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Masataka Otake,1 Shin Ono,1 Yuichiro Watanabe,1 Koichiro Kumagai,1 Koji Matsuzawa,1 Hiroyuki Kasahara,1 Masaya Ootake,1 Takuro Sugai,1,2 Toshiyuki Someya1 1Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Chuo-ku, Niigata, Japan; 2Murakami Hamanasu Hospital, Murakami, Niigata, JapanCorrespondence: Yuichiro Watanabe, Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, 757 Asahimachidori-ichibancho, Chuo-ku, Niigata, 951-8510, Japan, Tel +81-25-227-2213, Fax +81-25-227-0777, Email yuichiro@med.niigata-u.ac.jpPurpose: There is little evidence regarding the effects of dental status on body mass index (BMI) in inpatients with schizophrenia. Thus, we performed a cross-sectional study to explore the associations between the number of remaining teeth and BMI in Japanese inpatients with schizophrenia.Patients and Methods: We performed multiple regression analysis to assess the effects of potential predictors (age, sex, number of remaining teeth, number of antipsychotics prescribed, chlorpromazine equivalent dose, and antipsychotic type) on BMI in 212 inpatients with schizophrenia. We then compared the number of remaining teeth between inpatients with schizophrenia and the Japanese general population (3283 individuals) from the Japan Dental Diseases Survey 2016, using an analysis of covariance with age and sex as covariates.Results: Multiple regression analysis showed that the number of remaining teeth and the number of antipsychotics prescribed were significantly correlated with BMI (standardized regression coefficient = 0.201 and 0.235, respectively). In the analysis of covariance, inpatients with schizophrenia had significantly fewer remaining teeth compared with the Japanese general population (mean 14.8 [standard deviation: 10.9] vs mean 23.0 [standard deviation: 8.1]).Conclusion: These results suggested that tooth loss and antipsychotic polypharmacy affect BMI in inpatients with schizophrenia, and that inpatients with schizophrenia lose more teeth compared with the general population.Keywords: antipsychotic polypharmacy, body mass index, oral health, tooth loss

Maki Ogawa,1 Yuichiro Watanabe,1 Takaharu Motegi,1 Naoki Fukui,1 Koyo Hashijiri,1 Ryusuke Tsuboya,1 Takuro Sugai,1 Jun Egawa,1 Rie Araki,2 Kazufumi Haino,3 Masayuki Yamaguchi,3 Koji Nishijima,4 Takayuki Enomoto,3 Toshiyuki Someya1 1Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan; 2Nursing, Niigata University Medical and Dental Hospital, Niigata, Japan; 3Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan; 4General Center for Perinatal, Maternal and Neonatal Medicine, Niigata University Medical and Dental Hospital, Niigata, JapanCorrespondence: Yuichiro WatanabeDepartment of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, 757 Asahimachidori-Ichibancho, Chuo-ku, Niigata 951-8510, JapanTel +81-25-227-2213Fax +81-25-227-0777Email yuichiro@med.niigata-u.ac.jpPurpose: The Hospital Anxiety and Depression Scale (HADS) is a self-report questionnaire widely used to assess anxiety and depression. To the best of our knowledge, only four studies have examined the factor structure of the HADS for assessing pregnant women, with conflicting results. This study aimed to assess the factor structure and measurement invariance of the HADS for use with pregnant Japanese women.Participants and Methods: A total of 936 pregnant Japanese women completed the HADS questionnaire at three time points: the first and third trimester of pregnancy, and postpartum. We examined the factor structure of the HADS in Group 1 (n = 466) using exploratory factor analysis (EFA). We then compared the models identified in Group 1 with those from previous studies using confirmatory factor analysis (CFA) in Group 2 (n = 470). We performed multiple-group CFA for Group 2 to test the measurement invariance of the best-fit model across the three time points.Results: The EFA for the Group 1 data at the three time points revealed a two-factor model. In the CFA, the two-factor model from Group 1 showed the best fit with the data at the three time points. In the multiple-group CFA for Group 2, we confirmed the configural and metric invariance of the two-factor model across the three time points.Conclusion: Our findings provide evidence for a two-factor structure and weak measurement invariance of the HADS in pregnant Japanese women during the peripartum period.Keywords: confirmatory factor analysis, exploratory factor analysis, Hospital Anxiety and Depression Scale

Takaharu Motegi,1 Yuichiro Watanabe,1 Naoki Fukui,1 Maki Ogawa,1 Koyo Hashijiri,1 Ryusuke Tsuboya,1 Takuro Sugai,1 Jun Egawa,1 Rie Araki,2 Kazufumi Haino,3 Masayuki Yamaguchi,3 Koji Nishijima,4 Takayuki Enomoto,3 Toshiyuki Someya1 1Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan; 2Nursing, Niigata University Medical and Dental Hospital, Niigata, Japan; 3Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan; 4General Center for Perinatal, Maternal and Neonatal Medicine, Niigata University Medical and Dental Hospital, Niigata, JapanCorrespondence: Yuichiro WatanabeDepartment of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, 757 Asahimachidori-Ichibancho, Chuo-Ku, Niigata 951-8510, JapanTel +81-25-227-2213Fax +81-25-227-0777Email yuichiro@med.niigata-u.ac.jpPurpose: Postpartum depression is a well-known risk factor, and postpartum anxiety and parity are potential risk factors, for mother–infant bonding disorder. However, few studies have focused on the relationships among these factors and mother–infant bonding. This cross-sectional study explored the associations between depression, anxiety and parity, and mother–infant bonding.Materials and Methods: Japanese mothers, both primiparas and multiparas, completed the Mother-to-Infant Bonding Scale (MIBS) and the Hospital Anxiety and Depression Scale (HADS) one month after childbirth. We performed a stepwise multiple regression analysis with the forward selection method to assess the effects of HADS anxiety and depression scores and parity as independent variables on mother–infant bonding as the dependent variable.Results: A total of 2379 Japanese mothers (1116 primiparas and 1263 multiparas) took part in the study. MIBS score (2.89 ± 2.68 vs 1.60 ± 2.11; p < 0.0001) was significantly higher in primiparas than in multiparas. HADS anxiety (6.55 ± 4.06 vs 4.63 ± 3.41; p < 0.0001) and depression (6.56 ± 3.43 vs 5.98 ± 3.20; p < 0.0001) scores were also significantly higher in primiparas than in multiparas. A stepwise multiple regression analysis with the forward selection method revealed that HADS depression and anxiety scores and parity were significantly associated with MIBS score (p = 0.003, 0.015 and 0.023).Conclusion: Depression, anxiety and primiparity were negatively associated with mother–infant bonding one month after childbirth.Keywords: HADS, Japanese, MIBS, parity, postpartum

Norio Sugawara,1,2 Norio Yasui-Furukori,1,2 Manabu Yamazaki,3 Kazutaka Shimoda,1,2 Takao Mori,3 Takuro Sugai,2,4 Hiroshi Matsuda,3 Yutaro Suzuki,2,4 Yuji Ozeki,2,5 Kurefu Okamoto,3 Toyoaki Sagae,3,6 Toshiyuki Someya2,4 1Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Tochigi 321-0293, Japan; 2Japanese Society of Clinical Neuropsychopharmacology, Chiyoda-ku, Tokyo 101-0003, Japan; 3Japan Psychiatric Hospital Association, Minato-ku, Tokyo 108-8554, Japan; 4Department of Psychiatry, Graduate School of Medical and Dental Sciences, Niigata University, Chuo-ku, Niigata 951-8510, Japan; 5Department of Psychiatry, Shiga University of Medical Science, Otsu, Shiga 520-2134, Japan; 6Department of Health and Nutrition, Yamagata Prefectural Yonezawa University of Nutrition Sciences, Yonezawa, Yamagata 992-0025, JapanCorrespondence: Norio SugawaraDepartment of Psychiatry, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi 321-0293, JapanTel +81-28-287-2153 (extension: 7141)Fax +81-28-286-5187Email nsuga3@dokkyomed.ac.jpBackground: Reliable and easy screening for metabolic syndrome (MetS) is important for patients with schizophrenia. The aim of this study was to assess the predictive utility of body mass index (BMI) for MetS among patients with schizophrenia in Japan.Methods: In total, 8468 patients (4705 males, 3763 females) with schizophrenia or schizoaffective disorders based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), or the International Classification of Diseases, tenth revision (ICD-10), were assessed for MetS using the criteria of the National Cholesterol Education Program Adult Treatment Panel III (ATP III-A). We applied a stratum-specific likelihood ratio (SSLR) analysis, which is independent of the prevalence of the target disease.Results: The mean (± standard deviation) age of these patients was 57.4 ± 13.5 years. The prevalence of MetS was 20.4%. Among males, the SSLRs predicting MetS were 0.03 (95% CI 0.02– 0.06), 0.54 (95% CI 0.48– 0.60), 2.77 (95% CI 2.44– 3.14) and 8.75 (95% CI 7.40– 10.36) for BMI < 20 kg/m2, 20 kg/m2 ≤ BMI < 25 kg/m2, 25 kg/m2≤ BMI < 28 kg/m2, and 28 kg/m2≤BMI, respectively. For females, the SSLRs predicting MetS were 0.08 (95% CI 0.05– 0.12), 0.73 (95% CI 0.66– 0.82), 2.50 (95% CI 2.16– 2.90) and 4.83 (95% CI 4.12– 5.67) for the same BMI categories, respectively.Conclusion: The predictive utility of BMI is confirmed, and BMI has more predictive value in males than in females. Patients with a BMI of 28 kg/m2 or greater had a significantly higher SSLR than those with a BMI less than 28 kg/m2.Keywords: body mass index, metabolic syndrome, schizoaffective disorder, schizophrenia

Norio Sugawara,1–3 Norio Yasui-Furukori,2,3 Manabu Yamazaki,4 Kazutaka Shimoda,3,5 Takao Mori,4 Takuro Sugai,3,6 Hiroshi Matsuda,4 Yutaro Suzuki,3,6 Yoshitake Minami,4 Yuji Ozeki,3,5 Kurefu Okamoto,4 Toyoaki Sagae,7 Toshiyuki Someya3,6 1Aomori Prefectural Center for Mental Health and Welfare, Aomori, 2Department of Neuropsychiatry, Hirosaki University School of Medicine, Hirosaki, 3Japanese Society of Clinical Neuropsychopharmacology, 4Japan Psychiatric Hospital Association, Tokyo, 5Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, 6Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, 7Department of Health and Nutrition, Yamagata Prefectural Yonezawa University of Nutrition Sciences, Yonezawa, Japan Background: Metabolic syndrome is a growing concern among patients with schizophrenia because metabolic abnormalities are widely regarded as a major risk factor for cardiovascular disease and premature death. The current study assessed attitudes toward metabolic adverse events among patients with schizophrenia. Methods: A brief questionnaire was constructed to investigate patient recognition of the following broad areas: dietary habits, lifestyle, self-monitoring, knowledge, and medical practice. Between January 2012 and June 2013, questionnaires were sent to patients associated with 520 outpatient facilities and 247 inpatient facilities belonging to the Japan Psychiatric Hospital Association. All of the participants (n=22,072; inpatients =15,170, outpatients =6,902) were diagnosed with schizophrenia based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, or the International Classification of Diseases, tenth revision. Results: Approximately 55.0% (8,069/14,669) of inpatients and 44.8% of outpatients (2,978/6,649) reported that they did not exercise at all. Although 60.9% (4,116/6,760) of outpatients reported that they felt obese, only 35.6% (5,261/14,794) of inpatients felt obese. More than half of the inpatients (51.2%; 7,514/14,690) and outpatients (60.8%; 4,086/6,721) hoped to receive regular blood tests to prevent weight gain and diseases such as diabetes. Conclusion: Although more than half of patients hoped to prevent weight gain and diabetes, only a minority of patients were mindful of eating balanced meals and having physical exercise. Educational efforts and the promotion of the best pharmacotherapy and monitoring practices are needed for patients with schizophrenia. Keywords: metabolic syndrome, schizophrenia, attitude, Japan

Dimethyl sulphoxide (DMSO) reductase is present in all brewing yeast strains tested, but is more readily detectable using activity stains on polyacrylamide gels than through direct spectrophotometric assay of crude extracts. The enzyme is detectable at higher activities in yeast cultivated at lower temperatures and this is because of increased expression of the primary gene that codes for the enzyme in yeast, MXR1. DMSO somewhat increases enzyme expression, notably in lager yeast by up to 70%, whereas methionine suppresses it. Both ale and lager strains produce enzymes of ~100,000 in molecular weight, but ion exchange chromatography divides the activity for both ale and lager yeasts into two fractions with distinct properties (heat tolerance, pH optimum, kinetic parameters). Copyright © 2017 The Institute of Brewing & Distilling.

The article presents a case study of a patient with a mosquito bite reaction, discussing the clinical features, treatment options, and preventive measures, while highlighting the broader significance of mosquito bites in zoonosis transmission and the need for increased awareness and research.

This article discusses the challenging condition of envenomation by weever fish. The author presents data on 160 patients who were treated for weever fish stings between May 2000 and June 2022. The usual effects of envenomation include intense pain, numbness, edema, and systemic symptoms. The recommended treatment involves local injections of xylocaine or lidocaine, corticosteroid ointment, and methylprednisolone. Immediate treatment can lead to total resolution within 24 hours, although some patients may experience residual symptoms. The article also highlights the need for further research on fish venoms and the development of effective treatment protocols. [Extracted from the article]