Computational modeling refers to a framework for representing the neural computational processes underlying behavior using mathematical models, such as reinforcement learning models, and for estimating their parameters and structure from behavioral data. The advantages of computational modeling lie in its ability to utilize information overlooked by traditional analysis methods, thereby enabling the estimation of latent computational processes and capturing detailed individual behavioral characteristics. Furthermore, simulations based on the estimated models can predict behavior in environments beyond experimental settings. In recent years, computational modeling has been increasingly used to characterize behaviors associated with mental and psychosomatic disorders. This article provides an overview of computational modeling, including its advantages and limitations, based on an example of modeling behavioral data from a two-armed bandit task using reinforcement learning models. The discussion also covers the potential contributions of computational modeling and pathways for its application in psychiatry and psychosomatic medicine.

Many opportunities exist in the field of palliative care and psychiatric liaison to use antipsychotics for delirium as well as the behavioral and psychological symptoms associated with dementia, such as irritability, excitement, refusal, insomnia, and nausea.

Delirium is often encountered in clinical practice; however, tiapride is the only drug covered by insurance for delirium. Delirium is partly caused by impaired consciousness due to an imbalance of neurotransmitters in the brain. Symptomatic drug therapy mainly involves the administration of antipsychotics that have antidopaminergic effects. Presently, no strong evidence exists for the selection of drugs and dosage settings, and patients are often forced to use drugs off-label, hindering the use of antipsychotics. In addition, oral administration is difficult in many situations, such as in the terminal stages of cancer and ileus; as such, injections and patches are often required. A wide range of methods, such as injections, patches, and sublingual tablets, can be used to administer antipsychotics among the psychotropic drugs. This article explains the optimal selection of antipsychotics in clinical situations from a pharmacological perspective.

Antidepressants and sleep medications are commonly used in psychiatric liaisons. As these medications are primarily used in patients with physical comorbidities, factors, such as tolerability, metabolism, and pharmacological interactions should be considered before prescribing them. Among antidepressants, SSRIs are the most commonly used ; however, they are associated with several adverse effects. Other antidepressants include SNRIs, other novel antidepressants, and older class of drugs such as trazodone which are used for managing insomnia and delirium. Regarding sleep medications, four types of sleep medications are currently available in Japan, benzodiazepines (BZDs), non-BZDs, melatonin receptor agonists (MRAs), and dual orexin receptor antagonists (DORAs). BZDs and non-BZDs should not be used alone to treat delirium. Ramelteon, an MRA, is well-tolerated and may effectively prevent sleep-wake disturbances and delirium ; however, its effects at maintaining sleep is not high. DORAs are novel sleep medications that suppress the arousal system ; they are well-tolerated but may induce nightmares. Some studies suggest that these drugs may effectively treat delirium and might be useful in psychiatric liaison.

In the field of consultation-liaison psychiatry in general hospitals, Kampo medicine can be effective in treating mental symptoms (e.g., delirium and depression) that accompany physical illnesses. It is useful in cases where Western medicine is difficult to use or when medical staff aim to improve both physical and mental symptoms simultaneously. Kampo medicine emphasizes the patient’s natural healing power and has the potential to enhance physical and mental conditions, prevent oversedation, and give medical staff time to wait for the effects of treatment. Taking medication using the five senses and providing feedback to medical staff encourages patients to take an active role in their own treatment, leading to improvements in the mind-body connection, a recovery in treatment motivation and energy, a shift in the awareness of medical staff, a reduction in treatment procedures such as gastrostomy, and an improvement in the hospital ward atmosphere. Kampo medicine can also be applied to disaster response, cancer treatment, surgeries, and post coronavirus disease 2019 conditions. Additionally, it supports the mental health of both medical staff and patients and is expected to enhance the psychological safety of the entire hospital in the field of psychosomatic medicine.

Objectives : This study aimed to examine whether parental attitudes influence attention deficit/hyperactivity disorder (ADHD) symptoms in adulthood.

Methods : An online cross-sectional survey of adults aged ≥18 years was conducted. The survey yielded 1,017 valid respondents. Of these, the study participants comprised 146 individuals with ADHD symptoms in adulthood and a matched control group of 146 individuals selected based on age and sex from a pool of 871 respondents without ADHD symptoms in adulthood. Logistic regression analysis was conducted considering presence or absence of ADHD symptoms as dependent variables, and parental attitudes as independent variables.

Results : In determining the presence of ADHD symptoms, the odds ratio for the paternal affectionless control group was 3.64 compared with other parenting attitude groups. The odds ratio for the maternal affectionless control group was 2.12 compared with the other parenting attitude groups.

Conclusion : Affectionless control attitudes of fathers and mothers were associated with an increased likelihood of exhibiting adult ADHD symptoms.

Objectives : This study aimed to translate the Objectified Body Consciousness Scale (OBCS), which measures body awareness, into Japanese (OBCS-J) and examine its reliability and validity.

Methods : First, the OBCS was translated into Japanese with permission from the original author. Then, survey participants were recruited through an Internet research company and a questionnaire survey was conducted among 191 women.

Results : Confirmatory factor analysis, calculation of reliability coefficients, and correlation analysis of each subscale and the EAT-26, PHQ-9, and EISS-J were conducted. The results of the confirmatory factor analysis confirmed that the two-factor structure was a better-fitting model than the three-factor structure, and the results of the reliability coefficients and correlation analysis were similar to those of previous studies.

Conclusion : The OBCS-J was confirmed to have acceptable reliability and validity in the two- and three-factor structures.