•The prevalence of severe distress in Japan slightly increased in this decade.•The prevalence of moderate distress in Japan remained mostly unchanged.•The use of mental health services in Japan ...steadily increased in this decade.•The prevalence of severe distress was highest among women aged 25–29 years old.
Little is known regarding trends of psychological distress and use of mental health services in Japan during recent years.
This study examined trends in severe and moderate psychological distress and the use of mental health services among adults (≥18 years old), using the Comprehensive Survey of Living Conditions in Japan from 2007, 2010, 2013, and 2016 (Total N = 2,159,005, all survey years combined). We defined a score of ≥13 on Kessler Psychological Distress Scale (K6) as severe distress and a K6 score between 5 and 12 as moderate distress. Age- and sex-specific trends of psychological distress and the use of mental health services were also examined.
As compared with 2007, those with severe distress slightly increased in 2016 (4.01%–4.15%, p = 0.02) while those with moderate distress remained mostly unchanged (24.61%–24.69%, p = 0.61). The use of mental health services steadily increased in this decade for both with severe distress (11.95%–15.76%, p < 0.01) and with moderate distress (2.60%–3.56%, p < 0.01). The prevalence of severe distress among women aged 25–29 years old was highest in 2016 among all the age groups although the use of mental health services was not particularly high among women in this age group.
Cross-sectional nature of the data did not allow us to examine the causal relationship between psychological distress and the use of mental health services.
In spite of an observed increase in the use of mental health services, the prevalence of psychological distress slightly increased. Further studies are necessary to identify sources of treatment gap especially for vulnerable demographic subgroups.
The number of psychiatric care beds and the mean length of stay in psychiatric care beds in Japan have decreased over the past 10 years. However, as has long been indicated here and elsewhere, Japan ...lags behind other countries in terms of deinstitutionalization. Furthermore, the population of inpatients in psychiatric care beds is aging dramatically. In addition to the diversification of mental illness, the question of what measures to implement going forward regarding current psychiatric bed resources has emerged as a new challenge.
Using data from the Patient Survey and the 630 Survey, we examined trends in the number of long-term inpatients in psychiatric care beds in Japan through 2040. Population estimation was used for estimating long-term hospital bed demand because of small fluctuations in the admission and discharge of long-term inpatients.
In 2017, nearly one-third of all long-term hospitalized patients were aged ≥75 years, and an estimated 47% of the total are expected to die by 2040. Thus, the overall demand for long-term hospitalization is forecast to decrease sharply due to aging of currently hospitalized long-term inpatients. The number of long-term inpatients in 2017 was 167,579, and this is projected to decrease to 103,141 in 2040.
We believe it is necessary to adopt a multifaceted approach to promote hospital discharge and transition to the community, and to address the diversification of mental illness and the issue of psychiatric care bed supply/availability, which are forecast to decrease due to the natural decrease in long-term inpatients.
Abstract : Objectives : Personal lifestyle, including diet, exercise, and sleep, might have an impact on work engagement, though previous studies have not focused on these relationships. The aim of ...this study was to examine whether dietary intake of fish, regular exercise, sufficient sleep, abstinence from alcohol, and abstinence from tobacco were positively associated with work engagement. Methods : We recruited adults aged 40-74 years who attended the health checkups with a particular focus on the metabolic syndrome in central Tokyo. In December 2015, 797 people responded to a questionnaire and 592 (74.3%) who had regular jobs were selected for this study. Work engagement was assessed on the 9-item Utrecht Work Engagement Scale (UWES-9). Bivariate and multivariate regression analyses were performed to examine the relationships between lifestyle and UWES-9. Results : Dietary intake of fish, regular exercise, sufficient sleep, and abstinence from tobacco were significantly correlated with the total UWES-9 score, even after adjusting for age, sex, and depressive and anxiety symptoms. The results suggested a doseresponse relationship between dietary fish intake and work engagement. Conclusions : Dietary fish intake, regular exercise, sufficient sleep, and abstinence from tobacco might be lifestyle factors that can serve as resources for work engagement. These findings could be useful in motivating employees to make lifestyle improvements and convincing employers and managers that lifestyle is important not only for health but also for productivity.
Aim
It is important to investigate the current prescription status and clinical outcomes of patients with schizophrenia receiving long‐acting antipsychotic injections. We aimed to determine the ...prescription proportion of long‐acting antipsychotic injections and hospital readmission proportions of patients with schizophrenia in Japan.
Methods
An open dataset was created using data from the National Database of Health Insurance Claims and Specific Health Checkups of Japan. Patient records with the term ‘schizophrenia’ were included. In Analysis 1, antipsychotic prescription proportions were determined for outpatients who had visited psychiatric facilities between 1 February 2015 and 31 March 2017. In Analysis 2, patients who had been discharged from a psychiatric facility and had received a long‐acting antipsychotic injection prescription within 90 days after initial discharge were selected; then, their readmission proportion was examined for 365 days after the initial discharge.
Results
The long‐acting antipsychotic injection prescription proportion was 3.5% for outpatients with schizophrenia receiving antipsychotics. The readmission proportion was 41.0% in the entire patient population, 36.2% in patients receiving typical long‐acting antipsychotic injections alone, and 23.5% in patients receiving atypical long‐acting antipsychotic injections alone.
Conclusion
Long‐acting antipsychotic injections are not yet widely used in Japan. The readmission proportion was lower in the patients receiving atypical than typical long‐acting antipsychotics injections. The results may provide important basic information to develop new future research questions but should be interpreted with caution because generalizability may be limited by the use of aggregated data and the data structure of the database used.
The relationship between the number of nurses in psychiatric wards and frequency of use of seclusion and restraint has been unclear. We aimed to clarify this relationship in Japanese general ...psychiatric wards while controlling for patient and ward-level characteristics. We hypothesized that seclusion and mechanical restraint are less likely to be used in a ward with more nurses. We used data for individual admissions from April 2015 to March 2017 in hospitals participating in the Psychiatric Electronic Clinical Observation (PECO) system, which extracted data from each hospital's electronic health record system. We analyzed the data of 10,013 admissions in 113 wards of 23 hospitals. We examined the relationships between the number of nurses per 10 beds in each ward and the use of seclusion and mechanical restraint, controlling for the patients' age, sex, diagnosis, voluntary versus involuntary admission, prescribed dose of antipsychotics, severity of symptoms, and length of stay, in addition to ward-level characteristics including ward size, location (urban or rural), and type of ward (acute ward or not), using multilevel multivariate logistic regression analyses. The fraction of admissions exposed to at least one episode of seclusion or mechanical restraint was 36.7% and 14.9%, respectively. The odds ratios of the number of nurses per 10 beds for the use of seclusion and mechanical restraint were 2.36 and 1.74, respectively, indicating that both seclusion and mechanical restraint were actually used more frequently in wards with more nurses. A possible explanation is that patients anticipated to need coercive measures are more likely to be admitted to wards with many nurses. Increasing the number of nurses in a ward may not contribute to reducing the use of seclusion and restraint.
Training non-specialist workers in mental healthcare improves knowledge, attitude, confidence, and recognition of mental illnesses. However, still little information is available on which type of ...mental health training is important in the improvement of these capacities.
We studied web-based survey data of 495 public health workers to examine training types associated with knowledge and experience in supporting individuals with mental illness. Multivariable logistic regression analysis was conducted to evaluate the association between a lack of knowledge and experience (outcome) and mental health training (exposure). We fitted three regression models. Model 1 evaluated unadjusted associations. Model 2 adjusted for age and sex. Model 3 adjusted for age, sex, years of experience, mental health full-time worker status, and community population. Bias-corrected and accelerated bootstrap confidence intervals (CIs) were used.
For all training types, the association between a lack of knowledge and experience and mental health training attenuated as the model developed. In Model 3, a lack of knowledge and experience was significantly associated with training in specific illness (OR, 0.54; 95% CI, 0.32-0.93) and screening and assessment (OR, 0.63; 95% CI, 0.39-0.99). Non-significant results were produced for training in counseling, psychosocial support, collaborative work, and law and regulation in Model 3.
We believe that the present study provides meaningful information that training in specific illness and screening and assessment may lead to knowledge and experience of public health workers. Further studies should employ a longitudinal design and validated measurements.
Background Copy number variants (CNVs) have been shown to increase the risk to develop schizophrenia. The best supported findings are at 1q21.1, 15q11.2, 15q13.3, and 22q11.2 and deletions at the ...gene neurexin 1 ( NRXN1 ). Methods In this study, we used Affymetrix 5.0 arrays to investigate the role of rare CNVs in 575 patients with schizophrenia and 564 control subjects from Japan. Results There was a nonsignificant trend for excess of rare CNVs in schizophrenia ( p = .087); however, we did not confirm the previously implicated association for very large CNVs (>500 kilobase kb) in this population. We provide support for three previous findings in schizophrenia, as we identified one deletion in a case at 1q21.1, one deletion within NRXN1 , and four duplications in cases and one in a control subject at 16p13.1, a locus first implicated in autism and later in schizophrenia. Conclusions In this population, we support some of the previous findings in schizophrenia but could not find an increased burden of very large (>500 kb) CNVs, which was proposed recently. However, we provide support for the role of CNVs at 16p13.1, 1q21.1, and NRXN1.
Background: Although calcium channel blockers (CCB) are highly effective for suppression of vasospastic angina (VSA) attacks, their prognostic effects in VSA patients remain to be examined in a large ...number of patients. Methods and Results: Databases for related papers were searched and then a meta-analysis regarding the effects of CCB on major adverse cardiovascular events (MACE) in Japanese VSA patients with the 4 previous studies was performed. A total of 1,997 patients with positive coronary spasm provocation tests were evaluated. They were treated with either alone or combination of benidipine (n=320), amlodipine (n=308), nifedipine (n=182) or diltiazem (n=960). MACE were observed in 143 patients (cardiac death: 36, myocardial infarction: 51, heart failure: 26, stroke: 65, and aortic aneurysm: 11). The hazard ratio for the occurrence of MACE was significantly lower in patients treated with benidipine than in those with diltiazem. There was no significant difference in the clinical characteristics affecting the occurrence of MACE among the 4 CCB groups. Furthermore, the hazard ratio for the occurrence of MACE was significantly lower in those treated with benidipine, even after correction for patient characteristics that could have affected the occurrence of MACE (hazard ratio 0.41, P=0.016). Conclusions: These results suggest that among the 4 major CCB that effectively suppress VSA attacks in general, benidipine showed significantly more beneficial prognostic effects than others. (Circ J 2010; 74: 1943 - 1950)
Abstract A common functional polymorphism, Val108/158Met (rs4680), and haplotypes rs737865–rs4680–rs165599 in the Catechol-O-methyltransferase gene ( COMT ) have been extensively examined for ...association to schizophrenia; however, results of replication studies have been inconsistent. The aim of this study was to comprehensively evaluate the genetic risk of COMT for schizophrenia. First, we performed a mutation scan to detect the existence of potent functional variants in the 5′-flanking and exon regions. Second, we conducted a gene-based case–control study between tagging single nucleotide polymorphisms (SNPs) in COMT 19 SNPs including six possible functional SNPs (rs2075507, rs737865, rs4680, rs165599, rs165849) and schizophrenia in large Japanese samples (schizophrenics 1118, controls 1100). Lastly, we carried out a meta-analysis of 5 functional SNPs and haplotypes (rs737865–rs4680–rs165599). No novel functional variant was detected in the mutation scan. There is no association between these tagging SNPs in COMT and Japanese schizophrenia. In this updated meta-analysis, no evidence was found for an association between Val108/158Met polymorphisms, rs6267, rs165599, and haplotypes (rs7378655–rs4680–rs165599) and schizophrenia, although rs2075507 and rs737865 showed trends for significance in allele-wise analyses ( P = 0.039 in a multiplicative model, P = 0.025 in a recessive model for rs2075507, P = 0.018 in a dominant model for rs737865, uncorrected). This significance did not remain, however, after correcting the P -values using a false discovery rate controlling procedure. Our results suggest that the COMT is unlikely to contribute to susceptibility to schizophrenia.
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