記述言語：英語   掲載種別：研究論文（学術雑誌）  

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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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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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掲載種別：研究論文（学術雑誌）  

DOI： 10.1080/02673843.2022.2091939

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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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記述言語：日本語   出版者・発行元：(公社)日本精神神経学会  

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記述言語：日本語   出版者・発行元：(公社)日本精神神経学会  

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記述言語：日本語   出版者・発行元：(公社)日本精神神経学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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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記述言語：日本語   出版者・発行元：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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記述言語：日本語   出版者・発行元：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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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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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担当区分：筆頭著者   掲載種別：研究論文（学術雑誌）   出版者・発行元：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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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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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担当区分：筆頭著者   掲載種別：研究論文（学術雑誌）   出版者・発行元：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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その他リンク： http://journals.sagepub.com/doi/full-xml/10.1177/2333794X211001245

記述言語：英語   掲載種別：研究論文（学術雑誌）  

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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担当区分：責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

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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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：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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記述言語：日本語   出版者・発行元：(株)ワールドプランニング  

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記述言語：日本語   出版者・発行元：(公社)日本精神神経学会  

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記述言語：日本語   出版者・発行元：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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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

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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担当区分：責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

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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記述言語：日本語   出版者・発行元：(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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記述言語：日本語   出版者・発行元：(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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担当区分：筆頭著者   記述言語：英語  

DOI： 10.1111/pcn.13090

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記述言語：日本語   出版者・発行元：(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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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：英語  

DOI： 10.1111/pcn.12935

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.30773/pi.2019.03.21.2

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.psychres.2018.12.135

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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：日本語   出版者・発行元：(公社)日本精神科病院協会  

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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1111/ped.13662

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記述言語：日本語   出版者・発行元：(公社)日本精神神経学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：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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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：日本語   出版者・発行元：(公社)日本精神神経学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：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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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：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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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：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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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：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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記述言語：日本語   出版者・発行元：(一社)日本睡眠学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BIOMED CENTRAL LTD  

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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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：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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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：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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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：日本語   出版者・発行元：(公社)日本精神神経学会  

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記述言語：日本語   出版者・発行元：愛媛医学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：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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記述言語：英語   出版者・発行元：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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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1155/2014/561071

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1155/2014/520215

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記述言語：英語   出版者・発行元：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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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：日本語   出版者・発行元：(公社)日本精神神経学会  

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記述言語：英語   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

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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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：日本語   出版者・発行元：(株)三原医学社  

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記述言語：日本語   出版者・発行元：(公社)日本精神神経学会  

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記述言語：日本語   出版者・発行元：(公社)日本精神神経学会  

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記述言語：英語   出版者・発行元：日本臨床精神神経薬理学会  

<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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記述言語：日本語   出版者・発行元：(公社)日本精神神経学会  

インターネットはいまや日常的に必要不可欠なツールとなっており,接続できるデバイスもパーソナルコンピューターのみならず,スマートフォンやタブレット,テレビや携帯型ゲームなどさまざまである.その一方で,インターネット使用の制御が困難となり,生活上の問題をきたすインターネット依存が社会的問題になっている.2018年6月に世界保健機関(WHO)から公表されたICD-11においては,ゲーム障害が収載された.国際的にもインターネット依存およびゲーム障害に関して報告が蓄積されつつある.本稿では,これまでの報告を踏まえ,精神医療におけるインターネット依存の現状について整理する.(著者抄録)

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記述言語：日本語   出版者・発行元：(株)ワールドプランニング  

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記述言語：日本語   出版者・発行元：(株)ワールドプランニング  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語  

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記述言語：日本語   出版者・発行元：(株)アークメディア  

新版K式発達検査2001(KSPD)を用いた発達指数(DQ)がWISC-IVを用いたIQの代替となり得るかについて検討した。自閉スペクトラム症(ASD)の対象者は、2016年7月から2017年3月に愛媛大学医学部附属病院子どものこころセンターを受診した5から10歳の患者のうち、DSM-5の診断基準によりASDと診断され、WISC-IVにより測定されたFSIQが70以上の9名(男児8名、女児1名、平均月齢99.7ヵ月)とした(ASD群)。また、通常学級または一般の幼稚園に通う児童6名(男児3名、女児3名、平均月齢86.2ヵ月)を定型発達群とした。ASD群において、WISC-IVの言語理解とKSPD全領域DQおよび言語・社会DQとそれぞれ0.859、0.872の相関が確認されたが、定型発達児においては、同指標の相関係数は0.162であった。KSPDとWISC-IVから算出されるDQ・IQの関連性は認められるが、DQ・IQの代替や縦断的に評価には慎重を期す必要があることが示唆された。

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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

【背景】摂食障害(Eating Disorder:ED)を取り巻く課題として低年齢化が挙げられているため、EDと疑われる児童・生徒を早期発見して、支援を明確化していくことは重要である。ED児童・生徒の存在を調査する目的で、養護教諭を対象にした有病率調査は行われているが、養護教諭のED支援の状況やDSM-5をもとにした調査は、あまり見られない。【目的】本研究では、養護教諭のDSM-5に基づくEDと思われる児童・生徒の早期発見や対応の現状、支援上のニーズを明らかにすることを目的とした。【方法】千葉、兵庫、愛媛、埼玉県の小・中・高・特別支援学校の養護教諭を対象に、2015年1〜6月にアンケート調査を実施した。EDと思われる児童・生徒を早期発見する実態や、対応する実態、支援する上でのニーズの実態を分析・検討した(1886人)。【結果】EDの児童・生徒の早期発見の手立てとして、養護教諭は、「体重測定の結果」を活用しており、対応では、「教員等に相談」を行っていた。支援のためのニーズでは、「医療機関リスト」が多かった。早期発見・対応の現状の「よくできている」、及び支援のためのニーズの「非常に必要である」のχ2検定後の残差分析では、兵庫県で有意に多い項目が見られた。【結論】EDと思われる児童・生徒をサポートする養護教諭に対する支援として、調査対象の全ての県において、EDについて相談できる機関や医療機関リストを提供することが有用だと思われる。(著者抄録)

DOI： 10.20615/jscap.59.4_461

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記述言語：日本語   出版者・発行元：(株)日本評論社  

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記述言語：日本語   出版者・発行元：(株)医学書院  

＜文献概要＞本研究は愛媛大学病院精神科外来において,成人期発達障害における発達障害の特徴を,診療パスの内容により検討することを目的とした。対象は2013〜16年に当院を初診し,発達障害の精査を希望した18歳以上の患者104名(男性57,女性47)である。診療パスは生育歴の聴取や主訴の問診票と,AQ-J,ASRS,CAARS,BDI-II,SFS,SRSなどの質問紙とWAIS-IIIで構成されている。対象者のうちASD29例,ADHD18例,精神疾患に該当しない18例の3群を比較した。結果,ASD群はADHD群と比較して有意に男性,精神症状の主訴が多く,SFSが低値,WAIS-IIIのVIQが高値であった。ADHD群は不注意の主訴,既婚者の割合,ASRSが有意に高かった。診療パスは精神症状や社会機能の把握に一定の有用性があった。本研究は予備的研究であり,診療パスにはさらなる検討が必要である。

DOI： 10.11477/mf.1405205600

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記述言語：日本語   出版者・発行元：(公社)日本精神神経学会  

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記述言語：日本語   出版者・発行元：(公社)日本精神神経学会  

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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

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記述言語：日本語   出版者・発行元：(公社)日本精神神経学会  

【目的】インターネットは急速に普及し,生活に必要不可欠なものとなりつつある一方,インターネット使用の制御が困難となるインターネット依存が社会的問題になっている.本研究では,中学生におけるインターネット依存の有病率を調査し,インターネット依存と精神的問題の関連および要因の特定を目的とした.【方法】12〜15歳の中学生874名を対象に,インターネット依存度テスト(IAT),日本語版精神健康調査質問紙短縮版30項目(GHQ)に加え,電子機器の使用状況に関する質問紙を行った.【結果】中学生853名(回収率97.6%,男子425名,女子428名)から回答を得た.IATの平均総得点は32.4±13.6(男子31.4±13.2,女子33.3±13.9)であった.IATの重症度分類では,addictedが2.0%(男子2.1%,女子1.9%),possibly-addictedが21.7%(男子19.8%,女子23.6%)であった.IATの得点に影響する因子は,学年(P=0.001)とGHQ総得点(P<0.001)が有意であった.GHQの平均総得点は,addictedが12.9±7.4,possibly-addictedが8.8±6.0,non-addictedが4.3±4.6であり,依存傾向があるaddictedおよびpossibly-addictedはnon-addictedより有意に得点が高く,問題を抱えた生徒の割合が多かった.また,スマートフォンを自由に使用できることがインターネット依存と関連があった.【考察】インターネット依存の有病率は,possibly-addictedを含め中学生の23.7%にみられ,精神的問題との関連が考えられた.インターネットの適切な利用に関して,保護者,教育機関,医療機関がそれぞれ注意する必要がある.(著者抄録)

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記述言語：日本語   出版者・発行元：(公社)日本精神神経学会  

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記述言語：日本語   出版者・発行元：(公社)日本精神神経学会  

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記述言語：日本語   出版者・発行元：(公社)日本精神神経学会  

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記述言語：日本語   出版者・発行元：(有)科学評論社  

症例は18歳女性で、17歳頃から幻聴が絶えず出現し、被害念慮が増悪したため、アリピプラゾールによる薬物療法を開始したが、症状に改善を認めず、入院となった。絵画欲求不満テストでは、場面状況理解は悪く、場面に関係なく自責的な反応を多く認め、柔軟な対応が困難であることが分かった。会話はオウム返しが多く、周囲の話題についていけないといった社会的コミュニケーションの障害を認め、飲み物の温度に関するこだわり、感覚刺激に対する過敏さといった限局的反復的な行動パターンを認め、DSM-5による自閉症スペクトラム症(ASD)の診断基準を満たした。現在までの行動観察と心理検査結果を総合し、ASDに精神病症状が併存する状態であると診断した。本人に対しては、苦手なところをどう補っていくのかを具体的に伝えるなどした。

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記述言語：日本語   出版者・発行元：(株)世論時報社  

バウム・テストは臨床場面において一般的に用いられる投影法だが、自閉スペクトラム症(Autism Spectrum Disorders:ASD)児にバウム・テストを用いた先行研究は多くない。本研究はASD児に併存する抑うつ状態を検出できる指標を明らかにすることを目的に、抑うつ状態ありと児童精神科医が判断したASD児を対象として、バウム・テストとバールソン児童用抑うつ性尺度(Birleson Depression Self-Rating Scale for Children:DSRS-C)を実施し、臨床症状を反映しえるか検討した。その結果、DSRS-Cの総点はASD児の抑うつ状態の有無によって有意差を認めず、バウム・テストの気分の落ち込みを示す指標は、抑うつ状態を伴うASD群で出現数が有意に多かった。バウム・テストの気分の落ち込みを示す指標の出現が、ASD児の抑うつ状態の検出に有用である可能性が示された。(著者抄録)

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記述言語：日本語   出版者・発行元：(株)医学書院  

注意欠如・多動症(ADHD)は生涯にわたる障害であるが,成人期におけるADHDの診断は小児期より困難をきわめる。本研究では,標準注意検査法(CAT)を用いて,成人期ADHDの注意機能の特徴を明らかにすることを目的に調査を行った。当院外来を受診した18歳以上の知的障害を伴わないADHD患者を対象とし,認知機能検査としてWAIS-IIIを,注意機能検査としてCATを実施した。CAT各検査結果とWAIS-III全検査IQとの関連について検討し,標準化データと比較検討した。CATの各課題のうち,知的機能の影響を受けず注意障害を認めたものは,Visual Cancellation Task, Auditory Detection Task, PASATであった。成人期ADHDでは視覚的・聴覚的な選択性注意,ワーキングメモリーが特徴的に障害されることが示唆された。(著者抄録)

DOI： 10.11477/mf.1405205390

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記述言語：日本語   出版者・発行元：メディカルフロントインターナショナル(有)  

2014年11月に、愛媛県伊予郡松前町内の公立中学校3校に在籍する生徒874名を対象に、地域の中学生においてインターネットの利用・依存が睡眠習慣に与える影響について調査し検討した。最終的な有効回答は853名(男子425名、女子428名、平均13.6±0.9歳)であった。IATスコアによる重症度分類では依存状態が2.0%、依存傾向が21.7%であった。重症が高い即ち依存傾向が強いほど、睡眠の問題が有意に多く、平日の睡眠時間・就寝時刻、休日の起床・就寝時刻に群間差を認め、インターネット依存と睡眠習慣・睡眠衛生への関与が示唆された。

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記述言語：日本語   出版者・発行元：(株)北隆館  

児童青年期の睡眠覚醒の問題は、精神機能・認知・行動に影響を及ぼす。睡眠の不足や睡眠障害は学校でのパフォーマンスに影響し、近年急速に普及しているインターネットは、依存の問題に加え、睡眠習慣を悪化させることによる影響も懸念される。睡眠の問題を早期に発見する簡便で有効な手法は確立されておらず、睡眠習慣への介入も有効ではあるものの、持続的な効果をえるためには更なる取り組みが必要である。(著者抄録)

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記述言語：日本語   出版者・発行元：(一社)日本児童青年精神医学会  

本研究は、自閉スペクトラム症(Autism Spectrum Disorders:ASD)児の認知特性、特に視覚性注意機能の特徴をCog Health認知機能検査を用いて明らかにすることを目的とした。愛媛大学医学部附属病院精神科に外来受診中の7〜15歳のASD児37例と、7〜15歳の健常対象児131例を対象とした。ASD群にはCog Health認知機能評価の1ヵ月以内にWechsler Intelligence Scale for Children(WISC)を用いて知的水準を評価し、両群に対しCog Health認知機能検査を用いて注意機能およびワーキングメモリーの評価を行った。知的能力とCog Health各課題の正答率の関連については、遅延再生課題の正答率のみ知能指数と有意な関連があった。遅延再生を除いた各課題の誤回答数、見込み反応数、時間切れ反応数、正答率、反応速度の結果を比較したところ、注意分散課題において対照群に比べ、ASD群の見込み反応数が有意に低く、反応速度が有意に遅く、正答率が有意に高く、注意分散課題でのASD児の優位性が明らかとなった。ASD児の中枢統合性の障害や、視覚探索能力の高さ、字義通り性などの認知機能を反映している可能性が示された。(著者抄録)

DOI： 10.20615/jscap.57.4_618

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記述言語：日本語   出版者・発行元：世論時報社  

CiNii Books

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記述言語：日本語  

PubMed

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記述言語：日本語   出版者・発行元：メディカルフロントインターナショナル(有)  

2014年度に愛媛県久万高原町の全中学生を対象に、夏季休暇時期に生活習慣についてのワークブックを作成し、その取り組みおよび介入効果について検討した。夏季休暇開始1週間前に学校担任からワークブックを配布してもらい、配布日の夜から記入を開始し、夏季休暇終了後1週間目までの記入を依頼した。全中学生204名のうち、171名(中学1年生49名、中学2年生60名、中学3年生62名)からワークブックを回収することができた。ワークブックへの記入を実施した後のアンケート(有効回答137名)では、「頑張って取り組めた」15.3%、「まずまず取り組めた」42.3%、「あまり取り組めなかった」19.0%、との回答であった。睡眠改善の課題についての自覚的達成感について尋ねたところ、「達成できた」「やや達成できた」と、規則正しい生活の確立で72%、光環境の調整で52%、メディア環境の調整で53%が回答した。中学生自身が記入するワークブックは、睡眠改善などに有効なことが示唆された。

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記述言語：日本語   出版者・発行元：愛媛医学会  

【目的】昨今、発達障害者に対する就労支援の関心も高まりつつある。発達障害者の現場での就労状況について実態を把握することを目的に、事業所スタッフを対象とした実態調査を行った。【対象と方法】2013年8〜12月の期間、愛媛県内の専属産業医を選任している事業所8ヶ所に勤務する産業医及び人事労務管理担当者を対象に対面での聞き取り調査を行った。【結果】対象事業所は5ヶ所で、発達障害者の雇用をしている事業所は1ヶ所、過去に雇用経験がある事業所は2ヶ所であった。これら3ヶ所の事業所で雇用されている、もしくはされていた発達障害者は、メンタルヘルス不調で休職後に広汎性発達障害と診断された。【考察】メンタルヘルス不調をおこした発達障害者に対し、不調の根底にあるであろう障害特性への対応を早期に行うことが望ましい。当事者と会社が障害特性を把握し、その特性を考慮した環境調整が必要であることを両者が理解する必要がある。発達障害者の雇用増加に備え、適切な対応が期待される。(著者抄録)

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記述言語：日本語   出版者・発行元：(株)アークメディア  

2010年4月1日から2012年3月31日迄にA児童発達支援センターに通所した児童のうち、毎日(週5)通所しており、難聴児・肢体不自由児を除く91名(男児75名、女児16名)を対象に、児童の養育者および児童指導員双方からみた児童の精神健康状態の認識の違いを明らかにするために、強さと困難さ質問票(Strengths and Difficulties Questionnaire:SDQ)を用いた調査を行った。地域の児童と比較して児童発達支援センターに通所する児童は男女ともSDQにおける殆どの下位尺度(情緒面、多動・不注意、仲間関係、向社会性)で困難さが存在し、支援の必要性が高いと考えられた。男児のSDQ「総スコア」および下位尺度の「多動・不注意」において、児童指導員は養育者よりも支援の必要性を有意に高いと認識していることが分かった。女児に関しては養育者と児童指導員の比較で有意差を認めなかった。SDQは児童の困難さを数値化し表すことができ、養育者と教師が共通理解を得るために役立つことが示唆された。

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記述言語：日本語   出版者・発行元：(株)世論時報社  

【目的】本研究は愛媛大学医学部附属病院精神科の児童青年期精神科部門における外来診療の10年間の変遷を明らかにすることを目的に調査を行った。【方法】2002年と2012年の1年間の18歳以下の初診患者を対象に、性別、初診時年齢、受診経路、主訴・主症状、診断、転帰について診療録に基づいて後方視的に比較検討を行った。【結果】2002年と比較し2012年では18歳以下の初診患者の増加、患者の低年齢化、紹介率の増加、発達障害と診断される患者の増加を認めた。主訴として最も多かった不登校に関して、契機と発達障害の有無について追加調査したところ、発達障害を伴う不登校は伴わない不登校と比べ男性に多く、低年齢の傾向があった。【考察】精神科医療を必要とする児童青年期患者の増加に伴い、より専門的な診療体制を整えることが必要である。また、発達障害に関する精査や発達障害を伴う不登校の増加から、医療・教育・福祉、さらには就労も視野に入れた連携と強化が必要と考えられた。(著者抄録)

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記述言語：日本語   出版者・発行元：(株)医学書院  

自殺に関する意識の高い愛媛県久万高原町において,若年者の自殺予防対策の一環として,中学生のメンタルヘルスの実態を明らかにすることを目的に,日本語版Profile of Mood States-Brief Formと日本版精神健康調査質問票を用いて調査を行った。町内全生徒220名から回答を得た。全体の傾向として,中学2,3年で精神的不調の訴えが多かったが,女子で特にその傾向が強かった。抑うつ感情は中学2,3年の女子が男子に比し有意に高く,自殺しようと考えたことがあると回答した生徒は男子9名,女子12名で計21名(9.5%)であった。自殺予防の観点から,特に中学2,3年女子に一定の配慮が必要であると思われた。今後,縦断的な自殺対策活動と支援体制の確立が必要である。(著者抄録)

DOI： 10.11477/mf.1405102754

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記述言語：日本語   出版者・発行元：(株)星和書店  

成人期の注意欠如・多動性障害(Attention-Deficit/Hyperactivity Disorder:ADHD)の治療においては、効果判定は主観的な臨床評価によっており、客観的な評価方法は確立されていない。今回我々は、atomoxetineを用いた成人期ADHD患者の診断・治療効果判定に、客観的臨床評価手法として標準注意検査法(Clinical Assessment for Attention:CAT)を使用し、臨床経過をよく反映した1例を経験したので報告する。症例は40歳女性、中学時代から学校への忘れ物が多く、集中力がないことを自覚し始めた。21歳時にうつ病と診断されていたが、40歳時に発達障害を疑われ当院に紹介された。改めて病歴聴取を行い、学童期以降のADHD症状を確認し、CATの結果も参考にしながら、ADHDとの診断に至った。Atomoxetineを40mg/日から内服開始し、80mg/日に増量したところ、日常生活およびCATでの評価における不注意症状の改善を認めた。成人期ADHDでは、不注意が生活の障害となることが多いが、CATは、ADHDの不注意症状を反映する可能性があると思われた。(著者抄録)

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記述言語：日本語  

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記述言語：日本語   出版者・発行元：(有)科学評論社  

愛媛県内には児童・青年期精神科専門の病棟や情緒障害児短期治療施設は存在せず、児童青年期精神医療に関する相談機関の配備にも遅れが目立つ。このような状況下で精神科医が広汎性発達障害(PDD)の診療や支援を行うにあたり、苦慮していることは想像に難くない。そこで今回、今後の支援体制を構築していく上で、まず医療機関におけるPDDの診療状況を把握することが必要と考え、県内の医療機関に従事する精神科医153名にアンケートを行った。82名から回答が得られ、次のようなことが明らかになった。1)2010年1年間に一人の医師が診療した児童青年期PDD患者数は、「10人以上」と答えた医師が7.5%、「1〜9人」が21.2%、「診療しなかった」が71.3%であった。2)2010年1年間に一人の医師が診療した成人期PDD患者数は、「10人以上」が17.5%、「1〜9人」が56.3%、「診療しなかった」が26.3%であった。3)児童青年期PDDの診療で苦慮すること(複数回答)は、「社会資源の不足」51.9%、「確定診断の困難さ」48.1%、「他機関との連携」44.4%、「親の理解」37%、「社会認識」37%などであった。4)成人期PDDの診療で苦慮することは、「確定診断の困難さ」58.7%、「発達歴の聴取」56.5%、「社会資源の不足」50%、「併存症状の存在」47.8%、「社会認識」41.3%などであった。

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記述言語：日本語   出版者・発行元：(株)医学書院  

症例1:63歳女、症例2:65歳男。2症例は、表出は少ないものの、幻覚や妄想など陽性症状の存在が疑われ、感情の平板化、活動性減退、情動的ひきこもりなどの陰性症状も強かった。コミュニケーション障害があり、感情の不安定および問題行動などから病棟での他患者との共同生活が難しく、結果として長期隔離を余儀なくされた。抗精神病薬の投与が行われたが、結果に乏しかった。Quetiapineへの置換により理学療法や作業療法などが受けられるまで陰性症状が改善した。

DOI： 10.11477/mf.1405102249

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記述言語：日本語   出版者・発行元：(株)世論時報社  

2010年に本邦で上市されたramelteonは、メラトニン受容体MT1、MT2に選択的なアゴニストであり、入眠作用や生体リズム位相変位作用を有する。現在の睡眠薬の主流はベンゾジアゼピン系睡眠薬や非ベンゾジアゼピン系睡眠薬であるが、精神疾患が基盤にある睡眠障害に対しては、抗うつ剤や抗精神病薬も治療に使用されている。このような精神疾患を伴う不眠に対し、ramelteonを使用し、30症例(男性19例、女性11例)の治療を行った。平均年齢は56.2±19.0歳(16〜89歳)であり、症例の内訳は統合失調症14例、認知症圏6例、気分障害圏4例、神経症性障害圏3例、発達障害圏3例であった。Ramelteon継続症例は22例(73.3%)であり、切り替え前後で有意に併用睡眠薬が減少した。精神疾患を伴う不眠に対するramelteonの使用は、既存の睡眠薬を減薬することができ、忍容性が高いことが示唆された。今後、精神疾患を伴う不眠へのramelteonの有効性に関して、臨床知見の蓄積が必要である。(著者抄録)

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記述言語：日本語   出版者・発行元：医学書院  

DOI： 10.11477/mf.1405102179

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記述言語：日本語  

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記述言語：日本語   出版者・発行元：(有)科学評論社  

過去に統合失調症と診断され、精神運動興奮状態のため入院に至ったが、入院中の詳細な生育歴の聴取や入院中の行動観察、および薬物反応よりアスペルガー障害と診断を改め、支援および治療を再検討することにより軽快した2症例(25歳男性、24歳女性)について報告した。本2例は家庭内不適応で入院に至ったが、入院治療中の目的を明確にし、退院後の方向性を入院中に決めておくことや退院後の生活の基盤となる家族への疾患教育が必須であると示唆された。

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記述言語：日本語   出版者・発行元：(株)星和書店  

トゥレット障害の主な薬物療法は、haloperidolやpimozide、risperidoneなどの抗精神病薬が使用されるが、近年、トゥレット障害に対するaripiprazoleの使用についての報告が散見される。AripiprazoleはドーパミンD2受容体部分アゴニストであり、多くの抗精神病薬がドーパミンD2受容体アンタゴニストであることから、特殊な薬理学特性を持つ抗精神病薬と言える。Aripiprazoleは、また、強力な抗精神病作用を有し、錐体外路症状、代謝異常や過鎮静をきたしにくい安全性の高い抗精神病薬のため、統合失調症の第一選択薬として国内で認識され、広く使われている。今回、我々は、トゥレット障害と診断し、多彩なチック症状に対してaripiprazoleの使用により改善に至った2症例を経験したので報告する。1例目は14歳男性、risperidoneによる治療を開始したが、過鎮静と効果不十分のためaripiprazoleに置換して6mg/日から開始、24mg/日まで増量し、奏効した。2例目は12歳男性、広汎性発達障害が併存していた。Aripiprazole 3mg/日から開始し、12mg/日まで増量したところ、チック症状は改善した。2症例とも副作用は眠気のみであった。以上から、aripiprazoleは、継続投与が可能で忍容性が高く、効果が期待でき、トゥレット障害に用いることのできる薬物治療の選択肢の1つであると判断した。(著者抄録)

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記述言語：日本語   出版者・発行元：(株)星和書店  

児童青年期双極性障害における睡眠障害は、躁病エピソード・うつ病エピソードいずれにも関連する臨床症状として重要な所見である。睡眠の質・量の低下や睡眠覚醒リズムの問題は、日中の活動性・認知面・学習面への影響が大きく、特に児童期において発達に及ぼす影響を考慮すると、早期発見・早期介入が必要である。児童青年期における睡眠障害の薬物療法については、十分なコンセンサスが得られておらず、心理学的介入や認知行動療法が主として用いられる。認知行動療法的アプローチをする上で、夜間の睡眠状態に加えて日中の活動性も把握できる睡眠日誌は有用である。(著者抄録)

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記述言語：日本語   出版者・発行元：医学書院  

DOI： 10.11477/mf.1405101591

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