研究者詳細 - 高江洲　義和

論文 - 高江洲　義和

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通信制高校において、個別化した睡眠衛生指導は登校率を向上させた

志村哲祥, 伊藤潤, 野村亮太, 高江洲義和, 井上猛

日本睡眠学会定期学術集会プログラム・抄録集 ( (一社)日本睡眠学会 ) 42回 202 - 202 2017年06月

掲載種別: 研究論文（その他学術会議資料等）

Childhood parental bonding affects adulthood trait anxiety through self-esteem

Akiyoshi Shimura, Yoshikazu. Takaesu, Yukiei Nakai, Akiko Murakoshi, Yasuyuki Ono, Yasunori Matsumoto, Ichiro Kusumi, Takeshi Inoue

COMPREHENSIVE PSYCHIATRY ( W B SAUNDERS CO-ELSEVIER INC ) 74 15 - 20 2017年04月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

Introduction: The association between trait anxiety and parental bonding has been suggested. However, the mechanism remains uncertain and there is no study focused on general adult population. We investigated the association and the mechanism between childhood parental bonding and adulthood trait anxiety in the general adult population. Material and methods: A cross-sectional retrospective survey was conducted in 2014 with 853 adult volunteers from the general population. The Parental Bonding Instrument, Rosenberg Self-Esteem Scale, and State-Trait Anxiety Inventory Form Y (STAI-Y) were self-administered. Structural equation modelling was used for the analysis. Results: Childhood parental bonding affected adulthood trait anxiety indirectly mediated by self-esteem. Trait anxiety was decreased by parental care and increased by parental overprotection through self-esteem. This model explained 51.1% of the variability in STAI-Y trait anxiety scores. Conclusions: This study suggests an important role of self-esteem as a mediator between childhood parental bonding and adulthood trait anxiety. (C) 2016 Published by Elsevier Inc.

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Associations among depressive symptoms, childhood abuse, neuroticism, and adult stressful life events in the general adult population

Kotaro Ono, Yoshikazu Takaesu, Yukiei Nakai, Akiyoshi Shimura, Yasuyuki Ono, Akiko Murakoshi, Yasunori Matsumoto, Hajime Tanabe, Ichiro Kusumi, Takeshi Inoue

Neuropsychiatric Disease and Treatment ( Dove Medical Press Ltd. ) 13 477 - 482 2017年02月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

Background: Recent studies have suggested that the interactions among several factors affect the onset, progression, and prognosis of major depressive disorder. This study investigated how childhood abuse, neuroticism, and adult stressful life events interact with one another and affect depressive symptoms in the general adult population. Subjects and methods: A total of 413 participants from the nonclinical general adult population completed the Patient Health Questionnaire-9, the Child Abuse and Trauma Scale, the neuroticism subscale of the shortened Eysenck Personality Questionnaire -Revised, and the Life Experiences Survey, which are self-report scales. Structural equation modeling (Mplus version 7.3) and single and multiple regressions were used to analyze the data. Results: Childhood abuse, neuroticism, and negative evaluation of life events increased the severity of the depressive symptoms directly. Childhood abuse also indirectly increased the negative appraisal of life events and the severity of the depressive symptoms through enhanced neuroticism in the structural equation modeling. Limitations: There was recall bias in this study. The causal relationship was not clear because this study was conducted using a cross-sectional design. Conclusion: This study suggested that neuroticism is the mediating factor for the two effects of childhood abuse on adulthood depressive symptoms and negative evaluation of life events. Childhood abuse directly and indirectly predicted the severity of depressive symptoms.

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A pilot study: a priority oriented tailored sleep hygiene intervention reduced sleep disturbance and absenteeism among correspondence high school students

Shimura A, Ito J, Takaesu Y

Sleep Medicine ( Elsevier ) 40 e304 - e304 2017年 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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Lithium in drinking water may be associated with depressive and irritable temperaments in nonclinical population.

Ishii N, Terao T, Matsuzaki H, Inoue T, Takaesu Y, Kohno K, Takeshima M, Baba H, Honma H

Clin Neuropsychopharmacol Ther ( 日本臨床精神神経薬理学会 ) 8 7 - 11 2017年 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

<p>Purpose: Recently, we reported that lithium levels in drinking water were significantly and positively associated with hyperthymic temperament scores, whereas latitude was significantly and negatively associated with the scores, suggesting that lithium in drinking water may positively maintain hyperthymic temperament and that latitude may negatively maintain it. In the present study, from the viewpoint of psychopharmacology, we investigated the other 4 affective temperaments in reference to lithium in drinking water with adjustment for latitude, temperature, and sunshine. Methods: We re-examined our previous dataset consisting of temperament data of 609 residents in Sapporo, Obihiro, Takaoka, Koshigaya, and Oita cities, in addition to the lithium levels in drinking water and climatic data of the five cities. Multiple regression analyses via the forced entry method were performed, whereby the individual temperament scores were dependent factors, and age, gender, the other four affective temperaments, lithium in drinking water, latitude, temperature, and sunshine were independent factors. Results: The multiple regression analysis revealed that lithium levels in drinking water were significantly and negatively associated with depressive temperament scores. The other three temperaments (i.e. irritable, cyclothymic and anxious temperaments) were not significantly associated with lithium levels in drinking water. Discussion: In conclusion, the present findings suggest that lithium in drinking water may be negatively associated with depressive temperament.</p>

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Effect of aripiprazole on non-24-hour sleep-wake rhythm disorder comorbid with major depressive disorder: a case report

Kentaro Matsui, Yoshikazu Takaesu, Takeshi Inoue, Ken Inada, Katsuji Nishimura

NEUROPSYCHIATRIC DISEASE AND TREATMENT ( DOVE MEDICAL PRESS LTD ) 13 1367 - 1371 2017年 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

Background: Patients with non-24-hour sleep-wake rhythm disorder (N24SWD) exhibit a sleep pattern that is asynchronous with the external light-dark cycle, typically involving a cycling, relapsing-remitting pattern of sleep disturbances, including nighttime insomnia and daytime sleepiness. Here, we report the case of a patient with N24SWD comorbid with major depressive disorder, who was successfully treated with a low dose of aripiprazole. Case presentation: A 47-year-old female presented with an 8-year complaint of difficulty falling asleep and waking up in the morning. The patient was diagnosed with major depressive disorder at the age of 35 years and was treated with various antidepressants since that time. At the age of 40 years, the patient's sleep-wake cycle began to extend without exacerbation of depressive symptoms. The patient was diagnosed with N24SWD at the age of 43 years. Ramelteon 8 mg/d and then melatonin 1 mg/d were administered, but these did not provide effective treatment. In January 2016, after treatment with aripiprazole 3 mg/d in the morning for 4 weeks, the patient's sleep-wake cycle became markedly synchronized to the environmental light-dark cycle. Her sleep-wake cycle remained synchronized when the same dose of aripiprazole was administered for at least 6 months. Conclusion: Treatment-refractory asynchrony of the sleep-wake cycle in an N24SWD patient with depression was successfully treated with aripiprazole. Although the detailed mechanism of action is unclear, aripiprazole may be an appropriate treatment for patients with circadian rhythm sleep-wake disorders.

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Association between the high-dose use of benzodiazepines and rehospitalization in patients with schizophrenia: A 2-year naturalistic study

Yukika Takita, Yoshikazu Takaesu, Kotaro Ono, Kunihiro Futenma, Akiyoshi Shimura, Akiko Murakoshi, Yoko Komada, Yuichi Inoue, Takeshi Inoue

Neuropsychiatric Disease and Treatment ( Dove Medical Press Ltd. ) 12 3243 - 3247 2016年12月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

Background: High-dose use of benzodiazepines (BZPs) reportedly causes adverse effects on cognitive function and quality of life in patients with schizophrenia. However, effects of BZPs on the clinical course of schizophrenia have not been clarified. This study was set out to investigate the association between BZPs and rehospitalization of patients with schizophrenia. Methods: In this retrospective study, patients with schizophrenia who were discharged from Tokyo Medical University Hospital between January 2009 and February 2012 were eligible as subjects. One hundred and eight patients who continued treatment for &gt 2 years after hospital discharge were included in this study. Clinical characteristics, doses of prescribed medication such as BZPs and antipsychotics, and Global Assessment of Functioning scores at discharge were investigated. The primary outcome was rehospitalization of patients for any reason. Results: In a total of 108 subjects with schizophrenia, 44 subjects (40.7%) experienced rehospitalization during the 2-year study period. A multivariate analysis by the Cox proportional hazards model revealed that low educational history (hazard ratio =2.43, P=0.032), younger onset age of schizophrenia (hazard ratio =2.10, P=0.021), and higher diazepam-equivalent dose (hazard ratio =6.53, P=0.011) were significantly associated with the time to rehospitalization after hospital discharge. Conclusion: The results of this study suggest that high-dose use of BZPs at discharge in patients with schizophrenia might be associated with a shorter time to rehospitalization.

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Later sleep schedule and depressive symptoms are associated with usage of multiple kinds of hypnotics

Akiyoshi Shimura, Yoshikazu Takaesu, Sayaka Aritake, Kunihiro Futenma, Yoko Komada, Yuichi Inoue

SLEEP MEDICINE ( ELSEVIER SCIENCE BV ) 25 56 - 62 2016年09月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

Objective: Usage of high doses of hypnotics possibly causes various adverse events. However, the risk factors of using multiple kinds of hypnotics have been inconclusive. To clarify this, we conducted a web based cross-sectional questionnaire survey on the Japanese adult population. Methods: A cross-sectional Internet-linked survey was conducted on 10,016 individuals and 1030 participants (10.3%) having subjective insomnia proceeded to subsequent analyses. The analyzed subjects were categorized into non-users of hypnotics (n = 833; 80.9%), users of a single kind of hypnotic (n = 96; 9.3%), and users of multiple kinds of hypnotics (n =101; 9.8%). The descriptive variables including demographic data, scores of Center for Epidemiological Studies Depression Scale (CES-D), Short Form-8 Health Related Quality of Life [QOL (SF-8)], Pittsburgh Sleep Quality Index (PSQI), and other parameters were compared among the groups. Results: The users of multiple kinds of hypnotics had the highest mean score of CES-D, the lowest mental component summary of QOL (SF-8), and the latest sleep schedule among the three groups (p < 0.001). Logistic regression analyses revealed that sex (female: OR= 2.38; p <0.001) and age (>= 43 years old: OR= 2.61; p < 0.001) were independently associated with use of a single kind of hypnotic, while later sleep schedule (midpoint of sleep >= 5:30 a.m.: OR = 2.26; p < 0.001) and higher CES-D score 6 points: OR = 2.41; p < 0.001) were independently associated with use of multiple kinds of hypnotics. Conclusions: Characteristics of users of multiple kinds of hypnotics were different from those of users of a single kind of hypnotic. (C) 2016 Elsevier B.V. All rights reserved.

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Prevalence of and Factors Associated With Sleep-Related Eating Disorder in Psychiatric Outpatients Taking Hypnotics

Yoshikazu Takaesu, Jun Ishikawa, Yoko Komada, Akiko Murakoshi, Kunihiro Futenma, Shingo Nishida, Yuichi Inoue

JOURNAL OF CLINICAL PSYCHIATRY ( PHYSICIANS POSTGRADUATE PRESS ) 77 ( 7 ) E892 - E898 2016年07月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

Objective: To clarify the prevalence and clinical features of sleep-related eating disorder (SRED) in psychiatric outpatients taking hypnotics as well as factors associated with the disorder. Methods: From February 1, 2012, to February 29, 2012, a cross-sectional study was undertaken. A questionnaire addressing demographics, the Japanese version of the Pittsburgh Sleep Quality Index (PSQI), presence of abnormal behavior during sleep focusing on SRED and sleepwalking, and duration of hypnotic medication and subjective side effects of the drug was distributed to psychiatric outpatients who were taking hypnotics at the time of the survey. Results: Of 1,318 patients taking hypnotics, 1,048 patients (79.5%) provided valid responses, and 88 of them (8.4%) had experienced SRED. The SRED group was significantly younger, had a significantly higher total PSQI score, and took higher bedtime diazepam-equivalent doses of hypnotics than the non-SRED group (P < .01 for all comparisons). In the SRED group, subjective side effects due to hypnotics were present at significantly higher proportions than in the non-SRED group. Multiple logistic regression analysis showed that younger age (adjusted odds ratio [aOR] = 0.98, 95% CI = 0.96-0.99, P = .021), taking 2 or more kinds of antipsychotics (aOR = 3.41, 95% CI = 1.93-6.05, P < .001), and the bedtime diazepam-equivalent dose of a hypnotic (aOR = 1.03, 95% CI = 1.01-1.05, P = .039) were significantly associated with the experience of SRED. Conclusion: The prevalence of SRED in psychiatric outpatients taking hypnotics is elevated, particularly in younger patients, and the hypnosedative effects of the drugs could be responsible for the occurrence of the disorder in this population. (C) Copyright 2016 Physicians Postgraduate Press, Inc.

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Prevalence of Circadian Rhythm Sleep-Wake Disorders and Associated Factors in Euthymic Patients with Bipolar Disorder

Yoshikazu Takaesu, Yuichi Inoue, Akiko Murakoshi, Yoko Komada, Ayano Otsuka, Kunihiro Futenma, Takeshi Inoue

PLOS ONE ( PUBLIC LIBRARY SCIENCE ) 11 ( 7 ) e0159578 2016年07月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

Recent studies have suggested that there are certain pathophysiological relationships between bipolar disorder (BD) and circadian rhythm dysfunction. However, apparently no studies have clarified the prevalence of circadian rhythm sleep-wake disorders (CRSWD) in patients with BD. This study was set out to investigate the prevalence of CRSWD and associated factors in patients with BD. One hundred four euthymic BD outpatients participated in this study. The subjects were asked to answer questionnaires including demographic variables, clinical course of BD, and family history of psychiatric disorders and suicide. Severity of BD was assessed by the Montgomery-sberg Depression Rating Scale and Young Mania Rating Sca. CRSWD was diagnosed by clinical interview, together with sleep logs, according to the International Classification of Sleep Disorders, third edition (ICSD-3). Thirty-five subjects (32.4%) met the criteria for CRSWD. The age at the time of investigation and that at the onset of BD were both lower in the CRSWD group than in the non-CRSWD group. The rates of family history of psychiatric disorders and suicide in the CRSWD group were higher than those in the non-CRSWD group. Multiple logistic regression analysis revealed that the presence of CRSWD was significantly associated with younger onset age of BD and family history of suicide. The prevalence of CRSWD could be quite high in BD patients. Younger onset age of BD and family history of suicide were associated with presence of CRSWD in BD patients.

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[Major depression and insomnia comorbid with diabetes].

Takaesu Y, Ichiki M, Inoue T

Nihon rinsho. Japanese journal of clinical medicine 74 Suppl 2 470 - 476 2016年04月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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Affective temperaments play an important role in the relationship between childhood abuse and depressive symptoms in major depressive disorder

Hiroyuki Toda, Takeshi Inoue, Tomoya Tsunoda, Yukiei Nakai, Masaaki Tanichi, Teppei Tanaka, Naoki Hashimoto, Yoshikazu Takaesu, Shin Nakagawa, Yuji Kitaichi, Shuken Boku, Hajime Tanabe, Masashi Nibuya, Aihide Yoshino, Ichiro Kusumi

PSYCHIATRY RESEARCH ( ELSEVIER IRELAND LTD ) 236 142 - 147 2016年02月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

Previous studies have shown that various factors, such as genetic and environmental factors, contribute to the development of major depressive disorder (MDD). The aim of this study is to clarify how multiple factors, including affective temperaments, childhood abuse and adult life events, are involved in the severity of depressive symptoms in MDD. A total of 98 participants with MDD were studied using the following self-administered questionnaire surveys: Patient Health Questionnaire-9 measuring the severity of depressive symptoms; Life Experiences Survey (LES) measuring negative and positive adult life events; Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego auto-questionnaire (TEMPS A) measuring affective temperaments; and the Child Abuse and Trauma Scale (CATS) measuring childhood abuse. The data were analyzed using single and multiple regression analyses and structural equation modeling (SEM). The neglect score reported by CATS indirectly predicted the severity of depressive symptoms through affective temperaments measured by TEMPS-A in SEM. Four temperaments (depressive, cyclothymic, irritable, and anxious) directly predicted the severity of depressive symptoms. The negative change in the LES score also directly predicted severity. This study suggests that childhood abuse, especially neglect, indirectly increases the severity of depressive symptoms through increased scores of affective temperaments in MDD. (C) 2015 Elsevier Ireland Ltd. All rights reserved.

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Factors associated with discontinuation of aripiprazole treatment after switching from other antipsychotics in patients with chronic schizophrenia: A prospective observational study

Yoshikazu Takaesu, Taishiro Kishimoto, Akiko Murakoshi, Nobutada Takahashi, Yuichi Inoue

PSYCHIATRY RESEARCH ( ELSEVIER IRELAND LTD ) 236 71 - 74 2016年02月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

The purpose of the study was to identify factors associated with discontinuation of aripiprazole after switching from other antipsychotics in patients with schizophrenia in real world clinical settings. From January 2011 to December 2012, a prospective, 48-week open-label study was undertaken. Thirty-eight subjects on antipsychotic monotherapy were switched to aripiprazole. Patients who discontinued aripiprazole were compared to those who continued with regards to demographic characteristics as well as treatment factors. Multiple regression analysis was conducted to identify predictors for aripiprazole discontinuation. Thirteen out of 38 patients (34.2%) discontinued aripiprazole during the follow up period. Nine patients (23.7%) discontinued aripiprazole due to worsening of psychotic symptoms. Multiple logistic regression analysis revealed that only the duration of previous antipsychotic treatment was associated with aripiprazole discontinuation after switching to aripiprazole. The receiver operating curve (ROC) analysis identified that the cut-off length for duration of illness to predict aripiprazole discontinuation was 10.5 years. Longer duration of illness was associated with aripiprazole discontinuation. Greater caution may be required when treating such patients with aripiprazole. (C) 2016 Elsevier Ireland Ltd. All rights reserved.

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Comparison of clinical features between primary and drug-induced sleep-related eating disorder

Yoko Komada, Yoshikazu Takaesu, Kentaro Matsui, Masaki Nakamura, Shingo Nishida, Meri Kanno, Akira Usui, Yuichi Inoue

NEUROPSYCHIATRIC DISEASE AND TREATMENT ( DOVE MEDICAL PRESS LTD ) 12 1275 - 1280 2016年 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

Purpose: The aim of this study was to ascertain the clinical characteristics of drug-induced sleep-related eating disorder (SRED).Patients and methods: We retrospectively reviewed the medical records of 30 patients with primary SRED (without any comorbid sleep disorders and who were not taking any possible causative medications), and ten patients with drug-induced SRED (occurrence of SRED episodes after starting nightly medication of sedative drugs, which completely resolved after dose reduction or discontinuation of the sedatives).Results: All patients with drug-induced SRED took multiple types of sedatives, such as benzodiazepines or benzodiazepine receptor agonists. Clinical features of drug-induced SRED compared with primary SRED were as follows: higher mean age of onset (40 years old in drug-induced SRED vs 26 years old in primary SRED), significantly higher rate of patients who had total amnesia during most of their SRED episodes (75.0% vs 31.8%), significantly lower rate of comorbidity of night eating syndrome (0% vs 63.3%), and significantly lower rate of history of sleepwalking (10.0% vs 46.7%). Increased doses of benzodiazepine receptor agonists may be responsible for drug-induced SRED.Conclusion: The clinical features of drug-induced SRED were different from those of primary SRED, possibly reflecting differences in the underlying mechanisms between these two categories of SREDs.

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The influence of childhood abuse, adult life events, and affective temperaments on the well-being of the general, nonclinical adult population

Yoshiaki Kanai, Yoshikazu Takaesu, Yukiei Nakai, Masahiko Ichiki, Mitsuhiko Sato, Yasunori Matsumoto, Jun Ishikawa, Yasuyuki Ono, Akiko Murakoshi, Hajime Tanabe, Ichiro Kusumi, Takeshi Inoue

NEUROPSYCHIATRIC DISEASE AND TREATMENT ( DOVE MEDICAL PRESS LTD ) 12 823 - 832 2016年 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

Background: Previous studies have shown the effects of childhood abuse, life events, and temperaments on well-being (positive affect) and ill-being (negative affect). We hypothesized that childhood abuse, affective temperaments, and adult life events interact with one another and influence positive and negative affects in the general adult population and tested this hypothesis using structural equation modeling. Methods: A total of 415 participants from the general, nonclinical adult population were studied using the following self-administered questionnaires: the Subjective Well-Being Inventory (SUBI); Life Experiences Survey (LES); Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Auto-questionnaire (TEMPS-A); and the Child Abuse and Trauma Scale (CATS). The data were analyzed with single and multiple regression analyses and structural equation modeling (Mplus). Results: Childhood abuse indirectly predicted the worsening of positive and negative affects through cyclothymic, anxious, and irritable temperaments as measured by the TEMPS-A in the structural equation model. The cyclothymic, anxious, and irritable temperaments directly worsened the positive and negative affects and the negative appraisal of life events that occurred during the past year, while the hyperthymic temperament had the opposite effects. Limitations: The subjects of this study were nonclinical volunteers. The findings might not be generalizable to psychiatric patients. Conclusion: This study demonstrated that childhood abuse, particularly neglect, indirectly worsened the well-being of individuals through cyclothymic, anxious, and irritable affective temperaments. An important "mediator" role of affective temperaments in the effect of childhood abuse on well-being was suggested.

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Mandibular Advancement Device as a Comparable Treatment to Nasal Continuous Positive Airway Pressure for Positional Obstructive Sleep Apnea

Yoshikazu Takaesu, Satoru Tsuiki, Mina Kobayashi, Yoko Komada, Hideaki Nakayama, Yuichi Inoue

JOURNAL OF CLINICAL SLEEP MEDICINE ( AMER ACAD SLEEP MEDICINE ) 12 ( 8 ) 1113 - 1119 2016年 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

Study Objectives: Positional obstructive sleep apnea (P-OSA) is a clinically common phenotype of OSA, which can be treated effectively with mandibular advancement devices (MADs). We hypothesized that the efficacy of an MAD is comparable to that of nasal continuous positive airway pressure (nCPAP) in P-OSA patients. Methods: Among patients diagnosed with OSA at a single sleep center from January 2008 to May 2014, male subjects with moderate OSA were recruited and stringently categorized as having P-OSA when the ratio of their lateral apnea-hypopnea index (AHI) to supine AHI was <= 0.5, their lateral sleep time was > 60 minutes, and their lateral REM sleep time was longer than 10 minutes. Treatment efficacy was compared between P-OSA subjects with an MAD (n = 34) and those with nCPAP (n = 34) after matching for age, body-mass index, and baseline AHI. Results: There were no significant differences in baseline AHI (MAD: nCPAP = 20.6 +/- 3.9/h: 21.3 +/- 1.7/h, p = 0.35) or in follow-up AHI (MAD: nCPAP = 4.7 +/- 3.5/h: 3.4 +/- 3.7/h, p = 0.12) between the 2 treatment groups, and hence MADs lowered the AHI to the same extent as nCPAP. Conclusions: These findings suggest that an MAD is as efficacious as nCPAP for P-OSA patients. MAD treatment for this specific phenotype may be a promising patient-tailored and first-line approach to OSA. Commentary: A commentary on this article appears in this issue on page 1079.

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Prevalence and associated factors of hypnotics dependence among Japanese outpatients with psychiatric disorders

Akiko Murakoshi, Yoshikazu Takaesu, Yoko Komada, Jun Ishikawa, Yuichi Inoue

PSYCHIATRY RESEARCH ( ELSEVIER IRELAND LTD ) 230 ( 3 ) 958 - 963 2015年12月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

This study aimed to investigate the prevalence of the dependence for benzodiazepine or their agonist (BZDs) hypnotics, as well as factors associated with this dependence among Japanese psychiatric outpatients. One thousand and forty-three patients in the psychiatric outpatient clinic of Tokyo Medical University Hospital receiving treatment with BZDs hypnotics were analyzed. The subjects answered questionnaires including demographic variables, subjective sleep difficulty assessed by the Pittsburg Sleep Quality Index (PSQI), duration of hypnotics medication, dose of diazepam equivalent BZDs hypnotics, the presence or absence of subjective side effects due to BZDs hypnotics (dizziness, fatigue, daytime sleepiness, amnesia, and headache), and dependency assessed by the Dependency 2-A (D 2-A) score. Subjects with a D 2-A score >= 10 were considered as having BZDs hypnotics dependence, and the variables associated with the presence of dependence were examined using logistic regression analyses. Eighty-two out of the 1043 subjects (7.9%) were determined to have BZDs hypnotics dependence. Compared with the non-dependence group, the dependence group had a significantly higher proportion of positive respondents for all the side effects. Multiple logistic regression analyses showed that the dependence was significantly associated with younger age, higher total PSQI score, and higher daily dose of BZDs hypnotics. Younger age, higher total PSQI score, and higher dose may be associated with BZDs hypnotics dependence. The finding that patients with BZDs hypnotics dependence frequently suffered from subjective side effects and had greater sleep difficulty encourages the establishment of alternative treatments for patients with insomnia symptoms refractory to BZDs hypnotics treatment. (C) 2015 Elsevier Ireland Ltd. All rights reserved.

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A preliminary study on the relationships between diurnal melatonin secretion profile and sleep variables in patients emergently admitted to the coronary care unit

Yoshikazu Takaesu, Kunihiro Futenma, Mina Kobayashi, Yoko Komada, Nobuhiro Tanaka, Akira Yamashina, Yuichi Inoue

CHRONOBIOLOGY INTERNATIONAL ( TAYLOR & FRANCIS INC ) 32 ( 6 ) 875 - 879 2015年07月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

To clarify the significance of melatonin secretion under intensive care conditions, we investigated melatonin secretion profiles and sleep parameters of 23 patients just after admission to the coronary care unit (CCU) and 19 age-matched controls. Sleep parameters were evaluated by actigraphy, and melatonin secretion was assessed by measuring the urinary 6-sulphatoxy melatonin (6-SMT). 6-SMT secretion was lower and nocturnal sleep parameters were less satisfactory in the subjects than those in the controls, and there were positive correlations between these variables, particularly in the subject patients. The lowered melatonin secretion might be involved in the mechanism of insomnia in CCU patients.

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精神科病棟入院患者における転倒リスク要因の検討

大野浩太郎, 高江洲義和, 志村哲祥, 瀧田千歌, 丸田敏雅

精神神経学雑誌 ( (公社)日本精神神経学会 ) ( 2015特別 ) S757 - S757 2015年06月

掲載種別: 研究論文（学術雑誌）

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Impact of hypnotics use on daytime function and factors associated with usage by female shift work nurses

Kunihiro Futenma, Shoichi Asaoka, Yoshikazu Takaesu, Yoko Komada, Jun Ishikawa, Akiko Murakoshi, Shingo Nishida, Yuichi Inoue

SLEEP MEDICINE ( ELSEVIER SCIENCE BV ) 16 ( 5 ) 604 - 611 2015年05月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

Objective: We investigated quality of life (QOL) and work performance of hypnotics users, and explored the factors associated with multiple hypnotics usage in shift work nurses. Methods: We conducted a questionnaire-based, cross-sectional survey on nurses in university hospitals. We analyzed responses from 1202 nurses; 997 were female shift work nurses (82.9%), including 696 and 281 two-and three-shift workers, respectively. Results: The rate of hypnotics use was 10% (6.9% were single hypnotic users and 3.1% were multiple hypnotics users). The rate of insomnia did not differ between the single and multiple hypnotics users. However, multiple hypnotics users showed lower QOL, more severe depressive symptoms, and greater frequencies of work-related errors than those using a single hypnotic. A multiple logistic regression analysis revealed that age >= 27 years, presence of depression, eveningness chronotype, and presence of insomnia symptoms were significantly associated with hypnotics use. On the other hand, only the existence of shift work disorder (SWD) was significantly associated with usage of multiple hypnotics. Conclusions: The present study suggested that usage of multiple hypnotics is not beneficial for relieving insomnia or for keeping better QOL in shift work nurses. It would be desirable to explore the causal relationship between SWD and multiple hypnotics use in a future longitudinal study. (C) 2014 Elsevier B.V. All rights reserved.

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