Clinical Neuropsychopharmacology and Therapeutics
Online ISSN : 1884-8826
ISSN-L : 1884-8826
Volume 10
Displaying 1-4 of 4 articles from this issue
Original Article
  • Susumu Higuchi, Izuru Nakamura, Yoshiyuki Shibasaki
    Article type: Original Article
    2019 Volume 10 Pages 1-9
    Published: May 24, 2019
    Released on J-STAGE: May 24, 2019

    Purpose: There has been little research into the effects of therapies for alcohol dependence in Japanese patients with depression and drinking problems. The aim of this study was to: 1) assess the prevalence of problem drinking in patients with depression and 2) evaluate the association between depression severity and problem drinking.

    Methods: This cross-sectional survey was conducted in Japanese patients aged ≥ 20 years old with depression. Survey 1 identified those who engaged in habitual drinking and these individuals completed survey 2, which assessed alcohol consumption, depression severity and alcohol dependence or abuse.

    Results: Overall, 2354 patients completed survey 1 and 425 patients completed survey 2. Of the patients who completed survey 2, 112 (26.4%; 95% confidence interval 22.2, 30.8) had alcohol dependence. Survey 2 showed that the severity of depression was significantly associated with the prevalence of alcohol dependence (p < 0.0001), suspected alcohol dependence (p = 0.0001) and high or very high drinking risk level (DRL; p < 0.0001). Univariate logistic regression analysis showed that alcohol dependence (p < 0.0001), suspected alcohol dependence (p = 0.0112), high DRL (p = 0.0027) and very high DRL (p = 0.0004) were significantly associated with severity of depression.

    Conclusions: Among patients with depression who engaged in habitual drinking, the prevalence of alcohol dependence and suspected alcohol dependence were substantially higher than in the general population. Depression severity was significantly associated with alcohol dependence, suspected alcohol dependence and high or very high DRL.

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  • Hotaka Shinzato, Tsuyoshi Kondo
    Article type: Original Article
    2019 Volume 10 Pages 18-25
    Published: September 09, 2019
    Released on J-STAGE: September 09, 2019

    Purpose: This study aimed to investigate the relationship of the newly developed 12-item dimensional scale of depressive mixed state (DMX-12) with categorical diagnoses of mixed depression (MD) defined by Benazzi in 2008 and mixed features (MF) as a specifier for depressive and bipolar disorders by DSM-5 in 2013.

    Methods: The DMX-12 questionnaire was administered to 154 patients (57males and 97 females; 13-83 years) with major depressive episode (MDE) to quantify DMX symptoms. Receiver operating characteristic (ROC) curves were applied to examine the relationship between the DMX-12 and MD or MF.

    Results: Among 154 patients, 28 cases (18.2%) showed MD while 7 cases (4.5%) showed MF. Selected 6 symptoms with AUC values more than 0.6 for ROC curves differentiating both MD and MF were overreactivity, inner tension, racing/crowded thought, impulsivity, dysphoria and risk-taking behavior. The AUC of ROC curve using the sum of these 6 symptoms scores was higher (.716 for MD and.761 for MF) than those using total score (.670 for MD and.704 for MF) and disruptive emotion/behavior subscale score (.684 for MD and.714 for MF) of the DMX-12. When the cut-off value in common for both MD and MF was set at ≥14, the sensitivity and negative predictive value for prediction of MD and MF were.750 and.920 for MD and.857 and.989 for MF, respectively.

    Discussion: The selected 6 symptoms of the DMX-12 may be useful for sensitive screening and negative check of clinically relevant DMX with considerable severity in patients with MDE.

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Invited Review
  • Minoru Takeshima
    Article type: Invited Review
    2019 Volume 10 Pages 10-17
    Published: September 02, 2019
    Released on J-STAGE: September 02, 2019

    Mixed depression refers to the co-existence of a major depressive episode (MDE) and sub-threshold manic/hypomanic symptoms. Mixed depression is a common clinical entity, occurring in approximately 50% and 30% of MDEs due to bipolar disorder (BD) and major depressive disorder (MDD), respectively. However, it remains underdiagnosed and very often misdiagnosed as simply "major depression," adjustment disorder, anxiety disorder, or borderline personality disorder. Mixed depression suggests a diagnosis of BD in patients experiencing an MDE, and is associated with future progression to BD, antidepressant-induced mania/hypomania, and a family history of BD in patients with MDD. Patients with mixed depression exhibit poor prognosis, experiencing more severe episodes of longer duration, less inter-episodic remission, higher recurrence rates, more rapid cycling, a higher rate of co-morbid substance use and anxiety disorders, and a higher risk of suicidality. Antidepressant use can exacerbate symptoms of agitation and irritability and induce newly-developed suicidality without improving depressive symptoms. Because treatment strategies differ for mixed and non-mixed states, it is important to screen all patients with depression for co-existing manic/hypomanic symptoms. In this report, the author briefly reviews the clinical presentation, diagnosis, and impact of mixed depression on the course of mood disorders and pharmacological treatment.

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Case Report
  • Shinji Sato, Yoichi Kawanishi, Masayuki Ide, Noriko Sodeyama, Hitoshi ...
    Article type: Case Report
    2019 Volume 10 Pages 26-28
    Published: November 08, 2019
    Released on J-STAGE: November 08, 2019

    Autism spectrum disorder (ASD) includes disturbances in communication, imagination, and social interaction. In individuals with ASD, selective mutism is a common symptom of a communication disability. Selective serotonin reuptake inhibitors (SSRIs) have been recommended to treat selective mutism, especially after psychosocial interventions fail. However, the mechanism and efficacy of SSRIs in treating selective mutism remain unclear. Here we report the case of an adult male with ASD whose selective mutism was improved by aripiprazole but not SSRIs. To the best of our knowledge, this is the first such case report. We believe that our patient's case highlights the value of differentiating between psychopathology and psychopharmacology when examining ASD symptoms.

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