A greater number of somatic pain sites is associated with poor mental health in adolescents: a cross-sectional study.

Background: Identifying indicators of poor mental health during adolescence is a significant public health issue. Previous studies which suggested an association between the number of somatic pains and depression have mainly focused on adults or have employed samples with a narrow age range. To date, results from previous studies have been inconsistent regarding the association between somatic pain and academic impairment.

Cost-effectiveness of family psychoeducation to prevent relapse in major depression: results from a randomized controlled trial.

Background: Family psychoeducation is a relatively simple and straightforward intervention whose prophylactic effectiveness and cost-effectiveness is well-established for schizophrenia. We have recently demonstrated its effectiveness for unipolar depression, but its cost-effectiveness has never been examined. We hereby report a cost-effectiveness analysis alongside a randomized controlled trial in order to assess its cost-effectiveness for preventing relapse/recurrence in depression.

Strategies and future attempts to reduce stigmatization and increase awareness of mental health problems among young people: a narrative review of educational interventions.

There is a need to reduce stigma and increase awareness in order to prevent social exclusion of people with mental illness and to facilitate the use of mental health services in young people. The purpose of this review was to examine the effects of educational interventions to reduce stigmatization and improve awareness of mental health problems among young people. An electronic search using MEDLINE, PsycINFO and Academic Search Complete was carried out for studies that evaluated the effectiveness of educational interventions.

Family psychoeducation for major depression: randomised controlled trial.

Background: The value of family psychoeducation for schizophrenia has been well established, and indications for its use have recently expanded to include bipolar affective disorder. However, no study to date has adequately examined its use in depression.

Aims: To examine family psychoeducation in the maintenance treatment of depression and to investigate the influence of the family's expressed emotion (EE) on its effectiveness.

Psychosocial job characteristics and smoking cessation: a prospective cohort study using the Demand-Control-Support and Effort-Reward Imbalance job stress models.

Introduction: A prospective cohort study was conducted to examine the effects of psychosocial job characteristics on smoking cessation. Previous studies have failed to indicate consistently that psychosocial job characteristics predicted smoking cessation. Using the Demand-Control-Support (DCS) and Effort-Reward Imbalance (ERI) models simultaneously, we assessed psychosocial job characteristics more comprehensively than did previous researchers.

Association between feasibility of discharge, clinical state, and patient attitude among inpatients with schizophrenia in Japan.

Aim: There have been some studies on the feasibility of discharging mentally ill inpatients from mental hospitals. The purpose of the present study was to investigate how a psychiatrist judges whether an inpatient can be discharged.

Methods: A survey regarding such judgments on discharge was conducted involving 549 inpatients with schizophrenia with a hospital stay of > or =1 year.

Psychosocial job characteristics and insomnia: a prospective cohort study using the Demand-Control-Support (DCS) and Effort-Reward Imbalance (ERI) job stress models.

Objective: To examine the prospective effects of psychosocial job characteristics evaluated with the Demand-Control-Support (DCS) and Effort-Reward Imbalance (ERI) models on insomnia.

Methods: A prospective cohort study with a two-year observation was performed. The subjects were 1022 middle-aged (>or= 39 years) Japanese workers.

[Effects of an educational intervention to reduce prejudice toward the mentally disabled among high school students].

Objective: To assess the efficacy of an educational intervention among high school students aimed at increasing correct knowledge of mental health and reducing prejudice toward the mental disabled.

Methods: A total 180 high school students (intervention group 99; control group 81) participated in the investigation. The intervention program comprised a 1 hour session about mental health and a 1 hour lesson in which 2 persons suffering from mental illness narrated their experiences.

Residential program for long-term hospitalized persons with mental illness in Japan: Randomized controlled trial.

Research on the merits of long-term group residences is inconclusive. The purpose of the present paper was to investigate the effects of supported group residence on the symptoms, social function, quality of life, general health quality, and the medical/psychiatric cost in Japan of a large number of psychiatric beds and long average length of stay. Patients were assessed every 6 months for 2 years using Positive and Negative Syndrome Scale, Katz Adjustment Scale, World Health Organization Quality of Life (WHO-QOL) and General Health Questionnaire 12-item version.

How many long-stay schizophrenia patients can be discharged in Japan?

The mental health-care system in Japan remains hospital-based, and has the largest number of psychiatric beds per capita in the world. However, serious discussion about deinstitutionalization has recently begun. This study attempts to determine the proportion of inpatients that would benefit from community-based programs, as judged by hospital psychiatrists, and to evaluate the need for community resources for their community placement.

Medical cost analysis of family psychoeducation for schizophrenia.

Family psychoeducation has been shown to prevent the relapse of schizophrenia. However, whether medical costs are reduced by this approach remains uncertain. The subjects were patients with schizophrenia who lived with high-expressed emotion (EE) families and were at high risk of relapse.

[Factors affecting WHOQOL-26 in community-dwelling patients with schizophrenia].

Objective: Schizophrenic patients' quality of life (QOL) has become increasingly important due to shift of mental health care from hospitals to communities. This paper describes a longitudinal study conducted to clarify relationships among the QOL, self-esteem, depressive mood, and uncooperativeness of schizophrenic patients identified in the authors' previous crosssectional study.

Methods: Subjects were 61 schizophrenic patients attending day care at mental hospitals.

Can stress management at the workplace prevent depression? A randomized controlled trial.

Background: Stress, mental health and depression at the workplace have emerged as common and significant problems. The effectiveness of a stress-management program at the workplace was investigated.

Methods: The effectiveness of a stress-management program was examined in workers at a highly stressful workplace using a randomized controlled trial.

Seasonality of birth in patients with schizophrenia in Japan.

Although most Western studies have found a birth excess during winter or early spring among patients with schizophrenia, this has not been found in Japanese samples. The purpose of the present paper was to investigate this finding using a large Japanese sample. Distributions of monthly birth numbers of patients with schizophrenia were compared to those of the general population.

A prospective study on the influences of workplace stress on mental health.

The purpose of this study was to clarify the influences of subjective stress in the workplace on mental health according to work contents in subjects without mental health problems. In a survey in fiscal 1997, 1,246 (84.6%) of all 1,363 workers of a manufacturing company in Japan, responded to a questionnaire including questions on subjective stress and GHQ60, and 1,135 workers answered all questions (effective response rate, 83.

Effects of environmental deprivation on negative symptoms of schizophrenia: a nationwide survey in Japan's psychiatric hospitals.

Research into the effects of environmental deprivation on negative symptoms of schizophrenia is limited, and few attempts have been made to differentiate secondary symptoms caused by the social environment. Japan's mental health system allows us to examine the extent to which understimulating social environments in hospitals contribute to negative symptoms of institutionalized patients while controlling for other factors. A random sample of inpatients of diagnosed with schizophrenia and hospitalized for 1 year or longer was drawn from the universe of inpatients attending a convenience sample of 20 hospitals across Japan.

A cross-cultural study on expressed emotion in carers of people with dementia and schizophrenia: Japan and England.

Expressed emotion (EE) research has been productive in investigating the influence of the interpersonal environment on a range of disorders. The majority of EE research on the influence of carers has been carried out in the west. This is the first EE study of the carers of people with dementia in Japan.

Association between psychosocial job characteristics and insomnia: an investigation using two relevant job stress models--the demand-control-support (DCS) model and the effort-reward imbalance (ERI) model.

Background And Purpose: The details of risky psychosocial job characteristics related to insomnia are unclear, although potential relationships between the two have been suggested. The study objective was to clarify these relationships by using the demand-control-support (DCS) model and the effort-reward imbalance (ERI) model.

Patients And Methods: A cross-sectional questionnaire survey was conducted with 1081 middle-aged (39 years and older) workers in a corporate group of electric products in Osaka, Japan.

Quality of life of schizophrenic patients living in the community: the relationships with personal characteristics, objective indicators and self-esteem.

The relationship of personal characteristics, objective indicators, and self-esteem to quality of life (QOL) was investigated cross-sectionally in 73 Japanese schizophrenic patients, and the question of how objective conditions affect subjective evaluation was evaluated. Depressive mood and uncooperativeness were negatively correlated with self-esteem, and self-esteem was positively correlated with QOL. Self-esteem was considered to directly affect QOL, and depressive mood and uncooperativeness to affect QOL via self-esteem.

Does seropositivity for Helicobacter pylori antibodies increase outpatient costs for gastric and duodenal ulcer or inflammation?

Background: Helicobacter pylori is regarded as an important cause of both peptic ulcer and chronic gastritis. In particular, seropositivity is highest in patients with duodenal ulcer. No studies have determined whether there are differences in the direct medical costs associated with gastric/duodenal ulcer or inflammation, between seropositive and seronegative patients.

[Clinical study using activity-based costing to assess cost-effectiveness of a wound management system utilizing modern dressings in comparison with traditional wound care].

In recent years, the concept of cost-effectiveness, including medical delivery and health service fee systems, has become widespread in Japanese health care. In the field of pressure ulcer management, the recent introduction of penalty subtraction in the care fee system emphasizes the need for prevention and cost-effective care of pressure ulcer. Previous cost-effectiveness research on pressure ulcer management tended to focus only on "hardware" costs such as those for pharmaceuticals and medical supplies, while neglecting other cost aspects, particularly those involving the cost of labor.

A study on a reduction in visits to physicians after introduction of 30% co-payments in the employee health insurance in Japan.

The purpose of the study is to evaluate influences of the introduction of 30% co-payments on potential visit behavior using a questionnaire in order to determine whether "employment state of the spouse" and "number of dependent children", as indicators of economic backgrounds, affect visits to physicians in a health insurance society. The subjects were 1,674 insured consisting of 1,165 males and 509 females, who underwent a regular health examination in July 2002, in a health insurance society. In the survey, they were asked whether the subject "will reduce" or "will not reduce" visits to physicians due to the increase in co-payments in the health insurance system scheduled in 2003.

Effects of an increase in patient copayments on medical service demands of the insured in Japan.

Objectives: To examine quantitatively the effects of an increase in patient copayments from 10% to 20% on the demand for medical services in Japan.

Methods: The subjects of the study were the employees insured by the 1,797 health insurance societies, belonging to the National Federation of Health Insurance Societies, in 1996 and 1998. Indicators of medical service demands analyzed include the inpatient, outpatient, and dental case rates, the number of serviced days per case, the medical cost per day and the medical cost per insured.

Institutionalisation and schizophrenia in Japan: social environments and negative symptoms: Nationwide survey of in-patients.

Background: The number of psychiatric beds per capita in Japan is the highest in the world, and a replication of earlier British research is needed to identify possible means of improving the mental health system. Aims To describe the current situation of psychiatric hospitals in Japan and to examine the relationship between negative symptoms of schizophrenia and social environments.

Method: In-patients with schizophrenia were randomly selected from 139 hospitals.