Children may have difficulty recognizing their own mental health problems, and may be reluctant to seek help even if they recognize the problems. Parents may need to recognize their children’s problems and help them access to mental health services. The aim of this study is to identify parental factors that may facilitate or limit the access to the services for parents who have children with mental health problems. The present study reviewed studies which investigated facilitators and/or barriers for the parents to access to the services. The database including PubMed, Web of Science, CiNii, and ICHUSHI were searched, with search terms including “parent”, “child (or words including “child”)”, “service use”, “mental health”, and “factor OR barrier”. As a result, following parental factors were identified as possible facilitators and/or barriers: (1) parental recognition of children’s mental health problems, (2) parental perception of children’ functional impairments and parental perception of their children’s problems being a burden on family, (3) parent-child relationship and characteristics of parents. The results also indicated that in parents’ perspective, parental knowledge and recognition about professional help and service systems, and financial and time burdens for the service use may be the factors related to service use for their children.

Social support is known as a protective and buffer factor for mental health problems. One of the significant types of social support is in the form of a confidant whom one can talk to about personal problems; help from a confidant provides a buffer for stress and may provide improvements for mental health. This study systematically reviews Studies of a relationship between the number of confidants and the risk of anxiety/depressive symptoms. Electronic databases (PubMed, PsycInfo, CINAHL, CiNii, ICHUSHI Web) were searched in December 2019, with 14 out of 341 studies meeting the inclusion criteria. The results indicated that individuals who have few or no confidants are more likely to have depressive symptoms, or higher severity of depressive symptoms. Having few or no confidants was also associated with anxiety symptoms, although only two studies examined this relationship. These results suggest that those who have few or no confidants are at high risk of having mental health problems and may require more social support.

The present study examined the influence of sub-factors of rejection hypersensitivity and social skills on Social Anxiety Disorder (SAD) symptoms among healthy university students (N = 186). Data were collected from the participants through questionnaires. First, a correlation analysis revealed a positive correlation between the sub-factors of rejection hypersensitivity and SAD symptoms. A negative correlation between social skills and SAD symptoms, as well as a negative correlation between sub-factors of rejection hypersensitivity and social skills were also discovered. Then, a multiple regression analysis, using sub-factors of rejection hypersensitivity and social skills as independent variables and SAD symptoms as the dependent variable, indicated that the effect of anxiety on relationship collapse and social skills was significant. Finally, the results of pass analysis revealed that fear of breakup of a relationship and obsequence to others impacted negatively SAD symptoms. In addition, fear of breakup of a relationship and discrepancy between social self-image and true self-image had a significant worse effect on SAD symptoms, when social skills mediated these sub-factors. From the results of this study, it is revealed that the effect of rejection hypersensitivity on SAD symptoms varies depending on the various sub-factors.

Anxious-depressive attack (ADA) is a recently proposed symptom cluster consisting of sudden intense feelings of distressing emotions with no direct psychological cause. It is characterized by intrusive rumination of mainly regretful memories accompanied by a violent emotional storm, resulting in countermeasures including acting out behaviors. ADA seems to manifest in various anxiety and affective disorders as well as some personality disorders, but may have been overlooked. A previous study showed that patients with ADA were more socially anxious and more depressive than those without ADA, regardless of their diagnoses. Social anxiety disorder (SAD) is one of such disorders with a high prevalence of ADA (44.4%). According to clinical reports, patients with SAD appear hypersensitive to rejection or criticism. The present study examined the relationships among ADA, social anxiety, depression and rejection sensitivity (RS) in patients diagnosed with SAD using structural equation modeling (SEM). Findings showed that RS directly significantly affects ADA, as well as indirectly via depression and social anxiety. Depression had a direct, positive effect on ADA, whereas social anxiety had an indirect effect on ADA via depression. The present study suggests that RS may contribute to the development of ADA in patients with SAD.

Cognitive behavioral therapy (CBT) for obsessive-compulsive disorder is a powerful therapeutic approach. However, the implementation of CBT in Japanese psychiatric clinics is limited. We submitted digital slides of CBT for the treatment of obsessive-compulsive disorder from a previous, remote, clinical trial at the Center for Cognitive Behavior Therapy at Chiba University Hospital. Beginners in CBT can especially benefit from digital teaching materials during the treatment process. If the patient is unable to visit once a week, she or he can supplement face-to-face CBT by self-help using digital materials. Digital teaching materials that visually represent the core knowledge and skills of CBT can facilitate understanding for some patients. Therefore, the use of teaching materials that facilitate the implementation of CBT for obsessive-compulsive disorder can help ensure the quality of treatment. Digital teaching materials may contribute to the increased use of CBT by reducing the burden of its practice, without additional cost for psychiatric clinics. In the manuscript, we reported three case series of obsessive-compulsive disorder and the use of digital teaching materials.