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全文: "schizophrenia"
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  • The Keio Journal of Medicine
    2000年 49 巻 supplement2 号 A11
    発行日: 2000年
    公開日: 2009/03/27
    ジャーナル フリー
  • The Keio Journal of Medicine
    2000年 49 巻 supplement2 号 A47-A49
    発行日: 2000年
    公開日: 2009/03/27
    ジャーナル フリー
  • TOHRU OHNUMA, HEII ARAI
    順天堂醫事雑誌
    2017年 63 巻 1 号 8-16
    発行日: 2017年
    公開日: 2017/04/20
    ジャーナル フリー

    Schizophrenia is a debilitating disorder with a prevalence of approximately 0.5%-1% within any given population. The pathophysiology of schizophrenia involves complex genetic, environmental, and psychological etiologies. Here we summarize 26 years of research completed by the Juntendo University Schizophrenia Projects study group on the “biopsychosocial model” of schizophrenia. Clinical brain morphological abnormalities in schizophrenia were detected with magnetic resonance imaging, and these findings led to gene expression analyses of neurotransmitters. The familial aggregation pattern in schizophrenia led to the completion of genetic studies, including linkage and genome-wide analyses, and studies on environmental factors, such as nutrition, aging, stress, and inflammation. Furthermore, we developed a collaborative multicenter study that consisted of a large number of samples. This study enabled us to clearly identify the relevant pathophysiology of schizophrenia, including genetics, altered neurotransmission, brain morphology, and clinical features.

  • Kaede Morimoto, Kayano Yotsumoto, Takeshi Hashimoto
    Asian Journal of Occupational Therapy
    2010年 8 巻 1 号 31-38
    発行日: 2010年
    公開日: 2012/04/26
    ジャーナル フリー
    The objective of the study was to identify the reasons behind difficulties in learning computer operation skills among persons with schizophrenia. Twelve persons with schizophrenia and 14 control subjects without neuropsychiatric diseases took a course in personal computer usage consisting of ten 60-minute weekly lessons. All subjects took a computer operation skills test before and after the course. For the persons with schizophrenia, relationships between the test results and scores on the Brief Psychiatric Rating Scale (BPRS) were analyzed quantitatively. Difficulties with computer operation were identified using a questionnaire and analyzed qualitatively. The mean test scores after the course increased for the control group, but were unchanged for the persons with schizophrenia. There was no correlation between the total BPRS score and the test results, but ‘positive symptoms’ scores were negatively correlated with test scores and the number of input letters. In the qualitative analysis, 24 items in 6 categories were identified as reasons for difficulty with computer operation, with 11 of these items being unique to the persons with schizophrenia. These findings indicate the need to develop a computer learning course that is compatible with the characteristics of persons with schizophrenia.
  • Hiroshi Ujike, Yukitaka Morita
    Journal of Pharmacological Sciences
    2004年 96 巻 4 号 376-381
    発行日: 2004年
    公開日: 2004/12/22
    ジャーナル フリー
    Cannabis consumption may induce psychotic states in normal individuals, worsen psychotic symptoms of schizophrenic patients, and may facilitate precipitation of schizophrenia in vulnerable individuals. Recent studies provide additional biological and genetic evidence for the cannabinoid hypothesis of schizophrenia. Examinations using [3H]CP-55940 or [3H]SR141716A revealed that the density of CB1 receptors, a central type of cannabinoid receptor, is increased in subregions of the prefrontal cortex in schizophrenia. Anandamide, an endogenous cannabinoid, is also increased in the CSF in schizophrenia. A genetic study revealed that the CNR1 gene, which encodes CB1 receptors, is associated with schizophrenia, especially the hebephrenic type. Individuals with a 9-repeat allele of an AAT-repeat polymorphism of the gene may have a 2.3-fold higher susceptibility to schizophrenia. Recent findings consistently indicate that hyperactivity of the central cannabinoid system is involved in the pathogenesis of schizophrenia or the neural mechanisms of negative symptoms.
  • 谷川 浩隆, 村田 志保
    中部日本整形外科災害外科学会雑誌
    2000年 43 巻 3 号 597-598
    発行日: 2000年
    公開日: 2008/03/26
    ジャーナル 認証あり
  • Kiyofumi Yamada
    Biological and Pharmaceutical Bulletin
    2011年 34 巻 9 号 1357
    発行日: 2011/09/01
    公開日: 2011/09/01
    ジャーナル フリー
  • The Keio Journal of Medicine
    2000年 49 巻 supplement2 号 A16-A18
    発行日: 2000年
    公開日: 2009/03/27
    ジャーナル フリー
  • Kazumasa Suzuki, Shuichi Awata, Takehisa Takano, Yukio Ebina, Kosei Takamatsu, Toshihiko Kajiwara, Kae Ito, Tsuyoshi Shindo, Shunichi Funakoshi, Hiroo Matsuoka
    The Tohoku Journal of Experimental Medicine
    2006年 210 巻 3 号 213-220
    発行日: 2006年
    公開日: 2006/11/01
    ジャーナル フリー
    Schizophrenia is a serious psychiatric disorder that develops mainly in young adults. Electroconvulsive therapy (ECT) is known to be effective and safe in patients with schizophrenia with acute psychotic exacerbation. Because of the shortage of systematic studies, we conducted a prospective naturalistic study to examine the short-term effects of acute ECT and its safety in young adults with medically intractable first-episode schizophrenia. Subjects were seven consecutive patients, 15-35 years of age, with first-episode schizophrenia or schizophreniform disorder (Diagnostic and Statistical Manual of Mental Disorders, 4th edition; DSM-IV), who had failed to respond to neuroleptics. The seven patients were treated with a first course of ECT, and their clinical symptoms were evaluated on the basis of the Brief Psychiatric Rating Scale (BPRS) (18 items, rated 0-6) and Global Assessment of Functioning (GAF) Scale. The GAF Scale is presented in DSM-IV as a means of assessing global functioning of a psychiatric patient. Scores range from 1-100; the higher GAF score indicates the higher global functioning. Adverse effects resulting from acute ECT were also evaluated. The total BPRS score 1 week after the final session improved significantly compared to the total pre-ECT BPRS score. The GAF score also improved significantly compared to the pre-ECT GAF score. There were no adverse effects during the acute ECT course, except for mild delirium. We conclude that ECT may be an effective and safe treatment option for young adults with intractable first-episode schizophrenia.
  • The Keio Journal of Medicine
    2000年 49 巻 supplement2 号 A36
    発行日: 2000年
    公開日: 2009/03/27
    ジャーナル フリー
  • Sumiko Yoshida, Yohtaro Numachi, Setsu Fukushima, Kazunori Matsumoto, Hisato Yamazaki, Kazuhito Osakabe, Hiroo Matsuoka
    The Tohoku Journal of Experimental Medicine
    2006年 209 巻 2 号 159-162
    発行日: 2006年
    公開日: 2006/05/17
    ジャーナル フリー
    It has been hypothesized that not only genetic but also environmental factors contribute to the onset of schizophrenia. We therefore conducted psychophysiological studies on a pair of identical twins discordant for schizophrenia, to differentiate non-genetic from genetic indexes possibly associated with this disease. The affected and unaffected twins were 28 year-old females. The affected twin was diagnosed as having schizophrenia based on the Diagnosis and Statistical Manual of Mental Disorders, third edition revised (DMS-III-R), whereas the unaffected twin had no psychiatric disorders. The brain potentials evoked by visual stimulation (visual event-related potential [visual ERP]) were recorded. The components of the visual ERP, which are believed to reflect pattern cognition, semantic processing and the failure to use preceding word information, were compared with normal subjects. Both twins showed abnormal semantic processing and similar failure to use preceding word information. Abnormality of semantic processing was marked in the affected twin. These results indicate that failure to use preceding word information might reflect only genetic factors, whereas abnormal semantic processing might reflect both genetic and non-genetic factors because the affected twin was considered to show accelerated deterioration after the disease onset. However, only the affected twin showed abnormal pattern cognition, which might be attributable to non-genetic factors such as an acquired vulnerability to schizophrenia. We suggest that the impairment of pattern cognition evaluated by visual ERP may be a critical index for the onset of schizophrenia.
  • Kentaro Oniki, Masamichi Ishioka, Natsumi Osaki, Yuki Sakamoto, Yuki Yoshimori, Tetsu Tomita, Ryoko Kamihashi, Shoko Tsuchimine, Norio Sugawara, Koji Otake, Yasuhiro Ogata, Junji Saruwatari, Norio Yasui-Furukori
    Clinical Neuropsychopharmacology and Therapeutics
    2017年 8 巻 25-37
    発行日: 2017/12/15
    公開日: 2017/12/15
    ジャーナル フリー

    Purpose: Oxidative stress contributes to the development of schizophrenia and metabolic abnormalities among schizophrenia patients. This study investigated whether the oxidative stress-related genes polymorphisms affected the risk for metabolic abnormalities among schizophrenia patients or not.

    Methods: A cross-sectional analysis was conducted among 256 schizophrenia patients and 194 age- and gender-matched controls. The effects of the polymorphisms of methylenetetrahydrofolate reductase (MTHFR) (rs1801133, C677T; rs1801131, A1298C) and glutathione S-transferase (GST) T1 null, GSTM1 null, GSTK1 (rs1917760, G-1308T) on the risk for metabolic abnormalities were investigated by structural equation modeling.

    Results: Among the female schizophrenia patients, the MTHFR rs1801133 T/T genotype increased the risk of overweight, and this genotype effect was associated with a risk of metabolic abnormalities. Among the schizophrenia patients with current-smoking status, the MTHFR rs1801133 T/T genotype also increased the risk of overweight, thus affecting the risk of metabolic abnormalities. The effects of GSTK1 T allele carriers and GSTM1 null genotypes on the increased risk of overweight were confirmed in the male schizophrenia patients and/or the patients with current-smoking status. In contrast, no association between the polymorphisms and risk of metabolic abnormalities was observed in control subjects.

    Discussion: These findings suggest that the polymorphisms of oxidative stress-related genes, including MTHFR, may be a significant risk factor for overweight-related metabolic abnormalities among schizophrenia patients in relation to gender differences and/or smoking status. This information regarding the effect of high-risk genotypes may be used to prevent overweight and metabolic abnormalities.

  • Dan Nakamura, Osamu Takashio, Akira Iwanami, Tepei Morita, Ayumi Ikeda, Kenichi Saitou, Yosihito Hirata, Kaori Umezawa, Toshiyuki Tamura, Hiroki Yamada, Masayuki Tani, Atsuko Inamoto, Nobumasa Kato
    Clinical Neuropsychopharmacology and Therapeutics
    2015年 6 巻 16-27
    発行日: 2015年
    公開日: 2015/08/31
    ジャーナル フリー
    Purpose: Individuals with schizophrenia have a vastly reduced lifespan compared with the general population; comorbid cardiovascular disease (CVD) is the leading cause of death for them. Furthermore, these individuals are more likely to have metabolic syndrome-related disorders (MSDs), which increase CVD risk. We examined the medical records of long-term inpatients with schizophrenia to identify methods for preventing CVD and MSDs.
    Method: A retrospective survey was conducted on 56 inpatients with schizophrenia. The prevalence rates of CVD and MSDs among inpatients with schizophrenia were compared with Japanese general population data from the 2010 National Health and Nutrition Examination Survey. Then, we compared the variables influencing CVD and MSDs between first- and second-generation antipsychotic drug groups.
    Results: The prevalences of hyperlipidemia, diabetes mellitus, hypertension, myocardial infarction, and cerebral hemorrhage among individuals with schizophrenia were lower than those among the Japanese general population. This effect is likely attributable to the nursing care offered to individuals with schizophrenia, which includes dietary advice, moderate exercise support, and body weight and blood pressure measurement. Medication did not correlate with CVD or MSD prevalence.
    Discussion: Long-term hospitalization appeared to be particularly useful in preventing CVD and MSDs; thus, nursing care equivalent to that provided in hospitals can reduce the prevalence of CVD and MSDs among patients with schizophrenia. Antipsychotic drugs might have only a minor influence on CVD and MSD prevalence with reliable nursing care. Japanese psychiatric personnel should attend to outpatients with schizophrenia, as this population is increasing and receives less care than do inpatients.
  • Hirotake Hida, Akihiro Mouri, Yukihiro Noda
    Journal of Pharmacological Sciences
    2013年 121 巻 3 号 185-191
    発行日: 2013/03/20
    公開日: 2013/03/20
    [早期公開] 公開日: 2013/03/01
    ジャーナル フリー
    Schizophrenia is a multifactorial psychiatric disorder in which both genetic and environmental factors play a role. Genetic [e.g., Disrupted-inschizophrenia 1 (DISC1), Neuregulin-1 (NRG1)] and environmental factors (e.g., maternal viral infection, obstetric complications, social stress) may act during the developmental period to increase the incidence of schizophrenia. In animal models, interactions between susceptibility genes and the environment can be controlled in ways not possible in humans; therefore, such models are useful for investigating interactions between or within factors in the pathogenesis and pathophysiology of schizophrenia. We provide an overview of schizophrenic animal models investigating interactions between or within factors. First, we reviewed gene-environment interaction animal models, in which schizophrenic candidate gene mutant mice were subjected to perinatal immune activation or adolescent stress. Next, environment–environment interaction animal models, in which mice were subjected to a combination of perinatal immune activation and adolescent administration of drugs, were described. These animal models showed interaction between or within factors; behavioral changes, which were obscured by each factor, were marked by interaction of factors and vice versa. Appropriate behavioral approaches with such models will be invaluable for translational research on novel compounds, and also for providing insight into the pathogenesis and pathophysiology of schizophrenia.
  • Masanari Itokawa, Tadao Arinami, Michio Toru
    Journal of Pharmacological Sciences
    2010年 114 巻 1 号 1-5
    発行日: 2010年
    公開日: 2010/09/16
    [早期公開] 公開日: 2010/08/12
    ジャーナル フリー
    Schizophrenia is a debilitating and complex mental disorder with a prevalence of approximately 1% worldwide. The etiology remains unclear, despite massive research efforts. Hyperactive dopaminergic signal transduction in the central nervous system is suggested to be involved in the pathophysiology of schizophrenia (the dopamine hypothesis). The dopamine D2–receptor (DRD2) gene is thus a promising candidate for associations with risk of schizophrenia. We investigated DRD2 and found a novel missense nucleotide change causing an amino acid substitution of serine with cysteine at codon 311 (Ser311Cys). We performed an association study using 156 schizophrenia patients and 300 controls. Cys311 in DRD2 was significantly associated with schizophrenia. Patients with the Cys311 allele displayed shorter duration of hospitalization and less severe negative symptoms and were more frequently married compared to patients without this allele, suggesting good response to treatment. We expanded samples to 291 patients with schizophrenia (including 11 postmortem brain samples), 579 controls, and 78 patients with affective disorders in a further case-control study. Cys311 was associated with schizophrenia, particularly in patients without negative symptoms, and bipolar disorder with mood-incongruent psychotic symptoms. Three meta-analyses using over 20 published studies confirmed the association. In vitro studies showed that Cys311-type D2 receptor impairs dopamine-induced sequestration, which appears to be consistent with the dopamine hypothesis.
  • The Keio Journal of Medicine
    2000年 49 巻 supplement2 号 A13-A15
    発行日: 2000年
    公開日: 2009/03/27
    ジャーナル フリー
  • Sadamu Kimura, Yoji Kagono, Yoko Harima, Akiko Watanabe, Shogo Shimizu, Akira Murata, Takako Wakabayashi
    関西医科大学雑誌
    1978年 30 巻 Supplement 号 S1-S11
    発行日: 1978/12/20
    公開日: 2013/02/19
    ジャーナル フリー
    The age-distribution and the birth or der have been investigated on 1,207 schizophrenics and on 270 patients of schizo-affective psychosis. At the same time,1,156 patients of psychogenic disorder were investigated for the aim of the comparison.
    1) Similarity was recognized in the age-distribution graph between schizophrenia and schizo-affective psychosis. But these psychoses seemed different from psychogenic disorders (mostly neurotics) in the age-distribution. In schizophrenia, excess of male patients over female patients was conspicuous before thirty but vice versa after thirty. So it seemed that the onset in female schizophrenics was somewhat later than in males. The incidence of schizophrenia was most frequently observed in ages 20-24 in both sexes.
    In schizo-affective psychosis, excess of female patients over male patients was recognized in every age-section and the male-female ratio was approximately 1: 3. The onsets were also most frequently distributed in ages 20-24, but this was more prominent in male patients.
    2) As to the birth order, schizophrenia seemed to indicate abnormal distribution in contrast to psychogenic disorders, and scbizo-affective psychosis seemed to be situated between the two. In addition, we were impressed that abnormal distribution of the birth order was quite apparent only in male patients of schizophrenia.
  • 久米 和興, 森 文子
    日本看護研究学会雑誌
    2001年 24 巻 1 号 1_89-1_98
    発行日: 2001/04/01
    公開日: 2016/03/31
    ジャーナル フリー
     前駆症状の定義は曖昧で,把握する事が難しい。 そのため早期警戒症状という実践的概念がでてきた。 これは,分裂病患者の再発前の差し迫った状態を含む。 しかし,前駆症状と同様に早期警戒症状を確実に捉えるには困難がある。 それは症状の測定に段階尺度を用いる必要があるためである。 そのため評価手段の粗さを補うために,量的かつ連続的な測定方法が求められている。
     本研究では,精神症状の変化に関係すると思われる歩数に着目した。 入院中の分裂病患者8人に万歩計を装着し,約1年間歩数を測定した。 そして週毎に平均歩数を求めた。 同時に精神症状の重症度を測定した。  その結果,5人が歩数の変動と精神症状の変動との間に有意な関係を示した。 4週間前から1週間前までの歩数と現在の精神症状との間にも有意な関係がみられた。 そのため歩数を測定することで,精神症状の変動を予測される患者の存在が示唆された。
     この方法は分裂病の病状悪化に先立つ早期介入を判断する看護技術の一つになると考えられた。
  • 大島 一成, 沖村 宰, 行実 知昭, 安宅 勝弘, 岩脇 淳, 西川 徹, 花村 誠一
    Journal of Medical and Dental Sciences
    2010年 57 巻 1 号 83-94
    発行日: 2010年
    公開日: 2016/09/26
    ジャーナル オープンアクセス
    Schizophrenia is defined by operative diagnostic criteria in DSM-IV with some typical symptoms as hallucinations and duration of the disease. Huber focused on the subjective experience of patients and coined the term “basic symptoms” and created BSABS. Our study investigated the reliability and the diagnostic validity of the 5 clusters of BSABS for DSM-IV-based diagnosis of schizophrenia with a cohort of 105 patients. Good inter-rater reliability was obtained except for one item D.10. As evaluated by Spearman’s rank correlation coefficients, among the 5 clusters excluding Cluster 2, internal consistency was good. This suggests that, although each cluster is heterogeneous, cluster symptoms are the expression of physiological and biological disturbances of schizophrenia. Receiver Operating Characteristic Curve analysis was also used to show the ability of each cluster to discriminate schizophrenia. Results showed that the area representing the powers in discriminate schizophrenia of Cluster 4 “Adynamia”, which is considered related to the dynamic aspect of thinking, was highest, at 0.739. Cluster 1 “Information processing disturbances” which has a predictive ability for schizophrenia showed 0.714 and Cluster 3 “Impaired tolerance to normal stress” showed 0.711. Our findings suggest that, although these clusters symptoms differ from DSM-Ⅳ criteria, they are related to fundamental process of schizophrenia. Use of some of these three clusters with other neurophysiological markers could allow clinical evaluation of schizophrenia from a new perspective.
  • Yoshiaki Miyamoto, Atsumi Nitta
    Journal of Pharmacological Sciences
    2014年 126 巻 4 号 310-320
    発行日: 2014/12/20
    公開日: 2014/12/20
    [早期公開] 公開日: 2014/11/18
    ジャーナル フリー
    A devastating psychiatric disorder, schizophrenia is characterized by three major symptoms, positive and negative symptoms and cognitive deficit. Almost all current therapeutic drugs for schizophrenia have efficacy for positive symptoms, and weak efficacy for negative and cognitive deficit. In particular, social withdrawal, diminished motivation, and anhedonia as the depressive aspects of negative symptoms are resistant to the treatment of antipsychotic drugs. Therefore, there is a need for development of new therapeutic drugs for negative symptoms of schizophrenia, and it is necessary to have comprehensive animal models to understand the neurobiological foundations of their symptoms. In this review, we represent the behavioral phenotypes in available animal models of schizophrenia for drug discovery, focusing on the depressive aspects of negative symptoms. We mention here animal models based on the pathology and epidemiology of schizophrenia, e.g., the pharmacological, neurodevelopmental, genetic, and gene-environment combination models. The animal models of schizophrenia are developed by various approaches and are assessed, but there are few models demonstrating negative symptoms with sensitivities to available therapeutic drugs. The development of comprehensive animal model reflecting negative symptoms and of novel compounds that can remedy them provide certain insight into the neurobiological process of schizophrenia and also point the way to a new therapeutic strategy.
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