In recent years, research and development of assistive robots have become active. They are aiming to support the independence of elderly and disabled people with reduced living functions, and to support caregivers around them. Since 2013, a project for the development of robotic care devices has started based on the “Priority Areas to Which Robot Technology is to be Introduced in Nursing Care”by determined by the Ministry of Economy, Trade and Industry (METI) and the Ministry of Health, Labor and Welfare (MHLW). Since 2016, some of the commercialized robotic devices have been certified for rental use in long-term care insurance. Communication robots, or social robots are also added to the priority areas and are expected to be developed and introduced more actively. This paper outlines the research and development of these assistive robots, and the describes the applications of communication robots especially related to psychiatry.

Recent advances in robotics enable us to think of robot applications as a valuable communication partner in the clinical field of psychiatry. Although the potential usefulness of both android and desktop humanoid robots has been examined for individuals with Autism Spectrum Disorders (ASD), these capabilities to keep talking has still been limited due to the immature technology causing inevitable errors in recognizing human utterances and intentions. Multi-party conversation using multiple robots has been proposed to conceal such errors and maintain conversation with humans. Meanwhile, this new technology is also expected to provide individuals with opportunities to easily observe the conversation between robots and allow them to skip responding to the robots. This paper reviews the basic concepts of robots and discusses these potential merits, namely (1) long lasting conversations and (2) objective viewpoints, which are caused by adopting multi-party conversation with multiple robots and should be fruitful for the treatment and education of individuals with ASD.

Recent robotic technology has made remarkable progress. Support for independence has become a social problem for autism spectrum disorders (ASD). There are various interventions for individuals with ASD. However, it was difficult for them to maintain motivation for interventions by human. Usually, interventions for individuals with ASD require patience for a long time. Robots are capable of constant movement for a long time, and are capable of maintaining the performance, so the expectations for the robots are high. In this article, we will outline the main robots which use for intervention for individuals with ASD. In addition, we will also describe the importance of appearance of robot for individuals with ASD and the current usages.

We reported that humanoid robots may be effective in improving the symptoms of autism spectrum (ASD). ①In communication via a robot, ASD has no fear because the robot has no gaze vector and has no emotion. ② ASD has difficulty in verbal communication, but it can be improved with written language communication. ③ASD is required to respond immediately by verbal communication, and it is difficult to select necessary information from many unorganized information and express it as words. ④ASD can improve the communication function by visualizing the thought process, organizing the thoughts using a keyboard, and externalizing and verbalizing the internal thoughts. Can be improved.

Hikikomori, a severe form of social withdrawal for more than six months, is increasingly a serious mental health issue. The majority of hikikomori sufferers are comorbid with psychiatric disorders. Because of stigma against psychiatric disorders and hikikomori, not only hikikomori individuals but also their family members tend to hesitate visiting psychiatric facilities and/or hikikomori support facilities. Thus, support for hikikomori is likely to be delayed. To combat the above situations, we have been conducting a hikikomori research clinic in a university hospital and developing a therapeutic approach based on multidimensional assessments. In this paper, we introduce our proposed hikikomori assessment system and therapeutic approach based on hikikomori-stages. Finally, we propose introduction of robots as a possible solution to support hikikomori sufferers in the future.

Research in the area of social robots has seen significant growth in recent years and offers tremendous possibilities for innovation in care and treatment for patients such as individuals with Autism Spectrum Disorder and dementia. Along with these developments, ethical questions have arisen, including: replacement of human care by mechanical care, privacy, and concerns of a philosophical nature about the differences between humans and robots. These issues demand the development of new cultural and legal tools that can provide the crucial answers to the most sensitive questions.

Objective: Our aim was to examine 1-year results of consultation-liaison service for referred epilepsy inpatients at an acute care general hospital. Methods: A retrospective review of medical records was conducted for the 12 epilepsy inpatients who were referred to our department of psychiatry, Hiroshima Citizens Hospital from the other departments from April 2017 to March 2018. Results: Study subjects included 10 men and 2 women with average age of 72.8 ± 12 years. Eight patients (66.7%) were admitted to the emergency medical center due to convulsive status epilepticus. Nine patients (75%) were admitted to emergency medical center at referral. Etiological underlying diseases were residual state of cerebrovascular diseases in 6, metastatic brain tumor from lung cancer in 2, and not specified in 2 other patients. Psychiatric diagnosis of 4 patients was delirium and that of 6 patients was delirium risk state. Psychopharmacologic intervention was performed in 11 patients. Conclusion: Active intervention for delirium and delirium risk state plays an important role for consultation-liaison psychiatrists at acute care hospitals where old age epilepsy patients are frequently admitted to emergency care centers.

The prevalence and incidence of epilepsy is highest among aged individuals, and it has become one of the important health issues in Japan where we are now facing the super-aged society. In the future, the consultation of elderly patients with epilepsy may increase in outpatient departments of psychiatry. We identified clinical profiles and trend of aged individuals who had visited our psychiatry outpatient department at Saitama Medical University Hospital for the past five years. Seven thousand eighty one patients were referred to the psychiatric outpatient department of our hospital from 2012 to 2016. One thousand four hundred and seventy six (20.8%) individuals were 65 years or older. The study revealed that 22 (1.5%) cases were diagnosed with epilepsy. Sixteen patients had developed epilepsy for the first time after the age of 65. The male to female ratio of 22 elderly patients with epilepsy was 14 to 8. Focal impaired awareness seizure was most frequently seen in that 54.5%, and 95.5% experienced focal epilepsy. Sixty percent of epilepsy cases did not show abnormalities causing epilepsy. The main reason elderly individuals came to our psychiatry outpatient department was to determine if they had been diagnosed with psychiatry symptoms including disability of cognitive function. Even if the main symptom is not a seizure, epilepsy should be taken in consideration, and do necessary examinations including electroencephalography should be made.

The authors present a 30-year-old woman with autism spectrum disorder and avoidant/restrictive food intake disorder who developed osteomalacia from malnutrition due to a compulsive vegan diet. The patient had communication problems and peculiarities from childhood. At the age of 17, she became interested in the vegan diet and started to lose weight. She consistently declined to see a doctor and developed spinal deformation with knee flexion contracture. The onset of pneumonia at age 30 brought the patient, whose body mass index was by that time 10.7 kg/m², to a medical ward and then to the psychiatric ward of our hospital. She was diagnosed with osteomalacia secondary to vitamin D deficiency. Her body weight improved, but she developed hemoptysis from a pulmonary arteriovenous fistula subsequent to recurrent inflammation in the lung. Although the hemoptysis resolved with conservative management, her clinical outcome remains unpredictable. The findings in this case highlight the need to accumulate clinical cases and reach a consensus on mandatory interventions in such cases.