300/P3, and phase-amplitude coupling, are promising translational biomarkers for schizophrenia, but their molecular underpinning is poorly understood. Focusing on ErbB receptor signals that are implicated in both schizophrenia and auditory processing/cognition, we explored the causal biological links between ErbB signals and these auditory traits with an experimental intervention into rats. We peripherally challenged rat pups with one of the amniotic ErbB ligands, epidermal growth factor (EGF), and characterized its consequence on the series of these auditory electrocorticographic measures. Auditory brainstem responses (ABRs) and cortical ON responses were also assessed under anesthesia to estimate the influence of higher brain regions. An auditory steady-state paradigm revealed attenuation of spectral power and phase synchrony to 40-Hz stimuli in EGF-challenged rats. We observed a reduction in duration mismatch negativity-like potentials and a delay of P3a responses, all of which are relevant to the reported auditory pathophysiological traits of patients with schizophrenia. Moreover, the perinatal EGF challenges resulted in enhanced theta-alpha/beta and theta-gamma coupling within the auditory cortex and changes in ABRs. However, the EGF challenges retained the normal ranges of cortical ON responses, potentially ruling out their fundamental auditory deficits. Perinatal exposure of an ErbB ligand to rats strikingly reproduced the whole series of aberrant auditory responses and oscillations previously reported in patients with schizophrenia. Accordingly, these findings suggest that developmental deficits in ErbB/EGF signaling might be involved in the auditory pathophysiology associated with schizophrenia.

Evidence regarding the effect of psychological factors and evacuation on cardiovascular disease occurrence after large-scale disasters is limited. This prospective study followed up a total of 37,810 Japanese men and women aged 30&ndash, 89 years from the Fukushima Prefecture with no history of stroke or heart disease at baseline (2012), until 2017. This period included 3000 cardiovascular events recorded through questionnaires and death certificates. The participants&rsquo, psychological distress, trauma reaction, and evacuation status were defined, and divided into four groups based on combinations of psychological factors and evacuation status. We calculated the hazard ratios and 95% confidence intervals for only psychological, only evacuation, or both of them compared with neither using Cox proportional hazard models. Psychological factors along with evacuation resulted in approximately 5% to 25% higher magnitude of stroke and heart disease risk than psychological factors only among men. Compared to neither, the multivariable hazard ratios of those with both psychological distress and evacuation were 1.75 for stroke and 1.49 for heart disease, and those of both trauma reaction and evacuation were 2.01 and 1.57, respectively, among men. Evacuation combined with psychological factors increased the risk of stroke and heart disease risks especially in men after the Great East Japan Earthquake.

As a treatment for cognitive dysfunction in schizophrenia, oxytocin nasal sprays potentially improve social cognition, facial expression recognition, and sense of smell. Mismatch negativity (MMN) is an event-related potential (ERP) reflecting auditory discrimination while MMN deficits reflect cognitive function decline in schizophrenia.To determine whether oxytocin nasal spray affects auditory MMN METHODS: We measured ERPs in healthy subjects during an auditory oddball task, both before and after oxytocin nasal spray administration. Forty healthy subjects were randomly assigned to either the oxytocin or placebo group. ERPs were recorded during the oddball task for all subjects before and after a 24 international unit (IU) intranasal administration, and MMN was compared between the two groups.Participants who received oxytocin had significantly shorter MMN latencies than those who received a placebo. Oxytocin had no significant effect on the Change in MMN amplitude.The shortened MMN latencies that were observed after oxytocin nasal spray administration suggest that oxytocin may promote the comparison-decision stage.

The Fukushima Daiichi Nuclear Power Station accident in 2011 produced over 100000 evacuees. In order to deal with an increased need of mental health care, brief, transdiagnostic Telephonic Interventions (TI) have been provided for those at risk of different mental health problems identified based on results of the Mental Health and Lifestyle Survey (MHLS). This study aimed to examine usefulness of TI with focusing on evacuees’ subjective estimation assessed in individual follow-up interviews. The sample comprised 484 persons who had been evacuated from 13 municipalities in Fukushima Prefecture to 8 safer regions in and out of Fukushima. We conducted semi-structured interviews for participants receiving TI (intervention group) and those not receiving TI despite being identified as high risk (non-intervention group). The intervention group was older, had a higher proportion of self-reported mental illness, and higher unemployment compared with the non-intervention group. The satisfaction proportion of those who underwent TI was as high as 74.6%. Satisfaction was significantly associated with advance knowledge of TI availability (OR = 3.00, 95% CI: 1.59‐5.64), and advice on health-related practices (OR = 2.15, 95% CI: 1.12‐4.13). Thus, TI is considered to be feasible and useful for public health management practices in major disasters.

Background People living in temporary housing for long periods after a disaster are at risk of poor mental health. This study investigated the post-disaster incidence and remission of common mental disorders among adults living in temporary housing for the 3 years following the 2011 Great East Japan Earthquake. Methods Three years after the disaster, face-to-face interviews were conducted with 1089 adult residents living in temporary housing in the disaster area, i.e., the shelter group, and a random sample of 852 community residents from non-disaster areas of East Japan. The World Health Organization Composite International Diagnostic Interview was used to diagnose DSM-IV mood, anxiety, and alcohol use disorders. Information on demographic variables and disaster experiences was also collected. Results Response rates were 49 and 46% for the shelter group and the community residents, respectively. The incidence of mood/anxiety disorder in the shelter group was elevated only in the first year post-disaster compared to that of the general population. The rate of remission for mood and anxiety disorders was significantly lower in the shelter group than in the community residents. The proportion seeking medical treatment was higher in the shelter group. Conclusions The onset of common mental disorders increased in the first year, but then levelled off in the following years among residents in temporary housing after the disaster. Remission from incident post-disaster mental disorders was slower in the shelter group than in the general population. Post-disaster mental health service could consider the greater incidence in the first year and prolonged remission of mental disorders among survivors with a long-term stay in temporary housing after a disaster.

Background Antipsychotics improve the positive symptoms of schizophrenia. However, little is known about the extent of antidepressive effects of antipsychotics and their correlation with effects on other symptom domains in schizophrenia. The aim was to investigate whether antidepressive effects of antipsychotics have a significant correlation with the effects on specific symptom domains of schizophrenia. Methods Electronic databases were searched to identify eligible studies that reported antidepressive effects of antipsychotics for the treatment of adult patients with schizophrenia in double-blind, randomized placebo-controlled trials (RCTs). Mean change from baseline in depressive symptoms was meta-analyzed, and the correlation with the effects on other symptom domains was examined through meta-regression analysis. Results Thirty-five RCTs (13 890 patients) were included in this meta-analysis. Overall, antipsychotics showed greater efficacy than placebo in reducing depressive symptoms, with small to medium effect sizes (standardized mean difference = −0.27, 95% confidence interval −0.32 to −0.22, P Conclusions Second-generation antipsychotics (except for ziprasidone) were associated with small to medium effects sizes on improvement in depressive symptoms among adult patients with schizophrenia. The antidepressive effect of antipsychotics was significantly correlated with improvement in other symptom domains, with the highest correlation observed for improvement in negative symptoms. PROSPERO registration number CRD42019133015

Objective We hypothesized that sensory memory associated with the temporal window of integration (TWI) would be impaired in patients with schizophrenia, an issue that had not been evaluated using omission mismatch negativity (MMN) of complex speech sounds. We aimed to assess the functional changes in auditory sensory memory associated with the TWI in patients with schizophrenia by investigating the effect of omission of complex speech stimuli on the MMN. Methods In total, 17 patients with schizophrenia and 15 control individuals participated in the study. The MMN in response to omission deviants of complex speech sounds was recorded, while the participants were instructed to ignore the series of speech sounds. Results The MMN latency in patients with schizophrenia was significantly prolonged by deviant stimuli to omissions corresponding to the early and late parts of the temporal TWI. There were no significant group differences in the amplitude of the MMN to omissions at different time points across the TWI. Conclusions Our results suggested that sensory tracing function in patients with schizophrenia is impaired in the early and the later half of the TWI. Significance We showed that certain MMN abnormalities in patients with schizophrenia may be caused by an impaired TWI.

We aimed to explore the effects of erosion of trust in authorities on the long-term mental health of community residents after the 2011 Fukushima nuclear power plant accident in Japan. We investigated the effects of distrust in authorities on mental health in a cohort study following non-evacuee community residents after the 2011 Fukushima nuclear power plant accident. A baseline questionnaire survey was administered five years after the accident for a random sample of 4900 residents outside the evacuation zone in Fukushima. Distrust in the national government and in science were assessed using a four-point single-item scale. Psychological distress was measured using the K6. Posttraumatic stress symptoms were measured using an abbreviated version of the Posttraumatic Stress Disorder Checklist-Specific version. Longitudinal associations of distrust in the government and science at baseline and psychological distress and posttraumatic stress symptoms eight years after the accident were examined, controlling for the baseline level of distress or symptoms using multivariate logistic regression analyses. Valid responses were obtained from 927 (18.9%) residents. Distrust in the government at baseline was significantly associated with posttraumatic stress symptoms at follow-up, albeit controlling for baseline symptoms. While distrust in the government was also associated with psychological distress at follow-up, the association became non-significant after controlling for baseline distress. Distrust in science at baseline was not associated with posttraumatic stress symptoms or psychological distress at follow-up. Distrust in government after a nuclear power plant accident may have adverse effects on mental health in the long-term.

Background: Today, schizophrenia remains stigmatized all over the world, and for patients with schizophrenia, the experience of stigma makes improving their lives difficult. Changing of attitudes toward schizophrenia is an important theme not only for medical professionals but also medical students. We therefore invested investigate negative attitudes toward schizophrenia among psychiatric staff, psychiatrists, physicians, medical students, and non-medical workers. Methods: Participants in this study included 490 medical students, 25 psychiatric staff, 13 psychiatrists, 48 physicians, and 222 non-medical workers in Fukushima Medical University, in Japan. We conducted an internet-based questionnaire survey, using a web-based survey tool. We used an 18-item questionnaire on attitudes toward schizophrenia that comprised three factors: stigma, underestimation of patients’ abilities, and skepticism regarding treatment. To compare the scores for each of these factors among the five participant groups, analysis of covariance (ANCOVA) was used to adjust for age and sex. Results: Psychiatrists’ “stigma” and “underestimation of patients’ abilities” scores were significantly lower than those of non-medical workers, physicians, and medical students. The “skepticism regarding treatment” scores were not significantly different among the five groups. For medical students, hoping to become a psychiatrist in the future had the great impact on improving attitudes toward schizophrenia. Conclusion: Medical students had more negative attitudes toward schizophrenia than psychiatrists, but equally negative attitudes compared with physicians and non-medical workers.

Background While the prevalence of post-disaster musculoskeletal pain has been documented, its associated disaster-related factors have not been investigated. This study was to investigate the association of lifestyle factors associated with musculoskeletal pain after the Great East Japan Earthquake. Methods We conducted a cross-sectional study of 34,919 participants, aged 40–89 years, without any major disabilities at about 1 year after the disaster. The participants were asked about their musculoskeletal pain (low back and limb pain) and lifestyle factors: use of evacuation shelters or temporary housing at any point of time, job loss after the disaster, decreased income after the disaster, current smoking status, current drinking status, lack of sleep, regular exercise, and participation in recreational or community activities. Furthermore, psychological factors, such as traumatic reactions, psychological distress, and uncomfortable symptoms, affecting musculoskeletal pain were assessed. We used multinomial logistic regression analysis to calculate odds ratios of each lifestyle factor for prevalent and prevalent plus exacerbated musculoskeletal pain. Results Musculoskeletal pain prevalence was 32.8%: 27.6% for prevalent and 5.2% for prevalent plus exacerbated musculoskeletal pain. Multivariable adjusted odds ratios and 95% confidence intervals of lifestyle factors associated with prevalent and prevalent plus exacerbated musculoskeletal pain were as follows: shelter use (prevalent: 1.02, 0.96–1.08; exacerbated: 1.44, 1.29–1.60), job loss (prevalent: 1.03, 0.96–1.10; exacerbated: 1.30, 1.16–1.47), decreased income (prevalent: 1.13, 1.05–1.21; exacerbated: 1.29, 1.14–1.45), current heavy drinking (prevalent: 1.33, 1.21–1.47; exacerbated: 1.38, 1.14–1.68), insomnia (prevalent: 1.22, 1.15–1.29; exacerbated: 1.50, 1.36–1.65), exercising almost daily (prevalent: 0.83, 0.77–0.91; exacerbated: 0.80, 0.68–0.95), and participating in community activities often (prevalent: 0.83, 0.75–0.92; exacerbated: 0.76, 0.61–0.95). Conclusions Prevalent and exacerbated musculoskeletal pain were inversely associated with exercising almost daily and participating in recreational or community activities sometimes or often, and positively associated with decreased income, current heavy drinking, and insomnia. Besides, the use of evacuation shelters or temporary housing/job loss was positively associated only with exacerbated musculoskeletal pain. These results suggest that post-disaster lifestyle factors are potentially associated with musculoskeletal pain. To achieve better post-disaster pain management, further studies are needed to confirm the consistency of these results in other disasters and to highlight the underlying causative mechanisms.

Previous studies have indicated associations between several OLIG2 gene single-nucleotide polymorphisms (SNPs) and susceptibility to schizophrenia among Caucasians. Consistent with these findings, postmortem brain and diffusion tensor imaging studies have indicated that the schizophrenia-risk-associated allele (A) in the OLIG2 SNP rs1059004 predicts lower OLIG2 gene expression in the dorsolateral prefrontal cortex (DLPFC) of schizophrenia patients and reduced white matter (WM) integrity of the corona radiata in normal brains among Caucasians. In an effort to replicate the association between this variant and WM integrity among healthy Japanese, we found that the number of A alleles was positively correlated with WM integrity in some fiber tracts, including the right posterior limb of the internal capsule, and with mean blood flow in a widespread area, including the inferior frontal operculum, orbital area, and triangular gyrus. Because the A allele affected WM integrity in opposite directions in Japanese and Caucasians, we investigated a possible association between the OLIG2 gene SNPs and the expression level of OLIG2 transcripts in postmortem DLPFCs. We evaluated rs1059004 and additional SNPs in the 5′ upstream and 3′ downstream regions of rs1059004 to cover the broader region of the OLIG2 gene. The 2 SNPs (rs1059004 and rs9653711) had opposite effects on OLIG2 gene expression in the DLPFC in Japanese and Caucasians. These findings suggest ethnicity-dependent opposite effects of OLIG2 gene SNPs on WM integrity and OLIG2 gene expression in the brain, which may partially explain the failures in replicating associations between genetic variants and psychiatric phenotypes among ethnicities.

Metabolic dysfunction is thought to contribute to the severity of psychiatric disorders; however, it has been unclear whether current high-simple-sugar diets contribute to pathogenesis of these diseases. Here we demonstrate that a high-sucrose diet during adolescence induces psychosis-related behavioral endophenotypes, including hyperactivity, poor working memory, impaired sensory gating, and disrupted interneuron function in mice deficient for glyoxalase-1 (Glo1), an enzyme involved in detoxification of sucrose metabolites. Further, the high-sucrose diet induced microcapillary impairments and reduced brain glucose uptake in brains of Glo1 deficient mice. Aspirin protected against this angiopathy, enhancing brain glucose uptake, and preventing abnormal behavioral phenotypes. Similar vascular damage to our model mice was found in the brains of randomly collected schizophrenia and bipolar disorder patients, suggesting that psychiatric disorders are associated with angiopathy in the brain caused by various environmental stresses, including metabolic stress.

Background The prevalence of depression and/or anxiety disorders is reported to be higher in patients with heart failure ( HF ) than in the general population, and patients with HF also have coexisting cognitive problems. Recently, the development of near‐infrared spectroscopy ( NIRS ) has enabled noninvasive measurements of regional cerebral blood volume and brain activity, in terms of cerebral oxyhemoglobin in the cerebral cortex, with a high time resolution. The aim of the current study was to determine the associations between frontal brain activity and depressive symptoms, anxiety status, and cognitive function in patients with HF . Methods and Results We measured and compared frontal brain activity determined by NIRS during a verbal fluency task in patients with HF (n=35) and control subjects (n=28). The Center for Epidemiologic Studies Depression Scale for assessment of depressive symptoms, State‐Trait Anxiety Inventory for assessment of anxiety status, Mini‐Mental State Examination for assessment of cognitive function, and NIRS were simultaneously conducted. NIRS showed that frontal brain activity was significantly lower in the HF group than in the control subjects (28.5 versus 88.0 mM·mm; P R =−0.228, P =0.046), Mini‐Mental State Examination ( R =0.414, P =0.017), and verbal fluency task ( R =0.338, P =0.007), but not with Center for Epidemiologic Studies Depression Scale ( R =−0.160, P =0.233). Conclusions Frontal brain activity assessed by NIRS is reduced and is associated with high anxiety status and low cognitive function in patients with HF .

Background: People living in temporary housing for long periods after a disaster are at risk of (developing) poor mental health. This study investigated the post-disaster incidence and remission of common mental disorders among adults living in temporary housing for the three years following the 2011 Great East Japan Earthquake. Methods: Three years after the disaster, face-to-face interviews were conducted with 1,089 adult residents living in temporary housing in Japan (the shelter group) and a random sample of 852 community residents of East Japan (the general population). The World Health Organization Composite International Diagnostic Interview (CIDI) was used to diagnose DSM-IV mood, anxiety, and alcohol use disorders. Information on demographic variables and disaster experiences was also collected. Results: Response rates were 49% and 46%, for the shelter group and general population, respectively. The incidence of mood/anxiety disorder in the shelter group was elevated only in the first year post-disaster compared to that of the general population, although the rate of remission was significantly lower in the shelter group. The proportion seeking medical treatment was higher in the shelter group. Conclusions: The onset of common mental disorders increased in the first year, but then levelled off in the following years among residents in temporary housing after the disaster. Remission from incident post-disaster mental disorders was slower. Post-disaster mental health service is required to take into account the prolonged remission of mental disorders among survivors with a long-term stay in temporary housing after a disaster.

Supplemental Digital Content is available in the text, We have been examining the Comprehensive Health Check of the Fukushima Health Management Survey of residents of 13 municipalities who were forced by the government to evacuate due to the 2011 Great East Japan Earthquake (GEJE). Our findings showed that evacuation is a risk factor for polycythemia and suggested that experiencing an unprecedented disaster and exposure to chronic stress due to evacuation might be a cause of polycythemia. We analyzed the relationship between the prevalence of polycythemia and the following factors observed in the Mental Health and Lifestyle Survey in an observational study with a cross-sectional design: traumatic symptoms, depression status, socioeconomic factors such as residential environment, and working situation after the GEJE. Target population of the survey included men and women who were at least 15 years of age and who lived in the evacuation zones specified by the government. Participants analyzed consisted of 29,474 persons (12,379 men and 16,888 women) who had participated in both the 2011 Comprehensive Health Check and Mental Health and Lifestyle Survey from June 2011 through March 2012. The prevalence of polycythemia was not associated with mental states associated with traumatic symptoms (Post-Traumatic Stress Disorder Checklist Scale ≥ 44) and depression status (Kessler 6-item Scale ≥ 13). Furthermore, multivariate analysis showed that there was a tendency for males to develop polycythemia, with characteristics such as being aged 65 years and older, highly educated, obese (body mass index ≥ 25), hypertensive, diabetic, having liver dysfunction, and a smoker being significantly related to the prevalence of polycythemia. Our findings conclusively demonstrated that polycythemia was not significantly related to psychological factors, but was significantly related to the onset of lifestyle-related disease after the GEJE.

Additional file 1: Table S1. Age- and sex-stratified prevalence of musculoskeletal pain after the Great East Japan Earthquake Table S2. Multinomial odds ratios of psychological factors with prevalent and exacerbated musculoskeletal pain Table S3. Multivariable adjusted multinomial odds ratios of associated post-disaster lifestyle factors with prevalent and exacerbated musculoskeletal pain stratified by pain region Table S4. Multivariable adjusted multinomial odds ratios of associated post-disaster lifestyle factors with prevalent and exacerbated musculoskeletal pain stratified by sex Table S5. Multivariable adjusted multinomial odds ratios associated post-disaster lifestyle factors with prevalent and exacerbated musculoskeletal pain stratified by age groups

Additional file 1:.

Supplemental material, Supplement200914 for Distrust in government and its relationship with mental health after the Fukushima nuclear power plant accident by Maiko Fukasawa, Norito Kawakami, Maki Umeda, Tsuyoshi Akiyama, Naoko Horikoshi, Seiji Yasumura, Hirooki Yabe, Yuriko Suzuki and Evelyn J Bromet in International Journal of Social Psychiatry

Neurons in schizophrenia (SCZ) brains tend to undergo gross morphological changes, but its molecular mechanism is still largely elusive. Using Kif3b+/- mice as a SCZ model, here we show that high betaine diet can significantly remedy their schizophrenic traits in neuronal morphogenesis and social behavior. We identified significant reduction and restoration by betaine of lamellipodial dynamics in developing Kif3b+/- neurons as a cause of neurite hyperbranching, according to a local deficiency of collapsin response mediator protein 2 (CRMP2) transported by the KIF3 motor. Betaine administration significantly decreased the CRMP2 carbonylation, which enhanced its F-actin bundling activity necessary for proper lamellipodial dynamics and peripheral microtubule exclusion, and thus may functionally compensate the KIF3 deficiency. Because KIF3 expression levels tended to be downregulated in human prefrontal cortex of postmortem SCZ patient brains, this mechanism may also take part in human SCZ pathogenesis, which we propose will be remedied by betaine administration.

Schizophrenia is a complex, multifactorial disease that displays heterogeneous behavioral and cognitive syndrome (Lieberman & First, 2018). The origin of schizophrenia appears to lie in genetic and/or environmental disruption of brain development (Owen et al, 2016). In spite of current treatment that largely consists in antipsychotic drugs combined with psychological therapies, social support, and rehabilitation, developing more effective therapeutic interventions is an essential issue., What if energy metabolism dysregulation was a pathomechanism underlying schizophrenia? Ide et al (2019) identify sulfide stress as a new player in this disorder.

Cardiometabolic risks were increasing in Fukushima residents after the Great East Japan Earthquake. We examined the association between dietary patterns and cardiometabolic risks in those aged &ge, 16 years. Dietary patterns were derived by principal component analysis for participants who underwent at least one diet assessment using a short-form food frequency questionnaire during 2011&ndash, 2013 and a health checkup in 2014 and 2015 (n = 15,409 and 14,999, respectively). In 2014, the adjusted prevalence ratio (PR) and 95% confidence interval (CI) in the highest versus lowest quartile of accumulative mean scores were 0.97 (0.96&ndash, 0.99) for overweight/obesity, 0.96 (0.95&ndash, 0.97) for total cholesterol (TC) &ge, 220 mg/dL, 0.96 (0.95&ndash, 0.98) for low-density lipoprotein cholesterol (LDL-C) &ge, 140 mg/dL, and 0.97 (0.96&ndash, 0.99) for triglycerides &ge, 150 mg/dL for a vegetable diet and 1.03 (1.01&ndash, 1.04) for TC &ge, 220 mg/dL and 1.02 (1.01&ndash, 1.04) for LDL-C &ge, 140 mg/dL for a juice/milk diet. In 2015, we found consistently significant associations for the vegetable and juice/milk diets, and the PR and 95% CI were 0.99 (0.98&ndash, 1.00) for HDL-C &lt, 40 mg/dL for a meat diet. The continuous promotion of the vegetable pattern diet is necessary to reduce cardiometabolic risks, particularly dyslipidemia, in Japan.

Background The molecular mechanisms underlying schizophrenia remain largely unclear, and we recently identified multiple proteins significantly altered in the postmortem prefrontal cortex (PFC) of schizophrenia patients amongst which aldehyde dehydrogenase 4 family member A1 (ALDH4A1) was especially elevated. In this study, we aimed to investigate the expression of ALDH4A1 in the PFC and superior temporal gyrus (STG) and to elucidate functional correlations between schizophrenia risk alleles and molecular expression profiles in the postmortem brains of patients with schizophrenia. Methods The levels of ALDH4A1 protein expression in the PFC and STG in postmortem brains from 24 patients with schizophrenia, 8 patients with bipolar disorder, and 32 controls were assessed using enzyme-linked immunosorbent assay. Moreover, we explored the associations between ALDH4A1 expression and genetic variants in enzymes associated with proline metabolism, including ALDH4A1 (schizophrenia [n = 22], bipolar disorder [n = 6], controls [n = 11]). Results ALDH4A1 levels were significantly elevated in both the PFC and STG in patients with schizophrenia and tended to elevate in patients with bipolar disorder. Furthermore, ALDH4A1 expression levels in the PFC were significantly associated with the following three single-nucleotide polymorphisms: rs10882639, rs33823, rs153508. We also found partial coexpression of ALDH4A1 in mitochondria in a subset of putative astrocytes of postmortem brain. Limitations Our study population was relatively small, particularly for a genetic study. Conclusion These findings indicate that altered expression of ALDH4A1 may reflect the potential molecular mechanisms underlying the pathogenesis of schizophrenia and bipolar disorder, and may aid in the development of novel drug therapies.

Dopamine- and cAMP-regulated phosphoprotein of molecular weight 32 kDa (DARPP-32) integrates dopaminergic signaling into that of several other neurotransmitters. Calcineurin (CaN), located downstream of dopaminergic pathways, inactivates DARPP-32 by dephosphorylation. Despite several studies have examined their expression levels of gene and protein in postmortem patients’ brains, they rendered inconsistent results. In this study, protein expression levels of DARPP-32 and CaN were measured by enzyme-linked immunosorbent assay (ELISA) in the prefrontal cortex (PFC), and nucleus accumbens (NAc) of 49 postmortem samples from subjects with schizophrenia, bipolar disorder, and normal controls. We also examined the association between this expression and genetic variants of 8 dopaminergic system-associated molecules for 55 SNPs in the same postmortem samples. In the PFC of patients with schizophrenia, levels of DARPP-32 were significantly decreased, while those of CaN tended to increase. In the NAc, both of DARPP-32 and CaN showed no significant alternations in patients with schizophrenia or bipolar disorder. Further analysis of the correlation of DARPP-32 and CaN expressions, we found that positive correlations in controls and schizophrenia in PFC, and schizophrenia in NAc. In PFC, the expression ratio of DARPP-32/CaN were significantly lower in schizophrenia than controls. We also found that several of the aforementioned SNPs may predict protein expression, one of which was confirmed in a second independent sample set. This differential expression of DARPP-32 and CaN may reflect potential molecular mechanisms underlying the pathogenesis of schizophrenia and bipolar disorder, or differences between these two major psychiatric diseases.

Introduction The COMT Val 108/158 Met polymorphism (rs4680) may affect treatment response to antipsychotics, as well as metabolism and dynamics of neurotransmitters during the treatment of schizophrenia. We investigated the effects of the COMT Val 108/158 Met polymorphism on treatment response to aripiprazole and plasma monoamine metabolite levels in patients with acute schizophrenia. Materials and methods Forty patients with schizophrenia were treated with aripiprazole for 6 weeks. We measured Positive and Negative Syndrome Scale (PANSS) and plasma levels of homovanillic acid (HVA) and plasma MHPG (3-methoxy-4-hydroxyphenethyleneglycol) at baseline and endpoint. The COMT Val 108/158 Met polymorphism was genotyped with the polymerase chain reaction and restriction fragment length polymorphism. Results There were significant genotype-time interactions on PANSS total and general psychopathology scores, with Met/Met genotype showing greater improvement. The response rate to aripiprazole did not differ between COMT Val 108/158 Met genotype groups. We found a significant time effect on plasma MHPG levels, but no time effect on plasma HVA levels or time-genotype interactions in the plasma levels of HVA and MHPG. Although the responder rate did not differ among the 3 genotype groups. Conclusion Our results suggest that individuals with the Met/Met genotype had greater improvement in PANSS score after the treatment with aripiprazole. On the other hand, the Val 108/158 Met polymorphism may not induce changes in plasma levels of monoamine metabolites during aripiprazole treatment. Because of the small sample size, further studies are needed to confirm and to extend our results.

Background The effect of disasters on suicidality is not known. We aimed to retrospectively determine the cumulative incidence of suicidal ideation during the 3 years after the Great East Japan Earthquake among residents in temporary housing without prior suicidal ideation, as compared to the general population. Moreover, we aimed to identify the risk factors for the onset of suicidal ideation. Methods A cross-sectional survey involving face-to-face interviews was conducted 3 years after the earthquake with adult community residents in disaster-affected areas and a control area using the World Health Organization Composite International Diagnostic Interview version 3.0. We compared the cumulative incidence of suicidal ideation between the two areas using the Cox proportional hazard model and examined risk factors for the onset of suicidal ideation using a multiple logistic regression analysis. Results Among 1019 respondents in the disaster-affected areas, the cumulative incidence of suicidal ideation over 1, 2, and 3 years after the earthquake was 1.4%, 2.4%, and 2.8%, respectively, which was significantly higher than that in the control area. Not being married, being injured in the disaster, and poor subjective physical health were associated with the onset of suicidal ideation. Limitations We estimated the time of onset of suicidal ideation based on the respondents’ current age and self-reported onset age, which limits the accuracy of the onset timing. Conclusions We revealed a higher incidence of suicidal ideation in temporary housing residents and identified several risk factors, which suggests the importance of developing countermeasures to prevent suicide after a disaster.

Using near-infrared spectroscopy, we examined changes in the concentration of oxygenated hemoglobin ([oxy-Hb]) in the frontal lobe during a verbal fluency task in 20 patients with schizophrenia (10 patients each receiving olanzapine [OLZ] and risperidone [RIS]) and 10 healthy controls. We found that [oxy-Hb] levels in the prefrontal region were higher in the patients receiving OLZ than in those receiving RIS. These results suggest that antipsychotic drugs have different effects on cerebral hemodynamic patterns, which may reflect frontal lobe function. Further studies with a larger sample size are needed to verify our preliminary findings.

Purpose: Although mental health problems such as depression after disasters have been reported, positive psychological factors after disasters have not been examined. Recently, the importance of positive affect to our health has been recognised. We therefore investigated the frequency of laughter and its related factors among residents of evacuation zones after the Great East Japan Earthquake of 2011. Methods: In a cross-sectional study on 52,320 participants aged 20 years and older who were included in the Fukushima Health Management Survey in Japan's fiscal year 2012, associations of the frequency of laughter with changes in lifestyle after the disaster, such as a changed work situation, the number of family members, and the number of address changes, and other sociodemographic, psychological, and lifestyle factors were examined using logistic regression analysis. The frequency of laughter was assessed using a single-item question: "How often do you laugh out loud?" Results: The proportion of those who laugh almost every day was 27.1%. Multivariable models adjusted for sociodemographic, psychological, and lifestyle factors demonstrated that an increase in the number of family members and fewer changes of address were significantly associated with a high frequency of laughter. Mental health, regular exercise, and participation in recreational activities were also associated with a high frequency of laughter. Conclusion: Changes in lifestyle factors after the disaster were associated with the frequency of laughter in the evacuation zone. Future longitudinal studies are needed to examine what factors can increase the frequency of laughter.

The aim of the present study is to investigate a possible role of a single dose of (−)-epigallocatechin gallate (EGCG), the major catechin in green tea, for the pharmacokinetic interaction between green tea and nadolol in humans. In a randomized three-phase crossover study, 13 healthy volunteers received single doses of 30 mg nadolol orally with water (control), or an aqueous solution of EGCG-concentrated green tea extract (GTE) at low or high dose. Plasma concentrations and urinary excretion of nadolol were determined up to 48 h. In addition, blood pressure and pulse rate were monitored. In vitro transport kinetic experiments were performed using human embryonic kidney 293 cells stably expressing organic anion transporting polypeptide (OATP)1A2 to evaluate the inhibitory effect of EGCG on OATP1A2-mediated substrate transport. Single coadministration of low and high dose GTE significantly reduced the plasma concentrations of nadolol. The geometric mean ratios with 90% CI for area under the plasma concentration–time curves from 0 to infinity of nadolol were 0.72 (0.56–0.87) for the low and 0.60 (0.51–0.69) for the high dose. There were no significant differences in Tmax, elimination half-life, and renal clearance between GTE and water phases. No significant changes were observed for blood pressure and pulse rate between phases. EGCG competitively inhibited OATP1A2-mediated uptake of sulphobromophthalein and nadolol with Ki values of 21.6 and 19.4 μM, respectively. EGCG is suggested to be a key contributor to the interaction of green tea with nadolol. Moreover, even a single coadministration of green tea may significantly affect nadolol pharmacokinetics.

In children, storytelling provides many psychological and educational benefits, such as enhanced imagination to help visualize spoken words, improved vocabulary, and more refined communication skills. However, the brain mechanisms underlying the effects of storytelling on children are not clear. In this study, the effects of storytelling on the brains of children were assessed by using near-infrared spectroscopy (NIRS). Results indicated significant decreases of the blood flow in the bilateral prefrontal areas during picture-book reading when the subjects were familiarized in comparison to the cases of the subject naive to the stories. However, no significant differences in the blood flow were found during storytelling between the subjects naive and familiarized to the stories. The results indicated more sustained brain activation to storytelling in comparison with picture-book reading, suggesting possible advantages of storytelling as a psychological and educational medium in children.

We investigated the association between the frequency of laughter and lifestyle diseases after the Great East Japan Earthquake. We included 41,432 participants aged 30–89 years in the Fukushima Health Management Survey in fiscal year 2012 and 2013. Gender-specific, age-adjusted and multivariable odds ratios of lifestyle diseases were calculated using logistic regressions stratified by evacuation status. Those who laugh every day had significantly lower multivariable odds ratios for hypertension (HT), diabetes mellitus (DM) and heart disease (HD) for men, and HT and dyslipidemia (DL) for women compared to those who do not, especially in male evacuees. The multivariable odds ratios (95% confidence intervals) of HT, DM and HD (non-evacuees vs. evacuees) for men were 1.00 (0.89–1.11) vs. 0.85 (0.74–0.96), 0.90 (0.77–1.05) vs. 0.77 (0.64–0.91) and 0.92 (0.76–1.11) vs. 0.79 (0.63–0.99), and HT and DL for women were 0.90 (0.81–1.00) vs. 0.88 (0.78–0.99) and 0.80 (0.70–0.92) vs. 0.72 (0.62–0.83), respectively. The daily frequency of laughter was associated with a lower prevalence of lifestyle disease, especially in evacuees.

Psychiatric inpatients in the Fukushima prefecture were immediately evacuated from hospitals following the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident in 2011. Whereas the psychiatric status and physical condition of these patients have been considered as factors related to triage during hospital evacuation, few studies show how this background affects the evacuation destination. Thus, the study objective was to reveal associations between hospital evacuation destinations among psychiatric inpatients and their characteristics. This retrospective study enrolled psychiatric inpatients who had been evacuated by the Fukushima prefectural government following the FDNPP accident (N = 783). Patients were classified into two groups based on their evacuation destination (within/outside the Fukushima prefecture). Univariable and multivariable analyses were conducted to investigate the associations between evacuation destination and patients’ traits, including psychiatric/physical backgrounds. Three-quarters of inpatients were evacuated to hospitals outside the prefecture. Multivariable analysis showed that patients diagnosed with mental retardation (ICD-10 F70–79) and psychiatric patients with respiratory diseases (J00–99), genitourinary diseases (N00–99) as comorbidities tended to have been evacuated to hospitals within the prefecture. By contrast, patients with nervous system diseases (G00–99) as comorbidity tended to have been evacuated to hospitals outside the prefecture. In psychiatric patients, specific psychiatric diagnoses and several types of physical comorbidities were associated with the evacuation destination. Prospective follow-up studies are necessary to reveal how the presumed triage strategy has improved the outcomes in evacuated psychiatric patients.

Individuals with schizophrenia exhibit cognitive impairments, which are related to impairments in social functions. This study investigated the effects of cognitive remediation on cognitive, social, and daily living impairment. Participants were individuals with schizophrenia between 20 and 60 years old (N = 44). Participants were randomly assigned to two groups: a cognitive remediation intervention group and a non-intervention control group. The control group was provided with conventional drug therapy and either day care or occupational therapy. The intervention group was provided with the "neuropsychological educational approach to cognitive remediation" developed by Medalia and co-workers. We assessed cognitive functions using the brief assessment of cognition in schizophrenia (BACS), and evaluated social and daily living functions using the global assessment of functioning (GAF) scale. Significant group by time interaction effects indicated that verbal memory, working memory, attention, and executive function showed significantly greater improvement at post-intervention for the intervention group than the control group. Social and daily living function also improved in the intervention group and improvements were maintained one year after intervention. These preliminary findings indicate that the combination of cognitive remediation and psychiatric rehabilitation is effective for facilitating improvements in cognitive function and social and daily living functions in individuals with schizophrenia.

The present study aimed to clarify the associations among radiation exposure or psychological exposure to the Fukushima nuclear power plant accident (i.e., fear/anxiety immediately after the accident), current radiation anxiety, and psychological distress among non-evacuee community residents in Fukushima five years after the Great East Japan Earthquake, which occurred in March 2011. A questionnaire survey was administered to a random sample of non-evacuee community residents from 49 municipalities of Fukushima prefecture from February to April 2016, and data from 1684 respondents (34.4%) were analyzed. Environmental radiation levels at the time of the accident were ascertained from survey meter data, while environmental radiation levels at the time of the survey were ascertained from monitoring post data. In the questionnaire, immediate fear/anxiety after the accident, current radiation anxiety, and psychological distress were measured using a single-item question, a 7-item scale, and K6, respectively. Multilevel linear or logistic regression models were applied to analyze the determinants of radiation anxiety and psychological distress. The findings showed that environmental radiation levels at the time of the survey were more strongly associated with radiation anxiety than radiation levels immediately after the accident. Disaster-related experiences, such as direct damage, disaster-related family stress, and fear/anxiety after the accident, and demographic characteristics (e.g., younger age, being married, low socioeconomic status) were significantly associated with radiation anxiety. Environmental radiation levels at the time of the accident or survey were not significantly associated with psychological distress. Radiation anxiety largely mediated the association between fear/anxiety after the accident and psychological distress. In addition to environmental radiation levels, respondents’ radiation anxiety was affected by multiple factors, such as disaster-related experiences and demographic characteristics. Radiation levels were not associated with psychological distress in non-evacuee community residents. Rather, fear/anxiety after the nuclear power plant accident may be a determinant of psychological distress, mediated by radiation anxiety., Highlights • Environmental radiation levels affected radiation anxiety. • Environmental radiation levels did not affect psychological distress. • Fear/anxiety at time of nuclear power plant accident affected radiation anxiety. • Fear/anxiety at time of accident affected psychological distress. • Radiation anxiety mediated the effect of fear/anxiety on psychological distress.

// Keisuke Nishiura 1,* , Naoki Ichikawa-Tomikawa 1,* , Kotaro Sugimoto 1 , Yasuto Kunii 2,3 , Korehito Kashiwagi 1 , Mizuko Tanaka 1 , Yuichi Yokoyama 4 , Mizuki Hino 2 , Takashi Sugino 5 , Hirooki Yabe 2 , Hitoshi Takahashi 4 , Akiyoshi Kakita 4 , Tetsuya Imura 1,6 and Hideki Chiba 1 1 Department of Basic Pathology, Fukushima Medical University School of Medicine, Fukushima, Japan 2 Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan 3 Department of Psychiatry, Aizu Medical Center, Fukushima Medical University, Fukushima, Japan 4 Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan 5 Department of Diagnostic Pathology, Shizuoka Cancer Center, Shizuoka, Japan 6 Department of Surgical Pathology, Kyoto Prefectural University of Medicine, Kyoto, Japan * These authors contributed equally to this work Correspondence to: Hideki Chiba, email: // Keywords : blood-brain barrier; tight junction; claudin; protein kinase A; schizophrenia; Pathology Section Received : August 30, 2017 Accepted : October 04, 2017 Published : October 16, 2017 Abstract Schizophrenia is thought to be caused by a combination of genetic and environmental factors; however, its pathogenesis remains largely unknown. Here, we focus on the endothelial tight-junction protein claudin-5 (CLDN5), because the CLDN5 gene is mapped to the schizophrenia-associated 22q11.2 deletion region, and a single nucleotide polymorphism in the CLDN5 locus is also linked to schizophrenia. We show, by RT-qPCR and immunohistochemistry, that the expressions of CLDN5 mRNA and protein are significantly increased and decreased, respectively, in the schizophrenic prefrontal cortex (PFC) compared with control PFC. These changes were not observed in the schizophrenic visual cortex (VC), and neither the density nor diameter of the CD34-positive microvessels was altered in the schizophrenic PFC or VC. Interestingly, protein kinase A (PKA) was activated in the microvascular and perivascular regions of the schizophrenic PFC, and the pPKA-positive microvascular endothelial cells occasionally exhibited focal loss of CLND5. Since we previously demonstrated that cAMP induced CLDN5 mRNA expression and size-selective loosening of the endothelial barrier in PKA-independent and -dependent manners, respectively, a similar mechanism could contribute to the discrepancy between mRNA and protein expression of CLDN5 in the schizophrenic PFC. Taken collectively, these findings provide novel insights into the pathophysiology of schizophrenia.

Summary: In schizophrenia (SCZ), neurons in the brain tend to undergo gross morphological changes, but the related molecular mechanism remains largely elusive. Using Kif3b+/− mice as a model with SCZ-like behaviors, we found that a high-betaine diet can significantly alleviate schizophrenic traits related to neuronal morphogenesis and behaviors. According to a deficiency in the transport of collapsin response mediator protein 2 (CRMP2) by the KIF3 motor, we identified a significant reduction in lamellipodial dynamics in developing Kif3b+/− neurons as a cause of neurite hyperbranching. Betaine administration significantly decreases CRMP2 carbonylation, which enhances the F-actin bundling needed for proper lamellipodial dynamics and microtubule exclusion and may thus functionally compensate for KIF3 deficiency. Because the KIF3 expression levels tend to be downregulated in the human prefrontal cortex of the postmortem brains of SCZ patients, this mechanism may partly participate in human SCZ pathogenesis, which we hypothesize could be alleviated by betaine administration.

Background Paroxysmal kinesigenic dyskinesia (PKD) is a rare heritable neurologic disorder characterized by attacks of involuntary movement induced by sudden voluntary movements. No previous reports have described cases showing comorbidity with psychiatric disease or symptoms. In this case, we showed a patient with PKD who exhibited several manifestations of anxiety disorder. Case A 35-year-old Japanese man with PKD had been maintained on carbamazepine since he was 16 years of age without any attacks. However, 10 years before this referral, he became aware of a feeling of breakdown in his overall physical functions. He had then avoided becoming familiar with people out of concern that his physical dysfunctions might be perceived in a negative light. One day he was referred by the neurologic department at our hospital to the Department of Psychiatry because of severe anxiety and hyperventilation triggered by carbamazepine. We treated with escitalopram, aripiprazole, and ethyl loflazepate. Both his subjective physical condition and objective expressions subsequently showed gradual improvement. At last, the feelings of chest compression and anxiety entirely disappeared. Accordingly, increases in plasma monoamine metabolite levels were observed, and the c.649dupC mutation, which has been found in most Japanese PKD families, was detected in his proline-rich transmembrane protein 2 gene. Conclusion This is the first report to describe psychiatric comorbidities or symptoms in a PKD case. The efficacy of psychotropic medication used in this case, the resulting changes in plasma monoamine metabolite levels, and the recent advances in the molecular understanding of PKD suggested slight, but widespread alterations to the neurotransmitter systems in the brain.

Aki Tsuchiyagaito,1–3 Satoshi Horiuchi,4 Toko Igarashi,5 Yoshiya Kawanori,4 Yoshiyuki Hirano,1,3 Hirooki Yabe,2 Akiko Nakagawa1,3 1Research Center for Child Mental Development, Chiba University, Chiba, 2Department of Neuropsychiatry, Fukushima Medical University, Fukushima, 3United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Osaka, 4Faculty of Social Welfare, Iwate Prefectural University, Iwate, 5Graduate School of Education, Joetsu University of Education, Niigata, Japan Background: The Hoarding Rating Scale-Self-Report (HRS-SR) is a five-item scale that assesses the symptoms of hoarding. These symptoms include excessive acquisition, difficulty in discarding, and excessive clutter that causes distress. We conducted three studies to examine the factor structure, reliability, and validity of the Japanese version of the HRS-SR (HRS-SR-J). Methods: Study 1 examined its reliability; 193 college students and 320 adolescents and adults completed the HRS-SR-J and, of the college students, 32 took it again 2weeks later. Study 2 aimed to confirm that its scores in a sample of 210 adolescents and adults are independent of social desirability. Study 3 aimed to validate the HRS-SR-J in the aspects of convergent and discriminant validity in a sample of 550 adults. Results: The HRS-SR-J showed good internal consistency and 2-week test–retest reliability. Based on the nonsignificant correlations between the HRS-SR-J and social desirability, the HRS-SR-J was not strongly affected by social desirability. In addition, it also had a good convergent validity with the Japanese version of the Saving Inventory-Revised (SI-R-J) and the hoarding subscale of the Obsessive-Compulsive Inventory, while having a significantly weaker correlation with the five subscales of the Obsessive-Compulsive Inventory, except for the hoarding subscale. In addition, the strength of the correlation between the HRS-SR-J and the Japanese version of the Patient Health Questionnaire-9 and that between the HRS-SR-J and the Generalized Anxiety Disorder-7 were significantly weaker than the correlation between the HRS-SR-J and the SI-R-J. These results demonstrate that the HRS-SR-J has good convergent and discriminant validity. Conclusion: The HRS-SR-J is a notable self-report scale for examining the severity of hoarding symptoms. Keywords: Japanese version of the Hoarding Rating Scale-Self-Report, Hoarding Rating Scale, hoarding, reliability, validity

The mental health of hospital nurses is a key health issue in public health promotion during the recovery phase following the Fukushima disaster. In this study, conducted 4 years after the disaster, we analyzed the overall mental health, knowledge, risk perception of radiation, and work and daily life burdens of nurses working at medical institutions in the Fukushima Prefecture (collection rate = 89.6%; response number = 730). Overall mental health status was estimated using the 12-item version of the General Health Questionnaire, and 333 respondents (45.6%) scored above the 12-item General Health Questionnaire threshold point (≥4), indicating probable emotional distress compared with the general population under normal circumstances. Multivariate logistic analysis suggested that the ability to cope with daily life and work-related stressors were more important than risk perception and acquisition of knowledge regarding radiation and its control methods for supporting the mental health of nurses following the Fukushima disaster.

The longitudinal posttraumatic stress responses and resilient factors after the Fukushima Daiichi Nuclear Power Plant are yet unknown. Here we attempted to quantify the patterns of the course of posttraumatic stress disorder (PTSD) symptoms and we explored the factors associated with psychological recovery. The subjects were 12 371 residents in the municipalities categorized as the forced evacuated area. We categorized the subjects’ PTSD symptoms into 4 groups: Chronic, Resistant, Recovered, and Non-recovered. We applied a logistic regression to clarify the factors related to psychological recovery. We observed that laughter showed significant odds ratio in the Recovered group and the Resistant group. Meanwhile, elderly residents and those with poor living circumstances showed significant odds ratios for the Recovered group and the Resistant group. Laughter in daily life was associated with the psychological health in the evacuation area.

This study aimed to explore the relationship between psychological distress and degree of functional independence among elderly adults following the Great East Japan Earthquake. Participants were 20 282 adults aged 65 and older who lived in the Great East Japan Earthquake evacuation zone specified by the government on March 31, 2011. This study is a part of a detailed survey on mental health and lifestyle, the Fukushima Health Management Survey, which was conducted in 2012. Psychological distress was assessed using the Kessler 6 scale. Functional independence in different daily activities was assessed by asking participants whether they could independently perform activities: eating, dressing, toileting, and shopping. According to the multiple logistic regression analysis, psychological distress was significantly associated with independence in all models: without adjustment (Model 1), adjusting for demographic characteristics (Model 2), and adjusting for demographic characteristics and disaster-related factors (Model 3), with an adjusted odds ratio of 2.32 (95% confidence interval = 1.97-2.73). High psychological distress was associated with low functional independence, after controlling for demographic characteristics and disaster-related factors. Thus, using psychological distress as the dependent variable, we examined the relationship between low functional independence and psychological distress among elderly adults who were evacuated.

After the Great East Japan Earthquake and the subsequent nuclear reactor accident, the outdoor activities of children greatly decreased. We investigated adverse effects on the exercise habits and mental health of children after the disaster. The target subjects were children aged 6 to 15 years living inside the government-designated evacuation zone as of March 11, 2011 (n = 29 585). The subjects’ parents/guardians completed the Strengths and Difficulties Questionnaire (SDQ) and exercise habit data were obtained from the 2011 Fukushima Health Management Survey. A total of 18 745 valid responses were returned. We excluded questionnaires with incomplete answers leaving 10 824 responses for the final analysis. SDQ scores ≥16 indicated high risk of mental health. Children in the evacuation zone who did not get regular exercise had a higher risk of mental problems as evaluated by SDQ (multivariate-adjusted prevalence ratio [PR] = 1.49; 95% CI 1.38-1.62). When stratified by sex, age, place of residence, treatment for illnesses and experienced the nuclear reactor accident the associations were essentially the same. Regular exercise is important for maintaining children’s mental health after a disaster. This is the first large-scale report to examine the impact of outdoor exercise limitations among children in a nuclear accident.