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Article type: Cover
2015 Volume 55 Issue 8 Pages
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Article type: Cover
2015 Volume 55 Issue 8 Pages
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Article type: Index
2015 Volume 55 Issue 8 Pages
907-
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Article type: Index
2015 Volume 55 Issue 8 Pages
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Article type: Appendix
2015 Volume 55 Issue 8 Pages
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2015 Volume 55 Issue 8 Pages
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Article type: Appendix
2015 Volume 55 Issue 8 Pages
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Article type: Appendix
2015 Volume 55 Issue 8 Pages
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Yukito Shimizu
Article type: Article
2015 Volume 55 Issue 8 Pages
911-912
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Atsushi Sekiguchi
Article type: Article
2015 Volume 55 Issue 8 Pages
913-919
Published: August 01, 2015
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Brain gray and white matter structural alternations in several brain regions including hippocampus, amygdala, the anterior cingulate cortex (ACC) and the prefrontal cortex (PFC) were reported in patients with posttraumatic stress disorder (PTSD) or stressful life events. However, the causal relationship between psychological distress after stressful life events and the structural brain alternation had remained unclear, because of difficulties with prospective studies. Our recent investigation identified gray matter volume (GMV) and white matter integrity (WMI) changes in subjects soon after the The Great East Japan Earthquake. Our findings suggest that smaller anterior cingulate cortex (ACC) volume and lower WMI in the right anterior cingulum (Cg) were pre-existing vulnerability factors and that decreased volume of the orbitofrontal cortex (OFC) increased WMI in the left anterior Cg and uncinate fasciculus (Uf) were results of these acquired signs of post-earthquake distress. In addition, we examined the 1-year prognosis of the psychological and brain structural changes soon after the earthquake. The results unveiled that the right hippocampal volumes were significantly decreased and bilateral and medial OFC were significantly increased from soon after to 1-year after the earthquake. Also, the left OFC volume was associated with self-esteem scales. As for WMI, the transient increased WMI in the right cingulum and reduced WMI in the left uncinate fasciculus were observed. In this article, we reviewed our recent studies investigating the prognosis of the PTSD symptoms and brain structural changes. We assumed that a predictor of the recovery from stressful situation is a higher self-esteem and dynamic changes of WMI in the cingulum and uncinated fasciculus, whereas persistently lower WMI is a marker of cognitive dysfunction, implying the development of anxiety disorders.
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Yasuichiro Yusa
Article type: Article
2015 Volume 55 Issue 8 Pages
920-927
Published: August 01, 2015
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Many patients who have emotion regulation difficulties due to PTSD, borderline personality disorder, eating disorder, bipolar disorder, etc. also have various stress related physical problems, requiring treatment by the professionals in the field of psychosomatic medicine. These patients are often considered to be challenging patients due to their high level of emotional reactivity. Dialectical behavior therapy (DBT), whose effectiveness for this population of patients are strongly supported by scientific researches, considers "Validation" that the therapist takes to be as crucial strategy as the comprehensive combination of cognitive-behavioral strategies. Since the Japanese medical system will not allow the application of comprehensive cognitive-behavioral interventions required in DBT, therapist's validating attitude and behaviors will be all the more useful and important. Therefore, a guide for the therapist to become validating, in addition to the theoretical underpinning of validation will be presented.
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[in Japanese], [in Japanese]
Article type: Article
2015 Volume 55 Issue 8 Pages
928-
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Kotoyo Saitou, Jun Suzuki, Yutaka Nakamura, Hitoshi Kobayashi, Kouhei ...
Article type: Article
2015 Volume 55 Issue 8 Pages
929-935
Published: August 01, 2015
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In subjects with chronic obstructive pulmonary disease (COPD), systemic comorbidities are highly prevalent. Anxiety and depression are common comorbidities and associated with more exacerbations and higher mortality. The COPD Assessment Test (CAT) which has simple and quick questions, is recommended as a promising tool for assessing the impact of COPD on a patient's life comprehensively. Recently, it has been reported that anxiety and depression affect the CAT score. The COPD subjects may have anxiety or depression, as indicated by a high CAT score. In such cases, an additional specific evaluation should be undertaken. If symptoms of anxiety and depression reach the psychiatric disorder levels, appropriate treatments are required. The early interventions to anxiety and depression may contribute greatly to prognostic improvement of COPD patients.
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Kazufumi Yoshihara
Article type: Article
2015 Volume 55 Issue 8 Pages
936-941
Published: August 01, 2015
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The mind-body correlations of bronchial asthma and its pathological mechanisms have been clarified as basic research has progressed. This report outlines the knowledge obtained from basic research studies, such as epidemiological investigations, animal experiments, and brain imaging studies. Epidemiology based investigations report that patients with bronchial asthma often have coexisting diseases such as depression and anxiety disorder. In animal experiments, members of our department showed that early-life psychological stress-exposed mice exhibited exacerbation of inflammation and airway hyperresponsiveness to adult-onset bronchial asthma via the hypothalamus-pituitary-adrenal axis. Furthermore, brain-imaging studies have shown that activity in the anterior cingulate cortex and insula to asthma-relevant stimuli, compared with valence-neutral stimuli, is associated with markers of inflammation and airway obstruction in asthmatic subjects after an allergen inhalation challenge. In the future, it will be important to take advantage of the knowledge obtained from this basic research to clarify the pathology of bronchial asthma and to extend the results to the clinical sphere by developing effective treatments.
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[in Japanese], [in Japanese]
Article type: Article
2015 Volume 55 Issue 8 Pages
942-
Published: August 01, 2015
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Hiroe Kikuchi
Article type: Article
2015 Volume 55 Issue 8 Pages
943-948
Published: August 01, 2015
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Ambulatory monitoring is defined as a method to assess phenomena at the time and the place they occur and its ecological validity is thought to be high. Ambulatory monitoring for patient reported outcomes (PRO) is called ecological momentary assessment(EMA). EMA can avoid recall bias and temporal accuracy is also guaranteed when using computers as recording devices. It has been scrutinized from perspectives of some issues including measurement reactivity. Ambulatory monitoring is also conducted for objective measures and one of them is actigraphy for physical activity using accelerometers as actigraphs. It is generally used to estimate energy expenditure and sleep-wake state and even applied to quantitative measurement of behavioral pattern. Ambulatory monitoring is expected to be more utilized with due consideration of its advantages as well as disadvantages.
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Tetsuro Ishizawa
Article type: Article
2015 Volume 55 Issue 8 Pages
949-957
Published: August 01, 2015
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In the area of psychosomatic medicine, there are quite a few patients who need to examine autonomic nervous functions. Recently, heart rate variability (HRV), blood pressure variability (BPV) and baroreflex sensitivity (BRS) are frequently used as accurate and non-invasive investigations of autonomic nervous function. HRV measures the physiological phenomenon of variation in the time interval between heartbeats mainly regulated by cardiac autonomic function. In contrast, BRV measures the complex phenomenon that includes blood pressure fluctuation with peripheral cardiac sympathetic function and mechanical function caused by respiration movement. BRS calculated by a crossspectral method is known to reflect the parasympathetic bradycardia effect. Thus, by investigating BPV and BRS together with HRV with frequency domain analysis, cardiovascular sympathetic and parasympathetic nervous functions are evaluated more quantitatively. In addition, autonomic nonlinear characteristics could be evaluated with fractal analysis, such as detrended fluctuation analysis. This paper showed the findings in the quantitative evaluation of cardiac autonomic function with priority given to the latest studies with anorexia nervosa patients.
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Sachine Yoshida, Kumi O. Kuroda
Article type: Article
2015 Volume 55 Issue 8 Pages
958-966
Published: August 01, 2015
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Mother-infant relationship is critical for well being and development of mammalian infants. To promote this bond, infants have innate behaviours to seek maternal proximity and protest upon separation. However, the physiological mechanisms regulating these infant behaviours require further investigations. Here we present a novel infant cooperative response during maternal carrying. Infants under six months of age carried by a walking mother immediately stop voluntary movement and distress vocalization, compared with holding by a sitting mother, and infant heart rate rapidly decreased after the mother started walking. Furthermore, a strikingly similar response has been found in mouse preweaning pups, defined by immobility and diminished ultrasonic vocalizations and heart rate. Using pharmacologic and genetic interventions in mouse pups, we identified the upstream and downstream neural systems regulating the calming response. Somatosensory and proprioceptive input signalling are required for induction, and parasympathetic and cerebellar functions mediate cardiac and motor output, respectively. The loss of calming response hindered the maternal rescue of distressed pups, suggesting a functional significance for the identified calming response. These results demonstrate that the infant calming response to maternal carrying is a coordinated set of central, motor and cardiac regulations, and is a conserved component of mammalian mother-infant interactions. The possible clinical applications will be discussed, including (i) using the carrying test to assess the infants' autonomic nerve responsivity, which may contribute to early diagnosis and prognosis of perinatal brain damage; (ii) screening for abnormal sensory integration as an early biomarker of autism spectrum disorders. These findings may also impact current parenting theory and practice, since unsoothable crying is the major risk factor for child abuse.
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Sakura Suga, Masahiro Hashizume, Kinya Fujita, Koji Tsuboi
Article type: Article
2015 Volume 55 Issue 8 Pages
967-974
Published: August 01, 2015
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Background and Objective : Bipolar spectrum disorders are frequently unrecognized undiagnosed and untreated. The aim of this investigation is to estimate the proportion of bipolar spectrum in the outpatients of the department of psychosomatic medicine. Methods : A total of 259 outpatients attending the Psychosomatic Medicine Department, Toho University Omori Medical Center from December 6 to 11, 2010 completed the Mood Disorder Questionnaire (MDQ) and the Bipolar Spectrum Diagnostic Scale(BSDS). Results: 17.4 per cent of the total patients were screened as positive on MDQ and/or BSDS. These patients frequently exist not only in mood disorders but also in eating disorders, migraines and anxiety disorders. Conclusions : The patients who are screened as positive frequently exit in the outpatients of psychosomatic medical department mostly unrecognized and undiagnosed as such. Screening for bipolar spectrum disorder in such patients may improve recognition, identification and appropriate treatment.
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Yoshiyuki Takimoto
Article type: Article
2015 Volume 55 Issue 8 Pages
975-977
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Mina Morimura
Article type: Article
2015 Volume 55 Issue 8 Pages
978-983
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[in Japanese], [in Japanese]
Article type: Article
2015 Volume 55 Issue 8 Pages
984-
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[in Japanese]
Article type: Article
2015 Volume 55 Issue 8 Pages
985-
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[in Japanese]
Article type: Article
2015 Volume 55 Issue 8 Pages
986-
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[in Japanese]
Article type: Article
2015 Volume 55 Issue 8 Pages
987-
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[in Japanese]
Article type: Article
2015 Volume 55 Issue 8 Pages
988-
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Article type: Appendix
2015 Volume 55 Issue 8 Pages
989-
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Article type: Appendix
2015 Volume 55 Issue 8 Pages
991-
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Article type: Appendix
2015 Volume 55 Issue 8 Pages
992-993
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Article type: Appendix
2015 Volume 55 Issue 8 Pages
994-996
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Article type: Appendix
2015 Volume 55 Issue 8 Pages
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2015 Volume 55 Issue 8 Pages
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2015 Volume 55 Issue 8 Pages
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Article type: Appendix
2015 Volume 55 Issue 8 Pages
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2015 Volume 55 Issue 8 Pages
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2015 Volume 55 Issue 8 Pages
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2015 Volume 55 Issue 8 Pages
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Article type: Cover
2015 Volume 55 Issue 8 Pages
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