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Atsuko Ikenouchi,1,2 Yusuke Konno,1,3 Yoshihisa Fujino,3 Naoto Adachi,4 Yukihisa Kubota,4 Takaharu Azekawa,4 Hitoshi Ueda,4 Koji Edagawa,4 Eiichi Katsumoto,4 Eiichiro Goto,4 Seiji Hongo,4 Masaki Kato,5,6 Takashi Tsuboi,5,7 Norio Yasui-Furukori,5,8 Atsuo Nakagawa,5,9 Toshiaki Kikuchi,5,9 Koichiro Watanabe,5,7 Reiji Yoshimura1,5 1Department of Psychiatry, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan; 2Medical Center for Dementia, Hospital of the University of Occupational and Environmental Health, Japan, Kitakyushu, Japan; 3Department of Environmental Epidemiology, Institute of Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan; 4The Japanese Association of Neuro-Psychiatric Clinics, Tokyo, Japan; 5The Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan; 6Department of Neuropsychiatry, Kansai Medical University, Osaka, Japan; 7Department of Neuropsychiatry, Kyorin University, Tokyo, Japan; 8Department of Psychiatry, Dokkyo Medical University, Tochigi, Japan; 9Department of Neuropsychiatry, Keio University, Tokyo, JapanCorrespondence: Atsuko Ikenouchi, Department of Psychiatry, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishiku, Kitakyushu, 807-8555, Japan, Tel +81-93-691-7253, Fax +81-93-692-4894, Email atsuko-i@med.uoeh-u.ac.jpPurpose: To clarify the relationship between the length of unstable periods and employment status of patients with bipolar disorder.Patients and Methods: Medical records of outpatients with bipolar disorder who visited 176 member clinics of the Japanese Association of Neuro-Psychiatric Clinics were investigated during September–October 2016, and details of their medical care and employment were surveyed using a questionnaire. The odds ratios (ORs) of length of unstable period and unemployment were analyzed with a logistic regression model.Results: The study included 816 patients, of whom 707 were employed full-time (continuous employment) and 70 were unemployed (loss of employment). Univariate analysis showed that ORs were statistically significant for patients who were unstable for “almost all” of the year (OR = 10.4 [4.48– 24.28] p < 0.001), but not for “few” unstable periods (OR = 1.06 [0.56– 1.98] p = 0.849) and for “significant” unstable periods (OR = 1.65 [0.73– 3.74] p = 0.231) were not significantly different. Multivariate analysis showed that ORs were statistically “significant” for patients who were unstable for “almost all” (OR = 12.1 [4.37– 33.3] p < 0.001), but not for “few” unstable periods (OR = 1.07 [0.55– 2.07] p = 0.846) and for “significant” unstable periods (OR = 1.62 [0.66– 3.98] p = 0.290) did not differ significantly.Conclusion: Patients with bipolar disorder with a long unstable period were associated with a higher risk of unemployment.Keywords: mood disorder, loss of employment, nationwide study, real world

Yusuke Konno,1,2 Yoshihisa Fujino,2 Atsuko Ikenouchi,1,3 Naoto Adachi,4 Yukihisa Kubota,4 Takaharu Azekawa,4 Hitoshi Ueda,4 Koji Edagawa,4 Eiichi Katsumoto,4 Eiichiro Goto,4 Seiji Hongo,4 Masaki Kato,5,6 Takashi Tsuboi,5,7 Norio Yasui-Furukori,5,8 Atsuo Nakagawa,5,9 Toshiaki Kikuchi,5,9 Koichiro Watanabe,5,7 Reiji Yoshimura1,5 1Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Japan; 2Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan; 3Medical Center for Dementia, University Hospital of Occupational and Environmental Health, Kitakyushu, Japan; 4The Japanese Association of Neuro-Psychiatric Clinics, Tokyo, Japan; 5The Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan; 6Department of Neuropsychiatry, Kansai Medical University, Osaka, Japan; 7Department of Neuropsychiatry, Kyorin University School of Medicine, Tokyo, Japan; 8Department of Psychiatry, Dokkyo Medical University, Tochigi, Japan; 9Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, JapanCorrespondence: Yusuke KonnoDepartment of Psychiatry, University of Occupational and Environmental Health, 1-1, Iseigaoka, Yahatanishiku, Kitakyushu, 807-8555, JapanTel +81-93-691-7401Fax +81-93-692-4894Email yu-konno@med.uoeh-u.ac.jpObjective: The objective of this study was to clarify the relationship between mood episode and employment in patients with bipolar disorder to help improve their employment status.Methods: All medical records of patients with bipolar disorder who visited 176 member clinics of the Japanese Association of Neuro-Psychiatric Clinics in September–October 2016 were investigated in September–October 2017. Details of the medical care received were investigated using a survey sheet, which included employment status. Odds ratios of mood episodes for employment status were analyzed using a logistic regression model.Results: Among patients aged 60 years or less, 2292 described their occupation. On univariate analysis, odds ratios were statistically significant for depressive episode (OR = 2.68 [1.50– 4.78] p = 0.001) and manic episode (OR = 2.64 [1.07– 6.47] p = 0.034), whereas no significant difference was noted for mixed episode (OR = 1.72 [0.69– 4.33] p = 0.246). On multivariate analysis, odds ratios were statistically significant for depressive episode (OR = 2.16 [1.13– 4.13], p = 0.020) and manic episode (OR = 3.55 [1.36– 9.25], p = 0.010), whereas no significant difference was noted for mixed episode (OR = 1.83 [0.65– 5.14] p = 0.254).Conclusion: Employment status among these patients with bipolar disorder receiving outpatient treatment was 43.5%. Compared to remission episodes, manic and depressive episodes were associated with a higher risk of unemployment.Keywords: mood disorder, continuous employment, occupational health, Japan

Takashi Tsuboi,1,2 Takefumi Suzuki,2,3 Takaharu Azekawa,4 Naoto Adachi,4 Hitoshi Ueda,4 Kouji Edagawa,4 Eiichi Katsumoto,4 Yukihisa Kubota,4 Eiichiro Goto,4 Seiji Hongo,4 Yoichiro Watanabe,4 Masaki Kato,2,5 Norio Yasui-Furukori,2,6 Reiji Yoshimura,2,7 Atsuo Nakagawa,2,8 Toshiaki Kikuchi,2,8 Koichiro Watanabe1,2 1Department of Neuropsychiatry, Kyorin University School of Medicine, Tokyo, Japan; 2The Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan; 3Department of Neuropsychiatry, University of Yamanashi Faculty of Medicine, Yamanashi, Japan; 4The Japanese Association of Neuro-Psychiatric Clinics, Tokyo, Japan; 5Department of Neuropsychiatry, Kansai Medical University, Osaka, Japan; 6Department of Psychiatry, Dokkyo Medical University, Tochigi, Japan; 7Department of Psychiatry, University of Occupational and Environmental Health, Fukuoka, Japan; 8Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, JapanCorrespondence: Takashi TsuboiDepartment of Neuropsychiatry, Kyorin University School of Medicine, 6-20-2, Shinkawa, Mitaka-Shi, Tokyo 181-8611, JapanTel +81 422 47 5511Fax +81 422 45 4697Email takashi.tsuboi.0821@gmail.comPurpose: The aim of this study was to identify factors associated with non-remission in bipolar disorder.Patients and Methods: The multicenter treatment survey for bipolar disorder in psychiatric outpatient clinics (MUSUBI) study used a questionnaire administered at 176 clinics throughout Japan from September to October 2016. Clinic psychiatrists performed a retrospective medical record survey of consecutive cases with bipolar disorder. Patients were considered to be in remission if they met all of the following criteria: they were not in a mixed state, their manic or depressive symptoms were either borderline or nonexistent (corresponding to 2 or 1 points on the Clinical Global Impressions Scale, Bipolar Version), and their psychiatrists clinically considered them to be in remission. Enrolled patients were classified into remitters group and non-remitters group and demographic and clinical characteristics were contrasted between the groups. Non-remitters were compared with remitters, using a series of logistic regression analyses.Results: A total of 3130 patients (1420 men; mean age: 50.3 years) were included in this study; 1307 patients (41.8%) were in remission. Of the remaining 1823 patients, 1260 (40.3%) had mild to severe depression, 261 (8.3%) suffered from manic or hypomanic episodes, and 302 (9.6%) were in a mixed state. Logistic regression analyses found the following eight factors to be significantly correlated with non-remission in patients with bipolar disorder: female gender, younger age, unemployed status, rapid cycling pattern, comorbid alcohol/substance abuse, poorer social function, lithium non-use, and antidepressant use.Conclusion: The MUSUBI study, the largest nationwide investigation on bipolar disorder, identified eight clinically relevant factors associated with non-remission in bipolar patients. They have important clinical implications; further prospective studies are necessary to replicate these findings and to guide better managements for those in serious needs.Keywords: bipolar disorder, non-remission, nationwide study, mood stabilizer, antipsychotics

Br J Ophthalmol 2003;87:1279-1283 Aim: To determine the efficacy of using albumin tear supplements in the treatment of ocular surface disorders as a substitute for serum eye drops. Methods: The [...]

Aim: To test the short term efficacy and safety of an infrared warm compression device (IWCD, Eye Hot, Cept Co, Tokyo, Japan) as treatment for non-inflamed meibomian gland dysfunction (MGD). [...]

A superconducting quantum interference device pickup coil employed to measure magnetic-field distribution involving a superconducting patterned strip line sample indicated that accurate record of magnetic histories of the past are registered by superconducting films in the perpendicular magnetic field within the 500 muG-50 mG range. Superconducting thin films are penetrated by all magnetic fluxes. Electronic circuits of the Josephson-type are easily constructed using these results.

A highly sensitive magnetometer capable of determining the intensity of a weak magnetic field without requiring null flux calibration was developed. The magnetometer was designed using a new magnetometry technique based on the generation of even harmonics from Josephson functions. Its semiconductor circuit consists of a lump component tank circuit and a high-electron-mobility transistor or GaAs preamplifier. Simulation tests show that the proposed magnetometer can determine the variation of a weak magnetic field without the need for null flux calibration.

A new method for sweeping the trapped flux in superconducting films was presented. The method was based on a micro-heat-flushing technique and functioned by measuring the magnetic field distribution over a superconductor and removing the detected trapped flux. The heat flushing method allowed for the precise control of the flux movement and was capable of changing the hot spot, flux creations brought about by the thermoelectric potential of the material.