ABSTRACT

Objective

This study aimed to evaluate whether a self-management program using the eHealth system could reduce symptom severity in patients with irritable bowel syndrome (IBS). Impact of the intervention on quality of life and gut microbiota were also examined.

Design

This study was designed as an open label, simple randomized controlled trial comparing an intervention group that attended an eHealth self-management program and a treatment as usual group. Participants were Japanese women between the ages of 18 and 36. Forty symptomatic IBS individuals who met the inclusion criteria were recruited and randomly assigned to the two groups. The eHealth group received 8 weeks of unlimited access to the self-management program containing a wide variety of e-learning content. Participants’ severity of IBS symptoms, the main outcome, was assessed using the irritable bowel syndrome-severity index (IBS-SI) at baseline and 8 weeks. The secondary outcomes of participants’ quality of life and gut bacteria were also assessed at baseline and week 8.

Results

There was a significant difference in the net change in IBS severity index (IBS-SI) score between the eHealth and treatment as usual group (−50.1; 95% CI, −87.6 to -12.6; p = 0.010). The eHealth group had significantly lower IBS-SI scores following 8 weeks of intervention compared with the baseline scores (t = − 3.2, p < 0.01). The implementation of the eHealth program was accompanied by improvement of quality of life and decrease of phylum-level Cyanobacteria occupancy, respectively.

Conclusion

The implementation of eHealth for IBS was shown to reduce IBS symptoms.

Key Messages

What is already known on this topic –eHealth programs based on diet and probiotic use have shown good results in reducing IBS symptoms

What this study adds– a self-management program with an e-learning component based on a successful self-help guidebook for IBS

How this study might affect research, practice or policy– The proposed eHealth model reduces symptoms and improves the quality of life of IBS patients, providing an efficient and cost-effective intervention option to be adopted in policy and practice, and creates scope for future research in food intake, exercise, and sleep management through eHealth for IBS.

Hyperhidrosis significantly reduces patients' quality of life, with many reporting feeling highly anxious. However, the relationship between hyperhidrosis and anxiety induced by sweating has not been examined in detail. The current study examined the relationship between: (1) the presence of hyperhidrosis symptoms, (2) hyperhidrosis severity, and (3) the sites of the most sweating and anxiety induced by sweating. A cross-sectional web-based survey was conducted among university students, and 1080 consenting participants (600 males and 480 females; mean age, 18.8 years) were included in the analysis. The survey items were: (1) diagnostic criteria for hyperhidrosis, (2) Hyperhidrosis Disease Severity Scale, (3) presence of anxiety induced by sweating, and (4) site of the most sweating. The results of multiple logistic regression analysis adjusted for sex and age showed that the odds ratio (OR) for anxiety induced by sweating was significantly higher in participants who screened positive for hyperhidrosis than in those who screened negative (OR, 9.72 [95% CI, 5.80-16.27]). The OR of anxiety induced by sweating was 7.11 (95% CI, 3.99-12.65) for mild/moderate hyperhidrosis and 23.46 (95% CI, 7.15-76.93) for severe hyperhidrosis, compared with those who screened negative for hyperhidrosis. Compared with those who screened negative for hyperhidrosis, the OR for anxiety induced by sweating in those with the palmar, plantar, axillary, and head/face as the site of the most sweating was 7.74 (95% CI, 3.91-15.33), 14.86 (95% CI, 1.83-120.58), 16.92 (95% CI, 5.95-48.14), and 5.38 (95% CI, 1.39-20.74), respectively. Our findings suggest that participants who screened positive for hyperhidrosis, mild/moderate or severe, are at a higher risk of anxiety induced by sweating than participants who screened negative for hyperhidrosis.

BACKGROUND: Young adults with irritable bowel syndrome (IBS) occasionally exhibit specific abdominal symptoms, including abdominal pain associated with brain activity patterns. Decoded neural feedback (DecNef) is a biofeedback exercise that allows symptomatic people to exercise self-control over their brain activity patterns relative to those without symptoms. Thus, DecNef can be used to self-control abdominal pain in patients with IBS. To establish a DecNef practice for IBS, it is necessary to develop a classifier that can distinguish the electroencephalography (EEG) patterns (EEG signatures) of IBS between symptomatic and healthy people. Additionally, the accuracy of the "classifier" must be evaluated. METHODS: This study analyzed EEG data obtained from symptomatic and asymptomatic young adults with IBS to develop a support vector machine-based IBS classifier and verify its usefulness. EEG data were recorded for 28 university students with IBS and 24 without IBS. EEG data were frequency-analyzed by fast Fourier transform analysis, and IBS classifiers were created by supervised learning using a support vector machine. RESULTS: The diagnostic accuracy of IBS symptoms was verified for the whole brain and the frontal, parietal, and occipital regions. We estimated >90% accuracy of the IBS classifier in the whole brain and frontal region. CONCLUSIONS: The results of this study suggest that EEG data can be used to determine the presence or absence of IBS symptoms. With the IBS classifier, EEG may help provide feedback regarding the presence or absence of symptoms to patients, which is the basis for developing self-management strategies for IBS.

【背景】片頭痛と緊張型頭痛は、有病率が高く(Penzien et al.,2005)、症状の慢性化や痛みによる生活への支障が見られる(Keefe et al.,2004)。慢性疼痛患者において、セルフ・コンパッション(Self-compassion:SC)は痛みによる生活への支障と負の相関関係にある(Wren et al.,2012)。【目的】本研究は、片頭痛、緊張型頭痛を有する学生に対してSCをベースとしたプログラムを行うことによる、SCの上昇(仮説1)および頭痛による生活への支障の低減(仮説2)について検討することを目的とした。【方法】対象者は19名(21.84±2.39歳)であった。介入期間は4週間で週に1度、計4回の対面セッションを設けて介入を実施した。介入はSCとマインドフルネスを主要素とした。介入の前後で各変数のデータを測定した。さらに介入の前後各1週間には、SC行動と頭痛の程度を測定する質問をメールで送信し、回答を求めた。分析は、対応のあるt検定、マルチレベル分散分析、マルチレベルロジスティック回帰分析を用いた。【結果と考察】SC尺度の下位尺度であるマインドフルネスの得点が介入後に増加した。理由としてはマインドフルネスに時間をかけたことが関係するかもしれない。一方で、それ以外の下位尺度のスコア上昇は認められなかった。日常生活場面における行動に限定したSC行動の尺度は、ほとんど全ての項目において有意に増加した。SC行動の尺度のスコアが上昇した理由としては、対象者が有する特性としてのSCの上昇が認められる一歩手前として、日常的なSCの行動が増加した可能性がある。頭痛による生活への支障は低減しなかった。理由としては、対象者に対し、痛みの維持と生活への支障と、破局的思考、逃避・回避行動の相互の関連についての十分な心理教育を行っていなかったことが関係している可能性がある。(著者抄録)

先行研究で多汗症と不安との関連が示されているが、不安の測定に使用されている尺度はSTAIやLSASなど不安全般を扱ったものであり、多汗症の症状に対する不安が正確に測定されていない可能性がある。そこで今回、多汗症症状に対する不安尺度の開発に向けたパイロットスタディとして、発汗と不安との関連について詳細に検討した。大学生682名を対象とし、原発性局所多汗症の診断基準と、発汗・不安に関する質問項目(オリジナル)を用いた質問紙調査を行った。その結果、多汗症診断基準該当者は非該当者に比べて汗による不安を感じやすいことが明らかになった。また、多汗症患者特有の汗に対する不安として、「手汗で重要な書類が濡れてしまうのではないか」「人と握手をするとき相手に不快感を与えるのではないか」等があることが示唆された。

OBJECTIVES: This study comprised a randomized controlled trial to examine the effect of internet-based attention bias modification (iABM) on reducing workers' anxiety. METHODS: In total, 300 eligible participants were randomized according to sex and age; 180 were assigned to the intervention group and 120 to the control group. The word stimuli used in the iABM included eight positive words and eight neutral words. Participants were instructed to indicate the positive word's position as quickly and accurately as possible by tapping one of the two directions on display. The intervention included five sessions per participant over 1 month, resulting in a total of 600 trials. The main outcome measure was the total state anxiety score of the State-Trait Anxiety Inventory (STAI). RESULTS: There was no significant difference in the net change in STAI scores between the intervention and control groups. The mean reaction time of the fifth session was significantly shorter than the mean reaction time of the first session. Furthermore, although there was no effect on the index of effect size Δ, the paired t-test showed a significant decrease in the anxiety score. CONCLUSIONS: The iABM intervention in this study did not enhance the amelioration of workers' anxiety when compared with the control condition.

BACKGROUND: Post-stroke depression increases the likelihood of adverse physical symptoms. Attentional bias (AB) for negative stimuli is important in depression onset, maintenance, and remission. Stroke is more likely in older adults, who can have reduced cognitive function. Individuals with mild cognitive impairment (MCI) can have delayed reaction times (RTs). We hypothesized that RT to select neutral facial expression is affected by depressive symptoms and cognitive function in patients with stroke. METHODS: This study analyzed 61 patients with stroke. Beck Depression Inventory-Second Edition (BDI-II) and Profile of Mood States (short version) scores were determined. Task stimuli comprised eight pairs of facial expressions containing affective (angry) and neutral faces. AB was measured as the RT to select the neutral face in two simultaneously presented images using attention bias modification (ABM) software. Patients were grouped according to depressive symptoms using BDI-II scores. Between-subject factors of depressive symptoms and cognitive function were determined by ANCOVA. RESULTS: No significant interaction was found between depressive symptoms and cognitive function on RT. There was a main effect of cognitive function, but not depressive symptoms. In patients with hemiparesis and depressive symptoms, RT was significantly shorter in patients without MCI compared with patients with MCI. CONCLUSIONS: People with stroke and elevated depression symptoms with hemiparesis but without MCI quickly selected neutral facial expressions from neutral and aversive expressions, and thus do not need ABM to escape aversive stimuli. ABM in response to aversive stimuli may be useful in evaluating negative emotions in individuals with post-stroke depression without MCI.

Metabolic syndrome (MetS), mainly caused by intra-abdominal fat (IAF) accumulation, is an important risk factor for cardiovascular disease. The prevalence of MetS increases rapidly after the age of 40 years, and it is presumed that there is a substantial proportion of MetS in younger age groups. However, the association of IAF with MetS in adults aged 20 to 30 years has not been fully investigated.This study aimed to determine the prevalence of MetS and to verify whether IAF accumulation is associated with other MetS-related metabolic disorders including dyslipidemia, high blood pressure, and high blood glucose among the Japanese population in their 20s.In this cross-sectional study, IAF area (IAFA) and MetS-related metabolic parameters were evaluated in university students in their 20s (n = 1822, 21.5 ± 1.5 years). IAFA was measured using a non-invasive device, DUALSCAN, which can be readily measured through the dual impedance method. The participants were divided into four groups according to IAFA: 0-49.9, 50-74.9, 75-99.9, and ≥100 cm.MetS was prevalent in 3.3% and 0.0% of the males and females, respectively, according to the Japanese criteria of MetS. The sex- and lifestyle-adjusted odds ratios (ORs) for the three metabolic component levels of Mets were elevated in the larger IAFA groups compared to the smallest IAFA group, according to the level of IAFA. The levels particularly increased in participants with abdominal obesity, defined by both, IAFA and waist circumference rather than by waist circumference alone.IAF accumulation was significantly associated with MetS-related metabolic disorders in young adults. An evaluation of IAFA may contribute to the early prediction of the risk of developing MetS in the future.

【背景】

片頭痛と緊張型頭痛は，有病率が高く（Sakai ＆ Igarashi, 1997）痛みによる生活支障から症状の慢性化が見られる（Keefe, Rumble, Scipio, Giordano ＆ Perri, 2004）。慢性疼痛は，セルフコンパッション（Self-compassion: SC）が痛みの破局的な思考と負の相関があることが報告されている（Anava, et al., 2012）。

【目的】

本研究は，片頭痛，緊張型頭痛を有する学生に対してSCをベースとしたプログラムを行うことによる，SCの上昇（仮説1）および頭痛による生活支障度の低減（仮説2）を仮説検証することを目的とした。

【方法】

学生19名に対し，参加期間全6週間中4週間で介入を実施した。分析は対応のあるt検定，線形混合モデルを実施した。

【結果と考察】

SCの下位因子であるマインドフルネスの得点が介入後に増加した。また日常生活場面におけるSC行動に関する行動の指標は，ほとんど全ての項目において有意に増加した。一方，生活支障度は低減しなかった。介入プログラムでは頭痛の症状のメカニズムを学ぶ要素が不足していたと考察する。そのため，痛み，破局的思考，逃避・回避傾向と生活支障度の関連を十分に理解できるプログラムではなかったことが考えられた。

修学不適応感(不適応感)の緩和を目的とした認知行動療法プログラムを開発し、不適応感を持つ大学生14名に全6回のプログラムを実施した。プログラムの内容は、第1回「認知行動療法の基礎」、第2回「考え方の癖の把握」、第3回「上手な考え方-基礎編(認知再体制化の基本)」、第4回「上手な考え方-応用編1(認知再体制化を用いた不適応感を感じる場面の検討)」、第5回「上手な考え方-応用編2(原因分析)」、第6回「行動変容のコツ(問題解決療法)」とした。効果を検証するためプログラム実施前後に『不適応感尺度』『抑うつ尺度(BDI-II)』『精神健康調査票(GHQ-28)』等を用いたアンケートを行った。結果、プログラム実施後に7名(50%)で不適応感の改善がみられ、プログラム実施前に比べてBDI-IIとGHQ-12の平均スコアが有意に改善した。

Temperament and Character Inventory下位因子のうち損害回避(HA)は鬱病の危険因子とされている。そこで本学では、HAが高く鬱病性障害のない1年生に対して鬱病の予防目的に集団認知行動療法(GCBT)を行い、1年後の調査で抑鬱症状の軽減が認められたことを以前報告した。今回、3年後の追跡調査を行い、GCBTの長期的効果について検討した。結果、3年後も効果が持続していることが明らかになった。

Introduction: Attention bias towards pain-related information exists in patients with chronic pain, and recently, attention bias modification (ABM) training has been administered to patients with chronic pain. In this study, we conducted an attention bias modification task in conjunction with event-related potential measurements for individuals with chronic low back pain (LBP) and investigated the relationship between attention bias and psychological assessment. Methods: Eleven women and two men with chronic LBP participated in the study. Results: The Japanese version of the STarT Back Screening Tool (J-SBST) total score was significantly correlated with the N1 amplitude of Cz. The J-SBST psychological score was significantly correlated with the N1 amplitude of Cz and with reaction time (RT). The Japanese version of the Pain Catastrophizing Scale (PCS) and Japanese version of the Beck Depression Inventory-Second Edition (BDI-II) scores were significantly correlated with the P2 amplitude at Fz (only PCS), Cz, and Pz. Conclusions: Our findings suggest that J-SBST, which provides a comprehensive evaluation of psychological factors, PCN with measuring of catastrophizing in the context of actual or anticipated pain, and BDI-II, can likely help identify chronic LBP patients with attention bias. For chronic LBP patients who are classified according to J-SBST or PCN pain-related outcome improvement with ABM training can be expected.

Irritable bowel syndrome (IBS) is a common bowel disorder that manifests as unexplained abdominal pain or discomfort and bowel habit changes in the form of diarrhea, constipation, or alternating patterns of the two. Some evidences demonstrate that increased physical activity improves IBS symptoms. Hence, daily exercise is recommended in these patients. In this study, we aimed to investigate the relationship between physical activity and gastrointestinal symptoms in 101 university students (female = 78) with IBS. Participants were examined by Gastrointestinal Symptoms Rating Scale (GSRS), and gait steps were measured for 1 week using a pedometer. The association between the GSRS score and pedometer counts was determined by ordinal logistic modeling analysis. The ordinal logistic regression model for GSRS and locomotor activity showed a significant stepwise fit (z = -3.05, p = 0.002). The logistic curve separated GSRS score of 5 points (moderately severe discomfort) from 2 points (minor discomfort) by locomotor activity. The probability for daily locomotor activity to discriminate between 5 and 4 points of GSRS (i.e., likely to have reverse symptoms) decreased in accordance with increment of steps per day: 78% probability for 4000 steps, 70% probability for 6000 steps, 59% probability for 8000 steps, and 48% probability for 10000 steps. This study demonstrated that the severity of GSRS is associated with the amount of walking in younger people with IBS. These results may be used as a measure to determine the daily step count to reduce the severity of gastrointestinal symptoms in individuals with IBS.

BACKGROUND: This study was conducted to investigate the relationship between symptoms of gambling problems, gambling behaviours, and cognitive distortions among a university student population in Japan ages 20 to 29 years. We aimed to address the gap in knowledge of gambling disorders and treatment for this population. METHODS: Data were obtained from 1471 Japanese undergraduate students from 19 universities in Japan. Descriptive statistics and hierarchical multivariate regression analysis were used to investigate whether the factors of gambling cognitive distortions would have predictive effects on gambling disorder symptoms. RESULTS: Results indicated that 5.1% of the participants are classifiable as probable disordered gamblers. The bias of the gambling type to pachinko and pachislot was unique to gamblers in Japan. Of the students sampled, 342 self-reported gambling symptoms via the South Oaks Gambling Screen. Hierarchical multivariate regression analysis indicated that one domain of gambling cognitive distortions was associated significantly with gambling symptoms among the 342 symptomatic participants: gambling expectancy (β = 0.19, p < .05). The multivariate model explained 47% of the variance in the gambling symptoms. CONCLUSION: This study successfully contributed to the sparse research on university student gambling in Japan. Specifically, our results indicated a statistically significant relationship between gambling cognitive distortions and gambling disorder symptoms. These results can inform the development of preventive education and treatment for university students with gambling disorder in Japan. The report also describes needs for future research of university students with gambling disorder.

大学保健領域において、肥満の予防を目的とした認知行動的介入の普及に期待が寄せられるが、その介入ターゲットとして有効と考えられる認知的要因は多岐にわたり、整理されていない状態にある。本研究では、ダイエットに関する非機能的信念を包括的に測定するための尺度(DDBS)を開発し、その信頼性・妥当性の検証を目的とする。調査1では大学生301名、調査2では大学生126名を対象に自記式質問紙を実施した。探索的因子分析の結果、4因子が抽出され、尺度の内的整合性、再検査信頼性は許容できる値であった。DDBS得点は不合理な信念、食行動異常と関連することが示された。DDBSはダイエットに関する非機能的信念を測定する尺度として十分な信頼性・妥当性を有することが確認された。(著者抄録)

BACKGROUND: This study assessed whether a combined intervention of omega-3 polyunsaturated fatty acids (PUFAs) and psychoeducation better improved mild to moderate depression in workers compared to psychoeducation alone. METHODS: This study was a double-blinded, parallel group, randomized controlled trial that compared the intervention group, receiving omega-3 fatty acids, with a control group, receiving a placebo supplement. Participants receiving omega-3 fatty acids took 15 × 300 mg capsules per day for 12 weeks. The total daily dose of omega-3 PUFAs was 500 mg docosahexaenoic acid and 1000 mg eicosapentaenoic acid (EPA). The Beck Depression Inventory®-II (BDI-II) was used to assess the severity of depression after treatment. RESULTS: After 12 weeks of treatment, BDI-II scores were significantly lower in the placebo and omega-3 group, when compared to their respective baseline scores (Placebo: t = - 4.6, p < 0.01; Omega-3: t = - 7.3, p < 0.01). However, after 12 weeks of treatment, we found no significant difference between both groups with respect to changes in the BDI-II scores (0.7; 95% CI, - 0.7 to 2.1; p = 0.30). LIMITATIONS: This study did not measure blood omega-3 fatty acid concentration and presented a high-dropout rate. Moreover, our results may not be generalizable to other regions. CONCLUSIONS: The results show that a combination of omega-3 fatty acids and psychoeducation and psychoeducation alone can contribute to an improvement in symptoms in people with mild to moderate depression. However, there is no difference between the interventions in ameliorating symptoms of depression.

OBJECTIVES: The purpose of this study was to evaluate the effect of self-selection on motivation by measuring event-related potentials (ERPs) and reaction times (RTs), which are indicators of cognitive processing.DESIGN: Twenty healthy young Japanese adults participated in this study. The experiment performed had two conditions: a self-selection condition (the participant chooses the target stimulus) and a forced-selection condition (the target stimulus is specified by the others). Participants performed RT tasks under each condition, and ERPs were measured during the tasks. Subsequently, we analyzed the P300 component of the ERPs.RESULTS: In the self-selection condition, the P300 amplitude was significantly larger, and the RT was significantly shortened compared to the forced-selection condition. There was no significant difference in P300 latency between the self-selection and forced-selection conditions. Participants preferred to complete tasks in the self-selection condition.CONCLUSION: Our findings suggest that self-selection enhances motivation and task performance. These results are important for promoting the supportive and rehabilitative effects of therapy for clients with reduced motivation.

In industrialized countries, the turnover rate of preschool workers is extremely high and now represents a social problem. Consequently, it has become important to promote stable early care and educational environments for this population. Several factors related to working environments are known to affect turnover intention; however, the specific factors related to turnover intention among preschool workers have not yet been identified. Considering this, the objective of the present study was to determine factors associated with preschool workers' willingness to continue working.The participants of this study were 1137 preschool workers based in Nagasaki Prefecture, Japan. Multivariate logistic regression analysis was used to analyze the participants' data, with willingness to continue working for 5 years or more set as the dependent variable.Analysis of the results for all subjects clearly showed that male sex, older age, good mental health, high number of social supports, and good work engagement have a positive effect on willingness to continue working. Further, stratifying the participants in terms of age revealed that for preschool workers under 39 years, male sex, good mental health, high number of social supports, and good work engagement act positively in regard to willingness to continue working. Meanwhile, for those over 40 years, it was found that permanent employment and good work engagement act positively in this regard. Thus, work engagement was the only common factor between preschool workers under 39 and over 40.The findings of this cross-sectional study demonstrate that the factors associated with willingness to continue working among preschool workers differ between younger and older professionals. These findings underline the importance of considering age categories when attempting to maximize such professionals' willingness to continue working.

High harm avoidance (HA) scores on the temperament and character inventory appear to be a risk factor for depressive disorders and suicide. Since 2012, we have conducted group cognitive behavioral therapy (G-CBT) interventions for students at Nagasaki University with high HA and without depressive disorders, with the aim of preventing depression. Here, we report on the effects of the G-CBT at 1-year follow-up for the 2012 to 2015 period.Forty-two participants with high HA were included in the final analysis. Outcomes were measured with the Beck Depression Inventory II, Manifest Anxiety Scale, 28-item General Health Questionnaire, and Brief Core Schema Scales at baseline, and at 6-month, and 1-year follow-ups.Repeated-measures analyses of variance revealed a significant decrease in mean depressive symptom scores at the 6-month follow-up point; this decrease was maintained at 1 year. Improvements in cognitive schemas were also seen at 6 months and 1 year.We observed improvements in cognitive schemas associated with depression as a result of the G-CBT intervention, with effects maintained at 1 year post-intervention. This intervention may be effective in positively modifying the cognitions of students with HA and preventing future depression.

© 2018 John Wiley &amp; Sons Ltd Background: Attention bias modification normalizes electroencephalographic abnormalities in alpha and beta power percentages related to attention in patients with irritable bowel syndrome (IBS). Yet, it is unknown whether ABM contributes to the normalization of event-related potentials (ERP) in these patients. We hypothesized that ERP related to attention deficit would be normalized after ABM implementation in individuals with IBS. Methods: Thirteen patients with IBS and 10 control subjects completed a 2-month intervention that included five ABM sessions. Each session included 128 trials, resulting in a total of 640 trials during the study period. Event-related potentials were measured at the first and fifth sessions. As per the international 10-20 system for electroencephalographic electrode placement, right parietal P4 was evaluated to measure the attention component of facial expression processing. Key Results: A group comparison of P100 latency at P4 revealed that latencies were significantly different between groups in session 1 (IBS vs control, 108 ± 8 vs 97 ± 14; t = −2.51, P =.0203). This difference was absent in session 5 (94 ± 11 vs 93 ± 11, respectively; t = −0.397, P =.6954, r =.09), indicating an effect of ABM in the IBS group. Conclusions and inferences: Attention bias modification may have clinical utility for normalizing brain function and specifically attentional abnormalities in patients with IBS.

© 2018, Nagasaki University School of Medicine. All rights reserved. Background: Gastrointestinal symptom-specific anxiety (GSA) has been reported to impact symptom severity in irritable bowel syndrome (IBS), suggesting that GSA may be an important treatment outcome. The present study explored whether higher levels of GSA were associated with increased risk of having IBS, and whether individuals with IBS were at greater risk for severe gastrointestinal (GI) symptoms. Methods: Participants comprised 1156 university students. The Rome III modular questionnaire was used to assess for IBS. GSA was measured using the Japanese version of the Visceral Sensitivity Index (VSI). IBS-SI was used to assess severity of GI symptoms. Data were analyzed using univariate and multivariate logistic regression analysis. Results: The prevalence rate of IBS (provisional diagnosis, based on Rome III questionnaire responses) was 21%. Logistic regression analysis was performed using the VSI cutoff point as the independent variable, and the presence or absence of IBS as the dependent variable. Results indicate that for individuals above the VSI cutoff point, the adjusted odds ratio for having IBS was 2.64 (95% CI: 1.87-3.71). Furthermore, results indicate that in participants with high GSA, adjusted odds ratios for severity of IBS symptoms were 0.44 (95% CI: 0.33-0.58) for subclinical, 1.15 (95% CI: 0.90–1.46) for mild symptoms, 2.19 (95% CI: 1.57–3.07) for moderate symptoms, and 5.63 (95% CI: 2.24–14.15) for severe symptoms. Conclusion: Higher VSI scores were associated with having risk factors for IBS and greater severity of IBS symptoms.

Cancer patients with hematopoietic tumors exhibit particularly high rates of anxiety disorders and depression, and often develop negative affect. In addition, psychological problems experienced by cancer patients impair their quality of life. When cancer patients feel anxious, they tend to direct their attention toward stimuli associated with threat in the surrounding environment. If attentional bias occurs in patients with hematopoietic tumors, who are at particular risk of developing negative affect, resolution of the bias could be useful in alleviating their anxiety. The current study examined the association between attentional bias and negative affect in patients with hematopoietic tumors and tested the hypothesis that negative affect would be more severe in those who exhibited greater attentional bias. Twenty-seven patients with hematopoietic tumors participated in the study. Reaction time (RT) was measured as the time between the presentation of the threatening and neutral images, and the subject’s button press to indicate choice (neutral expressions). Eight combinations of “threatening” expressions with high emotional valence and “neutral” expressions with low emotional valence were presented. The images used to measure attentional bias were taken from the Japanese Female Facial Expression Database and had been rated as expressive of anger, sadness, or neutrality, with predetermined emotional valence. Psychological testing was performed with the Profile of Mood States (POMS). To examine the association between attentional bias and negative affect, we calculated Spearman’s rank correlation coefficients for RTs and POMS. Subjects’ mean RT was 882.9 (SD = 100.9) ms, and 19 of the 27 subjects exhibited slower RTs relative to healthy individuals. RT was significantly positively correlated with Tension-Anxiety (r = .679, p &lt
.01) and Fatigue (r = .585, p &lt
.01) subscale scores. The results of the study suggested that attentional bias toward threatening expressions could be positively correlated with the mental intensity of anxiety and fatigue in patients with hematopoietic tumors.

BackgroundGastrointestinal symptoms of irritable bowel syndrome (IBS) show a reciprocal relationship with anxiety. In this intervention-based study, we investigated the utility of attention bias modification (ABM) therapy in patients with IBS. We hypothesized that IBS-related electroencephalographic abnormalities would be normalized after ABM therapy.
MethodsSeventeen patients with IBS and 13 healthy subjects completed five ABM intervention sessions over a 2-month period. Each session included 128 ABM trials, resulting in a total of 640 trials across the intervention period. For each trial, subjects viewed a pair of facial expression images and were instructed to indicate the position of the neutral face as quickly and accurately as possible by pressing one of two buttons on a button box. Electroencephalography data (alpha and beta power percentages) were collected during the 1st and 5th sessions.
Key ResultsGeneralized estimating equations of relative alpha power revealed a significant effect of period was identified at O2 (P=.036). Paired t tests revealed that ABM significantly increased relative alpha power at O2 in patients with IBS. Generalized estimating equation of relative beta power revealed a significant effect of the group x period interaction was identified at Pz (P=.035). Paired t tests revealed that ABM significantly decreased relative beta power at Pz in patients with IBS.
Conclusions & InferencesAttention bias modification may normalize brain function related to attention and anxiety in patients with IBS.

Obesity has become a serious social problem in industrialized countries in recent years. Clinically, although the evaluation of dietary behavior abnormalities is as important as any method of risk assessment for obesity, almost all the existing scales with many items may have numerous practical clinical difficulties. In this study, we aimed to prepare a short questionnaire to assess the dietary behavior abnormalities related to obesity. A total of 1032 individuals aged 20 to 59 years participated in the present study. Using item response theory (IRT), we selected the items for a short version from among 30 items of Sakata Eating Behavior Scale (EBS), which is widely used in Japan. As a result of the IRT-based analysis on the original 30-item version, 7 items were adopted as the short version. The correlation between the total score of the original EBS and the EBS short form was extremely high (r=0.93, P=.001). In examining the criterion validity, for all participants (n=1032), male (n=516), and female (n=516), the correlation coefficients between the total score of the EBS short form and body mass index (BMI) were r=0.26, r=0.28, and r=0.28, respectively. The results of the receiver operating characteristic analysis was performed with obesity BMI&gt;25kg/m(2) as a dependent variable, the value of the area under the curve in the ROC was significantly higher in the 7-item version than in the total score of the original items (P=.0005). In conclusion, the 7-item EBS short form was created. Furthermore, it was found that the EBS short form is a reliable and valid measure that can be used as an indicator of obesity in both clinical and research settings.

We started a special education nine years ago in Japan. We analyzed factors that difficult to study at university using interview materials．Research results show that it is deeply related to their fault factors and executive functions that makes schooling difficult．Just like adjusting the environment, it is important to support development．This research is a preliminary study toward the creation of a better development support program with the goal of self-actualization of university students.

We started a special education nine years ago in Japan. In our research, in order to discover the developmental disorders, it was found that the confirmation of mental health is valid. In particular, it is difficult to distinguish between social anxiety disorder ・In Students who are at risk of developmental disorders, have anxiety and maladaptive sense of university life. Therefore, the screening, a plurality of test batteryis essential.

Background
Helicobacter pylori (HP) infection is implicated in gastric and extra-gastric diseases. While gastritis-related chronic inflammation represents a known trigger of metabolic disturbances, whether metabolic syndrome (MetS) is affected by gastritis status remains unclear. We aimed to clarify the effect of HP-related gastritis on the risk of MetS.
Materials and Methods
We retrospectively enrolled patients undergoing screening for MetS between 2014 and 2015. Investigations included HP-specific immunoglobulin G (IgG) antibody assays to detect HP infection, and serum pepsinogen assays to evaluate atrophic gastritis status. The risk of MetS was evaluated via multiple logistic regression analyses with two covariates: serum HP infection status (IgG levels) and atrophic gastritis status (two criteria were applied; pepsinogen I/II ratio &lt; 3 or both pepsinogen I levels &lt;= 70 mu g/L and pepsinogen I/II ratio &lt; 3).
Results
Of 1,044 participants, 247 (23.7%) were HP seropositive, and 62 (6.0%) had MetS. HP seronegative and seropositive patients had similar risks of MetS. On the other hand, AG (defined in terms of serum PG I/II &lt; 3) was significant risk of MetS (OR of 2.52 [95% CI 1.05-7.52]). After stratification according to HP IgG concentration, patients with low HP infection status had the lowest MetS risk (defined as an odds ratio [OR] adjusted for age, sex, smoking, drinking and physical activity status). Taking this result as a reference, patients with negative, moderate, and high HP infection status had ORs (with 95% confidence intervals [CI]) of 2.15 (1.06-4.16), 3.69 (1.12-16.7), and 4.05 (1.05-26.8).
Conclusions
HP-associated gastritis represents a risk factor for MetS. Research should determine why low and not negative HP infection status is associated with the lowest MetS risk.

Accumulation of intra-abdominal fat is related to hypertension. Despite this, a relationship between hypertension and intra-abdominal fat in young adulthood is not clear. In this study, we verify whether intra-abdominal fat accumulation increases a hypertension risk in young adult subjects.
In a cross-sectional study, intra-abdominal fat area was measured using a dual bioelectrical impedance analysis instrument in 697 university students (20.3 +/- 0.7 years, 425 men). Blood pressure and anthropometric factors were measured. Lifestyle variables including smoking, drinking, physical activity, and eating behavior were assessed with questionnaire. High blood pressure risk (systolic blood pressure &gt;= 130mm Hg and/or diastolic blood pressure &gt;= 85mm Hg) with increasing intra-abdominal fat area was evaluated.
Participants were divided into 5 groups according to their intra-abdominal fat area (&lt;= 24.9, 25-49.9, 50-74.9, 75-99.9, and &gt;= 100 cm(2)). As compared with the values of the smallest intra-abdominal fat area group, the crude and lifestyle-adjusted odds ratios (ORs) were elevated in larger intra-abdominal fat area groups [OR 1.31, 95% confidence interval (CI) 0.66-2.80; OR 3.38, 95% CI 1.60-7.57; OR 7.71, 95% CI 2.75-22.22; OR 18.74, 95% CI 3.93-105.64, respectively). The risk increase was observed only in men.
Intra-abdominal fat accumulation is related to high blood pressure in men around 20 years of age. These results indicate the importance of evaluation and reduction of intra-abdominal fat to prevent hypertension.

The Body Vigilance Scale is a self-report measure of attention to bodily sensations. The measure was translated into Japanese and its reliability, validity, and factor structure were verified. Participants comprised 286 university students (age: 19 I years). All participants were administered the scale, along with several indices of anxiety (i.e., Anxiety Sensitivity Index, Short Health Anxiety Inventory Illness Likelihood Scale, Social Interaction Anxiety Scale, and Hospital Anxiety and Depression Scale). The Japanese version of the Body Vigilance Scale exhibited a unidimensional factor structure and strong internal consistency. Construct validity was demonstrated by significant correlations with the above measures. Results suggest that the Japanese version of the scale is a reliable, valid tool for measuring body vigilance in Japanese university students.

We investigated the relationship between number of weekly working hours and the prevalence of diabetes in the urban Chinese population. Data regarding anthropometric measurements, fasting blood glucose level and number of hours worked per week were collected from 2228 workers in Shanghai, China (M-age=44years; 64% men). Participants were divided into three groups according to the number of hours worked per week (&lt;45, 45-54 and 55), and multiple logistic regression analysis was conducted with diabetes as the dependent variable. Subjects with a HbA1c of 6.5% or above or those prescribed anti-diabetic medications were defined as having diabetes. The multivariate adjusted odds ratio for having diabetes was found to be significantly higher for those who worked 55h per week compared with those who worked &lt;45h per week, but only for men. This finding indicates that working long hours could be a risk factor for diabetes in Chinese male workers. Copyright (c) 2014 John Wiley & Sons, Ltd.

脳卒中後うつ症状のある患者はリハビリテーションへの参加行動が抑制される。本研究は脳卒中後うつ症状のある患者への行動療法が身体活動量を改善させることを検証した。対象は回復期の脳卒中後うつ症状のある患者とない脳卒中患者それぞれ12名とした。抑うつの有無はZungうつ評価尺度を用いて判定し、行動抑制および行動活性の評価指標と機能的自立度評価を用いて群を統制した。抑うつ群は行動介入群と対照介入群に分けた。行動介入群には呼吸法と行動記録を週1回30分間行い、他の2群には同時間の作業療法を追加した。活動量の計測には携帯型記録計を用いた。介入から1週間の活動量は抑うつ群が非抑うつ群よりも有意に低かった。活動量変化率は介入から8週目において抑うつ対照介入群は非抑うつ群に比べて有意に低かったが、行動介入群は非抑うつ群と差がなかった。本研究で用いた行動療法は脳卒中患者の抑うつ症状による活動量低下に抗することが示唆された。(著者抄録)

BACKGROUND: Activated mineralocorticoid receptors influence the association between daily salt intake and blood pressure. A relatively low mineralocorticoid receptor function is reported to be a risk for mental distress such as depression. Since mental distress is also a known risk for hypertension and cardiovascular disease, understanding of the association between estimated daily salt intake and mental distress contributing to hypertension is important for risk estimation for cardiovascular disease. However, no single study has reported this association. METHODS: We conducted a cross-sectional study of 1014 Japanese men undergoing general health check-ups. Mental distress was diagnosed as a Kessler 6 scale score ≥5. We also classified mental distress by levels of hypertension. Estimated daily salt intake was calculated from a causal urine specimen. RESULTS: Independent from classical cardiovascular risk factors and thyroid disease, we found a significant inverse association between estimated daily salt intake and mental distress. When we analyzed for mental distress and hypertension, we also found a significant association. With the reference group being the lowest tertiles of estimated daily salt intake, the multivariable odds ratios (ORs) of mental distress and mental distress with hypertension for the highest tertiles were 0.50 (0.29-0.88) and 0.46 (0.22-0.96). CONCLUSIONS: Lower estimated daily salt intake is a significant risk of mental distress for rural community-dwelling Japanese men. Since depression is reported to be associated with cardiovascular disease, risk estimation for the lower intake of salt on mental distress, especially for mental distress with hypertension, may become an important tool to prevent cardiovascular disease.

The present study tested our hypothesis that university students with irritable bowel syndrome (IBS) may experience less satisfactory academic lives than those of students without IBS. We also verified the hypothesis that university students with IBS might have higher employment anxiety than students without IBS might. We conducted a cross-sectional study of 1,686 university students. Presence or absence of IBS was assessed via the Rome III Questionnaire. Two original items were used to evaluate academic life. The prevalence rates of IBS with diarrhea, IBS with constipation, mixed IBS, and unsubtyped IBS in the study population were 5%, 2%, 10%, and 3%, respectively. Regarding academic life, the proportions of participants who experienced maladjustment and employment anxiety were 29% and 50%, respectively. After adjusting for age, sex, and faculty, the odds ratios for maladjustment and employment anxiety were significantly higher in students who screened positively, relative to those who screened negatively, for IBS (OR, 1.62; 95% CI, 1.24-2.21; OR, 2.16; 95% CI, 1.68-2.81, respectively). In conclusion, maladjustment and anxiety over future employment were higher in university students with IBS relative to those without.

The purpose of this study was to investigate the factor structure of the Body Image Concern Inventory (BICI) using a Japanese population as a web-based survey. Two thousand and sixty individuals (1030 women, 1030 men) ranging from 20 to 69 years of age (M=40, SD = 16) took part in the present research. A confirmatory factor analysis showed that the second-order factor model of the BICI, which had three first-order factors and one second-order factor of dysmorphic appearance concern was an adequate fit to the data. Additionally, the Cronbach's alpha values of the overall and three subscales of the BICI were adequate. Furthermore, measurement invariance tests revealed that the second-order factor model of the BICI had acceptable measurement invariance at the scale and factor-loading levels between genders. These findings suggested that the BICI was reliable, and able to compare its mean scores between women and men in Japan. (C) 2014 Elsevier Ltd. All rights reserved.

Objective: The visceral sensitivity index (VSI) is a useful self-report measure of the gastrointestinal symptom-specific anxiety (GSA) of patients with irritable bowel syndrome (IBS). Previous research has shown that worsening GSA in IBS patients is related to the severity of GI symptoms, suggesting that GSA is an important endpoint for intervention. However, there is currently no Japanese version of the VSI. We therefore translated the VSI into Japanese (VSI-J) and verified its reliability and validity.Material and methods: Participants were 349 university students aged 18 and 19 years and recruited from an academic class. We analyzed data from the VSI-J, Anxiety Sensitivity Index (ASI), Hospital Anxiety and Depression scale (HAD), and Irritable Bowel Syndrome Severity Index (IBS-SI). The internal consistency, stability, and factor structure of the VSI-J and its associations with anxiety, depression and severity measures were investigated.Results: The factor structure of the VSI-J is unidimensional and similar to that of the original VSI (Cronbach's α = 0.93). Construct validity was demonstrated by significant correlations with ASI (r = 0.43, p < 0.0001), HAD-ANX (r = 0.19, p = 0.0003), and IBS-SI scores (r = 0.45, p < 0.0001). Furthermore, the VSI-J was a significant predictor of severity scores on the IBS-SI and demonstrated good discriminant (p < 0.0001) and incremental (p < 0.0001) validity.Conclusion: These findings suggest that the VSI-J is a reliable and valid measure of visceral sensitivity. © 2014 Saigo et al.; licensee BioMed Central Ltd.

身体醜形懸念は青年期に高まることが知られている。これまでに，高い身体醜形懸念を有する群に特有の認知や行動の特徴が明らかにされてきた。しかし，高い身体醜形懸念を有する群の対人的な認知の特徴については，未解明な点が多い。相談へのアクセシビリティ向上，介入技法の改善のために，高い身体醜形懸念を有する群に特有の対人的な認知の特徴の解明が望まれる。本研究では，高い身体醜形懸念を有する大学生の対人的な認知の特徴を検討することを目的とした。281名の大学生（男性117名，女性164名）がデモグラフィック項目，日本語版Body Image Concern Inventory，Short Fear of Negative Evaluation Scale，他者意識尺度，社会規定的完全主義尺度へ回答した。高い身体醜形懸念を有する者は，男女ともに，高い水準の他者からの否定的評価への恐れ，外的他者意識，社会規定的完全主義を示す傾向が認められた。女性においてのみ，高い身体醜形懸念を有する者は，内的他者意識も有意に高い水準の得点を示した。高い身体醜形懸念を有する者が，深刻な対人的な認知の問題を抱えていることが示唆された。

青年期に、肥満予防の介入を効率よく行うことは、重要な課題である。青年期成人の食行動や肥満認識をより正確に評価するために、青年期成人向けの食行動質問表を新たに作成した。青年期成人1,588人(男性910人、女性678人、20.6±2.0歳)の、身長、体重、腹囲を測定し、食行動質問表(原版30)に回答させた。項目反応理論にて、原版30の質問の識別力を解析し上位14の質問を抽出した(選別14)。原版30と選別14の得点間には非常に良い相関関係を認めた(r=0.93、p&lt;0.0001)。さらに、BMI25以上と未満を見分けるためのカットオフ値をROC曲線から求めた。男女とも選別14のカットオフ値は37点であった。選別14得点で見分けた場合のROC曲線の曲線下面積(AUC)は、原版30得点のAUCよりも大きい傾向があった。次に、特異的項目機能分析にて、1年後の肥満移行者と非移行者の間で有意な得点差が生じる4つの質問を抽出した(選別4)。1年後の肥満移行を見分けるための、選別4のカットオフ値は、男性で10点、女性で11点であったが、陽性的中率は低かった(それぞれ12%、2%)。そこで、BMI、腹囲のカットオフ値をも含めた3因子すべてを満たした場合の陽性的中率は、男性で40%、女性で17%であった。若年成人の肥満予防を効率的に行うには、体格に加えて、青年期成人向けの食行動質問表を活用することが有用であると示唆された。(著者抄録)

本研究では、東日本大震災における災害医療支援者の派遣後約1.5ヶ月時点でのPTSD有症状者の把握、および侵入的想起症状に対するコントロール可能性と外傷後ストレス症状との関連について検討することを目的とした。本研究の仮説は、侵入的想起症状に対するコントロール可能性が高い者は外傷後ストレス症状が低く、逆にコントロール可能性が低い者は外傷後ストレス症状が高いとした。東日本大震災に伴い長崎大学から各県に派遣された災害派遣医療チーム（Disaster Medical Assistance Team: DMAT）、救援物資輸送支援、被ばく医療支援、地域医療支援に従事した災害医療支援者54名に対して、フェイスシートを含む、外傷後ストレス症状、および侵入的想起症状に対するコントロール可能性の測定を実施した。派遣後約1.5ヵ月時点でのPTSD有症状者は0名であった。侵入的想起症状に対するコントロール可能性と外傷後ストレス症状との相関分析の結果、コントロール可能性と外傷後ストレス症状を測定するIES-R-J合計得点、およびIES-R-Jの下位因子である侵入的想起症状得点、過覚醒症状得点との間に有意な負の相関が認められた。侵入的想起症状に対するコントロール可能性の高低による外傷後ストレス症状の差を検討したところ、コントロール可能性低群では、コントロール可能性高群と比べてIES-R-J合計得点および、侵入的想起症状得点、過覚醒症状得点が有意に高かった。本研究の結果から、侵入的想起症状に対するコントロール可能性が外傷性ストレス症状に対して抑制的に働くことが示唆された。

OBJECTIVE: Previous studies have reported that patients with irritable bowel syndrome (IBS) show high neuroticism. However, the precise association between the IBS subtypes and the degree of neuroticism in younger populations is largely unknown. We tested our hypothesis that subjects with diarrhea-predominant IBS may have a higher degree of neuroticism than subjects without IBS or those with other subtypes of IBS. We also verified the additional hypothesis that the severity of neuroticism might be correlated with the severity of IBS in younger populations. METHODS: We conducted a cross-sectional survey of 557 university students, ranging in age from 18 to 21 years. Presence/ absence of IBS and determination of the IBS subtype was by the Rome II Modular Questionnaire, while the severity of IBS was determined by the IBS severity index (IBS-SI). The degree of neuroticism was evaluated using the Maudsely Personality Inventory (MPI). The presence/absence of psychological distress was measured with the K6 scale. RESULTS: Neuroticism scores in the subjects with diarrhea-predominant IBS were significantly higher than those in the non-IBS subjects or subjects with constipation-predominant IBS. The neuroticism scores were significantly correlated with the IBS-SI scores in all subjects with IBS. CONCLUSION: These results suggest that neuroticism is involved in the pathophysiology of IBS in young subjects, especially in that of the diarrhea-predominant subtype.

Physical activity and psychological stress were hypothesized to improve more in participants with high self-efficacy than in those with low and medium self-efficacy, after a one-week intervention. 39 female university students participated. The intervention had two steps: a lecture on self-monitoring and goal setting (160 min.) and a one-week pedometer intervention. Analyses were conducted on tertile groups according to self-efficacy at baseline. Pedometer step counts were higher in the high self-efficacy group than in the low self-efficacy group after intervention. Helplessness decreased time dependently after intervention only in the high-self-efficacy group. Because physical activity improved more in the high self-efficacy group after a one-week intervention, one hypothesis was supported.

過敏性腸症候群(irritable bowel syndrome、IBS)は、消化器知覚過敏、消化器運動異常、心理的異常を特徴とし、体性知覚過敏の存在も指摘されている。IBS治療では薬物療法とともに食行動改善と運動介入によって生活習慣改善を促す。しかし、IBS患者は運動による体性知覚で不快な情動を惹起しやすい可能性がある。本研究はIBS有症状者の運動時大脳皮質酸素化ヘモグロビン量を測定した。運動中のOxy-Hb量は右体性感覚野領域でIBS群は無症状群に比べ有意に高かった(T=2.49、P=0.02)。IBS症状の有無と男女による二元配置分散分析の結果、有意な交互作用が認められた(F[3,31]=3.62、p=0.02)。IBS群男性が女性に比べ有意に高かった(post-hoc p=0.005)。IBS有症状者は運動時に体性知覚過敏を呈し、その反応に性差があることが示唆された。(著者抄録)