It is estimated that 1 in 4 people will experience a mental illness in their lifetime, and the stigma associated with mental illnesses remains a major social issue. The perception that mental illness is incurable is thought to be the major factor contributing to the formation of stigma. Furthermore, stigma itself makes recovery from the illness more difficult: stigma is known to develop and worsen as the psychosis progresses from the prodromal stage to the overt stage. The presence of stigma discourages help-seeking, ultimately delaying the initiation of appropriate treatment and slowing recovery. Stigma is classified into 4 categories: self-stigma, stigma by association, public stigma, and structural stigma. Furthermore, public stigma can be divided into 3 subtypes: misinformation, prejudice, and discrimination. Promoting effective social contact between members of the public and people with mental illness has been examined as a way to reduce stigma. However, a meta-analysis of programs aimed at reducing the stigma of mental illness failed to identify any clearly effective programs or their contents to reduce stigma. Meanwhile, it is expected that the implementation of early intervention, a global trend in psychiatry, will contribute to reducing the stigma associated with mental illness by preventing the onset of overt mental illness and promoting the achievement of a favorable prognosis. This will also lead to true recovery from mental illness. Furthermore, momentum for improving mental health literacy is growing in Japan, with mental illness now being covered in high school health and physical education classes. It is essential to continue our efforts to build a society in which the prevention of mental illnesses becomes more realistic and certain, and in which people can feel at ease even if they suffer from a mental illness.

The impressive progress in palliative medicine has led to significant improvements in the management of physical symptoms. However, many patients endure suffering beyond the limits of their physiology and psychology. This aspect of suffering, referred to as spiritual pain, arises when one's sense of meaning, identity, or autonomy is fundamentally threatened by illness and approaching death. Based on Cicely Saunders' concept of "total pain" and Murata's three-dimensional model of spiritual pain, this review examines the conceptual structure of spiritual pain and its educational implications for healthcare professionals. This study explores how medical education can foster sensitivity to existential suffering, encourage reflective practice, and integrate spiritual care into multidisciplinary clinical training. In conclusion, understanding spiritual pain is not only a clinical competency but also an ethical and humanistic foundation for medicine that supports the act of living.

Introduction: The coronavirus disease 2019 (COVID-19) pandemic led to the rapid development of vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), such as the Pfizer/BioNTech manufactured vaccine BNT162b2. In Japan, the preferential vaccination of healthcare workers began in January 2021 due to the high risk of exposure to SARS-CoV-2 in hospital settings, including at the Toho University Omori Medical Center. However, because BNT162b2 is based on a novel messenger ribonucleic acid (mRNA) vaccine platform, its ability to induce antigen-specific humoral and cellular immune responses has not yet been fully elucidated.

Methods: We examined the levels of antibodies and numbers of T cells in the blood, which were specific to the SARS-CoV-2 spike (S) protein, after BNT162b2 vaccination. The immune responses were evaluated among healthcare workers who had received two doses of BNT162b2.

Results: S protein-specific antibodies were induced in all participants following administration of two doses of BNT162b2. S protein-specific T cell expansion was also observed following vaccination. However, no correlation was observed between antibody titers and the magnitude of T cell responses among the participants.

Conclusions: Vaccine efficacy is often assessed using antigen-specific antibody titers, although T cells play an important role in adaptive immunity. Our findings indicate that the evaluation of antigen-specific T cell responses is necessary for accurately assessing the immunological effects of vaccination. Furthermore, these findings caution against reliance on antibody titers alone as a surrogate of vaccine-induced immunity.