Language：English   Publishing type：Research paper (scientific journal)  

AIMS: Body dissatisfaction (BD) is a serious problem related to the incidence of eating disorders. Social media (SM) use is known to be associated with BD. With a view to preventing the incidence of eating disorders, this study aimed to investigate the association between SM and BD, particularly, the role of SM in the encouragement of thinness and its relationship with adolescent girls' BD. METHODS: Junior high school girls aged 12-15 in Japan completed the Body Shape Questionnaire (BSQ), Eating Attitudes Test-26, Bulimic Investigatory Test Edinburgh, Depression Self-Rating Scale for Children, and SM usage. Participants were classified into two groups based on their BSQ cut-off score. RESULTS: Overall, 161 students were recruited (44 participants with BD; 117 without BD). The BD group used SM more than the non-BD group (χ2 (1) = 4.61, p = .032). The frequency of following SM accounts related to thinness was significantly higher in the BD group than in the non-BD group (χ2 (1) = 7.76, p = .005). The association between BD and following SM accounts focused on thinness was the most important (adjusted OR = 3.82; 95 % CI: 1.05-13.89). CONCLUSIONS: The risks of SM use increasing BD in adolescent girls should be considered to prevent mental disorders, including eating disorders.

DOI： 10.1016/j.eatbeh.2022.101685

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In recent years, concerns about internet addiction (IA) among children have been increasing. This study focused on the awareness of IA in elementary school teachers. A web-based anonymous survey was conducted in November 2021. The participants completed an original questionnaire about their awareness of IA. The participants were divided into three groups based on their positions in the classroom: class teachers, support teachers, and administrative teachers. Out of 283 participants, over 70% had not approached students with IA and had little practical knowledge about the disorder. Support and administrative teachers had more opportunities to interact with students with IA than class teachers (p < 0.001 in both cases). Support teachers had more opportunities to ask their colleagues about IA than class teachers (p < 0.01); similarly, administrative teachers also had more opportunities to discuss IA with colleagues than class teachers (p = 0.04). Preventive interventions are recommended for people who communicate with children with IA. Students with IA might cause anxiety among teachers; therefore, preventive education strategies should be implemented with the cooperation of psychiatrists, psychologists, and public health nurses.

DOI： 10.3389/fpsyt.2023.1187387

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DOI： 10.1080/02673843.2022.2091939

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Esports (electronic sports) programs are a variant of competitive gaming and have expanded worldwide in recent years. The prevalence of problematic gaming and gaming disorders (GD) is predicted to increase in adolescents. Children with autism spectrum disorder (ASD) have a high rate of digital gaming use, and their characteristics, such as social communication deficits and restricted interests, might contribute to problematic gaming. In this study, we aimed to examine whether participation in an Esports program would lead to problematic gaming or GD in children with ASD. The Internet Gaming Disorder Test (IGD-20) scores, Kid-KINDL scores, and gaming time at home were assessed in eight children with ASD before beginning the Esports program and at the three-month follow-up timepoint. The program was held once a week at the welfare service center, where the participants played a set game for 60 min. The results indicated there was no significant worsening in any of the scores after the program. Our program provided the participation time and frequency of Esports, type of game, and motivation of the participants are adequately considered. Even though this pilot study is limited by the small sample size, we concluded that the risk of these activities leading to problematic gaming might be low.

DOI： 10.3390/bs12060172

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Language：Japanese   Publisher：(公社)日本精神神経学会  

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Language：Japanese   Publisher：(公社)日本精神神経学会  

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Language：Japanese   Publisher：(公社)日本精神神経学会  

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Overadaptation, the behavior of individuals who follow the expectations of others as perfectly as possible, is often observed and related to maladjustment, school refusal, and physical symptoms; however, no method has been proposed yet to assess the overadaptive tendency. This study evaluated the efficacy of the draw-a-man test as a projective measure of overadaptation in community children. METHODS: Eighty children (36 boys, 44 girls) aged 6-8 years were assessed for their ability to draw a man using the Goodenough Draw-A-Man Test (DAM test). Class teachers were asked to assess whether the child was overadapting. The total and subscale DAM scores and pass rates were compared between children with a teacher-assessed tendency for overadaptation and control children, separately for girls and boys. RESULTS: The mean total DAM score was significantly higher for girls versus boys for both the overadapting children and controls. For boys, no significant differences on the total and subscale DAM scores were noted between the overadapting boys and controls. Conversely, for girls, total and three subscale DAM scores (Mouth/Nose/Ears, Hairs, Fingers) were significantly higher in the overadapting girls versus controls. Moreover, for girls, the DAM pass rates on five items (ratio of head; ears present; position and shape of nose; depiction of hair, not to see the scalp; details of fingers) were higher in the overadapting girls versus controls. CONCLUSIONS: The DAM test could extract the overadaptive tendencies of girls aged 6-8 years.

DOI： 10.1111/ped.14919

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Language：Japanese   Publisher：日本うつ病学会・日本認知療法・認知行動療法学会  

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Language：Japanese   Publisher：日本うつ病学会・日本認知療法・認知行動療法学会  

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Language：English   Publishing type：Research paper (scientific journal)  

Children with autism spectrum disorder (ASD) could experience more stress due to the changes consequent to school closures because of the coronavirus disease 2019 (COVID-19) pandemic. This study investigated differences in behavioral affect between children with ASD and typically developing children (TD). We conducted an online survey with mothers. The data of 84 children with ASD and 361 TD children aged 6 to 18 years were analyzed. Children with ASD were more frustrated due to the changes in their schedule and engaged more in restricted and repetitive behavior. Children with ASD had different types of behavioral affect compared to TD.

DOI： 10.1080/87565641.2021.1939350

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BACKGROUND: Sleep is essential for mental health at all ages, but few studies have investigated the importance of sleep for mental health in early childhood. Therefore, this study examined the association between mental health and sleep habits/problems in children aged 3-4 years. METHODS: Children aged 3 to 4 years who were living in the community (n = 415; 211/204 boys/girls) were recruited for this study. Their mental health was assessed using the Strengths and Difficulties Questionnaire (SDQ), and their sleep habits/problems were evaluated using the Child and Adolescent Sleep Checklist. RESULTS: Based on the total difficulties score of the SDQ, the children were divided into two groups: a poor mental health group (n = 76) and a control group (n = 339). In terms of sleep habits, which included total sleep time, bedtime, wake time, and nap conditions, there were no differences between the two groups. Regarding sleep-related problems, however, anxiety before going to sleep (p = 0.026), circadian rhythm abnormalities (p = 0.014), and sleepiness during classes outside of naptimes (p = 0.031) were significantly higher in the poor mental health group than in the control group. Multiple regression analysis showed that poor mental health status was significantly associated with sleepiness and snoring (p = 0.017 and p = 0.018, respectively). CONCLUSIONS: The mental health status of 3-4-year-old children was associated with sleep-related problems, namely sleepiness and snoring. Healthcare providers should pay attention to children's irregular sleep-wake patterns; moreover, interventions for appropriate sleep hygiene will reduce the psychological burden on both children and their families.

DOI： 10.1186/s13030-021-00213-2

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Authorship：Lead author   Publishing type：Research paper (scientific journal)   Publisher：MDPI AG  

The purpose of this study was to elucidate the relationship between the severity of Internet addiction and various media-related applications. The participants were junior high school students between 12 and 15 years old. A total of 529 students (283 males, 246 females) were included. The participants answered Young’s Internet Addiction Test (IAT) and a structural questionnaire about their access to electronic devices and applications. An Internet addiction prevalence of 4.3% (95% CI: 2.8–6.5%) was reported in this study, with an additional 26.3% (95% CI: 22.6–30.2%) of participants possibly addicted. The accessibility of gaming devices was significantly higher in male students than in female students. The use of applications for SNSs was significantly higher in female students than in male students. Twitter accessibility was a factor that contributed to Internet addiction in both genders. The prevalence of severe Internet addiction among school students in Japan was 4.3%, and Twitter was the most important factor associated with this addiction. Media literacy must be increased in adolescents and their friends, teachers, and families.

DOI： 10.3390/ijerph18094844

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BACKGROUND: Autism spectrum disorder (ASD) is characterized as a neurodevelopmental disorder, and one of the main hypotheses regarding its cause is genetic factors. A previous meta-analysis of seven microarray studies and one RNA sequencing (RNA-seq) study using the blood of children with ASD identified dysregulation of gene expressions relevant to the immune system. In this study, we explored changes in global gene expression as the phenotype of ASD in the blood of adults with ASD. METHODS: We recruited an RNA-seq cohort (ASD vs. control; n = 6 each) and a replication cohort (ASD vs. control; n = 19 each) and conducted RNA-seq to explore changes in global gene expression. We then subjected the significantly up- and downregulated genes to gene ontology (GO) and core analyses. Weighted gene correlation network analysis (WGCNA) was performed with all 11,617 genes detected in RNA-seq to identify the ASD-specific gene network. RESULTS: In total, 117 significantly up- and 83 significantly downregulated genes were detected in the ASD compared with the control group, respectively (p < 0.05 and q < 0.05). GO analysis revealed that the aberrant innate and adaptive immunity were more obvious in the 117 upregulated than in the 83 downregulated genes. WGCNA with core analysis revealed that one module including many immune-related genes was associated with the natural killer cell signaling pathway. In the results for the replication cohort, significant changes with same trend found in RNA-seq data were confirmed for MAFB (p = 0.046), RPSAP58 (p = 0.030), and G2MK (p = 0.004). LIMITATIONS: The sample size was relatively small in both the RNA-seq and replication cohorts. This study examined the mRNA expression level, so the interaction between mRNA and protein remains unclear. The expression changes between children and adults with ASD were not compared because only adults with ASD were targeted. CONCLUSIONS: The dysregulated gene expressions confirmed in the blood of adults with ASD were relevant to the dysfunction of innate and adaptive immunity. These findings may aid in understanding the pathogenesis of ASD.

DOI： 10.1186/s12974-021-02154-7

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Authorship：Lead author   Publishing type：Research paper (scientific journal)   Publisher：SAGE Publications  

Objective. The perception of emotion and behavior is different between adolescents and their parents. Parent-adolescent agreement on emotional and behavioral problems has not been well researched. The aim of this study was to explore and compare how well the information from themselves matches with the judgments by their parents in terms of emotional and behavioral problems. Methods. The cross-sectional study was conducted using the self-report and parent-report Strengths and Difficulties Questionnaire (SDQ). A total of 1254 Japanese school adolescents aged 12 to 18 and their parents were assessed almost the same time. The results were analyzed using the paired t-test and 2-way analysis of variance for the discrepancies of parent-adolescent agreements in each age and gender groups. Results. Adolescents obtained higher total difficulty and all subscales scores of SDQ than their parents. The effect of grade on the self/parent discrepancy scores were significantly observed on the conduct problems ( P &lt; .001), hyperactivity ( P = .009), and prosocial behavior ( P &lt; .001). The effect of gender was shown significantly on the emotional problems ( P &lt; .001), conduct problems ( P &lt; .001), and peer problems ( P = .002). Conclusion. Adolescents reported more problems than their parents did. For comprehensive evaluation of adolescents’ mental health, it is necessary to draw information from both the adolescents themselves and their parents, and pay attention to the gap between adolescents and their parents’ perception.

DOI： 10.1177/2333794X211001245

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Other Link： http://journals.sagepub.com/doi/full-xml/10.1177/2333794X211001245

Language：English   Publishing type：Research paper (scientific journal)  

School closure due to coronavirus disease 2019 (COVID-19) pushed children across ages and nationalities into a state of mental health crisis. In Japan, children between the ages of 6 and 18 were ordered to stay at home and observe social distancing for several months. This study is aimed at investigating the effects of quarantine due to COVID-19 on children belonging to different developmental stages in life. Data were collected from mothers of typically developing children aged between 6 and 18 years. The differences in psychological and behavioral changes following school closure during the COVID-19 pandemic were explored. A total of 535 children, including 145 students in lower grades of elementary school (6-9 years), 124 students in higher grades of elementary school (9-12 years), 132 students in junior high school (12-15 years), and 134 students in high school (15-18 years), were recruited. Children in lower grades of elementary school (lower grades group) gained significantly lower understanding about COVID-19 and the necessity of COVID-19 restrictions than children in the other groups. Moreover, they had more psychological problems: they easily cried and complained, were unable to keep calm, and were dependent on parents and family members. Changes in sleep patterns were more prevalent in junior and senior high school students. We concluded that mental health care should be provided based on the growth period of each child not only during school closure but also after school reopening.

DOI： 10.1155/2021/5567732

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Authorship：Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

Sleep disturbances are the comorbid conditions most frequently associated with autism spectrum disorder (ASD). Sleep problems might precede and worsen the behavioral outcomes of ASD. This study examined the association between sleep habits/problems and autistic traits in toddlers. Eighteen-month-old toddlers (N= 426; boys/girls, 204/222) were assessed for autistic traits using the Japanese version of the Modified Checklist for Autism in Toddlers and sleep habits/problems using the Child and Adolescent Sleep Checklist during health checkups. There were no significant differences in sleep habits, including total sleep time, wake time, bedtime, and naps, between autistic toddlers (n= 26) and non-autistic toddlers (n= 400). However, toddlers with autistic traits more commonly exhibited bedtime resistance, abnormality in circadian rhythm, and sleepiness outside of naptime than toddlers without autistic traits. Moreover, autistic traits were significantly associated with daytime sleepiness. Autistic traits are associated with sleep problems in toddlers. In particular, daytime sleepiness might be avisible symptom that enables the earlier detection of ASD in children.

DOI： 10.1080/87565641.2020.1865357

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Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Frontiers Media SA  

Internet use in the youth has increased manifold during the coronavirus disease 2019 (COVID-19) pandemic. Individuals with autism spectrum disorder (ASD) generally have a higher risk of problematic internet use. The aim of this study is to investigate the differences in internet and related digital media use between children with ASD and their typically developing counterparts during the COVID-19 pandemic. In this online survey in Japan conducted from April 30 to May 8, 2020, we analyzed digital media time of 84 children with ASD and 361 age- and gender-matched controls before and after school closure. Digital media use duration was significantly longer in the ASD group than in the control group before the pandemic. The increase of media use time was more prominent in the control group than in the ASD group. We observed excessive Internet use among children with ASD and without ASD, especially during the COVID-19 pandemic. It is necessary to establish strategies to prevent excessive internet use in not only children and adolescents with ASD but also without ASD in the post-pandemic world.

DOI： 10.3389/fpubh.2020.609347

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Language：Japanese   Publisher：(株)ワールドプランニング  

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Language：Japanese   Publisher：(公社)日本精神神経学会  

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Language：Japanese   Publisher：日本神経精神薬理学会・日本生物学的精神医学会・日本精神薬学会  

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Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Internet addiction is a serious problem, and the incidence has increased significantly in recent years. In two cross-sectional studies over a 4-year period, we investigated Internet addiction in adolescents and evaluated the resulting changes in their lives. METHODS: Junior high-school students (aged 12 to 15 years) were assessed in 2014 (survey I) and in 2018 (survey II). They filled out Young's Internet Addiction Test (IAT), the Japanese version of the General Health Questionnaire, and a questionnaire on sleep habits and usage of electric devices. RESULTS: In total, 1,382 students were recruited for the two surveys. The mean IAT score was significantly higher in survey II (36.0 ± 15.2) than in survey I (32.4 ± 13.6) (P < 0.001). The increase in total IAT score indicates that the rate of Internet addiction was significantly higher in 2018 than in 2014. For each subscale of the General Health Questionnaire, social dysfunction scores were significantly lower in survey II than in survey I (P = 0.022). During the weekend, mean total sleep time was 504.8 ± 110.1 min, and the time awake was 08:02 h in survey II; the total sleep time and time awake were significantly longer and later, respectively, in survey II than in survey I (P < 0.001, P = 0.004, respectively). Smartphone use was also significantly higher in survey II than in survey I (P < 0.001). CONCLUSIONS: The prevalence of Internet addiction differed over the 4 years of this study.

DOI： 10.1111/ped.14250

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Authorship：Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

Children are increasingly exposed to electronic media, which can potentially influence their sleep habits. However, few studies have investigated the effects of children's life patterns on sleep habits and electronic media usage. This study investigated the differences in sleep habits and electronic media usage between 18- and 42-month-old children attending nursery schools, kindergartens, or staying at home, and respectively enrolled 183 (boys, n = 93; girls, n = 90) and 215 (boys, n = 104; girls, n = 111) 18- and 42-month-old children who underwent health check-ups. We found that 18-month-old children attending nursery school had significantly earlier wake times on weekdays and shorter sleep durations on weekends than children who stayed at home despite no differences in electronic media usage. There were no differences in sleep duration among 42-month-old children attending nursery schools, kindergartens, or staying at home; however, kindergarteners demonstrated a higher use of portable and home video games. Different life patterns affect electronic media usage in preschool children, especially those attending kindergarten. Particular attention should be paid to the higher usage of electronic media devices by kindergarteners, although they had the same sleep duration, as did other preschool children.

DOI： 10.3390/ijerph17145189

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Language：Japanese   Publisher：(株)医学書院  

＜文献概要＞愛媛大学医学部附属病院は2015年4月に子どものこころセンターを開設した。本調査では,開設後2年間の初診患者の動向を明らかにすることを目的に,後方視的に調査を行った。初診患者は1〜15歳の292例(男性192例,女性100例)であった。約9割が紹介受診であり,最も多い紹介元は院外の小児科(49.7%)であった。ICD-10に基づいて行った診断では,F8が最も多く(43.6%),F4,F9と続いた。2017年3月現在の転帰は,治療継続中が150例(51.4%)で,その3/4が発達障害圏の患者であった。センター化したことで,初診患者数が増加し,低年齢化した。また,小児科からの紹介が増加し,発達障害圏を中心に患者が集約されていた。しかし,地域と当センターの連携の不十分さなどの課題も明らかとなり,今後のセンターのあり方について模索中である。

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Language：Japanese   Publisher：(株)医学書院  

＜文献概要＞愛媛大学医学部附属病院は2015年4月に子どものこころセンターを開設した。本調査では,開設後2年間の初診患者の動向を明らかにすることを目的に,後方視的に調査を行った。初診患者は1〜15歳の292例(男性192例,女性100例)であった。約9割が紹介受診であり,最も多い紹介元は院外の小児科(49.7%)であった。ICD-10に基づいて行った診断では,F8が最も多く(43.6%),F4,F9と続いた。2017年3月現在の転帰は,治療継続中が150例(51.4%)で,その3/4が発達障害圏の患者であった。センター化したことで,初診患者数が増加し,低年齢化した。また,小児科からの紹介が増加し,発達障害圏を中心に患者が集約されていた。しかし,地域と当センターの連携の不十分さなどの課題も明らかとなり,今後のセンターのあり方について模索中である。

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Authorship：Lead author   Language：English  

DOI： 10.1111/pcn.13090

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Language：Japanese   Publisher：(株)世論時報社  

自閉スペクトラム症(Autism Spectrum Disorder:ASD)の診断には、社会的コミュニケーション障害の評価が必須であるが、その手法はまだ十分に確立されているとはいえない。本研究では、絵画欲求不満テスト(Picture Frustration Study:P-Fスタディ)に着目し、ASDのスクリーニングツールとして有用性についてどうかを検討した。地域中学生と中学生ASDを対象として、P-Fスタディ児童版の集団一致度、アグレッションの型と方向、U反応数とその特徴について比較検討を行った。中学生ASD16名(M:F=11:5、平均13.63±0.60歳)及び地域中学生43名(M:F=24:19、平均14.0±1.00歳)である。ASD群では集団一致度が有意に低値(p<.01)であった。アグレッション型では要求固執(N-P)が有意に低値であり(p<.01)、アグレッション方向は他責が有意に高値であり(p<.05)、自責(I-A)と無責(M-A)が有意に低値であった(p<.01)。U(Unscorable:評価不可能)反応数は、ASDが有意に多く、中でも意味不明反応がコントロール群に比べて有意に多いことを確認した(p<.01)。以上よりP-Fスタディ反応は、ASDの問題解決の方略の乏しさと関連する結果となり、ASDの社会的コミュニケーション障害のスクリーニングツールとしての有用性が示された。(著者抄録)

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Language：English   Publishing type：Research paper (scientific journal)  

CTL-associated antigen 4 (CTLA4) and its downstream signals compose an important mechanism that suppresses immune activity. Recent studies have shown that immune abnormalities are associated with the pathogenesis of schizophrenia (SCZ), but little research has been performed on the relevance of CTLA4 and SCZ. In the present study, we investigated the relationship between CTLA4 mRNA expression and SCZ. We examined the expression of CTLA4 mRNA in blood from patients with SCZ, bipolar disorder (BD), and major depressive disorder (MDD). We compared 50 SCZ subjects, 46 BD subjects, and 63 MDD subjects with age- and sex-matched healthy controls (HCs). Quantitative real-time PCR was performed to examine CTLA4 mRNA expression in peripheral blood using TaqMan probes. Levels of CTLA4 mRNA expression were significantly lower in patients with SCZ compared with HCs (p < 0.001), whereas no differences were found between affective disorder (BD and MDD) patients and HCs. We analyzed the correlation between CTLA4 mRNA expression and clinical parameters, but no significant correlation was found. The expression of CTLA4 mRNA was lower specifically in SCZ, suggesting that abnormal CTLA4 expression may be particularly related to the pathogenesis of SCZ. CTLA4 may be a useful diagnostic marker and a potential therapeutic target of SCZ.

DOI： 10.1016/j.ajp.2020.102112

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Introduction: Although ATP-binding cassette sub-family A member 7 gene (ABCA7) is known to be associated with Alzheimer's disease, the relationship between ABCA7 and schizophrenia has been unknown. Methods: Schizophrenia patients (n = 50; 24 males, 62.1 ± 0.50 years old) and age- and sex-matched healthy controls (n = 50) were recruited for the mRNA analysis. Additionally, a case-control study for the rs3764650 genotypes was performed with 1308 samples (control subjects; n = 527, schizophrenia patients; n = 781). All participants were Japanese, unrelated to each other, and living in the same area. Results: The distributions of the rs3764650 genotypes in schizophrenia patients were not different from that of controls. However, the ABCA7 mRNA expression levels in schizophrenia patients were significantly higher than those in controls by a logistic regression analysis. Additionally, the ABCA7 mRNA expression levels in schizophrenia patients were correlated with the rs3764650 genotypes in a dose-dependent manner. Discussion: The ABCA7 mRNA expression levels in peripheral blood with the rs3764650 genotypes may be related to pathological mechanisms in schizophrenia and may be a biological marker for schizophrenia.

DOI： 10.2147/NDT.S238471

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Language：English   Publishing type：Research paper (scientific journal)  

Background: Few studies have explored school refusal in children with autism spectrum disorder (ASD), despite being considered a serious problem. One of the leading causes of school refusal is bullying, which is defined by the feelings of students who are bullied or not, and psychological suffering caused by a psychological or physical attack. This study investigated the characteristics of school refusal in children with ASD. Methods: A total of 94 outpatients with school refusal and ASD and 143 outpatients with school refusal without ASD aged 6-18 years were included. Chi squared tests and Mann-Whitney tests were used to compare the characteristics of school refusal in children with and without ASD. Univariate and multivariate logistic regression analyses were performed to analyze the reasons for school refusal in children with ASD by sex. Results: School refusal significantly occurred earlier in children with ASD than in those without. In addition, "bullying" was significantly associated with school refusal in both boys and girls with ASD. Conclusions: These findings suggest that school refusal should be monitored early in children with ASD. The importance of recognizing bullying among children with ASD should be highlighted as an opportunity for early intervention.

DOI： 10.1186/s13034-020-00325-7

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Language：Japanese   Publisher：(一社)日本児童青年精神医学会  

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Language：Japanese   Publisher：(一社)日本児童青年精神医学会  

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Language：Japanese   Publisher：(一社)日本児童青年精神医学会  

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Language：Japanese   Publisher：(一社)日本児童青年精神医学会  

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Language：Japanese   Publisher：(一社)日本児童青年精神医学会  

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Language：Japanese   Publisher：(一社)日本児童青年精神医学会  

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Language：English  

DOI： 10.1111/pcn.12935

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Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVE: This study examined the association between sleep habits and problems and Internet addiction in adolescents. METHODS: Junior high school students from a local town in Japan (n=853; male/female, 425/428) were the subjects of this study, and were assessed for severity of Internet addiction and sleep habits and problems using the self-reported version of the Young's Internet Addiction Test (IAT) and Child and Adolescent Sleep Checklist (CASC). RESULTS: The wake time on weekdays was not significantly different among the three groups; addicted, possibly-addicted, and non-addicted. In the addicted group, the total night sleep time was significantly shorter, and the bedtime was significantly delayed on both weekdays and weekends compared with those in the possibly-addicted and non-addicted groups. The wake time of the addicted group was significantly later than that of the other groups. The total scores of sleep problems measured by the CASC were significantly higher in the addicted and possibly-addicted groups than in the non-addicted group. CONCLUSION: Internet addiction is strongly associated with sleep habits and problems in adolescents. These findings suggest that internet addiction should be considered while examining adolescent lifestyle.

DOI： 10.30773/pi.2019.03.21.2

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AIM: Several studies have reported that internet addiction (IA) is more prevalent in adolescents with autism spectrum disorder (ASD). However, the characteristics of ASD adolescents with IA are unclear. The objective of this study was to investigate the prevalence of IA in ASD adolescents, and compare the characteristics between the IA and the non-IA groups in adolescents with ASD. METHODS: The study included 55 participants who were outpatients at Ehime University Hospital and Ehime Rehabilitation Center for Children in Japan, aged 10-19 years, diagnosed with ASD. Patients and their parents answered several questionnaires including the Young's Internet Addiction Test (IAT), Strengths and Difficulties Questionnaire (SDQ), Autism Spectrum Quotient (AQ), and Attention Deficit Hyperactivity Disorder Rating Scale-IV (ADHD-RS). RESULTS: Based on the total IAT score, 25 out of 55 participants were classified as having IA. Although there were no significant differences in AQ and Intelligence Quotient, the higher scores of ADHD symptoms in SDQ and ADHD-RS were observed in the IA group than the non-IA group. The IA group used portable games more often than the non-IA group. CONCLUSION: The ADHD symptoms were strongly associated with IA in ASD adolescents. More intensive prevention and intervention for IA are needed especially for the ASD adolescents with ADHD symptoms.

DOI： 10.1016/j.ridd.2019.03.002

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OBJECTIVES: Ghrelin regulates appetite and also plays important roles in cognition and may be involved in vulnerability to SCZ. METHODS: In this study, we measured mRNA expression of the ghrelin-related molecules, growth hormone secretagogue receptor 1a (GHS-R1a) and 1b (GHS-R1b), and the ghrelin activator, membrane bound O-acyltransferase 4 (MBOAT4). Peripheral leukocytes from Japanese patients with SCZ (n = 49; 23 males, 26 females; age = 61.8 ± 13.3 years) and controls (n = 50; 25 males, 25 females; age = 62.0 ± 14.3 years) were recruited according to their clinical information. We also studied the DNA methylation rates of these genes in DNA from leukocytes. RESULTS: The mRNA expression of GHS-R1a was significantly decreased in SCZ (SCZ vs. control: 0.35 ± 0.081 vs. 1.00 ± 0.059, respectively, p = 0.007), but expression levels of GHS-R1b and MBOAT4 were significantly increased in SCZ (SCZ vs. control: 2.02 ± 0.91 vs. 1.00 ± 0.32, p = 0.023, 1.37 ± 0.21 vs. 1.00 ± 0.11, respectively, p = 0.014). No differences in methylation rates for any genes were found. CONCLUSION: We conclude that opposite expression of GHS-R1a and GHS-R1b, and elevated MBOAT4 mRNA expression may reflect the mechanisms of SCZ.

DOI： 10.1016/j.psychres.2018.12.135

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Language：Japanese   Publisher：(一社)日本児童青年精神医学会  

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Language：Japanese   Publisher：(公社)日本精神科病院協会  

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Language：Japanese   Publisher：(一社)日本児童青年精神医学会  

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Language：Japanese   Publisher：(一社)日本児童青年精神医学会  

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BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is characterized by inattention and hyperactivity/impulsivity, and is often treated pharmacologically. It is necessary to use both subjective and objective assessments to diagnose and determine the efficacy of pharmacological treatment in children with ADHD, but cognitive assessment tools for ADHD are scarce. We examined a computer-administered, brief, and repeatable cognitive assessment tool: CogHealth. The aims of this study were to use the CogHealth battery, an objective assessment tool, to compare cognitive function between children with ADHD or ADHD + autism spectrum disorder (ASD) and healthy children and to assess improvements in cognitive function following pharmacological treatment. METHODS: We measured the cognitive function of nine children with ADHD or ADHD + ASD using CogHealth and compared the results with those of 33 age-matched children from the community. Cognitive function comparisons were made before and after psychostimulant treatment with methylphenidate. RESULTS: We detected significant cognitive abnormalities in the children with ADHD, compared with the control subjects. The children with pre-treatment ADHD had significantly more errors on the detection task (DT), and more anticipatory errors in the one card learning task, compared with control children. The children with ADHD significantly improved their accuracy on the one back test (OBT), and had significantly fewer errors, anticipatory errors, and shorter reaction times after osmotic-release oral system methylphenidate treatment. CONCLUSION: The DT is a useful neurocognitive function assessment for children with ADHD, and the OBT can measure pharmacological treatment effectiveness in children with ADHD.

DOI： 10.1111/ped.13662

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Language：Japanese   Publisher：(公社)日本精神神経学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：MARY ANN LIEBERT, INC  

Objectives: Suvorexant is the first dual orexin receptor antagonist for treating insomnia. This study aimed to evaluate the tolerability, efficacy, and safety of suvorexant on insomnia in adolescents. Methods: Thirty patients (8 male and 22 female; mean standard deviation age: 15.72.4 years; range: 10-20) with insomnia were administered suvorexant. Clinical background, persistence rate, the Clinical Global Impression (CGI), and the Athens Insomnia Scale (AIS) were compared between patients who continued and discontinued suvorexant treatment. Results: Seventeen patients (56.7%) successfully continued taking suvorexant. Among the 13 patients who did not continue treatment, 5 patients were lost to follow-up. Of the remaining eight who did not continue treatment, four decided to discontinue of their own accord, two decided to discontinue due to lack of effectiveness, and two decided to discontinue due to adverse reaction, namely abnormal dreams. Among patients who completed the study, CGI significantly decreased from 3.6 +/- 0.8 to 3.1 +/- 0.9 (p=0.014). The score of sleep quality in AIS was significantly higher among the patients who discontinued suvorexant than those who continued suvorexant (p=0.02). Conclusion: Our results indicate that suvorexant could be considered a treatment option for adolescents.

DOI： 10.1089/cap.2016.0206

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Language：Japanese   Publisher：(一社)日本児童青年精神医学会  

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Language：Japanese   Publisher：(一社)日本児童青年精神医学会  

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Language：Japanese   Publisher：(一社)日本児童青年精神医学会  

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Language：Japanese   Publisher：(一社)日本児童青年精神医学会  

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Language：Japanese   Publisher：(公社)日本精神神経学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

BackgroundAutism spectrum disorders (ASD) are characterized by persistent deficits in social communication and social interaction across contexts, and are associated with restricted patterns of behavior. The developmental quotient (DQ) is based on the developmental age and chronological age of children. This study investigated the utility of the DQ to estimate cognitive ability in young children with ASD.
MethodsThe DQ and intelligence quotient (IQ) were assessed using the Kyoto Scale of Psychological Development 2001 (KSPD) and Wechsler Intelligence Scale for Children-III (WISC-III), respectively. The correlation between the DQ and IQ was then analyzed among children with ASD.
ResultsWe enrolled 18 children with ASD (16 boys, two girls; age, 63.6 9.4 months; age range, 45-83 months). Overall, Cognitive-Adaptive and Language-Social DQ scores were significantly correlated with IQ score in the full scale, verbal, and performance domains. Full-scale IQ and overall DQ had a linear correlation (y = -22.747 + 1.177x, R-2 = 0.677, R = 0.823).
ConclusionsThe DQ scores obtained using the KSPD were a reasonable estimate of cognitive ability in children with ASD. The KSPD may be a useful alternative to the WISC-III for young children with ASD and could facilitate earlier assessment.

DOI： 10.1111/ped.12969

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Language：Japanese   Publisher：(一社)日本児童青年精神医学会  

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Language：Japanese   Publisher：(一社)日本児童青年精神医学会  

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Language：Japanese   Publisher：(一社)日本児童青年精神医学会  

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Language：Japanese   Publisher：(一社)日本児童青年精神医学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：BIOMED CENTRAL LTD  

Background: The lowering of the age of onset and chronicity have been key problems related to eating disorders (EDs). As the proportion of teens in the estimated onset ages has increased, it has become important to detect students with EDs and to clarify how they can be supported. Though epidemiological surveys of Yogo teachers (school nurse/health science teachers) have been conducted to inquire about the number of such students, none of these were done according to ED type based on DSM-5. Thus, we conducted a wide area survey in Japan with the goal of proposing a better framework of support for Yogo teachers in their efforts to care for students with EDs.
Methods: A questionnaire survey organized by ED type (based on DSM-5) was administered to Yogo teachers working at elementary/junior high/senior high/special needs schools in four prefectures of Japan in 2015, and 1,886 responses were obtained. Based on the results, the encounter rates (the proportion of Yogo teachers who had encountered a student with an ED) were calculated, and factors that could affect the rates were examined by logistic regression analysis.
Results: The order of the encounter rates of the ED types was as follows: Anorexia Nervosa (AN) &gt; Bulimia Nervosa (BN) &gt; Avoidant/Restrictive Food Intake Disorder (ARFID) &gt; Binge Eating Disorder (BED) &gt; Others. The factors significantly affecting the rates were "location, school type, number of students, experience years, and AN knowledge" for AN, "school type, experience years, and BN knowledge" for BN, "school type, experience years, and BED knowledge" for BED, "location, experience years, and ARFID knowledge" for ARFID, and "school type, experience years, and Others knowledge" for Others.
Conclusions: Because the encounter rate of AN was the highest, providing support for AN would be the most effective. Moreover, one factor that affected the encounter rate of all ED types was ED knowledge. In addition to this, senior high schools had the highest encounter rates for AN, BN and BED, and special needs schools had the highest rates for Others. These findings imply that, in order to detect and support ED students at an early stage, it is necessary to offer knowledge of the most prevalent ED types to Yogo teachers at the corresponding school type.

DOI： 10.1186/s13030-016-0079-z

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：TAYLOR & FRANCIS LTD  

Objectives: According to the dopamine hypothesis, several studies on the gene for the dopamine receptor D2 (DRD2) have been conducted. However, no trait biomarkers on DRD2 are available. We examined whether the methylation rates in the upstream region of DRD2 in leukocytes are different in schizophrenia (SCZ) subjects compared to control subjects.Methods: We selected seven CpG sites in the upstream region of DRD2 that may theoretically bind major transcription factors. The methylation rates in these regions of 50 medicated and 18 drug-naive SCZ subjects were compared with those of age-matched control subjects.Results: The methylation rates were significantly lower in medicated (CpG2, P&lt;0.0001; CpG4, P=0.013; CpG7, P&lt;0.0001; and average: 12.91.8 vs. 14.1 +/- 2.2, P=0.005) and drug-naive SCZ subjects (CpG1, P=0.006; CpG2, P =0.001; CpG3, P=0.001; CpG5, P =0.02; CpG6, P=0.015; CpG7, P=0.027; and average: 9.86 +/- 0.9 vs. 11.2 +/- 1.3, P=0.002).Conclusions: We confirmed low methylation rates in the upstream region of DRD2 in both medicated and drug-naive SCZ subjects. Low methylation rates of DRD2 in leukocytes may be a trait biomarker for SCZ.

DOI： 10.1080/15622975.2016.1197424

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

AimInternet addiction disrupts the daily lives of adolescents. We investigated the prevalence of Internet addiction in junior high school students, elucidated the relation between Internet addiction and mental states, and determined the factors associated with Internet addiction in adolescents.
MethodsJunior high school students (aged 12-15 years) were assessed using Young's Internet Addiction Test (IAT), the Japanese version of the General Health Questionnaire (GHQ), and a questionnaire on access to electronic devices.
ResultsBased on total IAT scores, 2.0% (male, 2.1%; female, 1.9%) and 21.7% (male, 19.8%; female, 23.6%) of the total 853 participants (response rate, 97.6%) were classified as addicted and possibly addicted, respectively. Total GHQ scores were significantly higher in the addicted (12.9 7.4) and possibly addicted groups (8.8 +/- 6.0) than in the non-addicted group (4.3 +/- 4.6; P &lt; 0.001, both groups). A comparison of the percentage of students in the pathological range of GHQ scores revealed significantly higher scores in the possibly addicted group than in the non-addicted group. Further, accessibility to smartphones was significantly associated with Internet addiction.
ConclusionStudents in the addicted and possibly addicted groups were considered problematic' Internet users. Use of smartphones warrants special attention, being among the top factors contributing to Internet addiction.

DOI： 10.1111/pcn.12402

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Language：Japanese   Publisher：(一社)日本睡眠学会  

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Backgrounds: Suicide is a leading cause of death in adolescence. Effective strategies are required to prevent suicide. We aimed to assess the prevalence of suicidal ideation in early teens and the relationship between family mental health and suicidal ideation of their child.
Methods: A population-based survey in a rural town included 185 junior high school students and their caregivers. Suicidal ideation and mental states were assessed with General Health Questionnaire (GHQ) and Profile of Mood States (POMS) form.
Results: Nineteen (10.3 %) students experienced suicidal ideation in the preceding weeks and had more mental health problems than students without suicidal ideation. Caregivers of students with suicidal ideation demonstrated significantly higher suicidal depression scores in GHQ. Multivariate logistic regression analysis revealed that suicidal depression of caregivers was the most important factor for suicidal ideation of students.
Conclusions: Suicidal ideation of children is associated with suicidal depression of their caregivers. For the prevention of suicide in adolescents, not only their own mental status but also that of caregivers should be taken into consideration.

DOI： 10.1186/s12888-016-0934-2

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER WIEN  

The pathological mechanisms of schizophrenia (SCZ) have not been clarified, but the microglia hypothesis has recently been discussed. We previously reported that the mRNA for a protein related to activation of microglia, triggering receptor expressed on myeloid cell 2 (TREM2), is expressed higher in peripheral leukocytes in SCZ than controls. In this study, we analyzed TREM2 mRNA expression in leukocytes from both SCZ and major depressive disorder (MDD) patients. We compared 50 SCZ patients and 42 MDD patients with age-matched controls. Levels of TREM2 mRNA in leukocytes were analyzed with quantitative real-time PCR method using TaqMan probe. TREM2 mRNA expression was significantly higher in leukocytes of SCZ subjects than controls, but the expression level was non-significantly different in MDD subjects. We observed a decrease in TREM2 mRNA expression in leukocytes from one SCZ patient after clozapine treatment. The expression did not change following ECT, but the expression level in this patient was still significantly higher than that in controls. We conclude that the high amount of TREM2 mRNA expression in leukocytes is specific to SCZ but not MDD and that changes in TREM2 mRNA expression may be a trait biomarker for SCZ.

DOI： 10.1007/s00702-016-1560-3

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：PUBLIC LIBRARY SCIENCE  

TREM2 and TYROBP are causal genes for Nasu-Hakola disease (NHD), a rare autosomal recessive disease characterized by bone lesions and early-onset progressive dementia. TREM2 forms a receptor signaling complex with TYROBP, which triggers the activation of immune responses in macrophages and dendritic cells, and the functional polymorphism of TREM2 is reported to be associated with neurodegenerative disorders such as Alzheimer's disease (AD). The objective of this study was to reveal the involvement of TYROBP and TREM2 in the pathophysiology of AD and schizophrenia. Methods: We investigated the mRNA expression level of the 2 genes in leukocytes of 26 patients with AD and 24 with schizophrenia in comparison with age-matched controls. Moreover, we performed gene association analysis between these 2 genes and schizophrenia. Results: No differences were found in TYROBP mRNA expression in patients with AD and schizophrenia; however, TREM2 mRNA expression was increased in patients with AD and schizophrenia compared with controls (P &lt; 0.001). There were no genetic associations of either gene with schizophrenia in Japanese patients. Conclusion: TREM2 expression in leukocytes is elevated not only in AD but also in schizophrenia. Inflammatory processes involving TREM2 may occur in schizophrenia, as observed in neurocognitive disorders such as AD. TREM2 expression in leukocytes may be a novel biomarker for neurological and psychiatric disorders.

DOI： 10.1371/journal.pone.0136835

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Language：Japanese   Publisher：(一社)日本児童青年精神医学会  

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Language：Japanese   Publisher：(一社)日本児童青年精神医学会  

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Language：Japanese   Publisher：(一社)日本児童青年精神医学会  

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Language：Japanese   Publisher：(一社)日本児童青年精神医学会  

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Language：Japanese   Publisher：(一社)日本児童青年精神医学会  

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Language：Japanese   Publisher：(公社)日本精神神経学会  

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Language：Japanese   Publisher：愛媛医学会  

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Common adverse effects of atypical antipsychotic treatments for schizophrenia are weight gain and lipid metabolism abnormality. We aimed to identify the signs of metabolic problems with continuous atypical antipsychotic treatment for schizophrenia over a 2-year period. The participants were 68 schizophrenic patients (29 males, 39 females
ages 53.4 ± 13.5 years old). Changes in carbohydrate metabolism and changes in physical characteristics were studied over a 2-year period. In addition, functional single nucleotide polymorphisms in the transcriptional regulatory region of the resistin gene were examined. We found no changes in the mental state of the participants over a 2-year period. Patients did show a significant decrease in total cholesterol and hemoglobin A1c levels, although physical changes such as body mass index and abdominal girth, were not observed. The amount of resistin may not be associated with mental states and physical parameters. We could not find physical factors related to metabolic changes of antipsychotics in this 2-year study. However, several psychological factors, such as health-related thoughts and behaviors, should be studied in the future. © 2015, SAGE Publications. All rights reserved.

DOI： 10.1177/2045125315596697

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

Aim: Children with autism spectrum disorders (ASD) often present with emotional and behavioral problems, which could change the clinical course, especially during childhood, and affect future quality of life. The aim of this study was to clarify the age- and sex-related differences of these problems in ASD.
Methods: The study subjects were 173 patients with ASD (age: 4-16 years) and 173 age-and sex-matched community children (control group). The parent version of the Strengths and Difficulties Questionnaire was used for comparison of the emotional and behavioral problems between the two groups.
Results: The Strengths and Difficulties Questionnaire scores were significantly higher in children with ASD than controls at all ages. The score of total difficulties was significantly higher in girls with ASD than in boys, while the score in male controls was significantly higher than in female controls. Age-related differences in emotional and behavioral problems were observed both in children with ASD and controls, but the characteristics were different: in children with ASD, emotional symptoms and peer problems in both sexes and conduct problems in girls increased significantly with age, while none of the problems in the controls changed with age except for a decrease in the score of hyperactivity/inattention developmentally in both sexes. Prosocial behaviors of children with ASD and controls showed small changes with age.
Conclusion: Emotional and behavioral problems are common in children with ASD and showed age-and sex-related differences. Our study emphasizes the importance of recognizing those differences among children with ASD for early intervention.

DOI： 10.1111/pcn.12164

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Language：English   Publisher：KOREAN COLL NEUROPSYCHOPHARMACOLOGY  

Acute pancreatitis with antipsychotic treatment is rare but sometimes causes a fatal adverse effect. Most cases of acute pancreatitis due to atypical antipsychotic agents are reported to occur within six months of starting antipsychotic administration. Acute pancreatitis caused by risperidone is rare. The patient had a high fever, stomachache and vomiting. The results of the abdominal computed tomograhpy scan were negative. The results of the abdominal ultrasonography were positive for gallstones in gallbladder and distention of the common bile duct. She had been fasting and received antibiotic intravenous injections. Amylase and lipase titers were high. After risperidone discontinuation, both the levels of the amylase and the lipase were gradually decreased. Three months later, the patient still maintains a good clinical balance. Although atypical antipsychotic-induced pancreatitis has been reported in conjunction with hyperglycemia, the pathophysiologic mechanism of these adverse events remains unclear. This case got pancreatitis 6 month after risperidone treatment. Using the antipsychotic agents, it is necessary to monitor pancreas function.

DOI： 10.9758/cpn.2014.12.1.67

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Children with autism spectrum disorders (ASD), including autistic disorder, frequently suffer from comorbid sleep problems. An altered melatonin rhythm is considered to underlie the impairment in sleep onset and maintenance in ASD. We report three cases with autistic disorder in whom nocturnal symptoms improved with ramelteon, a selective melatonin receptor agonist. Insomnia and behavior, assessed using the Clinical Global Impression-Improvement Scale, improved in two cases with 2 mg ramelteon and in the third case with 8 mg ramelteon. Our findings demonstrate that ramelteon is effective not only for insomnia, but for behavioral problems as well, in patients with autistic disorder.

DOI： 10.1155/2014/561071

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Obstructive sleep apnea syndrome (OSAS) in children does not only present with symptoms of sleep disturbances but also with associated symptoms such as growth failure, enuresis, academic learning difficulties, and behavioral problems, including attention deficit/hyperactivity disorder- (ADHD-) like symptoms. We evaluated neurocognitive functions before and after adenotonsillectomy in a patient with OSAS. An 11-year-old boy suspected of having ADHD with nocturnal enuresis was referred for evaluation. He was found to have adenotonsillar hypertrophy. Presence of snoring was evident only after detailed medical interview. Polysomnography confirmed the diagnosis of OSAS, which was subsequently treated by adenotonsillectomy. The apnea/hypopnea index decreased from 21.9 at baseline to 1.8 after surgery, and the frequency of enuresis fell from almost nightly to 2-3 times per month. Neurocognitive and behavioral assessment after the treatment of OSAS showed significant improvement in cognitive functions, especially attention capacity and considerable amelioration of behavioral problems including ADHD-like symptoms. As the most common cause of pediatric OSAS is adenotonsillar hypertrophy, medical interview and oropharyngeal examination should always be performed in children suspected of having ADHD. The necessity of sleep evaluation for children with ADHD-like symptoms was also emphasized.

DOI： 10.1155/2014/520215

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Language：English   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

Objective: Recently, atypical antipsychotic agents have primarily been used in pharmacological treatment of schizophrenia because of the fewer associated adverse effects. Blonanserin is a novel atypical antipsychotic recently introduced to treat patients with schizophrenia in Japan and South Korea. In this study, we examined the efficacy of switching antipsychotic medications to blonanserin monotherapy in patients with chronic schizophrenia with associated hyperprolactinemia.
Methods: Ten schizophrenic patients (5 males and 5 females) with hyperprolactinemia were recruited. Clinical data before (baseline) and 12 weeks after (end point) switching to blonanserin monotherapy were assessed using the Brief Psychiatric Rating Scale score, Drug-Induced Extrapyramidal Symptoms Scale, and serum prolactin levels.
Results: The mean (SD) blonanserin dosage was 14.8 (3.8) mg/d. After switching to blonanserin, there were significant improvements in the Brief Psychiatric Rating Scale in the patients from both sexes. Moreover, serum prolactin levels in the female patients significantly decreased to within reference range. There were no additional adverse effects observed with the blonanserin treatment.
Conclusions: Switching to blonanserin can reverse medication-induced prolactin elevations found in female patients-and blonanserin is a suitable antipsychotic for schizophrenic patients.

DOI： 10.1097/WNF.0000000000000006

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Language：Japanese   Publisher：(一社)日本児童青年精神医学会  

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Language：Japanese   Publisher：(公社)日本精神神経学会  

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Nocturnal eating/drinking syndrome is characterized by awakening in the middle of the night, getting out of bed, and consuming large quantities of food quickly and uncontrollably. We report a middle-aged male patient with schizophrenia who had nocturnal eating/drinking syndrome with restless legs syndrome whose condition improved with the administration of the herbal medicine Yi-Gan San (Yokukan-San in Japanese).

DOI： 10.1097/WNF.0b013e3182746a5b

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We present a schizophrenic patient who experienced neuroleptic malignant syndrome with risperidone treatment due to variants of the CYP2D6 gene with reduced function. Clinicians need to be aware of this potential complication. © 2011 Elsevier Inc.

DOI： 10.1016/j.genhosppsych.2011.03.003

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Language：Japanese   Publisher：(株)三原医学社  

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Language：English   Publisher：The Japanese Society of Clinical Neuropsychopharmacology  

<p><b>Purpose: </b>Although attention-deficit/hyperactivity disorder (ADHD) has historically been thought to be predominantly a childhood disorder, many cases of ADHD persist into adulthood. Therefore, it is necessary to assess the symptoms and efficacy of medication using objective assessment tools in adults with ADHD. The aim of this study was to assess usefulness of the Clinical Assessment for Attention Test (CAT) comprising Span, Cancellation and Detection Test, Symbol Digit Modalities Test, memory updating test, paced auditory serial addition test, position Stroop test, and continuous performance test (CPT) for adults with ADHD.</p><p><b>Methods: </b>ADHD outpatients without intellectual disorders (IQ ≥ 80) with age range of 20-39 years were recruited (15 males and 10 females; mean age 27.7 ± 5.5). The participants did not receive any psychopharmacological treatment and were assessed with CAT at baseline.</p><p><b>Results: </b>The patients showed significantly decreased attention scores in Cancellation and Detection Test (Visual Cancellation Task and Auditory Detection Task) and CPT, although this decrease was not correlated to age or intelligence quotient. The effect of psychopharmacological treatment was assessed in two participants using CAT.</p><p><b>Discussion: </b>Cancellation and Detection Test and CPT are useful tools to support the diagnosis of adults with ADHD as well as evaluation of the efficacy of psychopharmacological treatment.</p>

DOI： 10.5234/cnpt.11.35

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Language：Japanese   Publisher：(一社)日本老年医学会  

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DOI： 10.20615/jscap.59.4_461

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DOI： 10.11477/mf.1405205600

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Language：Japanese   Publisher：(公社)日本精神神経学会  

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DOI： 10.11477/mf.1405205390

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DOI： 10.20615/jscap.57.4_618

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CiNii Books

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Neurodevelopmental disorders, including attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD), are commonly associated with sleep disturbances. The etiology of sleep disorders is multifactorial, such as congenital vulnerability of the quality and quantity of sleep, congenital abnormality of the sleep-wake pattern, comorbid sleep problems with developmental disorders, and sleep disturbances associated with pharmacological treat- ment. Obstructive sleep apnea disorder (OSAS) and restless legs syndrome (RLS) are closely associated with ADHD. OSAS in children not only presents with symptoms of sleep distur- bances, but also with associated symptoms such as growth failure, neurocognitive and behav- ioral symptoms, ADHD-like symptoms, and enuresis. The first-line treatment is adenotonsillec- tomy. ADHD and RLS show high rates of comorbidity with common etiologies like iron defi- ciency and the alternation of dopamine transporter expression. Hypnotics are not effective for RLS, and a precise diagnosis is vital to treat RLS associated with ADHD. ASD is also associated with a high frequency of sleep disorders, especially insomnia, para- somnia, and sleep-wake disorders. The first strategy against sleep disturbances is behavioral intervention ; however, pharmacological treatment is sometimes needed. In clinical practice, excessive daytime sleepiness was reported in children with ADHD or ASD, which might lead to a deficit in alertness. Alertness deficits associated with neurodevel- opmental disorders remain uncertain, and so they should be assessed. The effect of stimulants on sleep in patients with ADHD differed among individuals, which might be the cause of insomnia and also treatment for ADHD and sleep hygiene. Non-stimu- lants are often effective for insomnia. Neurodevelopmental and sleep disorders are complex and bidirectional. Sleep disturbances should be taken into consideration in daily clinical practice.

PubMed

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DOI： 10.11477/mf.1405102754

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DOI： 10.11477/mf.1405102249

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DOI： 10.11477/mf.1405102179

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DOI： 10.11477/mf.1405101591

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