This study explored whether depression, anxiety, social support, and coping with stress are related to schoolwork engagement (SE) using structural equation modeling. This study investigated 798 Japanese elementary and junior high school students (4th to 9th grades) aged 9-15 years (M = 13.9 years, SD = 1.79 years). This study used the Utrecht Work Engagement Scale for Students, Patient Health Questionnaire-9 Items Modified for Adolescents, Generalized Anxiety Disorder-7, Adolescent Coping Orientation for Problem Experiences, and Social Support for Children and Adolescents. SE had no significant effect on anxiety or depression and vice versa. Coping with stress had a significant positive middle effect on SE (β = 0.509, p < 0.001) and a significant positive weak effect on anxiety (β = 0.225, p < 0.001). However, it did not have a significant effect on depression. Social support had a significant positive weak effect on SE (β = 0.175, p < 0.001). Moreover, it had a significant negative middle effect on anxiety (β = -0.378, p < 0.001) and a significant negative, weak effect on depression (β = -0.133, p < 0.01). Our study suggested that depression, anxiety, and SE have no relationship, and that strategies of coping with stress predict higher SE but also higher anxiety.

The prevalence of mental health issues among children and adolescents in Japan is rising, including school refusal, suicide, and neurodevelopmental disorders. In response, the Ministry of Health, Labour, and Welfare (MHLW) introduced insurance incentives in 2014 to expand access to outpatient psychiatric services for Japanese youth. This retrospective cohort study analyzed data from the National Database of Health Insurance Claims and Specific Health Checkups of Japan from fiscal years 2016 to 2022. Outpatient psychotherapy claims under the newly introduced insurance categories were analyzed by year, age group, sex, and prefecture. National trends and regional disparities were assessed using linear regression models. Nationwide outpatient psychotherapy claims nearly doubled, from 521.0 per 10,000 youth in fiscal year 2015 to 1034.5 in fiscal year 2022 (p < 0.001). The increase was most pronounced among adolescent girls. By fiscal year 2022, 94% of prefectures had implemented the policy. Some regions, such as Tokushima and Yamanashi, experienced more than a threefold increase. Nevertheless, regional disparities between prefectures remained. The MHLW's insurance reforms significantly increased access to psychiatric care for children and adolescents across Japan. The combined impact of national financial incentives and local medical subsidies likely contributed to increased service utilization, given the reduction in additional costs for families. Ongoing policy efforts are needed to ensure equitable access and high-quality care nationwide.

The aging of the global population has made healthy aging and the extension of healthy life expectancy significant challenges for many societies. Mental health, including cognitive function, is critical to the quality of life of older adults. Oxytocin, a neuropeptide involved in social bonding and stress regulation, has been shown to exert neuroprotective effects, while S100B, a calcium-binding protein, has been linked to neuroinflammation and neurodegenerative disorders, such as Alzheimer's disease. However, the relationship between oxytocin and S100B levels during aging remains unclear. This study investigated the association between serum oxytocin and S100B levels in community-dwelling older adults. This survey, conducted between November 2016 and September 2017 in Kurokawa-cho, Imari, Saga Prefecture, Japan, included community-dwelling older adults aged ≥65 years. Blood samples were collected to measure serum oxytocin and S100B levels using an enzyme-linked immunosorbent assay. The relationships among serum oxytocin, S100B, and cognitive function (Mini-Mental State Examination, Frontal Assessment Battery, and Clinical Dementia Rating) were analyzed using correlation and multiple regression analyses. A total of 95 participants (25 men, 70 women; mean age: 78.03 ± 5.12 years) were analyzed. Our analysis showed that serum oxytocin levels were negatively associated with serum S100B levels even after adjusting for age, sex, years of education, and body mass index. However, no significant correlations were found between these biomarkers and overall cognitive function. These findings suggest that the neuroprotective effects of oxytocin may influence blood S100B levels, though its direct role in cognitive function remains unclear.

Clinical attention to and understanding of women with impaired fetal bonding is important for early therapeutic intervention. This study aimed to clarify the clinical characteristics of women belonging to groups derived by cluster analysis of impaired maternal-fetal bonding. A mixed-method approach was adopted. We conducted a two-wave internet survey targeting pregnant women less than 36 gestational weeks by using a questionnaire (33-item Dimensional Assessment of Mother Baby Organization Questionnaire [DAMBO Q33]) with subsequent online interviews (Dimensional Assessment of Mother and Baby Organization-Research Version). The maternal-fetal bonding disorder items in the DAMBO Q33 were entered into a two-step cluster analysis. Two representative cases from each of the clusters, except for the positive bonding cluster, were selected to describe their clinical pictures. Finally, quantitative data and qualitative data were integrated and interpreted. A two-step cluster analysis elicited four clusters: bonding disorder (n = 101), ambivalent bonding (n = 156), positive bonding (n = 173), and lack of bonding emotions (n = 122). Women in the bonding disorder cluster were characterized by seriously negative feelings towards the fetus. Women in the ambivalent bonding cluster wished to be pregnant but were not sufficiently ready for the transition into parenthood. Women in the lack of bonding emotions cluster were characterized by a lack of strong interest in pregnancy and the fetus. Patterns of impaired maternal-fetal bonding were identified. We should not think of a pathological category of mental illness among them but recognize that such parents are targets for professional assessments and supportive (therapeutic) interventions. Understanding the meaning of getting pregnant and difficulties in the process of maternal role attainment is required.

Contemporary psychiatry is going through times of crisis. In this article, I will focus on the epistemological and historical aspect of the phenomenon. Three authors are the main references guiding the argumentation I offer in this text. They are Thomas Kuhn, Georges Lanteri-Laura and Juan Carlos Stagnaro. The text is intended as an introduction to the epistemological analysis of contemporary psychiatry, but it also proposes to look a little ahead in order to attempt a modest reflection on the future of the specialty.

Nonconvulsive status epilepticus (NCSE) can present with symptoms resembling catatonia, such as stupor, staring, and immobility. Distinguishing between the two conditions using electroencephalography (EEG) is crucial. However, reports of NCSE coexisting with catatonia are rare. We present a case of catatonia associated with schizophrenia complicated by NCSE. A 77-year-old woman with a 30-year history of well-controlled schizophrenia developed stupor and was admitted to our hospital. EEG revealed evolving spike-and-wave complexes, leading to a diagnosis of NCSE. Administration of levetiracetam improved the EEG findings, and subsequent monitoring confirmed resolution of epileptiform activity. However, the patient's stuporous state persisted despite the normalized EEG. Extensive workup showed no evidence of encephalitis or other neurological pathology. We diagnosed her with NCSE and catatonia associated with schizophrenia. Electroconvulsive therapy (ECT) was administered, resulting in complete resolution of the catatonic symptoms. This case highlights three key points. First, stupor can result from both NCSE and catatonia associated with schizophrenia. Second, when no physical cause for NCSE is identified and symptoms persist despite EEG improvement following antiepileptic treatment, coexisting catatonia associated with schizophrenia should be considered. Finally, ECT was effective in treating catatonia associated with schizophrenia complicated by NCSE. In patients presenting with stupor, it is important to differentiate between NCSE and catatonia associated with schizophrenia and to recognize the potential for their coexistence.

The Mental Health Continuum-Short Form (MHC-SF) is an assessment tool used worldwide to assess emotional, social, and psychological well-being. This study examined the structure, reliability, and validity of the Japanese version of the MHC-SF among adolescents. In total, 1588 adolescents aged 15-18 years completed the assessment (54.8% female; age mean ± standard deviation = 16.3 ± 0.94 years). The factor structure of the MHC-SF was evaluated using confirmatory factor analyses. The internal consistency, concurrent validity, and measurement invariance across sex and age were examined. A three-factor model of the MHC-SF yielded the best fit compared with the one- and two-factor models. Internal consistency was confirmed by a Cronbach's alpha (>0.8). Measurement invariance was observed across sex and age. Convergent and divergent validity were demonstrated by assessing the relationships with other measurements. This study established a three-factor model of the MHC-SF in Japanese adolescents. We confirmed the reliability and validity of the Japanese version of the MHC-SF for assessing emotional, social, and psychological well-being in adolescents.

The aim of this study was to investigate whether psychiatrists around the world believe they might encounter cases of hikikomori (prolonged social isolation), and how they formulate and treat such cases. A hikikomori case vignette was sent to psychiatrists of 34 countries around the world. Participants rated for the vignette: frequency of similar cases in one's practicing country; and aspects of formulation, diagnosis, suicide risk, and treatment plan. In total, 344 complete responses from 34 countries were returned. Eight countries/areas had 10 or more respondents: Japan (61), South Korea (54), Nepal (48), Iran (40), Thailand (32), India (23), Hong Kong (12), and UK (10); the remainder were placed in the "others" group (64). Respondents from all countries except Thailand felt that similar cases were seen. Diverse patterns of response were obtained regarding formulation and treatment. Japan, South Korea, and "others" favored psychosocial aspects in the formulation, while Iran, Nepal, and India favored biological factors. Most respondents felt the case could be treated by an outpatient visit, while others preferred hospitalization. Psychotherapy was rated highly as an intervention; Iran, South Korea, and "others" also rated pharmacotherapy highly. Despite its limitations as an exploratory study, we found evidence that hikikomori-like cases might exist around the world. However, opinions on how such cases should be formulated and treated vary significantly among countries. We believe this reflects how the experience of hikikomori is dependent on the related sociocultural context. Further comparative work, preferably with standardized assessment tools, will help to clarify how society might influence the individual experiences of practitioner and hikikomori patients.

Traumatic brain injury (TBI) is a brain injury caused by external forces and has a prevalence of 432 cases (95% uncertainty interval [UI]: 413-452) per 100,000 people in Japan. Previous studies have indicated that TBI is associated with numerous psychiatric disorders, including psychosis. A 70-year-old male with a history of diabetes, bipolar disorder, and TBI sustained at the age of 51 years presented with late-onset psychotic symptoms. This case highlights the delirium-like fluctuating nature of psychotic symptoms and their successful management with risperidone. Late-onset psychotic disorders due to TBI can emerge long after initial injury and require careful and continuous monitoring.

Impulse control disorders (ICDs), including hypersexuality, are associated with adverse effects of dopamine agonists, such as pramipexole, particularly in the treatment of Parkinson's disease and restless legs syndrome (RLS). The underlying mechanisms remain unclear in ICDs in patients with RLS, and no neuroimaging studies have investigated regional cerebral blood flow (rCBF) changes in RLS patients with ICDs. A 60-year-old man with RLS developed hypersexuality after initiating pramipexole at 0.5 mg/day. He exhibited inappropriate sexual behaviors toward hospital staff. Single-photon emission computed tomography revealed increased rCBF in the bilateral orbitofrontal cortex and medial frontal cortex, as well as in the left striatum and thalamus. The hypersexuality gradually resolved following pramipexole discontinuation. This case suggests that pramipexole-induced hypersexuality in RLS may be linked to increased rCBF within the mesocorticolimbic network, including orbitofrontal cortex, medial frontal cortex, and striatum, thereby impairing impulse control. Despite the relatively low dose of pramipexole (0.5 mg/day), individual susceptibility factors, such as depressive symptoms and intellectual disability, may have contributed to ICD onset. Given the lack of prior studies examining rCBF in RLS patients with ICDs, further research is needed to elucidate the pathophysiological mechanisms and risk factors associated with pramipexole-induced ICDs in RLS.