Mental Disorders In Japan Research Articles

A peer-led learning program about intimate and romantic relationships for persons with mental disorders (AIRIKI): co-creation pilot feasibility study

BackgroundIntimate and romantic relationships are important in life for individuals, irrespective of mental health status. We developed a four-hour peer-led learning program for persons with mental disorders about intimate and romantic relationships through a co-creation process with service users and examined its preliminary effectiveness and feasibility of implementing the program.MethodsA one-group pretest–posttest trial was conducted using a mixed-method design for 45 individuals with mental disorders in Japan. Outcome data were collected at three time points: baseline, post-intervention, and one month after program completion. Mixed models for repeated measures (MMRM) were used to examine changes over time in the Rosenberg Self-Esteem Scale (RSES), Recovery Assessment Scale (RAS), Herth Hope Index (HHI), and the original items. Group interviews were conducted for process evaluation.ResultsMMRM showed significant changes over time on RSES, RAS, HHI, and two original items “I am able to communicate well with others about myself” and “I am able to listen to others well.” In multiple comparisons, RSES and HHI were significant one month after the program. Participants reported changes during the first month after attending the program in terms of their positive attitude toward romantic relationships (n = 14), taking romantic actions (n = 11), and feeling their overall communication improved (n = 11). Although two participants had an unscheduled psychiatric visit that could be attributed to attending the program, all recovered after one month.ConclusionsThe program exhibited preliminary effectiveness to a moderate extent in improving recovery, particularly regarding self-esteem and hope. The program is feasible but requires further modifications regarding inclusion criteria for participants and the training of peer facilitators.Trial registrationUMIN000041743;09/09/2020.

Kampo Medicines Used in Psychiatry

Compared to psychotropic drugs, the clinical use of Kampo medicines (Japanese herbal medicines) is unclear because of the difficulty in accumulating scientific evidence for various reasons. This study reviews Kampo medicines frequently prescribed in psychiatry and the principles of disorders of qi, blood, and fluid for their use, which are considered particularly important in this field. Kampo medicines are one of the preferred treatment modalities for patients with mental disorders in Japan, and we hope that these will become a treatment option for patients refractory to psychotropic drugs.

Maternal personality and postpartum mental disorders in Japan: the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study

Personality has been shown to predict postpartum depressive symptoms (PDS) assessed by the Edinburgh Postnatal Depression Scale (EPDS). However, existing studies have not considered the underlying symptom dimensions in the EPDS. We analyzed data from 15,012 women who participated in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Personality was assessed in middle pregnancy using the short-form Eysenck Personality Questionnaire-Revised. PDS were defined as EPDS score ≥ 9 at 1 month after delivery. The EPDS items were further divided into three dimensions: depressed mood, anxiety, and anhedonia. Multiple analyses were conducted to examine the associations of each personality scale with PDS and three dimensions in the EPDS, adjusting for age, parity, mode of delivery, education, income, and social isolation. The prevalence of PDS assessed by the EPDS at 1 month after delivery was 13.1%. Higher neuroticism scores were associated with PDS (odds ratio [OR], 2.63; 95% confidence interval [CI], 2.48 to 2.79) and all three dimensions (all p < 0.001). Lower extraversion scores were associated with PDS (OR, 0.74; 95% CI, 0.70 to 0.78) and all three dimensions (all p < 0.001). Lower psychoticism scores were associated with PDS (OR, 0.89; 95% CI, 0.85 to 0.94) and anxiety (p < 0.001), but not with depressed mood (p = 0.20) or anhedonia (p = 0.92). In conclusion, higher neuroticism and lower extraversion were associated with PDS and the three underlying dimensions in the EPDS, while lower psychoticism was associated with anxiety, but not with depressed mood or anhedonia.

Latent Class Analysis of Stressors Based on Workplace Accident Compensation Cases Regarding Mental Disorders in Japan

Latent Class Analysis of Stressors Based on Workplace Accident Compensation Cases Regarding Mental Disorders in Japan

Appropriate Monitoring May Affect the Life Expectancy of Patients with Mental Disorders in Japan: Literature Review on Guidelines for Serious Physical Risks

Appropriate Monitoring May Affect the Life Expectancy of Patients with Mental Disorders in Japan: Literature Review on Guidelines for Serious Physical Risks

Reliability and Validity of the Japanese Version of the Barriers to Access to Care Evaluation Scale Version 3 for People With Mental Disorders: an Online Survey Study.

It is a serious problem when people with mental disorders avoid, delay, discontinue, or do not use treatment and support, despite the existence of evidence-based treatment and support methods. In this study, we aimed to clarify the factor structure of BACE v3, a scale to measure barriers to accessing mental health care, and to examine its reliability and validity among Japanese people with mental disorders. An online survey with 268 participants, 20 years old and over, who had received care from mental health services in the past 12 months was conducted. Exploratory and confirmatory factor analysis (EFA and CFA) were used to examine the structure of the BACE v3. Internal consistency and test-retest reliability of all subscales were examined. Convergent validity [correlation of one of the subscales of the BACE v3, the treatment stigma subscale with the Stigma Scale for Receiving Psychological Help (SSRPH) and with the Internalized Stigma of Mental Illness Scale (ISMI)] was assessed. EFA identified two factors (treatment stigma and non-stigma), and the results suggested that the factor structure of the Japanese version of BACE v3 was similar to the original 2-factor structure. Regarding the CFA result, the goodness-of-fit indices showed marginal fit (root mean square error of approximation = 0.087; Tucker–Lewis index = 0.842; standardized root mean square residual = 0.078; comparative fit index = 0.86). The internal consistency of the treatment stigma subscale was α = 0.90, and the intraclass correlation coefficient was 0.76 (confidence interval: 0.70–0.81). The internal consistency of the non-stigma subscale was α = 0.83, and the intraclass correlation coefficient was 0.64 (confidence interval: 0.56–0.71). The score of the treatment stigma subscale was significantly and positively correlated with the SSRPH and ISMI. Thus, the BACE v3 has acceptable consistency, reliability and validity for the assessment of barriers to accessing mental health care including treatment stigma among people with mental disorders in Japan.

Smoking and drinking among patients with mental disorders: Evidence from a nationally representative Japanese survey

BackgroundNo studies to date have addressed the association of mental disorder with smoking and drinking behaviors independent of anxiety and depressive symptoms. We therefore examined this association, stratified by age and sex, to determine the target population for behavioral modification in Japan. MethodsWe analyzed data from participants aged 20-79 years without hospitalized or institutionalized status who participated in the nationwide Comprehensive Survey of Living Conditions conducted in 2016. Prevalence ratios (PRs) for current smoking, heavy daily smoking (>20 cigarettes per day), at-risk drinking (>100 g alcohol per week), and heavy drinking (>350 g) were calculated with adjustment for potential confounders. After stratification by age (20-39, 40-64, and 65-79 years) and sex, prevalence and PRs were calculated using propensity scores. ResultsFrom among 340,194 participants, 8275 (2.4%) had mental disorder. Presence of mental disorder was significantly associated with current smoking (PR=1.18, 95%CI=1.12-1.23) and heavy daily smoking (PR=1.35, 95%CI=1.21-1.50) and inversely associated with at-risk drinking (PR=0.70, 95%CI=0.66-0.75). PRs for smoking behavior were higher in women than in men and in younger adults than in the other age groups. They were particularly high in younger women (PR=1.67 for current smokers and PR=2.17 for heavy daily smokers). LimitationsOur findings were obtained from a cross-sectional study. ConclusionThis is the first evidence that the association of mental disorder with smoking behavior is independent of anxiety and depressive symptoms. Our results indicate the need for tailored behavioral modification interventions for young people with mental disorders in Japan, particularly young women.

Prevalence, treatment, and the correlates of common mental disorders in the mid 2010′s in Japan: The results of the world mental health Japan 2nd survey

BackgroundDespite numerous changes in the mental health care system in Japan in 2000's, little is known about changes in the prevalence or treatment rates of mental disorders. MethodsThe World Mental Health Japan (WMHJ) 2nd Survey was a nationally representative face-to-face household survey of residents aged 20–75 years old conducted between 2013 and 2015. We compared the findings with those of an earlier study, the first WMHJ (WMHJ1) survey, conducted in 2002–2006. ResultsOverall, 2450 residents completed the interview. Lifetime prevalence of any common mental disorder was 22%, with high prevalence of alcohol abuse (15.1%). Twelve-month prevalence rates of any common mental disorder and major depressive disorder were 5.2% and 2.7%, respectively. Severe cases comprised 24% of 12-month disorders. Lifetime prevalence of any common mental disorder was greater for males. The persistence of any common mental disorder was greater for females. Proportion of those with 12-month disorders who sought treatment was 34%. Mental health care use was the most prevalent among 12-month cases. Twelve-month prevalence of any common mental disorder was similar to that of the WMHJ1 while the proportion of seeking treatment increased for disorders with moderate severity. LimitationsInstitutionalized people were not included. The lower response rate might also limit the interpretation of the findings. ConclusionsThe study found lower prevalence of mental disorders in Japan than in Western countries in the mid 2010's, suggesting that the prevalence of mental disorders remained stable in the last decade in Japan. Treatment rate increased for those with moderate disorders, which might reflect the government's attempt to raise people's awareness of mental health.

Violence exposure and resulting psychological effects suffered by psychiatric visiting nurses in Japan.

Introduction Psychiatric visiting nurses (PVNs) play a crucial role by providing medical services for community-living individuals with mental disorders in Japan. However, little is known about violence towards PVNs. Aim This cross-sectional study investigated violence during visits and the resulting psychological effects for PVNs. Methods PVNs were assessed using a violence exposure questionnaire and the Impact of Event Scale-Revised (IES-R-J); a measure of posttraumatic distress. Result Thirty-eight (41%) of 94 participants had experienced violence during the previous 12months and 49 (53%) over their entire career. The most frequent violence was verbal abuse. Career length as a PVN and number of visits per month were significantly positively associated with verbal abuse during the previous 12months. The IES-R-J scores indicated 28 of the 34 participants who completed the questionnaire exhibited psychological distress for the most traumatic violence during their career and two had a potentially high risk of posttraumatic stress disorder. Discussion and Implications Policies and strategies aimed at reducing violence in PVN settings should be developed according to characteristics of the violence, as well as the characteristics and work situation of PVNs. Furthermore, the provision of support and a safe workplace environment would be important for PVNs with residual psychological distress.

Spatial analysis for regional behavior of patients with mental disorders in Japan.

The aim of our study was to clarify the geographical movement of patients treated in psychiatric facilities, which can provide important information on the resources and health-care system of psychiatric services. We conducted an analysis of nationwide data on psychiatric patients, collected as an additional survey to the conventional '630 survey' in 2014. For the 151 848 initially admitted inpatients during 6 months and the 144 401 outpatients on a specific day, we identified whether a patient was admitted to a psychiatric facility located in the same medical area as his/her residence. We estimated percentages of being from (i) within the medical area, (ii) within the prefecture, and (iii) outside the prefecture, using a Bayesian statistical approach for each secondary medical area. The inpatients moved across wider areas than did the outpatients. Almost all inpatients and outpatients received their medical treatment at hospitals/clinics within their prefecture of residence. The current mental health medical system in Japan has been operating according to prefecture unit; thus, it may be appropriate to plan a medical system at a prefectural level.

Recent Reason for Hindering Medications for Perinatal Mental Disorders in Japan.

BackgroundWe examined the recent reasons for hindering antipsychotic medications during pregnancy in Japan.MethodsWe retrospectively analyzed the medical charts of all women who gave birth after 22 weeks’ gestation at Japanese Red Cross Katsushika Maternity Hospital from August 2016 to July 2017.ResultsFour pregnant women with mental disorders (three schizophrenia and one adjustment disorder) kept the interruption of medications under their partners’ compulsion. All of their partners had a history of mental disorders (two schizophrenia, one anxiety disorder and one adjustment disorder).ConclusionIn cases of pregnancy requiring mental health care, mental health care on partners seemed to be also needed.

The global distribution of mental and substance use disorders: research gains and challenges.

Commentary on: Ishikawa H, Kawakami N, Kessler R (2015). Lifetime and 12-month prevalence, severity, and unmet need for treatment of common mental disorders in Japan: results from the final dataset of World Mental Health Japan Survey. Epidemiology and Psychiatric Sciences. (doi:10.1017/S2045796015000566)

Changes in Families' Caregiving Experiences through Involvement as Participants then Facilitators in a Family Peer-Education Program for Mental Disorders in Japan.

A family peer-education program for mental disorders was developed in Japan, similar to existing programs in the United States and Hong Kong. Families that serve as facilitators in such programs may enhance their caregiving processes and, thereby, their well-being. This study's aim was to describe how families' caregiving experiences change, beginning with the onset of a family member's mental illness, through their involvement in a family group or peer-education program as participants then facilitators. Thus, this study was conducted in a family peer-education program for mental disorders in Japan. Group interviews were conducted with 27 facilitators from seven program sites about their experiences before, during, and after becoming facilitators. Interview data were coded and categorized into five stages of caregiving processes: (1) withdrawing and suppressing negative experiences with difficulty and regret; (2) finding comfort through being listened to about negative experiences; (3) supporting participants' sharing as facilitators; (4) understanding and affirming oneself through repeated sharing of experiences; and (5) finding value and social roles in one's experiences. The third, fourth, and fifth stages were experienced by the facilitators. The value that the facilitators placed on their caregiving experiences changed from negative to positive, which participants regarded as helpful and supportive. We conclude that serving as facilitators may improve families' caregiving processes.

Low prevalence rates of common mental disorders in Japan: does it still hold true?

Low prevalence rates of common mental disorders in Japan: does it still hold true?

Lifetime and 12-month prevalence, severity and unmet need for treatment of common mental disorders in Japan: results from the final dataset of World Mental Health Japan Survey.

The aim of this study is to estimate the lifetime and 12-month prevalence, severity and treatment of Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV) mental disorders in Japan based on the final data set of the World Mental Health Japan Survey conducted in 2002-2006. Face-to-face household interviews of 4130 respondents who were randomly selected from Japanese-speaking residents aged 20 years or older were conducted from 2002 to 2006 in 11 community populations in Japan (overall response rate, 56%). The World Mental Health version of the World Health Organization Composite International Diagnostic Interview (WMH-CIDI), a fully structured, lay administered psychiatric diagnostic interview, was used for diagnostic assessment. Lifetime/12-month prevalence of any DSM-IV common mental disorders in Japan was estimated to be 20.3/7.6%. Rank-order of four classes of mental disorders was anxiety disorders (8.1/4.9%), substance disorders (7.4/1.0%), mood disorders (6.5/2.3%) and impulse control disorders (2.0/0.7%). The most common individual disorders were alcohol abuse/dependence (7.3/0.9%), major depressive disorder (6.1/2.2%), specific phobia (3.4/2.3%) and generalized anxiety disorder (2.6/1.3%). While the lifetime prevalence of any mental disorder was greater for males and the middle-aged, the persistence (proportion of 12-month cases among lifetime cases) of any mental disorder was greater for females and younger respondents. Among those with any 12-month disorder, 15.3% were classified as severe, 44.1% moderate and 40.6% mild. Although a strong association between severity and service use was found, only 21.9% of respondents with any 12-month disorder sought treatment within the last 12 months; only 37.0% of severe cases received medical care. The mental health specialty sector was the most common resource used in Japan. Although the prevalence of mental disorders were quite low, mental disorders were the second most prevalent cause of severe role impairment among chronic physical and mental disorders. These results suggest lower prevalence of mental disorders in Japan than that in Western countries, although the general pattern of disorders, risk factors and unmet need for treatment were similar to those in other countries. Greater lifetime prevalence for males and greater persistence for females seems a unique feature of Japan, suggesting a cultural difference in gender-related etiology and course of disorders. The treatment rate in Japan was lower than that in most other high-income countries in WMH surveys.

Mental Health Care Reforms in Asia: The Regional Health Care Strategic Plan: The Growing Impact of Mental Disorders in Japan

In April 2013 Japan designated mental disorders as the fifth "priority disease" for national medical services, after cancer, stroke, acute myocardial infarction, and diabetes. All prefectures will be required to assess local mental health needs and develop necessary service components. This column provides an overview of the Regional Health Care Strategic Plan in the context of mental health and welfare reforms. The goals of the plan are to alter the balance between institutional and community-based care for patients with severe and persistent mental disorders, integrate general medical and mental health care, and support greater independence for people with mental disorders. It is a political challenge for Japan to reallocate resources to rebalance care services while maintaining free access to care.

Lifetime prevalence of mental disorders and its relationship to suicidal ideation in a Japanese rural community with high suicide and alcohol consumption rates.

The World Mental Health Survey Japan was conducted to address the current status of mental disorders in Japan. Among the various regions covered by the survey were Tendo City and Kaminoyama City in Yamagata Prefecture. The suicide and alcohol consumption rates in Yamagata are higher than the Japanese national average. Many studies have reported that major depressive disorder (MDD), alcohol use disorders (AUDs), and suicidal ideation are related to suicide risk. The prevalence of MDD, AUDs, and suicidal ideation, as well as the association between suicidal ideation and mental disorders must be investigated in order to implement mental health and suicide prevention measures in our community; however, only a few studies have addressed this issue. The survey involved face-to-face interviews. The study population consisted of 1,684 adult residents, of which 770 (mean age 54.0±17.4 years) who completed the interview process. Mental disorders were assessed using the World Mental Health version of the World Health Organization Composite International Diagnostic Interview. Among the study population, lifetime prevalence of MDD was 4.4%, which was similar to values reported in previous studies in Japan. Prevalence of AUDs, however, was 10.2%, which was higher those reported previously. We observed a significant association between suicidal ideation and MDD [odds ratio (OR) 7.6], our results showed precisely the opposite association between AUDs and suicidal ideation (OR 0.5, not significant) compared to previous studies. Although prevalences of MDD and suicidal ideation were not high, this study revealed a high lifetime prevalence of AUDs and a negative association between suicidal ideation and AUDs.

Implementing the Illness Management and Recovery Program in Japan

Implementing the Illness Management and Recovery Program in Japan

Association of childhood adversities with the first onset of mental disorders in Japan: Results from the World Mental Health Japan, 2002–2004

It is well known that childhood adversities (CAs) are a significant risk factor for mental disorders in later life. However, it is uncertain whether a similar association between CAs and mental disorders can be found in Japan. Few studies have employed an appropriate statistical model that takes into account the high comorbidity of CAs. The purpose of this study is to elucidate the association between CAs and the onset of mental disorders in Japan. We used the data from the World Mental Health Japan, 2002–2004 ( n = 1722). Respondents completed diagnostic interviews (the World Health Organization Composite International Diagnostic Interview) that assessed lifetime prevalence of 15 Diagnostic and Statistical Manual of Mental Disorders—Fourth Edition (DSM-IV) disorders. Associations of 12 retrospectively reported CAs with the lifetime prevalence of mental disorders were estimated using discrete-time survival analysis. Of the study sample, 32% reported as having experienced at least 1 CA during childhood. The studied CAs were highly comorbid. Parental mental illness showed significant sub-additive effects. The presence of 3 CAs showed a significant interactive effect on any mental health disorder. The number of CAs had a strong interactive effect on the onset of anxiety disorders. Predictive effects of CAs were found only among childhood onset mental disorders. It was confirmed that CAs are one of predictors of the onset of DSM-IV mental disorders, especially during childhood, in Japan.

Comparison of psychiatrists’ views on classification of mental disorders in four East Asian countries/area

Objective Authors of this study collaborated with psychiatrists in East Asia to undertake the international survey with the following objectives: (1) to identify the psychiatric classification systems currently used in East Asia, (2) to describe the views of psychiatrists on the classificatory systems of mental disorders in Japan, Korea, China and Taiwan, (3) to analyze their similarities and differences among the four countries/area, and (4) to discuss factors which influence the usages of the classificatory systems in East Asia. Method Views of psychiatrists in four East Asian countries/area were collected by a minimum of 100 psychiatrists in each country/area using the same questionnaire. Psychiatrists from East Asian countries/area completed the questionnaire developed originally by a New Zealand psychiatrist and translated into Japanese, Korean and Chinese. The questionnaire was designed to determine the views of psychiatrists in the utilization, preference, and opinion about the current classificatory systems represented by the DSM and ICD. Results The study revealed variations in the utilization, preference and opinion for further revision of the DSM and the ICD classificatory systems in East Asia. Psychiatrists in China and Japan routinely use the ICD, while psychiatrists in Korea and Taiwan favor using the DSM. The majority of Asian psychiatrists expressed the view that it was sometimes difficult to apply the system transculturally. Conclusions Views on psychiatric classification in a country/area are strongly influenced by several factors including mental health service systems, psychiatric resources and historical background.