記述言語：日本語   出版者・発行元：(株)ワールドプランニング  

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記述言語：日本語   出版者・発行元：(一社)日本認知症学会  

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記述言語：日本語   出版者・発行元：(一社)日本認知症学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The Cognitive Scale for Functional Bowel Disorders (CS-FBD) and Irritable Bowel Syndrome-Behavioral Responses Questionnaire (IBS-BRQ) are a useful measures to assess cognitive-behavioral aspects in individuals with IBS. This study aimed to confirm the reliability and validity of the Japanese versions of the CS-FBD (CS-FBD-J) and IBS-BRQ (IBS-BRQ-J). METHODS: Participants comprised 192 students and 22 outpatients diagnosed with irritable bowel syndrome (IBS). There were 76 students who met the diagnostic criteria for IBS and two students who received treatment for IBS. Participants completed questionnaires containing the CS-FBD-J, IBS Severity Index (IBS-SI), Visceral Sensitivity Index (VSI), 24-item Dysfunctional Attitudes Scale (DAS-24), Hospital Anxiety and Depression Scale (HADS), and Social Adaptation Self-evaluation Scale (SASS). RESULTS: Our exploratory factor analysis revealed that the CS-FBD-J had a unidimensional factor structure and that the factor loadings for two of the 25 items were less than 0.4. The IBS-BRQ-J had a two-factor structure, and the factor loadings for eight of the 26 items were less than 0.4. The confirmatory factor analysis for the 18-item version of IBS-BRQ-J showed that the model fit indices were not sufficient. The CS-FBD-J and IBS-BRQ-J had significant, moderate correlations with the IBS-SI and VSI in the IBS and control groups. Correlation between the DAS-24 and the CS-FBD-J was not significant. The CS-FBD-J and IBS-BRQ-J were significantly correlated to the HADS and SASS (IBS-BRQ-J) only in the IBS group. The scores of CS-FBD-J and IBS-BRQ-J showed significant group differences between the IBS patient group, non-patient IBS group, and control group. The internal consistencies of the CS-FBD-J and IBS-BRQ-J were high. The item-total correlation analysis for the CS-FBD-J and IBS-BRQ-J showed that the correlations between each item and the total score were significant. CONCLUSION: This study confirmed the reliability and validity of the 23-item version of the CS-FBS-J and the 18-item version of the IBS-BRQ-J with the deletion of items with low factor loadings. Regarding the IBS-BRQ-J, two factor structures were confirmed (factor 1: behavior obsessed with abdominal symptoms, factor 2: avoidance of abdominal symptoms and associated difficulties) although the model fit of the structure needs further study.

DOI： 10.1186/s13030-022-00244-3

PubMed

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier BV  

DOI： 10.1016/j.jagp.2021.07.002

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Matrix metalloproteinase 9 (MMP-9) has been reported to be correlated with declines in hippocampal volume and cognitive function in ApoE4-positive MCI patients. OBJECTIVES: The present study was aimed to investigate the effects of plasma matrix MMP-9 on the conversion risk between mild cognitive impairment (MCI) patients with and without ApoE4. DESIGN AND SETTING: Retrospective observational study using the data extracted from the Alzheimer's Disease Neuroimaging Initiative database. PARTICIPANTS: We included 211 ApoE4-positive MCI subjects (ApoE4+ MCI) and 184 ApoE4-negative MCI subjects (ApoE4- MCI). MEASUREMENTS: We obtained demographic and data including plasma MMP-9 levels at baseline and longitudinal changes in Clinical Dementia Rating (CDR) up to 15 years. We compared conversion rates between ApoE4+ MCI and ApoE4- MCI by the Log-rank test and calculated the hazard ratio (HR) for covariates including age, sex, educational attainment, drinking and smoking histories, medications, and plasma MMP-9 levels using a multiple Cox regression analysis of ApoE4+ MCI and ApoE4- MCI. RESULTS: No significant differences were observed in baseline plasma MMP-9 levels between ApoE4+ MCI and ApoE4- MCI. High plasma MMP-9 levels increased the conversion risk significantly more than low plasma MMP-9 levels (HR, 2.46 [95% CI, 1.31-4.48]) and middle plasma MMP-9 levels (HR, 1.67 [95% CI, 1.04-2.65]) in ApoE4+ MCI, but not in ApoE4- MCI. CONCLUSION: Plasma MMP-9 would be the risk of the future conversion to dementia in ApoE4+ MCI.

DOI： 10.14283/jpad.2022.19

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

The COVID-19 pandemic has been affecting the mental health of hospital workers. During the prolonged pandemic, hospital workers may experience much more severe psychological distress, leading to an increased risk of suicide. This study aimed to investigate changes in psychological effects on hospital workers over 12 months from the beginning of the pandemic and clarify factors associated with psychological distress and suicide-related ideation 1-year after the pandemic's beginning. These repeated, cross-sectional surveys collected demographic, mental health, and stress-related data from workers in 2 hospitals in Yokohama, Japan. The first survey, conducted in March-April 2020, contained the 12-item General Health Questionnaire (GHQ-12) assessing general distress and the Impact of Event Scale-Revised (IES-R) assessing event-related distress. In the second survey in March 2021, hospital workers at the same two hospitals were reassessed using the same questionnaire, and Item 9 of the Patient Health Questionnaire (PHQ-9) was added to assess their suicide-related ideation. The findings of the first and second surveys revealed that the average score of GHQ-12 (3.08 and 3.73, respectively), the IES-R total score (6.8 and 12.12, respectively), and the prevalence rates of severe general distress (35.0% and 44.0%, respectively) and severe event-related distress (7.0% and 17.1%, respectively) deteriorated. The second survey showed that 8.6% of the hospital workers were experiencing suicide-related ideation. Both the general and event-related distress were associated with suicide-related ideation. In these surveys, mental health outcomes among the hospital workers deteriorated over one year from the pandemic's beginning, and their severe psychological distress was the risk factor for the suicide-related ideation. Further studies are needed to compare the psychological effects on hospital workers during and after the prolonged pandemic and to explore appropriate measures to support hospital workers' mental health.

DOI： 10.1371/journal.pone.0277174

PubMed

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記述言語：日本語   出版者・発行元：(一社)日本認知症学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SERDI  

BACKGROUND: PET (positron emission tomography) and CSF (cerebrospinal fluid) provide the “ATN” (Amyloid, Tau, Neurodegeneration) classification and play an essential role in early and differential diagnosis of Alzheimer’s disease (AD). OBJECTIVE: Biomarkers were evaluated in a Japanese multicenter study on cognitively unimpaired subjects (CU) and early (E) and late (L) mild cognitive impairment (MCI) patients. MEASUREMENTS: A total of 38 (26 CU, 7 EMCI, 5 LMCI) subjects with the age of 65-84 were enrolled. Amyloid-PET and FDG-PET as well as structural MRI were acquired on all of them, with an additional tau-PET with 18F-flortaucipir on 15 and CSF measurement of Aβ1-42, P-tau, and T-tau on 18 subjects. Positivity of amyloid and tau was determined based on the positive result of either PET or CSF. RESULTS: The amyloid positivity was 13/38, with discordance between PET and CSF in 6/18. Cortical tau deposition quantified with PET was significantly correlated with CSF P-tau, in spite of discordance in the binary positivity between visual PET interpretation and CSF P-tau in 5/8 (PET-/CSF+). Tau was positive in 7/9 amyloid positive and 8/16 amyloid negative subjects who underwent tau measurement, respectively. Overall, a large number of subjects presented quantitative measures and/or visual read that are close to the borderline of binary positivity, which caused, at least partly, the discordance between PET and CSF in amyloid and/or tau. Nine subjects presented either tau or FDG-PET positive while amyloid was negative, suggesting the possibility of non-AD disorders. CONCLUSION: Positivity rate of amyloid and tau, together with their relationship, was consistent with previous reports. Multicenter study on subjects with very mild or no cognitive impairment may need refining the positivity criteria and cutoff level as well as strict quality control of the measurements.

DOI： 10.14283/jpad.2021.37

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

The aim of the present study was to investigate the psychological effects of the COVID-19 outbreak and associated factors on hospital workers at the beginning of the outbreak with a large disease cluster on the Diamond Princess cruise ship. This cross-sectional, survey-based study collected demographic data, mental health measurements, and stress-related questionnaires from workers in 2 hospitals in Yokohama, Japan, from March 23, 2020, to April 6, 2020. The prevalence rates of general psychological distress and event-related distress were assessed using the 12-item General Health Questionnaire (GHQ-12) and the 22-item Impact of Event Scale-Revised (IES-R), respectively. Exploratory factor analysis was conducted on the 26-item stress-related questionnaires. Multivariable logistic regression analysis was performed to identify factors associated with mental health outcomes for workers both at high- and low-risk for infection of COVID-19. A questionnaire was distributed to 4133 hospital workers, and 2697 (65.3%) valid questionnaires were used for analyses. Overall, 536 (20.0%) were high-risk workers, 944 (35.0%) of all hospital workers showed general distress, and 189 (7.0%) demonstrated event-related distress. Multivariable logistic regression analyses revealed that 'Feeling of being isolated and discriminated' was associated with both the general and event-related distress for both the high- and low-risk workers. In this survey, not only high-risk workers but also low-risk workers in the hospitals admitting COVID-19 patients reported experiencing psychological distress at the beginning of the outbreak.

DOI： 10.1371/journal.pone.0245294

PubMed

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担当区分：最終著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Although previous phase II and III clinical trials conducted in Japan showed that zonisamide improved parkinsonism in patients with dementia with Lewy bodies (DLB), some differences in efficacy outcomes were observed between the trials. OBJECTIVE: We aimed to further examine the efficacy and safety of zonisamide in DLB patients with parkinsonism in a post hoc analysis of pooled data from the previous phase II and III trials. METHODS: Both trials featured a 4-week run-in period followed by a 12-week treatment period with a double-blind, placebo-controlled, parallel-group, randomized, multicenter trial design. In our pooled analysis, the primary outcome was the change in Unified Parkinson's Disease Rating Scale (UPDRS) part III total score. Other outcomes included the changes in Mini-Mental State Examination (MMSE) and Neuropsychiatric Inventory-10 (NPI-10) scores, and the incidence of adverse events. RESULTS: Zonisamide significantly decreased the UPDRS part III total and individual motor symptom scores but did not affect the MMSE or NPI-10 scores at week 12. There was no difference in the incidence of adverse events between the zonisamide and placebo groups except for decreased appetite, which had an increased frequency in the zonisamide 50 mg group compared with placebo. CONCLUSION: Our findings indicate that zonisamide improved parkinsonism with DLB without deterioration of cognitive function and or worsening behavioral and psychological symptoms of dementia.

DOI： 10.3233/JAD-200893

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

INTRODUCTION: Zonisamide is approved in Japan for treating motor dysfunction in Parkinson's disease, and might also be effective for parkinsonism in patients with dementia with Lewy bodies (DLB). Our study evaluated the safety and efficacy of zonisamide for treating parkinsonism in patients with DLB. METHODS: This multicenter, randomized, double-blind, phase 3 trial was conducted in Japan between April 2015 and November 2017. Following a 4-week run-in period, outpatients diagnosed with probable DLB who had developed parkinsonism were randomized to receive oral zonisamide (25 or 50 mg/day) or placebo for 12 weeks, followed by a 40-week open-label extension. The primary endpoint was the change in Unified Parkinson's Disease Rating Scale (UPDRS) part III total score at Week 12. RESULTS: Of 351 patients randomized, 346 (mean age, 77.2 years; 188 males) were included in the modified intention-to-treat population. At Week 12, the group difference (least squares mean ± SEM) for changes from baseline (vs placebo) in UPDRS part III total score was -2.7 ± 0.9 (95% confidence interval [CI]: -4.4, -0.9, P = 0.005) in the zonisamide 25-mg group and -2.6 ± 0.9 (95% CI: -4.4, -0.8, P = 0.005) in the zonisamide 50-mg group. Adverse events were reported in 47.1%, 48.7%, and 54.5% of patients in the placebo and zonisamide 25- and 50-mg groups, and led to treatment discontinuation in 5.0%, 4.3%, and 9.8% of patients, respectively. CONCLUSION: Daily administration of 25- or 50-mg zonisamide significantly improved motor function compared with placebo; both doses were safe and well tolerated in patients with DLB.

DOI： 10.1016/j.parkreldis.2019.12.005

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: We performed a questionnaire survey of medical doctors engaged in the management of dementia to identify the actual status of treatment for dementia with Lewy bodies (DLB) in Japan. METHODS: Among participating medical doctors, we selected neurologists (Group N) and psychiatrists (Group P) because these physicians are usually involved in the management of DLB patients. The two groups were compared based on their diagnosis and treatment of DLB and in particular, parkinsonism. RESULTS: Neurological examinations and biomarker tests were less frequently performed by Group P than Group N. Antipsychotics and other psychotropics excluding anti-dementia drugs were significantly more frequently administered by Group P than Group N. The proportion of physicians who selected L-dopa as a first-line therapy for parkinsonism was significantly higher in Group N than in Group P. Despite these between-group differences, the following findings were common to the two groups: there was a discrepancy between the symptom that patients expressed the greatest desire to treat, and the awareness of physicians regarding the treatment of these symptoms; the initial agent was L-dopa; and physicians exercised caution against the occurrence of hallucinations, delusions, and other adverse drug reactions. CONCLUSIONS: The results of the present survey offer valuable insight for the formulation of future DLB therapeutic strategies.

DOI： 10.1111/psyg.12408

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Dementia with Lewy bodies (DLB) is a progressive form of dementia, accompanied by a range of behavioural and psychological symptoms. The aim of this study was to identify current clinical practice for the treatment of DLB in Japan. METHODS: We conducted a survey of medical doctors engaged in the management of dementia in Japan. Participants were divided into two groups: psychiatrists (Group P) and neurologists or neurosurgeons (Group NS). Doctors completed a questionnaire and we analysed their responses to compare the two groups with regard to diagnosis and treatment of DLB, and in particular the treatment of behavioural and psychological symptoms of dementia (BPSD). RESULTS: Responses suggested that Group P conducted biomarker examinations less frequently and decided on their own therapeutic strategies more frequently than did Group NS. Both groups most frequently selected hallucinations/delusions as the symptoms given highest treatment priority. More than 70% of respondents in both groups reported having difficulties in treating BPSD. Atypical antipsychotics were more frequently prescribed by Group P, but were also prescribed in 70% of patients in Group NS. A third of patients received atypical antipsychotics for more than 1 year. CONCLUSIONS: The responses to this survey highlighted the difficulties faced by clinicians managing patients with DLB and identified the need to effectively treat BPSD in such patients.

DOI： 10.1111/psyg.12399

PubMed

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記述言語：日本語   出版者・発行元：(公社)全国大学保健管理協会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: To investigate the efficacy and safety of zonisamide as an adjunct to levodopa therapy for parkinsonism in patients with dementia with Lewy bodies (DLB). METHODS: This phase 2, placebo-controlled, randomized, double-blind study consisted of run-in (placebo, 4 weeks) and treatment (placebo or zonisamide 25 or 50 mg once daily, 12 weeks) periods. Outpatients diagnosed with probable DLB were eligible for inclusion. The primary endpoint was the change from baseline in Unified Parkinson's Disease Rating Scale (UPDRS) part 3 total score at week 12. Cognitive function, behavioral and psychological symptoms of dementia (BPSD), caregiver burden, other UPDRS parts as secondary endpoints, and safety were also assessed. RESULTS: Overall, 158 patients with DLB received the study drug; 21 discontinued during treatment and 137 completed treatment. Improvement in UPDRS part 3 total score at week 12 was significantly greater in the zonisamide 50 mg group compared with placebo (between-group difference -4.1; 95% confidence interval -6.8 to -1.4; p = 0.003). Zonisamide did not worsen cognitive function, BPSD, or caregiver burden. The overall incidence of adverse events was higher in the zonisamide 50 mg than the 25 mg and placebo groups (65.3%, 43.1%, and 50.0%, respectively); similar rates of serious adverse events were observed among all groups. CONCLUSION: Zonisamide (adjunctive to levodopa) improved parkinsonism accompanying DLB without worsening cognitive function or psychiatric symptoms. CLINICAL TRIAL REGISTRATION: JapicCTI-122040. CLASSIFICATION OF EVIDENCE: This study provides Class I evidence that zonisamide (adjunctive to levodopa) improves parkinsonism and is well-tolerated in patients with DLB.

DOI： 10.1212/WNL.0000000000005010

PubMed

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記述言語：日本語   出版者・発行元：(株)アークメディア  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J01552&link_issn=&doc_id=20171206090011&doc_link_id=%2Fao1clphd%2F2017%2F004612%2F011%2F1521-1525%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fao1clphd%2F2017%2F004612%2F011%2F1521-1525%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.3174/ajnr.A5238

Web of Science

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記述言語：日本語   出版者・発行元：(株)ワールドプランニング  

早発性アルツハイマー型認知症として通院開始4年後、レビー小体型認知症(DLB)に診断が変更となった症例を呈示した。認知機能障害に加えて、病初期から抑うつ症状(大うつ病)および嗅覚異常を併存していた点が特徴的であった。DLBの診断基準を満たさない症例に対しても、前駆症状を理解し、移行を念頭においた検査や診察を注意深く行う診療姿勢が望まれる。(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J02464&link_issn=&doc_id=20170714050003&doc_link_id=%2Faj2rsizd%2F2017%2F002806%2F005%2F0593-0596%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Faj2rsizd%2F2017%2F002806%2F005%2F0593-0596%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BIOMED CENTRAL LTD  

BACKGROUND: To analyze voxel-wise correlation between cerebral blood flow (CBF) measured using ASL-MRI and cognition in patients with Alzheimer's disease (AD). METHODS: Forty-one patients diagnosed with AD or mild cognitive impairment due to AD were recruited for this study. CBF images were obtained using ASL-MRI (n = 41) with a post-labeling delay (PLD) of 1.5 and 2.5 s (PLD1.5 and PLD2.5, respectively) using a 3 T scanner, in addition to brain perfusion SPECT with N-isopropyl-4-[I-123]iodoamphetamine (n = 28). Voxel-based analyses were performed for ASL-MRI and SPECT using Mini-Mental State Examination (MMSE) scores as covariates. Differences in CBF between PLD1.5 and PLD2.5 were assessed using a paired t-test with SPM12. RESULTS: Significant positive correlations were observed between MMSE scores and CBF at PLD1.5 in the right posterior cingulate cortex (PCC), and both temporo-parietal association cortexes. At PLD2.5, significant positive correlations were determined for MMSE scores and CBF in the superior parietal lobule and the right temporo-parietal association cortex. SPECT showed significant positive correlations in the PCC and both temporo-parietal association cortexes (right-side dominant). PLD1.5 showed significantly higher CBF than PLD2.5 in the proximal areas of vascular territories of the anterior, middle, and posterior cerebral arteries. CONCLUSIONS: Significant positive correlations in CBF, measured with both ASL-MRI and SPECT, with cognition were found in the PCC and temporo-parietal association cortexes. PLD1.5 and PLD2.5 showed similar correlations with cognition, although the CBF images had significant differences.

DOI： 10.1186/s12883-017-0870-x

Web of Science

PubMed

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記述言語：日本語   出版者・発行元：(公社)全国大学保健管理協会  

近年の自殺対策の発展に伴い、国内外を問わず、大学では様々な自殺予防の取り組みが行われている。しかし、これらのプログラムの有効性に関するエビデンスはほとんど検討されていない。そこで我々は、大学における自殺予防対策のエビデンスを得ることを目的として、国内の大学生の自殺予防研究に関する系統的レビューを実施した。方法は、まず2つの文献データベース(CiNii、医中誌)を用い、大学、学生、自殺関連事象をキーワードとする検索式検索を行った。次に検索された597編の論文から、(1)研究デザインが無作為化対照試験(RCT)、非無作為化対照試験(nRCT)、分割時系列試験(ITS)、前後比較試験(CBA)のいずれか、(2)研究対象者が大学生、(3)何らかの介入が行われている、(4)アウトカムが記載されている、という適格基準を満たす論文を抽出した。最後に適格論文の内容を吟味してエビデンスを検討した。結果、抽出された適格論文は、12編(内容重複5編)と少なかった。研究デザインはRCTが1編もなく、自殺リスク、アウトカムの評価は不十分であった。結果から、我が国の大学生の自殺予防対策には、現時点では十分なエビデンスがないことが示された。(著者抄録)

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記述言語：日本語   出版者・発行元：(一社)日本総合病院精神医学会  

横浜市立大学附属市民総合医療センター精神医療センターで展開しているリエゾンチームによる認知症高齢者対応について紹介した。65歳以上の高齢者の割合はコンサルテーション・リエゾン活動の介入症例全体の58.9%であり、患者の精神医学的診断としては、せん妄や認知症、またそれを合併していたものが全体の71.0%を占めていた。2013年5月よりリエゾンチームの運用を開始した。当院におけるリエゾン運用開始前後2年間の大きな変化として、運用開始前に比べ介入依頼件数が増加していることがあった。65歳未満の患者に対する介入依頼件数の増加は11件であったが、65歳以上の高齢者に対する介入依頼件数は40件近くの増加であった。より多くの認知症高齢患者にたいして介入を行うことが可能になり、多職種によるチーム医療が実践できるようになった。高齢自殺企図者への対応は重要な活動であり、注意深い再企図リスクの評価と精神医学的評価を行うことなどの重要な介入が指摘できた。

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2015&ichushi_jid=J02373&link_issn=&doc_id=20150824050002&doc_link_id=10.11258%2Fjjghp.27.107&url=https%3A%2F%2Fdoi.org%2F10.11258%2Fjjghp.27.107&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

記述言語：日本語   出版者・発行元：(一社)日本臨床救急医学会  

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記述言語：日本語   出版者・発行元：(株)医学書院  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2015&ichushi_jid=J00749&link_issn=&doc_id=20150327070005&doc_link_id=10.11477%2Fmf.1405204870&url=https%3A%2F%2Fdoi.org%2F10.11477%2Fmf.1405204870&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

DOI： 10.11258/jjghp.27.100

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記述言語：日本語   出版者・発行元：神奈川県医師会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：AMER MEDICAL ASSOC  

IMPORTANCE: No highly effective interventions to prevent delirium have been identified. OBJECTIVE: To examine whether ramelteon, a melatonin agonist, is effective for the prevention of delirium. DESIGN, SETTING, AND PARTICIPANTS: A multicenter, rater-blinded, randomized placebo-controlled trial was performed in intensive care units and regular acute wards of 4 university hospitals and 1 general hospital. Eligible patients were 65 to 89 years old, newly admitted due to serious medical problems, and able to take medicine orally. Patients were excluded from the study if they had an expected stay or life expectancy of less than 48 hours. INTERVENTIONS: Sixty-seven patients were randomly assigned using the sealed envelope method to receive ramelteon (8 mg/d; 33 patients) or placebo (34 patients) every night for 7 days. MAIN OUTCOMES AND MEASURES: Incidence of delirium, as defined by the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition). RESULTS: Ramelteon was associated with a lower risk of delirium (3% vs 32%; P = .003), with a relative risk of 0.09 (95% CI, 0.01-0.69). Even after risk factors were controlled for, ramelteon was still associated with a lower incidence of delirium (P = .01; odds ratio, 0.07 [95% CI, 0.008-0.54]). The Kaplan-Meier estimates of time to development of delirium were 6.94 (95% CI, 6.82-7.06) days for ramelteon and 5.74 (5.05-6.42) days for placebo. Comparison by log-rank test showed that the frequency of delirium was significantly lower in patients taking ramelteon than in those taking placebo (χ(2) = 9.83; P = .002). CONCLUSIONS AND RELEVANCE: Ramelteon administered nightly to elderly patients admitted for acute care may provide protection against delirium. This finding supports a possible pathogenic role of melatonin neurotransmission in delirium. TRIAL REGISTRATION: University Hospital Medical Information Network Clinical Trials Registry Identifier: UMIN000005591.

DOI： 10.1001/jamapsychiatry.2013.3320

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記述言語：日本語   出版者・発行元：神奈川県精神医学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY-BLACKWELL  

OBJECTIVE: Attention to risk of antipsychotics for older patients with delirium has been paid. A clinical question was whether risk of antipsychotics for older patients with delirium would exceed efficacy of those even in the general hospital setting. METHODS: A prospective observational study proceeded over a 1-year period at 33 general hospitals, where at least one psychiatrist worked full time. Subjects were patients who developed delirium during their admission due to acute somatic diseases or surgery, and who received antipsychotics for delirium. The primary outcome was rates and kinds of serious adverse events. RESULTS: Among 2834 patients who developed delirium, 2453 patients received antipsychotics, such as risperidone (34%), quetiapine (32%), and parenteral haloperidol (20%), for delirium. Out of 2453 patients, 22 serious adverse events (0.9%) were reported. Aspiration pneumonia was the most frequent (17 patients, 0.7%), followed by cardiovascular events (4 patients, 0.2%) and venous thromboembolism (1 patient, 0.0%). There was no patient with a fracture or intracranial injury due to a fall. No one died because of antipsychotic side effects. The mean Clinical Global Impressions-Improvement Scale score was 2.02 (SD 1.09). Delirium was resolved within 1 week in more than half of the patients (54%). CONCLUSIONS: In the general hospital setting under management including fine dosage adjustment and early detection of side effects, risk of antipsychotics for older patients with delirium might be low, in contrast to antipsychotics for dementia in the nursing home or outpatient settings. A point may be not how to avoid using antipsychotics but how to monitor their risk.

DOI： 10.1002/gps.3999

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記述言語：日本語   出版者・発行元：神奈川県精神医学会  

児童・思春期の摂食障害の患者の家族を対象に心理教育的アプローチ(家族教室)を実施し、セッションの前後で行ったアンケートから家族教室の有効性および家族のニーズについて検討した。1回2時間全2回の家族教室で、毎回前半に疾病教育、後半に質疑応答および話し合いを行った。その結果、15名14家族が全プログラムを終了し、セッションの前後で、病気に対する知識・理解度は有意に増加した。病気に対する対処への自信や患者の状態に対する安心感には有意な変化は認められなかったが、参加後の感想として、気持ちの安定化に言及するコメントも複数見られた。また、内容に対する家族の評価は高かった。全ての家族が家族教室への継続参加を希望し、継続的な支援へのニーズの高いことがうかがわれた。家族教室は児童・思春期の摂食障害患者の家族に対し、疾患への適切な理解および心理的支援を提供する一つの有効な治療的アプローチであることが示唆された。(著者抄録)

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：PERGAMON-ELSEVIER SCIENCE LTD  

PURPOSE: Few studies looking for an effective biomarker to predict delirium have been performed. This study was designed to investigate whether a change in inflammatory status, indicated by blood natural killer (NK) cell activity, predicts delirium. METHODS: This prospective study, performed in 4 university and 1 general hospital from September, 2011 to October, 2012, included 29 patients. Eligible patients were 65-89years old, newly and emergently admitted. Patients were assessed daily, up to 7days, for occurrence of DSM-IV-defined delirium. The main outcome measure was change in blood NK cell activity between the first and second mornings after admission. RESULTS: The mean change in blood NK cell activity on the second morning, compared to the first morning, in patients developing delirium (n=9) was significantly greater than that in patients without delirium (n=20) (6.0% [SD 8.4] vs. -1.4% [9.0], respectively, t=2.10, P=0.045). Significant difference between the groups was still found after adjusting for age, the history of previous delirium, and the Clinical Dementia Rating score (F=6.63, P=0.017). Of note is that 8 of 9 (89%) patients developing delirium had increased blood NK cell activity, as did only 8 of 20 (40%) patients without delirium, giving measurement of this parameter, for distinguishing the two groups, a sensitivity of 89%, specificity 60%, positive predictive value 50%, negative predictive value 92%, positive likelihood ratio 2.22, and negative likelihood ratio 0.19. When combining this predictor with another predictor, a Delirium Rating Scale-Revised-98 severity score of 5 or more at baseline, positive and negative likelihood ratios were 7.80 and 0.24, respectively. CONCLUSION: Increase in blood NK cell activity may be associated with developing delirium. Further studies including larger numbers of patients are needed to justify the preventive use of drugs for patients meeting criteria for both predictors.

DOI： 10.1016/j.pnpbp.2013.09.008

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記述言語：日本語   出版者・発行元：(株)羊土社  

(1)患者さんの話を傾聴し、相手が抱えている問題を理解しようと努めること(2)患者さんの抑うつ症状に合わせて、急かさず、確実に身体治療を進めること(3)家族に対し、抑うつ状態に関する情報提供をし、患者さんへの接し方について指導すること(4)患者さんが希死念慮を訴えた場合、話をよく聞き切迫性を確認したうえで、すみやかに多職種間で情報を共有すること(5)そわそわと落ち着かない抑うつ状態の患者さんは、自殺の可能性に注意すること(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2013&ichushi_jid=J03286&link_issn=&doc_id=20131114150004&doc_link_id=%2Fai4resic%2F2013%2F001513%2F005%2F2390-2395%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fai4resic%2F2013%2F001513%2F005%2F2390-2395%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：(一社)日本救急医学会  

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記述言語：日本語   出版者・発行元：(一社)日本総合病院精神医学会  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2012&ichushi_jid=J02373&link_issn=&doc_id=20130710070002&doc_link_id=10.11258%2Fjjghp.24.342&url=https%3A%2F%2Fdoi.org%2F10.11258%2Fjjghp.24.342&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY-BLACKWELL  

Suicide attempt is a risk factor for suicide. To investigate trait impulsivity among suicide attempters, 93 attempters admitted to an emergency department and 113 healthy controls were evaluated using the Japanese version of the Barratt Impulsiveness Scale (BIS-11J). Impulsivity was analyzed in relation to clinical data in the attempters. Total BIS-11J, attention impulsiveness, and motor impulsiveness scores were significantly higher in the attempters than in the controls. Both total BIS-11J and non-planning impulsiveness scores were significantly higher in attempters with schizophrenia and other psychotic disorders among the diagnostic groups. Control of impulsivity should be considered as one of the targets for suicide prevention.

DOI： 10.1111/j.1440-1819.2012.02379.x

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY-BLACKWELL  

Mild cognitive impairment (MCI) is defined as 'a condition between a normal state and dementia indicated by a cognitive decline in comparison to previous results'. MCI groups as a whole are not necessarily in the prodromal stage of dementia. However, when patients are notified of their condition, communication must be cautious and account for the patient's personality, mental status, and examination findings. Hurriedly notifying patients may give the incorrect impression that they will certainly have dementia in the future and cause worry or emotional tension. The efficacy of pharmacotherapy and non-pharmacotherapy, such as cognitive function training, in preventing dementia in MCI patients has not yet been confirmed. As no particular types of intervention are currently shown to be effective for MCI, it is believed that periodically monitoring patients and providing lifestyle guidance, while also treating lifestyle-related diseases, is an appropriate treatment strategy for those with MCI.

DOI： 10.1111/j.1479-8301.2012.00417.x

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER IRELAND LTD  

Suicidality in patients with schizophrenia is high. To clarify the characteristics of suicidal behavior in patients with schizophrenia, we investigated suicide attempters with schizophrenia spectrum disorders in comparison with patients with mood disorders. One hundred patients with schizophrenia spectrum disorders and 155 patients with mood disorders admitted to an emergency department after a suicide attempt were interviewed in detail on items concerning 1) demographic characteristics, 2) previous suicidal behavior, and 3) index suicidal behavior. Differences between the two groups were subsequently analyzed. Patients with schizophrenia spectrum disorders showed a lower incidence of previous deliberate self-harm, and a higher incidence of a subsequent suicide attempt more than 1 year after the previous suicide attempt as well as a higher lethality of index suicide attempt compared to patients with mood disorders. Furthermore, the most common motive for making a suicide attempt in patients with schizophrenia spectrum disorders was having a mental problem. This study revealed the factors associated with suicide attempts among Japanese patients with schizophrenia spectrum disorders, and the nature of these factors makes it difficult to predict future attempts. This makes clear the importance of continuous long-term follow-up with careful attention to the mental symptoms and psychological burden for such patients.

DOI： 10.1016/j.psychres.2010.09.008

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY-BLACKWELL  

Zonisamide (ZNS) add-on administration was used to treat parkinsonian symptoms in three cases of dementia with Lewy bodies (DLB). ZNS was added after doses of the anti-Parkinson's disease drugs were fixed for at least 4 weeks. A total of 25 mg of ZNS produced mild-moderate improvement of parkinsonian symptoms in two cases, but it did not affect the cognitive functions and behavioral or psychological symptoms. Caregiver burdens were decreased in two cases. Although dizziness and drowsiness were detected, these were improved by decreasing the dose. ZNS may be useful for the treatment of motor symptoms in DLB patients.

DOI： 10.1111/j.1440-1819.2010.02075.x

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Family history of suicide attempt is one of the risks of suicide. We aimed at exploring the characteristics of Japanese suicide attempters with and without a family history of suicide attempt. METHODS: Suicide attempters admitted to an urban emergency department from 2003 to 2008 were interviewed by two attending psychiatrists on items concerning family history of suicide attempt and other sociodemographic and clinical information. Subjects were divided into two groups based on the presence or absence of a family history of suicide attempt, and differences between the two groups were subsequently analyzed. RESULTS: Out of the 469 suicide attempters, 70 (14.9%) had a family history of suicide attempt. A significantly higher rate of suicide motive connected with family relations (odds ratio 2.21, confidence interval 1.18-4.17, p < .05) as well as a significantly higher rate of deliberate self-harm (odds ratio 2.51, confidence interval 1.38-4.57, p < .05) were observed in patients with a family history of suicide compared to those without such history. No significant differences were observed in other items investigated. CONCLUSION: The present study has revealed the characteristics of suicide attempters with a family history of suicide attempt. Further understanding of the situation of such individuals is expected to lead to better treatment provision and outcomes, and family function might be a suitable focus in their treatment.

DOI： 10.1186/1471-244X-9-32

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記述言語：日本語   出版者・発行元：(株)ワールドプランニング  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

The effectiveness and safety of yokukansan (TJ-54), a traditional Japanese medicine (kampo) for the treatment of the behavioural and psychological symptoms of dementia (BPSD), were evaluated in 106 patients diagnosed as having Alzheimer's disease (AD) (including mixed-type dementia) or dementia with Lewy bodies. Patients were randomly assigned to group A (TJ-54 treatment in period I and no treatment in period II; each period lasting 4 wk) or group B (no treatment in period I and TJ-54 treatment in period II). BPSD and cognitive functions were evaluated using the Neuropsychiatric Inventory (NPI) and the Mini-Mental State Examination (MMSE), respectively. Activities of daily living (ADL) were evaluated using Instrumental Activities of Daily Living (IADL) in outpatients and the Barthel Index in in-patients. For the safety evaluation, adverse events were investigated. Significant improvements in mean total NPI score associated with TJ-54 treatment were observed in both periods (Wilcoxon test, p=0.040 in period I and p=0.048 in period II). The mean NPI scores significantly improved during TJ-54 treatment in groups A and B (p=0.002 and p=0.007, respectively) but not during periods of no treatment. Among the NPI subscales, significant improvements were observed in delusions, hallucinations, agitation/aggression, depression, anxiety, and irritability/lability. The effects of TJ-54 persisted for 1 month without any psychological withdrawal symptoms in group A. TJ-54 did not show any effect on either cognitive function or ADL. No serious adverse reactions were observed. The present study suggests that TJ-54 is an effective and well-tolerated treatment for patients with BPSD.

DOI： 10.1017/S146114570800970X

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER  

OBJECTIVE: The Mini-Mental State Examination (MMSE) is considered a useful supplementary method to diagnose dementia and evaluate the severity of cognitive disturbance. However, the region of the cerebrum that correlates with the MMSE score is not clear. Recently, a new method was developed to analyze regional cerebral blood flow (rCBF) using a Z score imaging system (eZIS). This system shows changes of rCBF when compared with a normal database. In addition, a three-dimensional stereotaxic region of interest (ROI) template (3DSRT), fully automated ROI analysis software was developed. The objective of this study was to investigate the correlation between rCBF changes and total MMSE score using these new methods. METHODS: The association between total MMSE score and rCBF changes was investigated in 24 patients (mean age +/- SD 71.5 +/- 9.2 years; 6 men and 18 women) with memory impairment using eZIS and 3DSRT. Step-wise multiple regression analysis was used for multivariate analysis, with the total MMSE score as the dependent variable and rCBF change in 24 areas as the independent variable. RESULTS: Total MMSE score was significantly correlated only with the reduction of left hippocampal perfusion but not with right (P < 0.01). CONCLUSIONS: Total MMSE score is an important indicator of left hippocampal function.

DOI： 10.1007/s12149-007-0148-2

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記述言語：日本語   出版者・発行元：(公社)日本精神神経学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Adherence to antipsychotic treatment is particularly important in the long-term management of schizophrenia and other related psychotic disorders since poor adherence to medication is associated with poor health outcomes. Although the patients' subjective satisfaction with the medication is crucial for adherence to medication, few studies have examined the relationship between subjective satisfaction with antipsychotics and adherence. In this study, we investigated subjective satisfaction with antipsychotics in patients with schizophrenia by using the Treatment Satisfaction Questionnaire for Medication (TSQM), a self-reporting instrument to assess the major dimensions of patients' satisfaction with their medication. The subjects included 121 clinically stabilized outpatients who met the following criteria: 1) patients between 20 and 65 years of age, diagnosed with schizophrenia or other psychotic disorders as defined by DSM-IV, 2) patients undergoing oral antipsychotic monotherapy or taking only an antiparkinsonian agent as an adjuvant remedy, and 3) patients who had received a stable dose of an antipsychotic for more than four weeks. Patients were asked to answer the TSQM questions, and their clinical symptoms were also evaluated by the Brief Psychiatric Rating Scale (BPRS). Satisfaction with regard to side-effects (p=0.015) and global satisfaction (p=0.035) were significantly higher in patients taking second-generation antipsychotics (SGAs, n=111) than those taking first-generation antipsychotics (FGAs, n=10), whereas no significant difference was found between the two groups in clinical symptoms according to BPRS (p=0.637) or the Drug-induced Extrapyramidal Symptoms Scale (DIEPSS, p=0.209). In addition, correlations were not significant between the subjective satisfactions and clinician-rated objective measures of the symptoms. These findings suggest that SGAs have more favorable subjective satisfaction profiles than FGAs in the treatment of schizophrenia. Since it is often difficult to detect the difference by a traditional objective assessment of the patients, it is desirable that physicians pay attention to the patients' subjective satisfaction in conjunction with their own objective clinical assessment.

DOI： 10.1016/j.pnpbp.2007.12.002

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記述言語：日本語   出版者・発行元：(株)星和書店  

精神病後抑うつは統合失調症の急性期症状消褪後に出現する抑うつ状態であるが、精神病後抑うつに焦点をあてた第二世代抗精神病薬の有効性に対する検討は少ない。今回精神病後抑うつ状態を呈した初発統合失調症4例に対して、陽性症状消褪後早期にrisperidoneからolanzapineへの切り替えを行い、陽性症状の再燃や副作用の発現なく、抑うつ状態の改善を得ることができた。Olanzapineは統合失調症の不安・抑うつに有用とされ、気分障害治療における抗うつ薬への強化療法として使用されるなど、感情面に対する効果が期待できる。また、D2受容体への親和性が低く、錐体外路系副作用の発現も少ないとされる。このような薬理特性から、精神病後抑うつを呈した統合失調症においてolanzapineが有効な症例があり、その際olanzapineを追加するのではなく、前薬から切り替えていくことが重要であると思われた。(著者抄録)

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記述言語：日本語   出版者・発行元：(公社)神奈川県医師会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BIOMED CENTRAL LTD  

BACKGROUND: The incidence of suicide has increased markedly in Japan since 1998. As psychological autopsy is not generally accepted in Japan, surveys of suicide attempts, an established risk factor of suicide, are highly regarded. We have carried out this study to gain insight into the psychiatric aspects of those attempting suicide in Japan. METHODS: Three hundred and twenty consecutive cases of attempted suicide who were admitted to an urban emergency department were interviewed, with the focus on psychosocial background and DSM-IV diagnosis. Moreover, they were divided into two groups according to the method of attempted suicide in terms of lethality, and the two groups were compared. RESULTS: Ninety-five percent of patients received a psychiatric diagnosis: 81% of subjects met the criteria for an axis I disorder. The most frequent diagnosis was mood disorder. The mean age was higher and living alone more common in the high-lethality group. Middle-aged men tended to have a higher prevalence of mood disorders. CONCLUSION: This is the first large-scale study of cases of attempted suicide since the dramatic increase in suicides began in Japan. The identification and introduction of treatments for psychiatric disorders at emergency departments has been indicated to be important in suicide prevention.

DOI： 10.1186/1471-244X-7-64

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(株)医学書院  

第2世代抗精神病薬であるオランザピンの剤型による服薬満足度の違いを、標準経口錠(SOT)と口腔内崩壊錠(ODT)の2種類について、治療満足度の評価スケールであるTSQM日本語版を作成して比較した。対象は「統合失調症およびその他の精神病性障害」と診断された通院中の患者46名とした。その結果、SOT群とODT群の間で、TSQMの「効果」、「副作用」および「全般満足度」の得点に関して有意差は認められなかったが、「利便性」に関してはODT群がSOT群より有意に高かった。SOT、ODT両群の間で、BPRSおよびDIEPSSのいずれについても総得点で有意な差は認められなかった。

DOI： 10.11477/mf.1405100998

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その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2007&ichushi_jid=J00749&link_issn=&doc_id=20070528260011&doc_link_id=10.11477%2Fmf.1405100998&url=https%3A%2F%2Fdoi.org%2F10.11477%2Fmf.1405100998&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Background: Improved management of elderly psychiatric patients requires further identification of their special needs and problems. Methods: We analyzed the characteristics of 1333 consecutive patients admitted to the Psychiatric Center of Yokohama City University Medical Center, a general hospital psychiatric unit, from January 2000 to December 2003. Patients 65 years old or older (the elderly group) accounted for 12.3% of all patients. Results: The duration of admission in elderly patients was significantly longer than in younger patients (less than 65 years old). Admission history and admission type were significantly different between these two groups. Prevalence of dementia or delirium as a primary or secondary diagnosis was significantly greater in the elderly group. About three-quarters of elderly patients were diagnosed as having a mood disorder (47.6%), or an organic mental disorder (31.1%). A significantly smaller fraction of patients were placed in seclusion in the elderly group than in the younger group, although the fraction of patients who were restrained did not differ between the two groups. A significantly higher fraction of elderly patients was transferred to general medical or surgical wards in the hospital to continue treatment for physical illness. In the elderly group, physical and mental prognoses were poorest in patients with organic mental disorders. Conclusions: Compared with the younger patients, the elderly psychiatric patients showed peculiar features. They were thought to require the treatments that were adapted to meet their needs. © 2006 Japanese Psychogeriatric Society.

DOI： 10.1111/j.1479-8301.2006.00147.x

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記述言語：日本語   出版者・発行元：(株)星和書店  

近年,わが国にも第二世代抗精神病薬(第二世代薬)が導入され,統合失調症治療における有用性が示されつつある.しかし,精神科救急における抗精神病薬の処方内容の変化については詳細な検討はなされておらず,急性期治療を考える上で,処方実態を検証することは極めて重要である.今回,横浜市立大学附属市民総合医療センター精神医療センターにおいて2000年から4年間に精神科ハード救急にて入院した統合失調症圏患者126例を対象とし,入院時期・治療歴の有無に着目し,処方実態について検討した.その結果,前期2年に比べて後期2年では第二世代薬の割合が増加しており,治療歴のない群では全抗精神病薬平均投与総量については,有意差は認められなかったものの,単剤化・経口投与による治療導入が進んでいることが示された.今回の調査から,精神科救急においても,第二世代薬単剤による治療導入の意識が進んでいることが示された(著者抄録)

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Although treatment with antipsychotics, particularly olanzapine and clozapine, has been implicated in weight gain and higher incidence of diabetes, the mechanism of these adverse reactions remains unclear. The purposes of this study were to explore the early effects of olanzapine on serum levels of ghrelin, adiponectin and leptin, three recently identified hormones that play crucial roles in the regulation of energy balance and glucose metabolism. Thirteen patients with schizophrenia who had not received any medication in the 4 weeks prior to this study were included. The patients received olanzapine at an average dose of 14.5mg/day. Serum levels of ghrelin, adiponectin, leptin and insulin, as well as weight and fasting glucose, were investigated at the baseline and at 4 weeks. Serum ghrelin levels had decreased (p 0.03) and leptin had increased (p 0.02), while adiponectin and insulin levels had not significantly changed at Week 4 (p 0.29 and p 0.25, respectively). Weight had increased (p 0.01), while fasting glucose had not significantly changed (p 0.46). These findings suggest that ghrelin levels decrease and leptin levels increase after initiation of olanzapine therapy. Weight gain is also considered to be an early change, while change in insulin sensitivity is not an early change of treatment with olanzapine. Further large-scale and longitudinal studies are warranted to elucidate metabolic changes involving ghrelin, adiponectin, leptin and insulin and their impact on weight and glucose metabolism during treatment with olanzapine and other antipsychotics.

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BLACKWELL PUBLISHING  

Few analyses have been carried out in Japan concerning factors contributing to physical restraint of patients. We compared demographic data for 241 inpatients who were restrained during a 4-year period with data for 1093 inpatients who were not restrained in a general hospital psychiatric unit in Japan. Increased likelihood of restraint use was associated with older age, male gender, off-hours admission, involuntary hospitalization, transfer from other departments of the hospital, frequent hospitalization, absence of previous treatment, physical complications, history of suicide attempts, organic mental disorders, mental and behavioral disorders from psychoactive substance use, schizophrenia, schizotypal and delusional disorders. Importantly, physical complications not only were more prevalent among restrained than unrestrained patients, but additionally in restrained patients physical complications were associated with more prolonged hospitalization and periods under restraint than were associated with assaultive behavior or periods of unconsciousness. In conclusion, general hospital psychiatric units in Japan often treat patients with psychiatric disorders or symptoms that were associated with physical problems. Particular caution is needed in deciding whether such patients should be restrained since hospitalization may be prolonged or functional status compromised.

DOI： 10.1111/j.1440-1819.2005.01422.x

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記述言語：日本語   出版者・発行元：神奈川県医師会  

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記述言語：日本語   出版者・発行元：(公社)神奈川県医師会  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Nine cases of atypical Pick's disease without Pick bodies (aPiD) and seven cases of dementia with motor neuron diseases (D-MND) were compared using immunohistochemistry of ubiquitin (ub) and ub-related proteins. All cases showed rostral-dominant atrophy in the temporal and frontal lobes, although the degree of atrophy with neuronal loss was much more severe in the aPiD cases. In both aPiD and D-MND cases, ub-positive and tau-negative structures were found mainly in the hippocampal dentate gyrus and cerebral cortex. Granular cells of the dentate gyrus showed similar ub-positive intraneuronal inclusions in both cases. In the aPiD cases, most of the ub-positive cortical structures were ub-positive dendrites in layers II-IIIab and layers V-VI, although some neurons also showed diffuse ub-positive staining in the cytoplasm. In the D-MND cases, some neurons showed ub-positive inclusions in layers II-IIIab, and ub-positive dendrites were unremarkable. The number of ub-positive neurons and dendrites in relation to the degree of neuronal loss in the cerebral cortex were then evaluated. The number of ub-positive neurons in the regions showing very mild to mild neuronal loss was significantly greater in the D-MND cases than in the aPiD cases. However, in the aPiD cases, the number of ub-positive neurons was significantly greater in the regions showing moderate neuronal loss. When double-immunostained, almost all ub-positive structures were positive for ub-binding protein p62. Some ub-positive or negative neurons in the cerebral cortex were immunostained with anti-ub ligase (Parkin) and anti-ub C-terminal hydrolase (UCH-L1) antibodies. Granular cells of the dentate gyrus were weakly positive for UCH-L1. There could be some differences in the mechanism by which neurons in the cerebral cortex accumulate ub between aPiD and D-MND.

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記述言語：日本語   出版者・発行元：神奈川県精神医学会  

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記述言語：日本語   出版者・発行元：(株)星和書店  

我が国の統合失調症患者における薬物治療は,定型抗精神病薬の多剤併用・大量療法と抗パーキンソン薬の同時投与がその中心であった.1996年に非定型抗精神病薬が上市され治療選択の幅が広がり,合理的な薬物投与への機運が高まった.しかし実際には単剤投与どころか,非定型抗精神病薬同士の併用なども行われており,旧態依然の薬物治療から抜け出すことができない状態にある.今回我々は多施設において計38症例の,主として慢性期の統合失調症患者の単剤治療への移行を目指し,定型抗精神病薬を中心とした前治療薬の減量と同時にolanzapineへの切り替えを行い,その有用性・安全性を検討した.方法としては前治療薬をhaloperidol換算で20mg以内に減量した後にolanzapineを上乗せ開始する,いわゆる「漸減・重複法」を用いた.臨床症状・錐体外路症状の評価は,切り替え前,2,4,8,12,24週後にBPRS・DIEPSSを用いて行った.切り替え後12週まで評価できたのは35症例で,24週まで評価できたのは20症例であった.抗精神病薬の投与量は試験開始前がhaloperidol換算で12.9±9.1mg/day,抗パーキンソン薬はbiperiden換算で3.4±2.4mg/day,12週終了時点ではそれぞれ5.2±7.9mg/dayと2.2±2.7mg/day,24週終了時点では3.0±4.8mg/dayと1.4±1.8mg/day,と有意に減少した.BPRS総合得点では開始前が49.9±16.7点で,12週後が39.3±14.8点,24週後が25.0±18.5点と明らかな改善が認められた.またDIEPSS総得点も有意な改善を認めた.体重増加が10例に認められたが,その他には危険性の高いと思われる副作用および有害事象は認められなかった.今回の結果から統合失調症治療におけるolanzapineへの切り替え療法は,安全性が高く,有用度が高いことが示唆され,今後積極的な切り替えへの取り組みが期待される(著者抄録)

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BLACKWELL PUBLISHING ASIA  

Frontal hypoperfusion and frontal dysfunction have been reported in patients with major depression. It was also found that frontal hypoperfusion correlated with frontal dysfunction evaluated by neuropsychological tests in depressive patients aged 60 or over. These findings suggested that depression may cause frontal dysfunction and frontal hypoperfusion, and that these pathophysiological changes are manifested as psychomotor retardation. We performed single photon emission computed tomography and Modified Stroop Test on 35 patients with depression aged 25-83 to investigate association of depressive symptoms and psychological tests with cerebral blood perfusion. Additionally, we divided the patients into a younger (less than 60 years old) and an older (60 or over) group to examine the effect of age. Significant correlations were found between frontal perfusion, interference measure on Modified Stroop Test, and psychomotor retardation in all patients. These correlations were also found in the younger group. There was no significant difference on frontal perfusion, interference measure of the Modified Stroop Test, and psychomotor retardation between the two groups. The present findings suggest that frontal hypoperfusion, frontal dysfunction, and psychomotor retardation were associated with one another in not only the old but also the young patients with depression.

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：4  

We report a 53-year-old male patient with late onset mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes(MELAS) with hallucination and delusion. The patient manifested various neurological symptoms including perceptive deafness, muscle weakness of limbs with loss of consciousness, sensory abnormalities in hands, feet and a face, abnormal sense of taste, tremor, palsy of upward eye movement and weak deep tendon reflexes prior to the psychotic episode. He was diagnosed as MELAS, because of high serum lactic acid and pyruvic acid, and the point mutation in the mitochondrial DNA 3243. SPECT imaging showed decreased perfusion in occipital cortex and thalamus. These SPECT changes improved after disappearing visual hallucination. Hallucination might be caused by delirium due to stroke-like episode. Dysfunction in the occipital cortex and thalamus might be involved with this perfusion change.

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Nine cases of atypical Pick's disease without Pick bodies were investigated immunohistochemically. Ubiquitin (ub)-positive and tau-negative structures were mainly found in the cerebral cortex and hippocampal dentate gyrus. In the cerebral cortex, most of the ub-positive structures had ub-positive dendrites in the neuropil, although some also showed diffuse ub-positive staining in the neuronal cytoplasm. These ub-positive structures were distributed throughout layers II-IIIab and layers V-VI. Granular cells of the dentate gyrus had ub-positive intraneuronal inclusions. When the numbers of ub-positive neurons and dendrites were evaluated in relation to the degree of neuronal loss in the cerebral cortex, the number of ub-positive neurons was significantly lower in regions showing very mild neuronal loss and higher in regions showing moderate neuronal loss. In contrast, ub-positive dendrites were detected even in cortical regions showing very mild neuronal loss. Immunoelectron-microscopically, ub-positive structures contained ub-positive ribosome-like granular components in the neuronal cytoplasm and dendrites, which were occasionally related to the rough endoplasmic reticulum and accompanied by a few filamentous components. Almost all ub-positive structures were positive for ub-binding protein p62 in double-immunostaining method. Some ub-positive or negative neurons in the cerebral cortex were positively immunolabeled with anti-ub ligase (Parkin) and anti-ub C-terminal hydrolase antibodies, whereas dendrites were not labeled by these antibodies. From the present study, it is suggested that in the cerebral cortex, these ubiquitinated proteins may firstly accumulate in the dendrites at the onset of neuronal degeneration, then appear in the neuronal cytoplasm before finally disappearing with neuronal loss.

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記述言語：英語  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

The microtubule-associated protein tau accumulates as cytoplasmic inclusions in Alzheimer's disease (AD), Pick's disease (PiD), progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD). We investigated the immunoreactivity of tau-positive structures using a panel of antibodies to epitopes spanning the entire length of the tau molecule. In ethanol-fixed brain tissues, most antibodies to the microtubule-binding domain (MBD) required formic acid (FA) treatment to stain tau inclusions in PSP and CBD. This is in contrast with the intense labeling of neurofibrillary tangles in AD without FA treatment. Pick bodies (PiB) in PiD showed an intermediate pattern with respect to the immunoreactivity of the MBD because accumulated tau in PiB mostly lacks the insertion of exon 10, and the proportion of tau phosphorylated at Ser262 is smaller than in other abnormal tau structures. Such immunohistochemical profiles appeared to correlate with the occurrence of the smeared tau on immunoblot analysis of brain homogenate. The smeared tau was more abundant in AD and PiD than in PSP and CBD. Since the smeared tau was N-terminally truncated and was characteristic of advanced forms of modified tau, these findings suggest that tau accumulated in AD and PiD was processed more markedly than that in PSP and CBD. The MBD of tau may be masked in the presence of the intact N terminus and require FA treatment for antibody recognition in tissue sections. Advanced modification may expose the MBD in brain tissues of AD and PiD. It is suggested that the processing of abnormally accumulated tau characterizes the pathophysiology of each tauopathy.

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

We previously reported a Japanese family with early-onset familial Alzheimer's disease associated with G 209 R presenilin 1(PS 1) mutation. There have been six patients across three generations in this family. In the present report, we described the clinical course, findings with neuroimaging and results of genetic examination of PS 1 and apolipoprotein E(ApoE) in three of six patients(II-1, III-1 and 2). The clinical course was common to all three patients. Memory disturbance, disorientation, amnestic aphasia, personality changes and perseveration appeared at early stages, whereas Gerstmann's syndrome, myoclonus and general convulsion were recognized at advanced stages. CT disclosed mild brain atrophy in the temporal lobes at early stages and diffuse brain atrophy predominantly in the fronto--temporal lobes at advanced stages. SPECT exhibited hypoperfusion in the fronto-temporal areas at early stages and hypoperfusion in the fronto-temporal and parieto-occipital areas at advanced stages. The age of onset in six patients demonstrated two clusters at age 53-55(I-1, II-1, 2 and 5) and age 46-48(III-1 and 2). PS 1 genotyping demonstrated that the heterozygous exonic missense mutation G 209 R was confirmed in all three patients. Regarding the ApoE genotyping, II-1(mother) was epsilon 3/epsilon 3, whereas III-1 and 2(children) were epsilon 3/epsilon 4. These findings suggest the possibility that there might be a gene dose effect, since the age of onset ranged from 5 to 7 years younger in patients who received epsilon 4 alleles from the father.

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

We examined the clinical and neuropathological findings in 3 cases of Pick's disease with Pick bodies (PiD) and 7 cases of atypical Pick's disease without Pick bodies (aPiD). PiD and aPiD cases corresponded clinically to frontotemporal dementia and semantic dementia, respectively, based on the clinical diagnostic criteria of frontotemporal lobar degeneration. Brain CT showed that cerebral atrophy was accentuated at an early stage of the illness in the anterior portion of the frontal lobes in PiD cases and in the anterior portion of the temporal lobes in aPiD cases. Neuropathologically, PiD cases showed more circumscribed lobar atrophy than aPiD cases. Both PiD and aPiD cases revealed moderate to severe degeneration with neuronal loss and gliosis in the affected cerebral cortex and subcortical nuclei, but only aPiD cases had pyramidal tract degeneration. Immunohistochemical analyses demonstrated that tauopathy with phosphorylated tau accumulation in the Pick bodies in PiD cases, while aPiD cases showed ubiquitinopathy with ubiquitin accumulation in the intraneuronal and dendritic inclusions. These findings suggested that two subtypes of Pick's disease in Japan can be distinguished not only neuropathologically but also clinically based on differences in pathogenesis.

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

The degeneration process of Pick's bodies (PB) was investigated using methenamine-silver (MS) staining and immunohistochemistry. Methenamine-silver staining sensitively detected extracellular PB as well as intracellular PB in the granular cell layer of the dentate gyrus. Extracellular PB appeared as granular masses with ill-defined boundaries in the neuropil. For MS electron microscopy, the extracellular PB were composed of randomly oriented fibrillary components measuring 9-12 nm in diameter with astroglial processes and degenerated organelles. Tau immunoreactivity of extracellular PB was reduced or abolished. These findings indicate that MS staining is a convenient method for detecting extracellular PB. In addition, it was shown that microglial involvement was associated with PB-bearing neurons at the late stage of the degeneration process and that extracellular PB remained in the neuropil with astroglial reaction.

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Springer Verlag  

We report a 62-year-old Japanese man with familial frontotemporal dementia and a novel missense mutation (N296H) in exon 10 of the tau gene. The patient presented with frontal signs followed by temporal signs and parkinsonism. The brain showed localized frontotemporal lobe atrophy including the precentral gyrus and discoloration of the substantia nigra, and revealed severe neuronal loss with proliferation of tau-positive protoplasmic astroglia in the affected cerebral cortex, tau-positive coiled bodies and threads in the subcortical white matter, and tau-positive pretangle neurons in the subcortical and brain stem nuclei. There were no tau-positive neurofibrillary tangles, Pick bodies, tuft-shaped astrocytes or astrocytic plaques in the cerebral cortex. Immunoelectron microscopically, phosphorylated tau accumulated in both neurons and glial cells in different modalities, such as glial filaments in protoplasmic astroglia, straight tubules in coiled bodies, and free ribosomes in pretangle neurons. These findings suggest that tau proteins are not always assembled in abnormal filaments such as twisted ribbons, paired helical filaments and straight tubules in neurons and glial cells, which have been shown in previous cases with frontotemporal dementia and parkinsonism linked to chromosome 17. Immunoblotting of sarkosyl-insoluble tau exhibited accumulation of four-repeat tau isoforms in the brain. The N296H mutation may interfere with the ability of mutated tau to bind with microtubules and lead to tau aggregation. Further study is necessary to determine whether this mutation can account for the characteristic tau pathology of this case.

DOI： 10.1007/s004010000333

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Six cases of atypical Pick's disease (PD) without Pick bodies (PB) were examined immunohistochemically. These cases showed severe neuronal loss with gliosis predominantly in the temporal cortices. Ubiquitin immunohistochemistry revealed ubiquitin-positive intraneuronal inclusions in the dentate gyms and ubiquitin-positive neurites in the cerebral cortex. In the dentate gyms, the dendrites in the stratum moleculare as well as the intraneuronal inclusions in the granular cells were positively stained. Both structures were composed of ubiquitin-positive ribosome-like granular components and a few filamentous components immunoelectron-microscopically. In the cerebral cortex, ubiquitin-positive neurites were distributed in layers II-IIIab and layers V-VI, and were considered to be the distal dendrites from the small neurons. The dendrites and perikarya of these neurons contained ubiquitin-positive components similar to those in the dentate gyms. Some ubiquitin-positive neurites were also found in the hippocampai subiculum, amygdala and striatum. The results of this study suggest that the granular cells in the dentate gyms and the small neurons in the cerebral cortex share common ubiquitin-related and ribosome-associated abnormalities in both the perikarya and dendrites, that the degeneration of the perforant pathway caused by the parahippocampal lesion participates in the ubiquitin related abnormalities in the granular cells, and that PD cases with and without PB have common affected neurons, as shown immunohistochemically.

DOI： 10.1016/S0022-510X(98)00168-3

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

An anti-heparan sulfate proteoglycan (HSPG) monoclonal antibody (3G10) recognized irregular round structures (IRSs) of various sizes adjacent to tau-positive intracellular Pick bodies (PBs) in the granular cell layer of the dentate gyrus and the superficial layers of the parahippocampal and other temporal gyri in Pick's disease. Some intracellular PBs were also weakly immunostained with 3G10. Only part of the IRSs were double-immunostained with 3G10 and anti-tau antibody. Immunoelectron-microscopic examination revealed that IRSs were composed of aggregated fibrillary structures with a diameter of 10-20 nm, corresponding to the appearance of ghost PBs. These findings suggest that 3G10 identifies ghost PBs better than intracellular PBs, and that heparan sulfate proteoglycans are involved in the process of PBs extinction.

DOI： 10.1016/S0304-3940(98)00027-5

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier B.V.  

The distribution and nature of age-related ubiquitin-positive granular structures (UPG) were examined in non-demented brains. In addition, their appearance pattern in some neurodegenerative disorders was investigated. In the transentorhinal cortex, they were distributed among cell islands of layer pre-α and in layers II and IIIab. In the amygdala, they were preferentially located in the accessory basal and basal nuclei. UPG were first observed in the transentorhinal cortex of non-demented middle-aged brains and increased in frequency and extended to other regions with increasing age. In Alzheimer-type dementia (ATD), they decreased with advance of the clinical stage. In diffuse Lewy body disease (DLBD), they decreased, accompanying linear neuritic structures. With the double-immunostaining, UPG were frequently overlapped with neurofilament-positive granules. The multipolar cells of layer pre-α and pyramidal cells of layers IIIc and V were also immunostained with anti-neurofilament antibody, and the obliquely ascending fibers of these cells were found frequently to continue to these neurofilament-positive granules. Using ubiquitin immunoelectron microscopy, UPG appeared to derive from degenerating terminal axons. These findings suggest that UPG originate mainly from the recurrent collateral ascending axons in layers II-IIIab and from projecting axons in the amygdala. The occurrence of UPG in the limbic system is an important morphological hallmark of aging. In addition, further studies on the appearance pattern of UPG in ATD and DLBD may clarify whether a difference in the degenerative process of both disorders exists.

DOI： 10.1016/0022-510X(96)00024-X

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier B.V.  

We performed a quantitative neuropathological investigation of senile plaques and neurofibrillary tangles in the brains of 14 Japanese patients with diffuse Lewy body disease (DLBD), and examined apolipoprotein E (APOE) gene polymorphism in these patients. Most DLBD brains had as many senile plaques as those with Alzheimer-type dementia (ATD), but fewer neurofibrillary tangles. The APOE ε4 allele frequency in DLBD was 39.3%, similar to that previously reported in pathologically diagnosed ATD. DLBD and ATD are. clinically and pathologically distinct, but may have common mechanisms with regard to the formation of amyloid deposition based on these findings. Future investigation of the pure form of DLBD may clarify the association between Lewy body dementia and APOE.

DOI： 10.1016/0022-510X(95)00312-P

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

An anti-tau monoclonal antibody tau-2 was demonstrated to react with the cells which characteristically appeared in the subcortical nuclei of certain neurodegenerative disorders. These cells had rod-like cell bodies and elongated processes, whose morphology was consistent with that of reactive microglia (tau-2 positive microglia-like cells
TPMC). TPMC were diffusely scattered in the subcortical nuclei, especially the putamen, irrelevant to focal tissue injury such as infacts and amyloid deposits. TPMC were positively immunostained with anti-ferritin antibody, but negatively with LN3, anti-GFAP, other kinds of anti-tau and anti-neurofilament antibodies. TPMC were found in some cases of Alzheimer type dementia and diffuse Lewy body disease, but not in the cases of Parkinson's disease, Pick's disease and control without neurological disorder. Similar microglia-like cells were found around infarctic foci and amyloid cores of senile plaques, regardless of the disorder. They were, however, different from TPMC in that they were positively immunostained with LN3. © 1995.

DOI： 10.1016/0304-3940(95)11595-N

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

A quantitative study of the distribution and incidence of Lewy bodies (LB) and senile changes was performed in seven subnuclei of the amygdala in 12 cases with diffuse Lewy body disease (DLBD). The results were compared with those in six cases of idiopathic Parkinson's disease (PD), six cases of Alzheimer‐type dementia (ATD) and six cases of non‐demented controls. Ubiquitin immunohisto‐chemistry for LB, methenamine‐silver stain for senile plaques (SP) and Gallyas stain for neurofibrillary tangles (NFT) were used in this study. In all DLBD cases and four PD cases, cortical LB occurred in all subnuclei with a tendency for their preferential occurrence in certain sub‐nuclei. The probable dysfunction in these subnuclei may contribute to the memory impairment of DLBD. Senile plaques and NFT occurred significantly more frequently in the baso‐lateral nuclear group than in the cortico‐medial nuclear group of the amygdala in DLBD cases as well as in ATD cases, although a tendency for these to occur predominantly in certain subnuclei was not observed. In the central amygdaloid nucleus (CE), many characteristic spherical or fusiform structures were stained positively with ubiquitin immunohistochemistry in all DLBD and PD cases, although the number was less in PD cases. These immunohistochemically ubiquitin positive structures were densely packed electronmicroscopically with ubiquitin‐positive granular and vesicular components. They might have arisen from selective degeneration of the terminal or distal axons of noradrenergic and dopaminergic afferents from the locus ceruleus and substantia nigra, respectively, to the CE. Copyright © 1995, Wiley Blackwell. All rights reserved

DOI： 10.1111/j.1440-1789.1995.tb00252.x

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

This report presents the results of a quantitative investigation on incidence and distribution of senile plaques (SPs) and neurofibrillary tangles (NFTs) in ten cases of late‐onset diffuse Lewy body disease (DLBD). The methenamine‐silver method was used. SP were distributed throughout the cerebral cortices of all cases. The SP stages in seven of them were compatible with those of Alzheimer‐type dementia (ATD). NFTs occurred most frequently in the transentorhinal and entorhinal pre α regions and the hippocampal CA‐1 area. The occurrence of NFTs was generally restricted to the hippocampus and parahippocampal cortex. NFTs were rarely encountered in the neocortex. The NFT stages of all ten cases were compatible with those borderline between ATD and physiological aging. When both, the SP and NFT stages are considered concurrently, the majority of our late‐onset DLBD cases had levels that corresponded to those in the very mild of ATD or the borderline between ATD and physiological aging. The occurrence of certain DLBD cases with senile changes that are insufficient for a diagnosis of ATD indicates that DLBD should not be regarded as representing part of an ATD spectrum. Copyright © 1994, Wiley Blackwell. All rights reserved

DOI： 10.1111/j.1440-1789.1994.tb00237.x

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Amyloid deposits (AmD) and neurofibrillary tangles (NFT) were quantitatively examined in methenamine‐silver stained hemisphere sections from 98 non‐demented elderly individuals and 30 patients with Alzheimer‐type dementia (ATD). Of the non‐demented cases, 35 (35.7%) had some AmD, and 72 (73.5%) had some NFT, whereas all the ATD cases had both AmD and NFT. AmD‐and NFT‐positive cases were classified into developmental stages, based on the distribution and incidence of each of these senile changes (AmD: A1, A2, B1, B2, C′ and C
NFT: Ia, Ib, IIa, IIb, III, and IV). When the AmD‐positive cases were divided into stages A‐B and stages C′‐C and the NFT‐positive cases into stages I‐III and stage IV, all the non‐demented individuals were found to belong to NFT stages I‐III and all the ATD cases to AmD stages C′‐C. This study provides evidence that an approximate dividing line can be drawn between non‐demented individuals and ATD patients by using quantitative neuropathological criteria, and that the distinction between the two groups can usually be made on the basis of the difference in the incidence of AmD in the precentral motor area and the incidence of NFT in the temporal isocortex. Copyright © 1993, Wiley Blackwell. All rights reserved

DOI： 10.1111/j.1440-1789.1993.tb00225.x

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(株)ライフ・サイエンス  

MBIは50歳以降に出現する行動,または人格面の変化により社会生活に支障を来した状態と定義され,将来の認知機能低下や認知症のハイリスク状態として提唱された概念である.先行研究ではMCI同様,認知症のハイリスク群であること,アルツハイマー病理との関連が報告されている.高齢者の心理に影響を及ぼす身体・生理的要因や,社会・環境的要因を理解した上で適切な支援・対応をしつつ,6ヵ月ごとの注意深い経過観察を実施することが望ましい.(著者抄録)

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J-GLOBAL

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記述言語：日本語   出版者・発行元：(公社)全国大学保健管理協会  

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記述言語：日本語   出版者・発行元：(一社)日本認知症学会  

レビー小体型認知症(DLB)患者を対象としたゾニサミド第三相試験から本邦承認用量(25mg/日)のみを服用した48症例を抽出し、52週投与時の有効性と安全性に関するポストホック解析を行った。ゾニサミドは、行動・心理症状や認知機能の評価指標であるNPI-10やMMSEスコアに大きな影響を与えず、運動機能の評価指標であるUPDRSパートIIIスコアを低下させた。また、投与中止に至った副作用の発現割合は10.4%(5症例)であり、安全性に大きな問題はみられなかった。以上、ゾニサミド25mg/日は行動・心理症状や認知機能に大きな影響を与えず、DLBの運動機能障害を長期にわたり改善すると考えられた。(著者抄録)

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記述言語：日本語   出版者・発行元：(一社)日本総合病院精神医学会  

近年のわが国の認知症対策として、2015年に「認知症施策推進総合戦略(新オレンジプラン)」が策定され、これまでに多くの取り組みが進められてきた。その後、当事者を含む様々な関係者の議論を経て、2019年6月に認知症施策推進大綱(以下、大綱)が発表された。大綱では、認知症の「共生」と「予防」を軸とした施策の推進が掲げられている。本稿では、大綱に記された認知症予防に関する考え方の解説およびわが国初となる大規模な認知症予防介入研究であるJapan-multimodal intervention trial for prevention of dementia(J-MINT研究)の概要について述べる。(著者抄録)

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記述言語：日本語   出版者・発行元：(NPO)全国大学メンタルヘルス学会  

国立大学法人保健管理施設協議会メンタルヘルス委員会を母体とする本学会(全国大学メンタルヘルス学会)では、複数大学の有志で2018年に「大学生の自殺予防プログラム開発研究」研究班を組織し、大学間連携により全国的な普及が可能な大学生の自殺予防プログラムの開発に着手した。今回、プログラムの開発に先立ち、わが国の大学における自殺予防対策の実態とプログラム開発上の課題を明らかにすることを目的に、全国の国公立私立大学を対象に「大学の自殺予防対策に関する現況調査」を実施し、195大学(国立49、公立37、私立109)より回答を得た。その結果、国立大学に比べ公立・私立大学は、学生数が少ない大学の比率が高く、保健管理施設は常勤精神科医師や身体科医師の配置が少なかった。自殺既遂者の把握率は国立大学で8割、公立・私立大学では約6～7割にとどまっており、3年間自殺者が出ていない大学は約3割に過ぎず、3年間で10～20人の既遂者が出ている大学も数%みられた。また、全学的な自殺対策を実施している大学は6割、大学生に対して自殺予防に関わる教育研修を実施している大学は3割程度で、自殺予防教育の必要性に異論のある大学はほとんどないが、講師や時間の確保、全学的な合意形成が困難という理由で実施困難なところが多かった。

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記述言語：日本語   出版者・発行元：(株)ワールドプランニング  

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記述言語：日本語   出版者・発行元：(株)ワールドプランニング  

身体合併症治療のために入院する認知症患者は、高率に認知症の行動・心理症状(BPSD)・せん妄状態を呈するため、「BPSD・せん妄治療と身体疾患の急性期治療の両立」が困難な場合が多く、大きな問題となってきた。この問題解決のため、一般総合病院では「認知症サポートチーム」などの多職種協働でのケアが推進されてきたが、「専門的治療を要する身体合併症に罹患し、かつ医療保護入院が必要な激しいBPSD・せん妄を呈した症例」にも対応できる治療設備と構造を有した医療施設(高度医療が実施できる病床を備える精神科閉鎖病棟を有する総合病院)の整備はいまだ十分ではない。その一方で、「総合病院における身体合併症を有する認知症患者のケア」には、正常な若者の場合とは異なるいくつかの意義がある。この入院意義について、具体的に例を挙げて解説した。(著者抄録)

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記述言語：日本語   出版者・発行元：(株)医学書院  

＜文献概要＞マニュアルのポイント ・一般病院に通院あるいは入院中の認知症および認知症が疑われる患者に対する実践的かつ具体的な対応マニュアルである。・ポケットサイズで携帯に便利であり,多忙な業務中でもすぐに参照できるよう使い勝手に配慮して作成されている。

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記述言語：日本語   出版者・発行元：(一社)日本自殺予防学会  

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記述言語：日本語   出版者・発行元：(公社)全国大学保健管理協会  

2016〜2018年度に本学のキャンパス相談を利用した学生のうちWAIS-IIIを受検した28名を対象とし、健診時に実施している自閉症スペクトラム指数10項目版(AQ-J-10)検査との関連について検討した。同期間の全健診受診者におけるAQ-J-10平均点は2.4点、カットオフポイント7点を超えた割合は約4%であったのに対し、WAIS-III受検者のAQ-J-10平均点は5.1点で、7点以上の割合は約36%であった。7点以上の群と6点未満群に分けてWAIS-IIIの成績を調べた結果、両群とも動作性IQに比べて言語性IQが有意に高く、7点以上群では[言語理解]と[知覚統合][処理速度]との間に有意差を認め、6点未満群では[言語理解]と[処理速度]との間、[作動記憶]と[処理速度]との間に有意差を認めた。

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記述言語：日本語   出版者・発行元：(公社)全国大学保健管理協会  

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記述言語：日本語   出版者・発行元：(一社)日本総合病院精神医学会  

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記述言語：日本語   出版者・発行元：(NPO)全国大学メンタルヘルス学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(一社)日本認知症学会  

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記述言語：日本語   出版者・発行元：(一社)日本認知症学会  

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記述言語：日本語   出版者・発行元：(一社)日本認知症学会  

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記述言語：日本語   出版者・発行元：(株)医学書院  

＜文献概要＞超高齢社会では,高齢者の医療・介護ニーズの増加に伴い病院中心の医療から在宅中心の医療への転換が推進されつつあり,今後,高齢者の救急・急性期治療のあり方が重要な課題となると予想される。現在,一般病院では,認知症者を含む高齢入院患者の心理・行動症状の対応に多職種チームによる介入を行う施設が増えている。高齢者の急性期治療においては,入院環境の調整や円滑な退院支援など,心理・社会的側面にも配慮が必要である。高齢者の精神科救急では,身体合併症など身体管理を要する事例が多く,治療難度の高いことが報告されている。今後の精神科救急,急性期医療において,高齢者の権利擁護に配慮した治療・ケアの提供を心がける必要がある。

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記述言語：日本語   出版者・発行元：(公社)全国大学保健管理協会  

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記述言語：日本語   出版者・発行元：(公社)全国大学保健管理協会  

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記述言語：日本語   出版者・発行元：Movement Disorder Society of Japan (MDSJ)  

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記述言語：日本語   出版者・発行元：Movement Disorder Society of Japan (MDSJ)  

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記述言語：日本語   出版者・発行元：Movement Disorder Society of Japan (MDSJ)  

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記述言語：日本語   出版者・発行元：(公社)日本精神神経学会  

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記述言語：日本語   出版者・発行元：(公社)日本精神神経学会  

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記述言語：日本語   出版者・発行元：(公社)日本精神神経学会  

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記述言語：日本語   出版者・発行元：(株)ワールドプランニング  

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記述言語：日本語   出版者・発行元：(株)ワールドプランニング  

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記述言語：日本語   出版者・発行元：(公社)日本精神神経学会  

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記述言語：日本語   出版者・発行元：(株)ワールドプランニング  

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記述言語：日本語   出版者・発行元：(株)ワールドプランニング  

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記述言語：日本語   出版者・発行元：(有)科学評論社  

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記述言語：日本語   出版者・発行元：(株)メディカルレビュー社  

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記述言語：日本語   出版者・発行元：(公社)全国大学保健管理協会  

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記述言語：日本語   出版者・発行元：日本産業ストレス学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(公社)日本医師会  

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記述言語：日本語   出版者・発行元：(一社)日本認知症学会  

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記述言語：日本語   出版者・発行元：(一社)日本精神科救急学会  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J03551&link_issn=&doc_id=20181010100005&doc_link_id=%2Feg0sekyu%2F2018%2F002100%2F006%2F0021-0023%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Feg0sekyu%2F2018%2F002100%2F006%2F0021-0023%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：(一社)日本認知症学会  

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記述言語：日本語   出版者・発行元：(一社)日本認知症学会  

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記述言語：日本語   出版者・発行元：(一社)日本認知症学会  

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記述言語：日本語   出版者・発行元：(一社)日本認知症学会  

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記述言語：日本語   出版者・発行元：(公社)全国大学保健管理協会  

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記述言語：日本語   出版者・発行元：(株)じほう  

＜Key Points＞・せん妄および認知症の行動・心理症状に対する治療は、認知症治療薬の投与および非薬物療法を優先し、効果がない場合に抗精神病薬、抗うつ薬、抗てんかん薬、抗不安薬、漢方薬などの投与を検討する。・認知症高齢者に対する抗精神病薬の処方は、必要最小用量を必要な期間のみ投与し、漫然と長期投与しないよう心がける。・パーキンソン病患者の精神症状に対する治療では、まず抗パーキンソン病薬の整理を行う。・高齢のパーキンソン病およびレビー小体型認知症患者のパーキンソン症状の治療には、レボドパ単剤の使用が推奨されている。(著者抄録)

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記述言語：日本語   出版者・発行元：Movement Disorder Society of Japan (MDSJ)  

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記述言語：日本語   出版者・発行元：Movement Disorder Society of Japan (MDSJ)  

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記述言語：日本語   出版者・発行元：(株)ワールドプランニング  

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記述言語：日本語   出版者・発行元：(株)ワールドプランニング  

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記述言語：日本語   出版者・発行元：(株)日本医事新報社  

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記述言語：日本語   出版者・発行元：(株)日本医事新報社  

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記述言語：日本語   出版者・発行元：(株)日本医事新報社  

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記述言語：日本語   出版者・発行元：(公社)全国大学保健管理協会  

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記述言語：日本語   出版者・発行元：(公社)全国大学保健管理協会  

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記述言語：日本語   出版者・発行元：日本産業ストレス学会  

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記述言語：日本語   出版者・発行元：(一社)日本精神科救急学会  

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記述言語：日本語   出版者・発行元：(公社)全国大学保健管理協会  

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記述言語：日本語   出版者・発行元：(一社)日本総合病院精神医学会  

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記述言語：日本語   出版者・発行元：神奈川県公衆衛生協会  

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記述言語：日本語   出版者・発行元：(公社)全国大学保健管理協会  

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記述言語：日本語   出版者・発行元：(一社)日本精神科救急学会  

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記述言語：日本語   出版者・発行元：(一社)日本総合病院精神医学会  

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記述言語：日本語   出版者・発行元：Movement Disorder Society of Japan (MDSJ)  

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記述言語：日本語   出版者・発行元：(一社)日本核医学会  

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記述言語：日本語   出版者・発行元：(株)日本医事新報社  

＜Point＞▼高齢者のうつ病は、注意・集中力や判断力の低下により一見認知症のように見えるため、仮性認知症と称される▼うつ病の診断には、抑うつ気分、興味・喜びの喪失、易疲労感、生活リズムの障害の有無について確認を行う▼認知症によくみられるアパシーと抑うつ症状を区別する▼高齢者のうつ病は、自殺のリスクに注意する▼高齢者のうつ(病)は、認知症の危険因子であり、経過を注意深く観察する(著者抄録)

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記述言語：日本語   出版者・発行元：日本うつ病学会・日本認知療法・認知行動療法学会  

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記述言語：日本語   出版者・発行元：日本うつ病学会・日本認知療法・認知行動療法学会  

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記述言語：日本語   出版者・発行元：(株)ワールドプランニング  

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記述言語：日本語   出版者・発行元：(株)新興医学出版社  

＜ポイント＞せん妄の症状は、注意障害および意識障害(見当識の低下)が特徴である。せん妄の診断は、症状の急性発症および変動性の経過を確認することが重要である。せん妄と認知症は症状が似ていることから鑑別はしばしば困難であり、高齢者は予め認知機能を評価しておくことが望ましい。認知症患者では、せん妄の合併が多いにもかかわらず、見逃されやすい。特に、低活動型せん妄の見逃しに注意する。(著者抄録)

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記述言語：日本語   出版者・発行元：(公社)全国大学保健管理協会  

2012年度に入学した国際総合科学部の学生を対象に、2015年度までの健診時BMIおよび問診票項目(生活形態・通学時間・喫煙・食事・睡眠)について調査し、相互の関連性について検討した。調査の結果、2012年度の健診においてBMIが25以上の割合は、男性8.8%、女性2.9%であった。2012年度にBMIが25以上で且つ以降2年以上健診を受けた学生37名(男性24名、女性13名)についてBMIの経年的変化をみると、25以上で推移した者が男性15名(63%)、女性8名(62%)、25未満になった者が男性7名(29%)、女性4名(31%)であった。2015年度に25以上であった者を"好転なし群、25未満を"好転群"とし、問診票項目の群間比較を行った結果、好転群には次のような特徴が認められた。1)男性で一人暮らしの割合が低い傾向にある。2)通学時間が1時間以上の割合が高い傾向にある。3)喫煙者がいない。4)男性で朝食を週3回以上抜く割合が低い傾向にある。

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記述言語：日本語   出版者・発行元：(公社)全国大学保健管理協会  

本学では、学生の健康状態の把握とその評価方法の確立を目指す取り組みの一環として、2012年度から健康関連QOLの測定とともに「抑うつ」「自殺念慮」のスクリーニングを実施している。今回、2012年度入学者のうち2012〜2015年度の定期健診を受けた学生を対象とし、メンタルヘルス状態やフォロー面談への来談状況の経年的変化について検討した。結果、うつ陽性者率は2012年度が9.2%、2013年度が5.6%、2014年度が3.9%、2015年度が5.4%であり、2012年度は2013・2014年度に比べて有意に高かった。うつ陽性でフォロー面談に来談した学生の割合は、2012年度と2013年度が20%前後、2014年度と2015年度が12%前後であった。自殺念慮陽性者の数は、2012年度が1名、2013年度が1名、2014年度が0名、2015年度が1名であり、この3名中フォロー面談に来談したのは2名であった。

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記述言語：日本語   出版者・発行元：(株)星和書店  

認知症は高齢者せん妄の最大の危険因子であり、認知症に伴うせん妄(DSD)への対応は喫緊の課題となっている。DSDの診断は容易でなく、認知症やうつ病との鑑別がしばしば困難であり、医療職による見逃しが多いことが指摘されている。DSDの薬物療法は、少量の抗精神病薬を適切なモニタリングのもと、短期間投与で行うことが推奨される。DSDは、非認知症群のせん妄と比べて改善率が低く、改善しない場合に患者の身体・認知機能の低下のみならず、入院期間やリハビリの長期化、早期の施設入所につながることが報告されている。また、最近では、せん妄が長期的な認知症の予測因子となることが指摘されている。(著者抄録)

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記述言語：日本語   出版者・発行元：(株)アークメディア  

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記述言語：日本語   出版者・発行元：(株)ワールドプランニング  

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記述言語：日本語   出版者・発行元：(有)科学評論社  

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記述言語：日本語   出版者・発行元：じほう  

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2017065149

記述言語：日本語   出版者・発行元：日本公衆衛生学会  

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記述言語：日本語   出版者・発行元：(一社)日本認知症学会  

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記述言語：日本語   出版者・発行元：神奈川県精神医学会  

レビー小体型認知症(以下、Dementia with Lewy bodies:DLB)は、アルツハイマー型認知症に次いで多い認知症である。抑うつ症状は、DLBの26%に前駆症状として存在するとされ、早ければ記憶障害が顕在化する16年前から認めると報告されているが、DLB前駆期の抑うつ症状に対して有効性が確立された薬物療法はなく、難治性・遷延性のうつ病として扱われる症例も多い。今回、われわれはDLB前駆期の抑うつ状態に対し、Donepezilを最大量の10mg投与し、著効した症例を経験した。本症例では主症状として抑うつ気分、意欲低下、食欲不振、希死念慮を認め、認知機能の低下は目立たなかった。当初うつ病に準じて治療をしたが、数種の抗うつ薬の効果がほとんど得られず、検査所見などからDLB前駆期と診断しDonepezilを最大量投与したところ、精神症状の著明な改善が得られた。DLB前駆期に生じた抗うつ薬抵抗性の抑うつ状態に対して、認知機能の低下が明らかではなくともアセチルコリンエステラーゼ阻害薬を投与することで抑うつ状態が改善される可能性があり、治療の幅が広がる可能性が示唆された。(著者抄録)

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記述言語：日本語   出版者・発行元：神奈川県精神医学会  

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記述言語：日本語   出版者・発行元：神奈川県医師会  

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記述言語：日本語   出版者・発行元：横浜市立大学医学会  

わが国では，長高齢化社会の到来により，医療機関を受療する高齢者および認知症患者が増加している．認知症高齢者の治療は，身体的問題に加えて心理社会的要因が病状に関連することから，保健医療福祉一体となった包括的支援が必要である．国が進める認知症施策推進総合戦略は，住まい・医療・介護・予防・生活支援を一体的に提供する地域包括ケアシステムを利用した地域主体の認知症医療・ケアの推進を目指している．その中で，総合病院における認知症患者の診療の実態と今後の課題について，主として精神医学的視点から，以下の項目にしたがって解説する．Ⅰ．総合病院における認知症医療の現況 １）外来診療，２）入院治療，３）救急医療，４）コンサルテーションⅡ．総合病院における認知症入院治療の課題１）緩和ケア，２）権利擁護（高齢者虐待），３）ＢＰＳＤおよび身体合併症対応，４）せん妄対応，５）医学教育

DOI： 10.15015/00000507

CiNii Books

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その他リンク： http://id.nii.ac.jp/1246/00000507/

記述言語：日本語   出版者・発行元：神奈川県精神医学会  

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記述言語：日本語   出版者・発行元：医学書院  

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2015158943

記述言語：日本語   出版者・発行元：神奈川県精神医学会  

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記述言語：日本語   出版者・発行元：神奈川県精神医学会  

救命救急センターには、多くの自殺企図者が搬送され、そのほとんどが精神疾患を合併していることが知られているが、搬送・退院時の精神症状の評価は不十分だと報告されている。本研究では、横浜市立大学附属市民総合医療センター高度救命救急センターに入院した自殺企図者の転帰に影響を与えた因子を明らかにすることを目的として、平成22年4月1日から3年間の期間に同センターに入院した自殺企図者315名を、精神科病棟における継続的な精神科治療を要した群とそれ以外の群とに分類し、その属性と臨床情報を比較した。精神科病棟での継続的な精神科治療を要した群では、在院期間が長く、また統合失調症患者の割合が多いということが有意差をもって示された。これらの特徴が、転帰に関与している可能性が示された。(著者抄録)

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記述言語：日本語   出版者・発行元：南江堂  

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2015323351

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記述言語：日本語   出版者・発行元：日本医療薬学会  

CiNii Books

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記述言語：日本語   出版者・発行元：神奈川県精神医学会  

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記述言語：日本語   出版者・発行元：神奈川県精神医学会  

自己効力感尺GSESC-R、子どもの行動チェックリストCBCL/6-18、そして、色彩バウム・テストを指標とし、高機能広汎性発達障害HFPDDにみられる二次的問題に対する箱庭療法の効果について、2事例を通して検討した。箱庭作品では、2事例とも、使用アイテム数や種類に変化はみられなかったが、人間アイテムでは、前半に消極的活動が多く、後半に積極的活動が多くなった。GSESC-Rには大きな変化はみられなかった。CBCL/6-18では一部を除き問題行動などが軽減した一方で、活動性の向上に伴って非行傾向も高まるようになった。これはHFPDDの場合、箱庭での象徴的体験が困難であるためと考えられた。したがって、HFPDDに箱庭を導入する場合、SSTのような生活に密着した指導の必要があると考えられた。(著者抄録)

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記述言語：日本語   出版者・発行元：(有)科学評論社  

向精神薬の急性薬物中毒患者で、保存的治療により意識障害は軽快したものの、急激に呼吸状態の増悪をきたし急性呼吸窮迫症候群(ARDS)と診断・加療を行った52歳の男性の症例を報告した。抑うつ症状のため、通院をしていたが、受診をし、直後に処方された内服薬を薬局で受け取り全量(paroxetine 840mg、duloxetine 840mg、chlorpromazine 2387.5mg、mianserin 525mg、nitrazepam 210mg、brotizolam 5.25mg、rilmazafone 42mg、etizolam 7mg)を服用し、ICUに緊急入院した。入院後全身管理の下で持続点滴による薬物の排出促進を図り、第2病日には呼吸循環動態は安定した。第3病日には精神科病棟に転棟して精神医学的介入を開始したが、同日の夜間より38.6℃の発熱を認め、SpO260%台と急激に低下したため、酸素投与を再度開始した。血液ガス所見、画像所見から、低酸素血症はARDSに伴う酸素化能の障害が原因と判断した。急性期から抗生剤ならびにステロイドパルス療法で治療を開始したことで著明な改善を認め、後遺障害もなく退院することができた。

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その他リンク： http://search.jamas.or.jp/link/ui/2014159229

記述言語：日本語   出版者・発行元：羊土社  

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2014054801

記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：CAMBRIDGE UNIV PRESS  

Web of Science

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記述言語：日本語  

Catatonia is a syndrome characterized by mutism, stupor, immobility, negativism, posturing, stereotypy, and echophenomena. Not only patients with schizophrenia, but also patients with general medical disease, mood disorder, and substance-related disorder exhibit catatonia. In the patients with catatonia, it is recommended to examine whether they have a general medical disease. We present two catatonic elder patients. Case 1 exhibited catatonia with vascular dementia, and was revealed to have anti-phospholipid antibody syndrome. Case 2 exhibited catatonia with dementia with Lewy bodies, and was revealed to have Hashimoto's encephalopathy. The first recommended treatment for catatonia is benzodiazepines. In case of benzodiazepine resistance or malignant catatonia, it should be considered electroconvulsive therapy, but it needs to be carefully implemented for elder patients.

PubMed

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記述言語：日本語   出版者・発行元：日本医療薬学会  

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記述言語：日本語   出版者・発行元：(一社)日本社会精神医学会  

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記述言語：日本語   出版者・発行元：(一社)日本総合病院精神医学会  

日本総合病院精神医学学会(JSGHP)会員の認知症治療の実態と課題を明らかにする目的で2012年3月に認知症診療に関するアンケート調査を実施した。87施設(総合病院42施設、大学病院24施設、精神科病院8施設、精神科診療所13施設)から回答を得た。認知症の主たる診療科は精神科86.2%、神経内科44.8%、脳神経外科5.7%、内科5.7%が担っており、認知症診療を行っていないとした施設は4施設であった。回答のあった87施設中認知症疾患医療センターの機能を有するのは10施設であった。「認知症診療を行う上での問題点と課題」について自由記載によるアンケート結果を整理したところ、専門医療機関の負担、BPSDへの対応、連携・教育の必要性、その他重度認知症への対応などについて意見があげられた。回答を得た大学病院・総合病院の65歳以上の入院における他科からのコンサルテーションにおいて、いずれも40%以上が認知症であった。

DOI： 10.11258/jjghp.25.171

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記述言語：日本語  

DOI： 10.3143/geriatrics.50.205

PubMed

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記述言語：日本語   出版者・発行元：(株)星和書店  

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J-GLOBAL

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：WILEY-BLACKWELL  

Web of Science

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記述言語：日本語   出版者・発行元：神奈川県医師会  

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記述言語：日本語   出版者・発行元：神奈川県精神医学会  

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J-GLOBAL

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記述言語：日本語   出版者・発行元：日本認知症ケア学会  

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記述言語：日本語   出版者・発行元：診断と治療社  

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2010148479

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記述言語：日本語  

J-GLOBAL

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記述言語：日本語   出版者・発行元：へるす出版  

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2009362242

記述言語：日本語   出版者・発行元：アークメディア  

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2009245446

記述言語：日本語   出版者・発行元：日本精神神経学会  

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2009129615

記述言語：日本語   出版者・発行元：日本てんかん学会  

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記述言語：日本語   出版者・発行元：(公社)日本精神神経学会  

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記述言語：日本語  

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記述言語：日本語   出版者・発行元：日本精神神経学会  

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その他リンク： http://search.jamas.or.jp/link/ui/2008078387

記述言語：日本語   出版者・発行元：羊土社  

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その他リンク： http://search.jamas.or.jp/link/ui/2007273543

記述言語：日本語   出版者・発行元：ワールドプランニング  

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その他リンク： http://search.jamas.or.jp/link/ui/2007107112

記述言語：日本語   出版者・発行元：科学評論社  

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2007008235

記述言語：日本語   出版者・発行元：神奈川県医師会  

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記述言語：日本語   出版者・発行元：ワールドプランニング  

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2006082903

記述言語：日本語   出版者・発行元：神奈川県精神医学会  

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記述言語：日本語   出版者・発行元：医学書院  

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2006024294

記述言語：日本語   出版者・発行元：日本精神神経学会  

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2006037004

記述言語：日本語   出版者・発行元：南山堂  

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2005151310

記述言語：日本語   出版者・発行元：医学書院  

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2005005012

記述言語：日本語   出版者・発行元：照林社  

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記述言語：日本語   出版者・発行元：医学書院  

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記述言語：日本語  

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記述言語：日本語   出版者・発行元：医学書院  

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その他リンク： http://search.jamas.or.jp/link/ui/2004045654

記述言語：日本語  

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記述言語：日本語   出版者・発行元：医学書院  

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その他リンク： http://search.jamas.or.jp/link/ui/2003067445

記述言語：日本語  

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記述言語：日本語  

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記述言語：日本語   出版者・発行元：神奈川県精神医学会  

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記述言語：日本語   出版者・発行元：神奈川県医師会  

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記述言語：日本語  

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記述言語：日本語  

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記述言語：日本語  

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記述言語：日本語  

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記述言語：日本語  

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記述言語：日本語  

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記述言語：日本語  

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記述言語：日本語  

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記述言語：日本語  

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記述言語：日本語  

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記述言語：英語  

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記述言語：日本語  

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