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：BIOMED CENTRAL LTD  

Background: Long-chain n-3 and n-6 polyunsaturated fatty acids (LC n-3/n-6 PUFA) play important roles in emotional regulation. We previously reported an association between fish consumption, which is major source of LC n-3 PUFA, and resilience to depression, where resilience is the ability to cope with stress in the face of adversity. Although the traditional Japanese dietary pattern of high fish consumption is associated with low depressive symptoms, the current Japanese diet pattern has become westernized. Westernized diets contain excessive amounts of LC n-6 PUFA due to high intake of vegetable oils commonly used in fried food and are associated with risk of depression. The aim of this study was to examine the association between frequency of fried food consumption and resilience to depression.
Methods: Participants were 715 Japanese company workers. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to measure depressive symptoms, and the 14-item Resilience Scale (RS-14) was used to measure resilience. Frequency of fish and fried food consumption was assessed using a self-report questionnaire based on the Food Frequency Questionnaire. Regression analyses using Preacher and Hayes' bootstrap script were used to adjust for demographic factors, frequency of physical exercise, and fish consumption.
Results: Significant associations were identified between frequency of fried food consumption and total CES-D score (path c, B = 0.72; P < 0.01), between frequency of fried food consumption and total RS-14 score (path a, B = -1.73, P < 0.01), and between total RS-14 score and CES-D score (path b, B = -0.35; P < 0.01). The association between fried food consumption and total CES-D score was not significant when we controlled for RS-14 score. Bootstrapping results showed that there was a significant positive indirect association between frequency of fried food and CESD score through RS-14 (95 % bias-corrected and accelerated confidence interval = 0.34 to 0.92).
Conclusion: Frequency of fried food consumption was associated with lower resilience to depression. Further nutritional interventional studies to increase resilience and prevent depression are warranted.

DOI： 10.1186/s12944-016-0331-3

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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：BIOMED CENTRAL LTD  

Background: Regular physical exercise has been reported to reduce depressive symptoms. Several lines of evidence suggest that physical exercise may prevent depression by promoting social support or resilience, which is the ability to adapt to challenging life conditions. The aim of this study was to compare depressive symptoms, social support, and resilience between Japanese company workers who engaged in regular physical exercise and workers who did not exercise regularly. We also investigated whether regular physical exercise has an indirect association with depressive symptoms through social support and resilience.
Methods: Participants were 715 Japanese employees at six worksites. Depressive symptoms were assessed with the Center for Epidemiologic Studies Depression (CES-D) scale, social support with the short version of the Social Support Questionnaire (SSQ), and resilience with the 14-item Resilience Scale (RS-14). A self-report questionnaire, which was extracted from the Japanese version of the Health-Promoting Lifestyle Profile, was used to assess whether participants engage in regular physical exercise, defined as more than 20 min, three or more times per week. The group differences in CES-D, SSQ, and RS-14 scores were investigated by using analysis of covariance (ANCOVA). Mediation analysis was conducted by using Preacher and Hayes' bootstrap script to assess whether regular physical exercise is associated with depressive symptoms indirectly through resilience and social support.
Results: The SSQ Number score (F = 4.82, p = 0.03), SSQ Satisfaction score (F = 6.68, p = 0.01), and RS-14 score (F = 6.01, p = 0.01) were significantly higher in the group with regular physical exercise (n = 83) than in the group without regular physical exercise (n = 632) after adjusting for age, education, marital status, and job status. The difference in CES-D score was not significant (F = 2.90, p = 0.09). Bootstrapping revealed significant negative indirect associations between physical exercise and CES-D score through the SSQ Number score (bias-corrected and accelerated confidence interval (BCACI) = -0.61 to -0.035; 95 % confidence interval (CI)), SSQ Satisfaction score (BCACI = -0.92 to -0.18; 95 % CI), and RS-14 score (BCACI = -1.89 to -0.094; 95 % CI).
Conclusion: Although we did not find a significant direct association between exercise and depressive symptoms, exercise may be indirectly associated with depressive symptoms through social support and resilience. Further investigation is warranted.

DOI： 10.1186/s12889-016-3251-2

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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：BIOMED CENTRAL LTD  

Background: Depression is a common disorder that is influenced by psychosocial factors in the workplace. Increasing resilience, the ability to cope with stress in the face of adversity, is considered an important strategy to prevent depression. It has been suggested that consumption of fish, which is a major source of long chain n-3 polyunsaturated fatty acids (LC n-3 PUFA), may prevent depression. However, associations between depression, resilience, and fish consumption have not been documented. The aim of the study is to investigate the association between fish consumption and resilience to depression.
Methods: Participants were 527 Japanese employees at three worksites of a large company. The Center for Epidemiologic Studies Depression (CES-D) Scale was administered to assess depressive symptoms, and the 14-item Resilience Scale (RS-14) was administered to assess resilience. A self-report questionnaire extracted from the Food Frequency Questionnaire was used to measure fish consumption frequency. Regression analyses were conducted to assess a mediation model based on a statistical analysis framework defined by Baron and Kenny. The indirect association of resilience was calculated with the bootstrapping method. Each analysis was adjusted by age, sex, marital status, work position, and educational background.
Results: The association between fish consumption frequency and total CES-D score was significant (B = -0.94; p = 0.011). The association between fish consumption frequency and total RS-14 score was significant (B = 1.4; p = 0.010), as was association total RS-14 score and the total CES-D score (B = -0.34; p < 0.001). When controlling for total RS-14 score, there was no longer a significant association between fish consumption frequency and total CES-D score. The bootstrapping results revealed that significant indirect association though fish consumption frequency and total CES-D score (bias corrected and accelerated confidence interval = -0.83 to -0.13; 95 % confidence interval) through total RS-14 score.
Conclusions: Fish consumption might be associated with resilience to depression. Further studies are needed, particularly double blind randomized placebo controlled intervention trials on the potential preventative effect of LC n-3 PUFA on resilience to depression.

DOI： 10.1186/s12944-015-0048-8

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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  

Although protracted cognitive impairment has been reported to occur after radiotherapy even when such therapy is not directed to brain areas, the mechanism remains unclear. This study investigated whether breast cancer patients exposed to local radiotherapy showed lower cognitive function mediated by higher plasma interleukin (IL)-6 levels than those unexposed. We performed the Wechsler Memory Scale-Revised (WMS-R) and measured plasma IL-6 levels for 105 breast cancer surgical patients within 1 year after the initial therapy. The group differences in each of the indices of WMS-R were investigated between cancer patients exposed to adjuvant regional radiotherapy (n = 51) and those unexposed (n = 54) using analysis of covariance. We further investigated a mediation effect by plasma IL-6 levels on the relationship between radiotherapy and the indices of WMS-R using the bootstrapping method. The radiotherapy group showed significantly lower Immediate Verbal Memory Index and Delayed Recall Index (P = 0.001, P = 0.008, respectively). Radiotherapy exerted an indirect effect on the lower Delayed Recall Index of WMS-R through elevation of plasma IL-6 levels (bootstrap 95% confidence interval = -2.6626 to -0.0402). This study showed that breast cancer patients exposed to adjuvant regional radiotherapy in conservation therapy might have cognitive impairment even several months after their treatment. The relationship between the therapy and the cognitive impairment could be partially mediated by elevation of plasma IL-6 levels.

DOI： 10.1002/cam4.174

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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 Although scales specific to resilience are available and widely used, qualities of resilience could be culturally sensitive. This study aimed to develop a concise scale of resilience for Japanese populations, and compare its validity to that of the Resilience Scale 14-item version (RS-14), one of the most widely used scales for measuring resilience. Methods The Tachikawa Resilience Scale (TRS) was developed on the basis of data obtained from unstructured interviews with Japanese motor vehicle accident survivors without psychiatric disorder. The reliability and validity of the TRS and RS-14 were then examined in cross-sectional studies performed with 523 company workers and 140 psychiatric outpatients. Results The TRS and RS-14 were negatively correlated with depressive symptoms in company workers and psychiatric outpatients and with anxiety in psychiatric outpatients, and were positively correlated with social support in company workers. Internal consistency and testretest reliability of the TRS were high. Construct validity of the TRS was equivalent to that of the RS-14 in company workers, and higher than that of the RS-14 in psychiatric outpatients. Conclusion The reliability and validity of the TRS and RS-14 in Japanese company workers and patients with psychiatric disorders were acceptable. The validity of the TRS was equivalent to or better than that of the RS-14. Although the TRS cannot be regarded as an established scale due to a lack of theoretical rationale, the results of this study suggest that scales measuring resilience that cover cultural aspects might be more relevant in given populations.

DOI： 10.1111/pcn.12028

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担当区分：筆頭著者  

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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：ELSEVIER SCIENCE BV  

Background: Secondary depression is common in the clinical oncology setting after pancreatic cancer diagnosis, following which the patients have to face the fact that they have a cancer with an extremely poor prognosis. However, the specific pathophysiology remains unclear. The present study examined the regional cerebral glucose metabolism using F18-fluorodeoxyglucose (F18-FDG) positron emission tomography (PET) in antidepressant-naive pancreatic cancer patients with a depressive episode after their cancer diagnosis and before their cancer treatment.Methods: Regional cerebral glucose metabolism in pancreatic cancer patients without any antidepressant medication after the cancer diagnosis was measured with F18-FDG PET. A depressive episode after the cancer diagnosis was defined as including major and minor depressive episodes, and was diagnosed using the Diagnostic and Statistical Manual, Fourth Edition (DSM-IV). The prefrontal and limbic regions were the primary regions-of-interest, and an uncorrected value of p < 0.005 was used as significant.Results: Six of 21 pancreatic cancer patients were diagnosed as having a depressive episode. Significantly higher glucose metabolism in depressed patients was found in the subgenual anterior cingulate cortex (sACC) (uncorrected p=0.002).Limitations: There was a small number of subjects, and there were no healthy controls.Conclusions: The higher metabolism in the sACC may be associated with the pathophysiology of secondary depressive episodes in patients following pancreatic cancer diagnosis. (c) 2006 Elsevier B.V. All rights reserved.

DOI： 10.1016/j.jad.2006.08.019

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担当区分：最終著者  

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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：JOHN WILEY & SONS INC  

BACKGROUND. Previous studies have shown cognitive impairment in breast cancer survivors who were exposed to adjuvant chemotherapy. Neural damage by chemotherapy might have played some part in these findings. The current study explored the regional brain volume difference between breast cancer survivors exposed to adjuvant chemotherapy (C+) and those unexposed (C-).
METHODS. High-resolution 1.5-tesla brain magnetic resonance imaging (MRI) databases of breast cancer survivors and healthy controls were used. Brain images were preprocessed for optimal voxel-based morphometry. Comparisons of gray matter and white matter were performed between the C+ and the C- groups, by using MRI scans from within 1 year (the 1-year study, n = 51 and n = 55, respectively) or 3 years after their cancer surgery (the 3-year study, n = 73 and n = 59, respectively). As exploratory analyses, correlation analyses were performed between indices of the Wechsler Memory Scale-Revised and regional brain volume where the volumes were significantly smaller. As a reference, MRI scans of cancer survivors were compared with those of healthy controls m 55 for the 1-year study and n = 37 for the 3-year study).
RESULTS. The C+ patients had smaller gray matter and white matter including prefrontal, parahippocampal, and cingulate gyros, and precuneus in the 1-year study. However, no difference was observed in the 3-year study. The volumes of the prefrontal, parahippocampal gyros, and precuneus were significantly correlated with indices of attention/concentration and/or visual memory. Comparisons with healthy controls did not show any significant differences.
CONCLUSIONS. Adjuvant chemotherapy might have an influence on brain structure, which may account for previously observed cognitive impairments. Cancer 2007; 109:146-56. (c) 2006 American Cancer Society.

DOI： 10.1002/cncr.22368

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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：ELSEVIER IRELAND LTD  

A previous study reported abnormally large cavum septi pellucidi (CSP) in posttraumatic stress disorder (PTSD). We utilized magnetic resonance imaging to examine the frequency of large CSP, as defined by Nopoulos et al. (1997), in cancer survivors with and without intrusive recollections in a sample identical to that of our previous study. The frequency of large CSP did not differ between the two groups. The results suggest that alteration in midline structures during the course of neurodevelopment may lead to severe PTSD, while subthreshold PTSD, such as intrusive recollections, appear not to be associated with such alterations. (c) 2006 Elsevier Ireland Ltd and the Japan Neuroscience Society. All rights reserved.

DOI： 10.1016/j.neures.2006.07.011

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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：OXFORD UNIV PRESS  

Objective: The purpose of the present study was to obtain preliminary findings regarding psychiatric disorders and background characteristics among Japanese family members of cancer patients.
Methods: We investigated the psychiatric diagnosis and background factors of family members of cancer patients by analyzing the consultation data of patients referred to the Psychiatry Division, National Cancer Centre Hospital East, Japan.
Results: Of a total of 1469 psychiatric consultation, 47 (3.2%) family members were referred, and 85% of them were spouses. The most common patient cancer site was the lung. Approximately one-half of the referred family encountered patients' end-of-life issues. The most common psychiatric diagnoses were adjustment disorders, followed by major depression.
Conclusions: These preliminary findings suggest that psychosocial support for family members is not fully delivered and development of a comprehensive support system for caregivers of cancer patients is an urgent issue in the clinical oncology setting in Japan.

DOI： 10.1093/jjco/hyl029

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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：ELSEVIER SCIENCE INC  

Background: Major and minor depressive episodes in cancer patients are frequent and are frequently seen as the first depressive episode in a patient's life. However, the neurological basis of these depressive episodes remains largely unknown.
Methods: Subjects were 51 breast cancer survivors (BCS) who has no history of any depressive episode before the cancer diagnosis (11 BCS with a history of a first minor depressive episode after cancer diagnosis, 11 BCS with a history of a first major depressive episode after cancer diagnosis, and 29 BCS with no history of any depressive episode after cancer diagnosis). We analyzed the prefrontal cortex (PFC) and amygdala volumes in a 1.5-Tesla Magnetic Resonance Imaging scanner. We characterized the structural correlates of depression using two conmplementary approaches. The first was voxel-based morphometry (VBM) that allowed us to scan the entire brain for reactive gray matter deficit. The second was classsical volumetry focussing on amygdala.
Results: Voxel-based morphometry revealed no brain region, including PFC, for which volume was significantly different among the three groups. There wee trend-level differences in the left amygdala volume in the manual tracing method among the three groups. The left amygdala volumes in the subjects with a first minor and /or major depressive episode were significantly smaller than in those with no history of any depressive episode.
Conclusion: It might be suggested that amygdala volume was associated with first minor and/or major depressive episode after cancer diagnosis.

DOI： 10.1016/j.biopsych.2005.08.018

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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  

It has been suggested that marital status and social support are associated with survival in cases of lung cancer, and that such an association may be mediated by several factors. In this prospective cohort study, we investigated the effect of marital status and social support on survival after curative resection for non-small cell lung carcinoma (NSCLC) in Japan. From June 1996 to April 1999, a total of 238 patients with resectable NSCLC were enrolled. Marital status and social support were assessed. The presence and absence of confidants and the satisfaction level with the confidants were used as factors reflecting social support. During the follow-up period, 57 deaths from all causes were identified through January 2004. For the statistical analysis, Cox proportional hazards regression analyses were used. With regard to marital status, the multivariable adjusted hazard ratio (HR) of unmarried patients versus married patients was 0.8 (95% confidence interval, 0.3-1.8) (P-value = 0.53) after controlling for potential confounding factors, including age, sex, occasion of cancer diagnosis, pathological stage, smoking status, smoking status after surgery and serum albumin level. Similarly, the multivariable adjusted HR of patients without confidants versus those with confidants was 1.0 (0.5-2.2) (P-value = 0.90), whereas the multivariable adjusted HR of the dissatisfied-with-confidants group versus the satisfied-with-confidants group was 0.7 (0.4-1.3) (P-value = 0.28). The present data do not support the hypothesis that marital status and social support are associated with survival in NSCLC.

DOI： 10.1111/j.1349-7006.2006.00159.x

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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  

Psychological depression is thought to be a predictor of poor survival among cancer patients. The objective of the present study was to investigate the association between depression and survival in surgically treated Japanese patients with non-small cell lung cancer (NSCLC). From June 1996 through April 1999, a total of 229 patients with postoperative lung cancer were enrolled. Three months after the patients' surgery, the Structured Clinical Interview for DSM-III-R (SCID) and the Profile of Mood States (POMS) were used to assess the patient for depression, based on the interviewers' rating and a self-report, respectively. The follow-up period consisted of a total of 14 342 person-months (median = 69 months). As of January 2004, 55 deaths had occurred within the follow-up period. A Cox regression was used to estimate the hazard ratio (HR) of mortality adjusting for age, sex, smoking status, occasion of diagnosis, pathological stage and preoperative percentage forced expiratory volume in 1 s. The depression-dejection subscale on the POMS was divided into three score levels. The multivariate HR of survival for individuals with depression, as diagnosed by the SCID, was 2.2 (95% confidence interval 0.8-6.0) (P-value = 0.14), compared with individuals without depression. The multivariate HR of survival for subjects in the highest level of the POMS Depression-Dejection subscale was 1.4 (0.7-2.6), compared with in the lowest level (trend P-value = 0.0502). This prospective cohort study in Japan does not support the hypothesis that depression is associated with survival among NSCLC patients after curative resection, but further analysis involving a long-term follow-up period is needed.

DOI： 10.1111/j.1349-7006.2006.00160.x

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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：SPRINGER  

We investigated the adverse effects of adjuvant chemotherapy on the hippocampus in Japanese breast cancer survivors with (n=44) and without (n=31) adjuvant chemotherapy. There were no significant differences in hippocampal volume (magnetic resonance imaging) or additionally in memory function (Wechsler Memory Scale-Revised) between the two groups.

DOI： 10.1007/s10549-005-1412-6

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出版者・発行元：11  

DOI： 10.1038/sj.bjc.6602610

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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  

Cortisol has been speculated to play a role in survival from cancer. The objective of this study was to investigate the association between 24-h urinary cortisol levels and survival from non-small cell lung cancer. From June 1996 to April 1999, a total of 226 patients with resectable non-small cell lung cancer were enrolled. Urine samples were collected over a 24-h period before the curative resections. A total of 14 650 person-months (median =71 months, range =1 -97 months) were accrued. Over the follow-up period, 56 deaths from all causes were identified through January 2004. Cox proportional hazards regression analyses were used to estimate the relative risk (RR) of death from all causes according to three categories of 24-h urinary cortisol levels. Multivariable RRs of death from all causes for individuals in the highest and intermediate categories, compared with the lowest category, were 1.09 (95% confidence interval 0.54-2.21) and 1.17 (0.55-2.46), respectively (p for trend = 0.17). The present data do not support the hypothesis that 24-h urinary cortisol levels are associated with survival from non-small cell lung cancer.

DOI： 10.1080/02841860510029635

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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 AS  

This study was conducted to investigate the profile of patients referred for Psychiatric evaluation of competency among patients with cancer. Among the 1721 referred cancer patients, 43 (2.5%) were referred for competency evaluation. The most common reason for competency evaluation was refusal of test or treatment, and the common psychiatric diagnoses were adjustment disorders, delirium and personality disorders. Cancer patients with personality disorders were more likely to be evaluated as competent, while patients with delirium and dementia were often incompetent; those with adjustment disorders, major depression and psychotic illness could be either competent or incompetent. While these findings were almost consistent with those reported from previous studies, some results may be unique to cancer patients.

DOI： 10.1080/1651500310001923

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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：AMER PSYCHIATRIC PRESS, INC  

Diagnosing depression in cancer patients has been challenging because the diagnostic criteria include somatic symptoms frequently attributed to the cancer itself or its treatment. However, few studies have explored how to appropriately deal with individual somatic symptoms. The authors used data from 220 cancer patients with major depression to examine the intercorrelations among the DSM-IV somatic and nonsomatic symptom criteria as well as whether the presence of an individual somatic symptom could discriminate the severity of major depression. Appetite changes and a diminished ability to think were positively associated with anhedonia. Sleep disturbance and fatigue were not significantly associated with nonsomatic symptoms. These associations were consistent after adjusting for physical functioning and pain. Only patients with appetite changes showed a higher severity of depression. These results suggest that individual somatic symptoms differ in nature and that appetite-related symptoms and a diminished ability to think may be useful for diagnosing depression in cancer patients, whereas sleep disturbances and fatigue may not be as useful.

DOI： 10.1176/appi.psy.44.3.244

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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：JOHN WILEY & SONS INC  

BACKGROUND. Adjustment disorders and major depression are common psychiatric disorders in patients with cancer and have a serious impact on quality of life. The problem in clinical oncology settings is underrecognition of these disorders; as a result, screening is recommended to detect them. The goal of the current study was to develop a new, brief screening tool for adjustment disorders and major depression and to compare its performance with that of existing screening methods.
METHODS. Patients with cancer completed the newly developed One-Question Interview (a 1-item, structured interview); the Distress Thermometer (a 1-item, self-report questionnaire), which previously was developed as a brief screening tool; and the Hospital Anxiety and Depression Scale (HADS; a 14-item, self-report questionnaire). Psychiatric diagnoses of adjustment disorders and major depression were made by psychiatrists and were based on criteria set forth by the Diagnostic and Statistical Manual of Mental Disorders, 4th edition.
RESULTS. Two hundred seventy-five patients participated in the study. Scores on both the One-Question Interview and the Distress Thermometer were significantly correlated with HADS score (One-Question Interview: r = -0.66, P &lt; 0.01; Distress Thermometer: r = 0.71, P &lt; 0.01). At the optimal cutoff points, the sensitivity and specificity for detection of adjustment disorders and major depression were 80% and 61%, respectively, for the One-Question Interview; 84% and 61%, respectively, for the Distress Thermometer; and 92% and 57%, respectively, for the HADS.
CONCLUSIONS. The results of the current study suggested that the One-Question Interview was a valid tool for use in screening patients with cancer for adjustment disorders and major depression. Its performance was inferior to that of the HADS but comparable to that of the Distress Thermometer. The One-Question Interview may be suitable for widespread use in routine screening. (C) 2003 American Cancer Society.

DOI： 10.1002/cncr.11358

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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：OXFORD UNIV PRESS  

Background: Previous epidemiological studies have indicated that the risk of suicide in cancer patients is higher than that of the general population. In addition, euthanasia and physician-assisted suicide (PAS) have recently become controversial medical, ethical and legal issues all over the world. Although suicide in cancer patients and appropriate management of cancer patients with suicidality are critical issues in clinical oncology practice, there have been very few studies to understand suicidality in cancer patients. The purpose of this study was to explore the clinical factors associated with suicidality in Japanese patients with cancer.
Methods: We investigated the clinical factors associated with suicidality in cancer patients by analyzing the consultation data of patients referred to the Psychiatry Division, National Cancer Centre Hospital and Hospital East, Japan.
Results: Of 1713 psychiatric referrals, 62 (3.6%) were related to suicidality, including 44 cases with suicidal ideation, 10 suicide attempts and eight cases who had requested euthanasia and/or continuous sedation. Most of the patients suffered from physical distress and/or psychiatric disorders. The results of a multivariate analysis comparing cancer patients with a psychiatric referral related to suicidality and those referred for other reasons indicated that impaired physical functioning and major depression were significant associated factors.
Conclusions: Our findings suggest that early detection and appropriate management of major depression and comprehensive care improving physical functioning may help to prevent suicide and manage suicidality in Japanese cancer patients.

DOI： 10.1093/jjco/hyf106

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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 AS  

INTRODUCTION: Treatment of major depression in advanced cancer patients is often difficult because of their special characteristics.
METHOD: The authors developed a treatment algorithm for major depression in advanced cancer patients and report on their clinical experience using it. The applicability, tolerability, and clinical efficacy of the algorithm were evaluated in 95 advanced cancer patients with major depression.
RESULTS: The algorithm was not suitable for seven patients and was not used correctly in 14 cases. It was correctly applied to 74 patients (77%), 23 of whom dropped out for cancer-related reasons (deterioration of physical condition, transfer to other hospitals, cancer death). As for tolerability, 22 patients (43%) of the 51 dropped out of the antidepressant treatment regimen because of delirium due to deterioration of their physical condition, adverse effects of the antidepressant, etc. In the 29 cases that could be followed up, clinical efficacy was evaluated for 4 weeks, and improvement was observed in 22 cases (76%).
CONCLUSION: These preliminary findings suggest that use of the algorithm may be feasible, but that it requires some alterations to manage major depression in advanced cancer patients.

DOI： 10.1080/136515002753724072

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Oxford University Press (OUP)  

DOI： 10.1093/jjco/hye039

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総ページ数：295   記述言語：日本語  

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総ページ数：331   記述言語：日本語  

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総ページ数：462   記述言語：日本語  

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担当区分：筆頭著者   記述言語：日本語   掲載種別：速報，短報，研究ノート等（大学，研究機関紀要）   出版者・発行元：日本医科大学  

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担当区分：筆頭著者   記述言語：日本語   出版者・発行元：(株)星和書店  

職域領域においては感情労働を中心とした様々な心理社会的ストレスがかかる。職域領域における精神障害のうちもっとも頻度の高いものは抑うつ障害である。近年食習慣と抑うつ障害、抑うつに関する様々な知見が報告されるようになってきている。ある特定の食品や特定の栄養素、さらには日本食など伝統的な食習慣、健康的な食習慣が働く世代において抑うつを予防する可能性が示唆されている。一方で、抑うつおよび食習慣は共に多面的な様々な心理社会的な要因が関連し合っている。今後はこのような複雑さを考慮した上での研究が必要であり、メンタルヘルスを改善するための有効な介入プログラムを作っていくことが必要である。食習慣を改善することは、生活習慣病を予防することのみならず、職域領域メンタルヘルスの改善のために重要な役割を担う可能性がある。(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J03168&link_issn=&doc_id=20191024180008&doc_link_id=issn%3D1343-3474%26volume%3D22%26issue%3D11%26spage%3D1079&url=http%3A%2F%2Fwww.pieronline.jp%2Fopenurl%3Fissn%3D1343-3474%26volume%3D22%26issue%3D11%26spage%3D1079&type=PierOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00005_2.gif

記述言語：日本語   出版者・発行元：(一社)日本総合病院精神医学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本総合病院精神医学会  

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記述言語：日本語   出版者・発行元：(一社)日本がん看護学会  

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記述言語：日本語   出版者・発行元：(一社)日本総合病院精神医学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：日本脂質栄養学会  

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記述言語：日本語   出版者・発行元：(NPO)日本緩和医療学会  

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記述言語：日本語   出版者・発行元：(NPO)日本緩和医療学会  

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記述言語：日本語   出版者・発行元：(NPO)日本緩和医療学会  

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：WILEY-BLACKWELL  

Web of Science

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記述言語：日本語   出版者・発行元：メディカルレビュー社  

CiNii Books

CiNii Research

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記述言語：日本語   出版者・発行元：(一社)日本総合病院精神医学会  

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記述言語：日本語   出版者・発行元：(株)総合医学社  

＜point＞●コミュニケーションでは、丁寧さ、相手への敬意、敬語や非言語的情報への注意、効果的な質問による情報収集とニードや苦痛などの評価、患者の社会生活への関心、患者の感情と背景の理解が大切である。●悪い知らせを伝える際には、患者が望むコミュニケーション(SHARE)を念頭におく。●不安にはよく耳を傾け背景を理解して、共感的な対応と背景に合せた対応をとる。●否認は自然な反応で時間とともに変化することが多いので、見守ることから始める。(著者抄録)

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記述言語：日本語   出版者・発行元：(NPO)日本緩和医療学会  

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記述言語：日本語   出版者・発行元：(NPO)日本緩和医療学会  

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記述言語：日本語   出版者・発行元：(株)へるす出版  

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記述言語：日本語   出版者・発行元：(株)癌と化学療法社  

がん医療においてよくみられ、対処が必要な精神障害にはせん妄、大うつ病がある。これらの状態に陥ると、時には安全に医療行為を行うことができなかったり、時に意思決定に重要な障害をもたらしたり、入院期間の延長に関連したり、さらには自殺など重大な問題を来すことが知られている。一方でこれらの精神障害は臨床の場で気づかれることが少なく、また気づかれたとしても対処されていないことも多いとされている。また、精神障害は気づかれぬまま重篤な状況になっていることもあり得る。がんにおける精神障害は、心理・社会的、生物学的など多面的な要素をもっており、状況、病態に応じた治療が必要である。さらに、がん自体が自殺のリスクを上げるとされる。これらの状況においては精神科医へのコンサルテーションはためらうべきではなく、十分な協力体制が必要である。精神科的な問題に対する関心を高め、スクリーニングなどを含め、精神科医療とのネットワークを充実させていくことが重要である。(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2008&ichushi_jid=J00296&link_issn=&doc_id=20081217360007&doc_link_id=%2Fab8gtkrc%2F2008%2F003513%2F007%2F2326-2329%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fab8gtkrc%2F2008%2F003513%2F007%2F2326-2329%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：(株)日本看護協会出版会  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2008&ichushi_jid=J01949&link_issn=&doc_id=20081016190008&doc_link_id=%2Fag0ngtdi%2F2008%2F002312%2F008%2F0048-0052%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fag0ngtdi%2F2008%2F002312%2F008%2F0048-0052%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：(一社)日本総合病院精神医学会  

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：JOHN WILEY & SONS LTD  

Web of Science

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：JOHN WILEY & SONS LTD  

Web of Science

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記述言語：日本語   出版者・発行元：(有)科学評論社  

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記述言語：日本語   出版者・発行元：(株)永井書店  

がん臨床の場においては、せん妄、適応障害、うつ病が、高頻度に認められ、大きなインパクトをもたらしている。一方でそれらが適切に評価されることは必ずしも多くない。がん患者の精神症状を緩和するためには、日常的に精神的な問題を表出することができるような関係性を作ることが重要である。また、身体的、心理的、社会的要因が複雑に関連していることが多く、多面的にアプローチしていく必要がある。(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2007&ichushi_jid=J00396&link_issn=&doc_id=20070507090012&doc_link_id=%2Faf2gktye%2F2007%2F009605%2F012%2F0942-0947%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Faf2gktye%2F2007%2F009605%2F012%2F0942-0947%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：(株)日本臨床社  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2007&ichushi_jid=J01205&link_issn=&doc_id=20061220020021&doc_link_id=%2Fag6niria%2F2007%2F006501%2F021%2F0123-0127%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fag6niria%2F2007%2F006501%2F021%2F0123-0127%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：WILEY-BLACKWELL  

Web of Science

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記述言語：日本語   出版者・発行元：永井書店  

がん患者の精神的苦痛の神経生物学的な病態を解明するツールとして脳画像研究の手法が導入され始めている.うつ状態を呈するがん患者では,機能的には前頭葉,帯状回,側頭頭頂葉などで糖代謝が低下し,形態的には左扁桃体が小さいことが示された.侵入性想起を有するがん患者では,左海馬と扁桃体が小さいことが示されている(著者抄録)

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：PERGAMON-ELSEVIER SCIENCE LTD  

Web of Science

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記述言語：日本語   出版者・発行元：国立精神・神経センタ-精神保健研究所  

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記述言語：日本語   出版者・発行元：(株)世論時報社  

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：JOHN WILEY & SONS LTD  

Web of Science

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：JOHN WILEY & SONS LTD  

Web of Science

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：AMER PSYCHIATRIC PRESS, INC  

Web of Science

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記述言語：日本語   出版者・発行元：(株)中外医学社  

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記述言語：日本語   掲載種別：記事・総説・解説・論説等（商業誌、新聞、ウェブメディア）  

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：JOHN WILEY & SONS LTD  

Web of Science

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記述言語：日本語   出版者・発行元：(一社)日本呼吸器学会  

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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  

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記述言語：日本語   出版者・発行元：(一社)日本総合病院精神医学会  

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記述言語：日本語   出版者・発行元：(一社)日本総合病院精神医学会  

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担当区分：筆頭著者   記述言語：日本語   出版者・発行元：(一社)日本総合病院精神医学会  

慢性呼吸器疾患を伴ううつ病とその関連因子および内科外来への影響を調査した.対象は,外来慢性呼吸器疾患を伴ううつ病患者114例(男性78例,女性36例・平均年齢69.8歳)であった.15例(13%)がHADSの点数で20点以上の大うつ病,42例(37%)が11点以上19点以下の閥値下うつ病と診断されたが,担当内科医が抑うつ的もしくは不安が強いと判断した症例は大うつ病症例で5例(33%),閥値下うつ病症例で20例(48%)で,適切な治療は行われていなかった.自覚的な呼吸困難感では大うつ病症例は非大うつ病(閥値下うつ病,非うつ病)症例に比し有意に強く,閥値下うつ病症例は非うつ病症例よりも強い傾向であった.救急外来利用頻度では大うつ病症例は非大うつ病症例に比し有意に高かった.一般外来における身体疾患に伴ううつ病の発見・治療を含む精神科医と身体科医の連携システムの構築が必要と考えられた

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記述言語：日本語   出版者・発行元：(一社)日本呼吸器学会  

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記述言語：日本語   出版者・発行元：厚生労働省精神・神経疾患研究班  

最近発売されたSSRI,SNRIを含む抗鬱薬について,癌患者やその他の身体的疾患を持つ患者の大鬱病への治療効果に関する文献の系統的レビューを行い,これらを踏まえて標記アルゴリズムの改訂版を作成した.第1版からの大きな変更点は,薬物の実証性についてより厳密な検討を行い不要な薬物を削除したこと,薬物選択の基準として即効性や患者の身体状態・併用薬剤に応じた副作用プロフィールを重視したこと等である

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記述言語：日本語   出版者・発行元：国立精神・神経センター  

第1版で明らかになった問題点に対応し,新しく本邦で使用可能になったSSRI,SNRIを取り入れた進行癌患者の大鬱病に対する薬物治療アルゴリズムを作成した.アルゴリズム作成に関する問題点として,進行癌患者を対象とした無作為化比較試験が非常に少ないことが挙げられた.SSRIについては,進行癌ではない癌患者を対象としたものや,身体疾患を有する患者,高齢者を対象とした検討で大鬱病に対する有効性が認められた.SNRIについては身体的に健康な患者や高齢者を対象とした複数の検討で大鬱病に対する有効性が認められた

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記述言語：日本語   出版者・発行元：(公財)先進医薬研究振興財団  

Nortriptylineを内服している進行がん患者及び身体的に健康な患者群を対象とし,一定量のnortriptylineを2週間以上内服した後に,高速液体クロマトグラフィーで血中濃度を測定し,PCR法でCYP2D6遺伝子多型を検討した.身体的に健康な患者群に比べ,進行がん患者群の定常血中濃度は有意に高値であったが,CYP2D6遺伝子多型ごとのサブグループ解析では有意差を認めなかった.又,進行がん患者群内では遺伝子多型ごとの定常血中濃度に差は認められなかった

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記述言語：日本語   出版者・発行元：(株)医学書院  

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DOI： 10.1093/jjco/hye039

PubMed

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記述言語：日本語   出版者・発行元：(一社)日本内分泌学会  

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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：金原出版(株)  

身体的苦痛が著しく心理的に共感しうる状況であったとしても,治療可能な精神科疾患が存在することは少なくない.婦人科悪性疾患の精神医学的問題の頻度は他の部位の癌とほぼ同等に存在すると考えられ,適応障害,大うつ病,せん妄等が多い.このような問題はQOL,身体治療に大きな弊害となることも少なくないにも関わらず,治療されていない場合が多く,精神科疾患のスクリーニングと精神科コンサルテーションが必要である.また婦人科領域の悪性腫瘍の場合,治療後の性機能の変化が大きく,精神症状に関与することもあり今後,重要な課題となり得る

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記述言語：日本語   出版者・発行元：(株)三輪書店  

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記述言語：日本語   出版者・発行元：(一社)日本総合病院精神医学会  

総合病院の中で,精神科病棟(届け出精神病床)を有する施設は21%にしかすぎない.しかし,総合病院における精神科日常臨床において,入院が必要と判断される症例は多い.そこで一般病床において,cluster beds(決まった内科或いは外科病棟に精神疾患症例を集中させ,精神科治療を行う)に入院した100症例についての検討を行った.cluster bedsであろうと大多数の気分障害症例ならびに広範囲にわたる精神科疾患の入院治療が可能であり,総合病院に搬入されることが多い自殺未遂症例の初期治療は可能である点が示された.つまり,cluster bedsをもつことで,総合病院精神科の役割を担うことが可能である点が示された

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記述言語：日本語   出版者・発行元：(一社)日本救急医学会  

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記述言語：日本語   出版者・発行元：(株)総合医学社  

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記述言語：日本語   出版者・発行元：日本赤十字社医学会  

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記述言語：日本語   出版者・発行元：(一社)日本血液学会-東京事務局  

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