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Miko Iwata,* Masakazu Hatano,* Kana Ito, Haruna Matsuzaki, Shigeki Yamada Department of Pharmacotherapeutics and Informatics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan*These authors contributed equally to this workCorrespondence: Masakazu Hatano, Department of Pharmacotherapeutics and Informatics, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan, Tel +81 562932157, Fax +81 562934537, Email hatanomasakazu@yahoo.co.jpPurpose: Several nationwide population-based studies have reported that patients with psychiatric disorders are at higher risk of developing chronic kidney disease, chronic liver disease, and metabolic syndrome than the general population; however, there are insufficient studies in the Japanese population. Thus, we aimed to clarify the influence of psychiatric disorders on clinical laboratory data in the Japanese population.Patients and Methods: This cross-sectional study was based on medical records from the Department of Psychiatry at Fujita Health University Hospital and the 6th National Database of Health Insurance Claims and Specific Health Checkups of Japan Open Data Japan (specific health checkups in 2018) in the Ministry of Health, Labor and Welfare. The primary endpoint was the incidence of clinical laboratory abnormalities in patients with psychiatric disorders and the general Japanese population.Results: Compared to the general Japanese population, patients with psychiatric disorders had significantly higher rates of the following clinical laboratory abnormalities: estimated glomerular filtration rate, alanine transaminase, aspartate aminotransferase (AST), body mass index (BMI), high-density lipoprotein cholesterol (HDL-C), triglycerides, and hemoglobin A1c (HbA1c). In the age-specific analysis, AST, BMI, HDL-C, and HbA1c levels were more frequently abnormal in patients with psychiatric disorders only in the 40– 49 and 50– 59 age groups.Conclusion: Our results showed that patients with psychiatric disorders have higher rates of various clinical laboratory abnormalities than the general Japanese population, with stronger influences in the middle-aged group. These data suggest the importance of monitoring and preventing chronic diseases in patients with psychiatric disorders in Japan.Keywords: big data, chronic kidney disease, diabetes mellitus, liver diseases, metabolic syndrome, mental disorders

Haruna Matsuzaki,1,* Masakazu Hatano,1,* Miko Iwata,1 Takeo Saito,2 Shigeki Yamada1 1Department of Clinical Pharmacy, Fujita Health University School of Medicine, Toyoake, 470-1192, Japan; 2Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, 470-1192, Japan*These authors contributed equally to this workCorrespondence: Masakazu Hatano, Department of Clinical Pharmacy, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, Japan, Tel +81 562932157, Fax +81 562934537, Email hatanomasakazu@yahoo.co.jpPurpose: Clozapine is more effective than other antipsychotics and is the only antipsychotic approved for treatment-resistant schizophrenia. The objective of this study is to reveal the effect of clozapine on employment using a bidirectional mirror-image model.Patients and Methods: This design was a retrospective observational study that investigated the employment status of patients with treatment-resistant schizophrenia based on medical records. The bidirectional mirror-image model consisted of 1) switching from other antipsychotics to clozapine and 2) switching from clozapine to other antipsychotics. The observation period was 1 year for each pre- and post-clozapine initiation and discontinuation.Results: We included 36 patients in the bidirectional mirror-image model. The regular employment plus employment support rate was significantly higher in the clozapine phase than in the other antipsychotic phase in the bidirectional mirror-image model (30.6% vs 11.1%, P = 0.039). The days of regular employment plus employment support were also significantly longer in the clozapine phase (61.3 ± 106.2 vs 24.7 ± 82.7 days, P = 0.032). As per the unidirectional mirror-image model, switching to clozapine resulted in significantly higher regular employment plus employment support rates in the clozapine phase than those in the other antipsychotic phase (33.3% vs 10.0%, P = 0.039). Switching from clozapine to other antipsychotics did not exhibit significant differences in any outcomes.Conclusion: The results suggest that clozapine is superior to other antipsychotics with respect to achieving employment in patients with treatment-resistant schizophrenia. However, biases specific to the mirror-image model need to be considered.Keywords: clozapine, antipsychotic agents, treatment-resistant schizophrenia, observational study, mental health recovery

Haruna Matsuzaki,1 Masakazu Hatano,1,2 Miko Iwata,1 Shigeki Yamada1 1Department of Clinical Pharmacy, Fujita Health University School of Medicine, Toyoake, Aichi, Japan; 2Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Aichi, JapanCorrespondence: Masakazu HatanoFujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, JapanTel +81 562932157Fax +81 562934537Email hatanomasakazu@yahoo.co.jpObjective: Asenapine is a second-generation antipsychotic agent that is classified as a multi-acting receptor-targeted antipsychotic and is similar to olanzapine. Our study aimed to compare the treatment continuation rate and reason for discontinuation of asenapine or olanzapine in schizophrenia using real-world data.Methods: This design was a retrospective study. The primary endpoint was Kaplan–Meier estimates of the continuation rate at six months, with the propensity score method applied to adjust for potential confounders.Results: A total of 95 patients were analyzed in this study (asenapine, n = 46; olanzapine, n = 49). Matched data were adjusted to consider six covariates (age, sex, chlorpromazine equivalent, diazepam equivalent, history of clozapine use, and history of modified electro convulsive therapy). The continuation rate at six months was 27.3% (95% CI, 15.6– 47.6) in the asenapine group and 50.8% (95% CI, 34.3– 75.3) in the olanzapine group (hazard ratio, 0.41; 95% CI, 0.21– 0.82; P = 0.0088 by the Log rank test) in matched data. Cases of discontinuation because of the lack of efficacy were almost as frequent for asenapine (13.0%) as for olanzapine (10.2%). Discontinuation due to bitter taste (6.5%) and burden of the dosing method (6.5%) were observed only with asenapine, whereas anticholinergic side effects such as dry mouth (4.1%) and constipation (2.0%) were observed only with olanzapine.Conclusion: The low continuation rate of asenapine in real-world data may be related to specific factors such as bitter taste and burden of the dosing method.Keywords: asenapine, olanzapine, antipsychotic agents, schizophrenia, retrospective studies, propensity score

The rate of supernovae in our local Galactic neighbourhood within a distance of about 100 parsecs from Earth is estimated to be one every 2-4 million years, based on the [...]