Search

Fumitoshi Kodaka,1,* Takahiko Noro,2,* Nanami Kishimoto,2 Mei Kurosawa,2 Yoshinori Itoh,2 Shumpei Ogawa,2 Tomoyuki Watanabe,2 Masaomi Kubota,2 Kiyotaka Hori,3 Masahiro Shigeta,1 Tadashi Nakano2 1Department of Psychiatry, The Jikei University School of Medicine, Tokyo, Japan; 2Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan; 3Japan Medical Affairs, Santen Pharmaceutical Co., Ltd, Tokyo, Japan*These authors contributed equally to this workCorrespondence: Tadashi Nakano, Department of Ophthalmology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 103-0003, Japan, Tel +81 3-3433-1111, Fax +81 3-3437-2665, Email tnakano@jikei.ac.jpPurpose: Over 50% of patients with early-stage glaucoma discontinue topical therapy within the first 6 months of treatment initiation. This risk of discontinuation could be reduced by how the ophthalmologist explains the treatment plan. Ophthalmologists can explain the treatment plan to patients in either positive or negative contexts. Although explanations in a negative context can be selected depending on the medical situation, identification of patients who will choose the treatment with explicit statistical prediction after an explanation in a negative context is important; personality traits are related to these emotional decisions. Therefore, in the present study, we examined the personality traits associated with choice of treatment with explicit statistical prediction after an explanation in a negative context.Patients and Methods: A total of 147 patients with glaucoma were recruited for this study. The questionnaire booklets used contained positively framed or negatively framed versions of an “Asian disease problem” to enable examination of the influence of the way in which a problem is framed (framing effect) on the participants’ decision-making. The Japanese version of the Ten-Item Personality Inventory was used to estimate the personality traits of the participants.Results: Low conscientiousness was identified as the only variable that was strongly predictive of the choice of treatment with explicit statistical prediction (β = − 0.44, z = 2.19, p = 0.03). In addition, while the association was not statistically significant, low neuroticism was found to be weakly predictive of the choice of uncertain treatment (β = − 0.37, z = 1.73, p = 0.08).Conclusion: In conclusion, we showed that low levels of conscientiousness predict the choice of treatment with explicit statistical prediction (ie, topical treatment) for glaucoma after an explanation in a negative context.Keywords: conscientiousness, neuroticism, glaucoma, big five personality traits

Hiroki Matsuura,1 Hidemi Iwasaka,2 Satoko Nezu,3 Toyosaku Ota,4 Kosuke Okazaki,4 Kazuhiko Yamamuro,4 Yoko Nakanishi,5 Naoko Kishimoto,4 Junzo Iida,6 Toshifumi Kishimoto4 1Department of Psychiatry, Nara Prefecture General Rehabilitation Center, Shiki-Gun, Nara, Japan; 2Developmental Center for Child and Adult, Shigisan Hospital, Ikoma-Gun, Nara, Japan; 3Department of Epidemiology, Nara Medical University, Kashihara, Nara, Japan; 4Department of Psychiatry, Nara Medical University, Kashihara, Nara, Japan; 5Department of Psychiatry, Akitsu Kounoike Hospital, Gose, Nara, Japan; 6Faculty of Nursing, Nara Medical University, Kashihara, Nara, JapanCorrespondence: Toyosaku OtaDepartment of Psychiatry, Nara Medical University, 840 Shijyo-Cho, Kashihara, Nara 634-8522, JapanTel +81-744-22-3051Fax +81-744-22-3854Email toyosaku@naramed-u.ac.jpBackground: School refusal behavior (SRB), which is the refusal to attend or remain in school, has been associated with emotional, psychological, and other behavioral problems, as well as a lower health-related quality of life (HRQOL). However, the effects of self-esteem and a psychiatric diagnosis in students with SRB on HRQOL are not yet known. Understanding these relationships could help to develop more effective therapeutic interventions.Methods: A total of 175 young people (aged 8– 18 years old) who visited our medical centers and outpatient clinics participated in the study. This comprised the SRB group (n = 70) and an age- and sex-matched control group (n = 105). Information about any psychiatric diagnosis was collected from medical records, HRQOL was measured using the J-KIDSCREEN-52, SRB was assessed using the School Refusal Assessment Scale-Revised for Japanese Attendance at School, self-esteem was measured using the Rosenberg Self-Esteem Scale, children’s mental health status was measured using the Strengths and Difficulties Questionnaire, and social support was measured using the Oslo 3-item Social Support Scale. We performed between-group comparisons and multiple regression analysis.Results: The SRB had a significantly lower HRQOL than the control group in several of the KIDSCREEN-52 dimensions. In the SRB group, 35.7% had chronic disease and 35.7% of their parents had health problems and were receiving treatment. The multiple regression analysis revealed that, within the SRB group, a psychiatric diagnosis was associated with a lower HRQOL. However, this was not the case for a diagnosis of autistic spectrum disorder. Self-esteem positively affected HRQOL in six dimensions of the KIDSCREEN-52 within the SRB group.Conclusion: Our results could inform the development of support strategies for young people with SRB. Namely, support that enhances self-esteem could be used to increase HRQOL in young people with SRB. Furthermore, the presence of psychiatric disorders should be assessed as early as possible.Keywords: school refusal behavior, health-related quality of life, KIDSCREEN, Rosenberg self-esteem scale, autism spectrum disorder

Kazuhiko Yamamuro,1 Toyosaku Ota,1 Junzo Iida,2 Yoko Nakanishi,1 Naoko Kishimoto,1 Toshifumi Kishimoto1 1Department of Psychiatry, 2Faculty of Nursing, Nara Medical University School of Medicine, Kashihara, Japan Aim: Cognitive impairment is an important predictor of functional outcome in patients with attention deficit/hyperactivity disorder (ADHD). However, the neurophysiology of ADHD-related cognitive impairments remains unclear. Event-related potentials (ERPs) represent the noninvasive measurement of neural correlates of cognitive function. Mismatch negativity (MMN) is an ERP component that is presumed to index the preattentive monitoring of changes in the auditory environment. Materials and methods: Previous studies have shown altered MMN amplitude and latency in patients with ADHD. However, little is known about the relationship between MMN and ADHD-symptom severity. To address this, we measured the amplitude and latency of MMN in ERPs and assessed correlations with the clinical severity of ADHD, as measured by the ADHD Rating Scale IV – Japanese version. Participants were 51 treatment-naïve children and adolescents with ADHD (mean age 10.42±3.35 years) and 15 normally developing age- and sex-matched children (mean age 11.8±3.36 years). Results: In the ADHD group, MMN amplitudes were attenuated at the central electrode and MMN latencies prolonged at the parietal electrode (Pz) relative to those in the control group. Furthermore, MMN amplitudes at Pz were negatively correlated with ADHD full-scale and hyperactivity–impulsivity and inattention subscale scores, and MMN latency at Pz was positively correlated with ADHD hyperactivity–impulsivity subscale scores. Conclusion: Our data suggest that MMN reflects the severity of ADHD symptoms in children and adolescents, and provides support for the use of ERPs in evaluating ADHD symptoms in patients. Keywords: attention deficit/hyperactivity disorder, event-related potentials, mismatch negativity, symptom severity, relationship

Naoko Kishimoto,1 Kazuhiko Yamamuro,1 Junzo Iida,2 Toyosaku Ota,1 Shohei Tanaka,1 Masanori Kyo,3 Sohei Kimoto,1 Toshifumi Kishimoto1 1Department of Psychiatry, 2Faculty of Nursing, Nara Medical University School of Medicine, 3Department of Psychiatry, Kyo Mental Clinic, Nara, Japan Objective: The differential diagnosis of schizophrenia (SZ) versus autism spectrum disorder (ASD) can be clinically challenging because accumulating evidence suggests both clinical and biological overlaps between them. The aim of this study was to compare Rorschach profiles between young adults with SZ and those with ASD.Methods: We evaluated quantitative tendencies on the Rorschach test among 20 patients diagnosed with SZ and 20 diagnosed with ASD. Both groups were matched for age, sex, and intelligence quotient.Results: We found significant differences in six response variables on the Rorschach comprehensive system. Those with SZ had significantly higher scores on D score, adjusted D score (Adj D), developmental quality code reflecting ordinary response (DQo), and form quality minus (FQ -) than those with ASD. In contrast, those with SZ had significantly lower scores on the active and developmental quality code reflecting synthesized response (DQ+) subscales than those with ASD.Conclusion: The present findings reveal that individuals with SZ might have more stress tolerance, stronger perception distortions, and simpler and poorer recognition than those with ASD. We suggest that the Rorschach test might be a useful tool for differentiating between SZ and ASD. Keywords: autism spectrum disorder, perception, psychopathology, Rorschach test, schizophrenia

Kazuhiko Yamamuro,1 Koji Okada,2 Naoko Kishimoto,1 Toyosaku Ota,1 Junzo Iida,3 Toshifumi Kishimoto1 1Department of Psychiatry, Nara Medical University School of Medicine, 2Department of Psychiatry, Jingumaecocorono-Clinic, 3Faculty of Nursing, Nara Medical University School of Medicine, Kashihara, Japan Aim: Earlier brain imaging research studies have suggested that brain abnormalities in obsessive-compulsive disorder (OCD) normalize as clinical symptoms improve. However, although many studies have investigated event-related potentials (ERPs) in patients with OCD compared with healthy control subjects, it is currently unknown whether ERP changes reflect pharmacological and psychotherapeutic effects. As such, the current study examined the neurocognitive components of OCD to elucidate the pathophysiological abnormalities involved in the disorder, including the frontal-subcortical circuits.Methods: The Yale-Brown Obsessive-Compulsive Scale was used to evaluate 14 adult patients with OCD. The present study also included ten age-, sex-, and IQ-matched controls. The P300 and mismatch negativity (MMN) components during an auditory oddball task at baseline for both groups and after 1 year of treatment for patients with OCD were measured.Results: Compared with controls, P300 amplitude was attenuated in the OCD group at Cz and C4 at baseline. Pharmacotherapy and psychotherapy treatment for 1 year reduced OCD symptomology. P300 amplitude after 1 year of treatment was significantly increased, indicating normalization compared with baseline at Fz, Cz, C3, and C4. We found no differences in P300 latency, MMN amplitude, or MMN latency between baseline and after one year of treatment.Conclusion: ERPs may be a useful tool for evaluating pharmacological and cognitive behavioral therapy in adult patients with OCD. Keywords: obsessive-compulsive disorder, event-related potentials, P300, mismatch negativity, improvement