論文 - 河西　千秋

【精神科臨床評価マニュアル(改訂版)】(第1章)精神科臨床評価 全般 自殺の危機介入の統合

河西 千秋, 成田 賢治, 川島 義高

臨床精神医学 ( (株)アークメディア )  49 ( 8 ) 1018 - 1024  2020年08月

Two-day assertive-case-management educational program for medical personnel to prevent suicide attempts: A multicenter pre-post observational study.

Yoshitaka Kawashima, Naohiro Yonemoto, Chiaki Kawanishi, Kotaro Otsuka, Masaru Mimura, Yasushi Otaka, Kazuya Okamura, Toshihiko Kinoshita, Osamu Shirakawa, Reiji Yoshimura, Nobuaki Eto, Satoshi Hashimoto, Hirokazu Tachikawa, Taku Furuno, Tatsuya Sugimoto, Katsumi Ikeshita, Masatoshi Inagaki, Mitsuhiko Yamada

Psychiatry and clinical neurosciences   74 ( 6 ) 362 - 370  2020年06月  [査読有り]  [国際誌]

　概要を見る

AIM: Suicide attempters have a high risk of repeated suicide attempts and completed suicide. There is evidence that assertive case management can reduce the incidence of recurrent suicidal behavior among suicide attempters. This study evaluated the effect of an assertive-case-management training program. METHODS: This multicenter, before-and-after study was conducted at 10 centers in Japan. Participants were 274 medical personnel. We used Japanese versions of the Attitudes to Suicide Prevention Scale, the Gatekeeper Self-Efficacy Scale, the Suicide Intervention Response Inventory (SIRI), and the Attitudes Toward Suicide Questionnaire. We evaluated the effects with one-sample t-tests, and examined prognosis factors with multivariable analysis. RESULTS: There were significant improvements between pre-training and post-training in the Attitudes to Suicide Prevention Scale (mean: -3.07, 95% confidence interval [CI]: -3.57 to -2.57, P < 0.001), the Gatekeeper Self-Efficacy Scale (mean: 10.40, 95%CI: 9.48 to 11.32, P < 0.001), SIRI-1 (appropriate responses; mean: 1.15, 95%CI: 0.89 to 1.42, P < 0.001), and SIRI-2 (different to the expert responses; mean: -4.78, 95%CI: -6.18 to -3.38, P < 0.001). Significant improvements were found on all Attitudes Toward Suicide Questionnaire subscale scores, except Unjustified Behavior. The effect of training was influenced by experience of suicide-prevention training and experience of working with suicidal patients. CONCLUSION: The training program (which was developed to implement and disseminate evidence-based suicide-prevention measures) improved attitudes, self-efficacy, and skills for suicide prevention among medical personnel. Specialized suicide-prevention training and experience with suicidal patients are valuable for enhancing positive attitudes and self-efficacy; furthermore, age and clinical experience alone are insufficient for these purposes.

DOI PubMed

Suicide prevention and postvention in hospitals in Japan: Current status and perspectives.

Keisuke Inoue, Chiaki Kawanishi, Kenji Narita, Yoshinori Cho, Kotaro Otsuka

Psychiatry and clinical neurosciences   74 ( 7 ) 414 - 415  2020年05月  [査読有り]  [国際誌]

DOI PubMed

自殺企図を契機にレビー小体型認知症の診断に至った1例

齋藤 京史郎, 岩本 倫, 佐久川 信, 松山 清治, 白石 将毅, 河西 千秋

精神神経学雑誌 ( (公社)日本精神神経学会 )  122 ( 5 ) 395 - 396  2020年05月

Response to "suicide prevention among patients with cancer".

Yoshitaka Kawashima, Naohiro Yonemoto, Masatoshi Inagaki, Keisuke Inoue, Chiaki Kawanishi, Mitsuhiko Yamada

General hospital psychiatry    2019年11月  [査読有り]  [国際誌]

DOI PubMed

大学生の自殺予防プログラムの開発に関する予備的検討

太刀川 弘和, 安宅 勝弘, 石井 映美, 衛藤 暢明, 岡本 百合, 小田原 俊成, 河西 千秋, 梶谷 康介, 川島 義高, 白鳥 裕貴, 菅原 大地, 高橋 あすみ, 布施 泰子, 堀 正士, 丸谷 俊之, 松原 敏郎, 三井 信幸, 渡辺 慶一郎

大学のメンタルヘルス ( (NPO)全国大学メンタルヘルス学会 )  3   95 - 95  2019年11月  [査読有り]

成人期ADHDの心理検査における特徴

伊東 美波, 石井 貴男, 白石 将毅, 煤賀 隆宏, 谷内 早苗, 津山 雄亮, 河西 千秋

総合病院精神医学 ( (一社)日本総合病院精神医学会 )  31 ( Suppl. ) S - 246  2019年11月

ACTION-Jのその後 二次解析、普及・啓発と新たな施策化 未遂者介入のエビデンスとこれからの可能性

米本 直裕, 川島 義高, 稲垣 正俊, 河西 千秋, 山田 光彦

自殺予防と危機介入 ( (一社)日本自殺予防学会 )  39 ( 2 ) 56 - 60  2019年09月

　概要を見る

本報告では、未遂者介入研究のレビューについて紹介し、そのエビデンスを解説する。加えて、最近の未遂者介入研究を解説し、今後の研究の課題と可能性について考察する。今後我が国において、さらに未遂者介入のエビデンスが蓄積され、未遂者の再企図の予防策が推進されることを望みたい。(著者抄録)

札幌市におけるゲートキーパー養成研修 地域住民がファシリテーターを務める参加型研修

川本 静香, 白石 将毅, 津山 雄亮, 河西 千秋

自殺予防と危機介入 ( (一社)日本自殺予防学会 )  39 ( 2 ) 102 - 105  2019年09月

Interventions to prevent suicidal behavior and ideation for patients with cancer: A systematic review

Yoshitaka Kawashima, Naohiro Yonemoto, Masatoshi Inagaki, Keisuke Inoue, Chiaki Kawanishi, Mitsuhiko Yamada

General Hospital Psychiatry   60   98 - 110  2019年09月  [査読有り]

　概要を見る

© 2019 Elsevier Inc. Objective: This study aimed to summarize interventions for suicide prevention in patients with cancer and highlight any methodological issues. Methods: We searched PubMed, PsycINFO, CINAHL, and the Cochrane database from their inception until July 2018. Additionally, we manually searched the references of included studies and recent systematic reviews of psychotherapy, antidepressants, and collaborative care for cancer patients with depression. Results: Of the 1365 retrieved articles, 11 randomized controlled trials and 11 intervention studies met the inclusion criteria. These were categorized by type of intervention: psychotherapy, pharmacotherapy, integrated collaborative care, muscle relaxation and therapeutic walking, and cancer treatment. The trials showed little evidence to confirm the effects of suicide prevention strategies. Seven trials were designed to assess the efficacy of interventions treating depression. In all studies, suicidal behavior or ideation was reported as one of the secondary outcomes. Three trials did not report information about suicidal ideation, despite assessing depressive symptoms using scales that contained suicidal ideation items. Most trials demonstrated inadequate study quality. Conclusions: Our review summarized interventions for suicide prevention in patients with cancer and revealed methodological issues. The findings highlighted a need to explore new treatment strategies that focus on unique suicide risk factors among patients with cancer.

DOI PubMed

厚生労働省自殺未遂者再企図防止事業 臨床現場におけるケース・マネージメント介入の実態

白石 将毅, 石井 貴男, 津山 雄亮, 岩木 敦子, 野呂 孝徳, 成田 賢治, 煤賀 隆宏, 田山 真矢, 木川 昌康, 河西 千秋

精神神経学雑誌 ( (公社)日本精神神経学会 )  ( 2019特別号 ) S642 - S642  2019年06月

Protocol for a prospective multicentre registry cohort study on suicide attempters given the assertive case management intervention after admission to an emergency department in Japan: post-ACTION-J Study (PACS).

Chiaki Kawanishi, Takao Ishii, Naohiro Yonemoto, Mitsuhiko Yamada, Hirokazu Tachikawa, Toshifumi Kishimoto, Noa Tsujii, Satoshi Hashimoto, Toshihiko Kinoshita, Masaru Mimura, Yoshiro Okubo, Kotaro Otsuka, Reiji Yoshimura

BMJ open   8 ( 9 ) e020517  2018年10月  [査読有り]  [国際誌]

　概要を見る

INTRODUCTION: Suicide attempt is the most important risk factor for later suicide. A randomised-controlled, multicentre trial of postsuicide attempt case management for the prevention of further suicide attempts in Japan, named ACTION-J, has established effective interventions for prevention of suicide reattempts. The ACTION-J assertive case management intervention programme was adopted by the Japanese Ministry of Health, Labour and Welfare in 2016, when medical fees were revised. This nationwide programme is provided to patients who attempt suicide and who are admitted to emergency departments in Japan.The aim of the present study is to examine the current implementation status of the ACTION-J programme. The present study also aims to clarify which patients' and hospitals' factors affect the implementation of the programme. METHODS AND ANALYSIS: This is a prospective, multicentre, patient registry cohort study. Participants will be suicide attempters admitted to the emergency departments of medical facilities with both psychiatry and emergency departments. The assertive case management programme will be delivered to participants by a case manager for up to 24 weeks, based on psychiatric diagnoses, social risks and patient needs. The core feature of the programme is to encourage patients to participate in psychiatric treatment.The primary outcome will be the proportion of patients still participating in the case management intervention at 24 weeks after registration. The secondary outcomes will include measures of the fidelity of the case management intervention. The fidelity will be evaluated using a fidelity assessment manual developed by the study group. ETHICS AND DISSEMINATION: This observational study has been approved by the ethics board of Sapporo Medical University. Enrolment began in October 2016 and will continue until December 2018. Dissemination plans include presentations at scientific conferences and scientific publications. TRIAL REGISTRATION: UMIN000024474.

DOI PubMed

Psychiatric Consultations at an Emergency Department in a Metropolitan University Hospital in Northern Japan.

Masaki Shiraishi, Takao Ishii, Yoshiyasu Kigawa, Masaya Tayama, Keisuke Inoue, Kenji Narita, Masaru Tateno, Chiaki Kawanishi

Psychiatry investigation   15 ( 7 ) 739 - 742  2018年07月  [国際誌]

　概要を見る

Many patients with mental disorders visit emergency departments (EDs). However, the majority of these patients do not receive psychiatric assessment. In the present study, we investigated the detailed proportion of patients with mental disorders visiting an urban ED in the largest northern city in Japan. A retrospective chart review study was performed at a University Hospital from January 2012 to December 2015. The reasons for psychiatric consultations made by ED staff, and the primary psychiatric diagnoses were investigated. Among all living patients, 20% of them received consultations. The most common reason for consultation was suicide attempt followed by agitation or insomnia. Of all diagnoses, organic mental disorder was the most frequent and the mean age was significantly higher than the other diagnostic groups. Our study indicated that the frequency of psychiatric consultation was high. This indicates the high demand for mental health services at the ED. A thorough psychiatric assessment can provide adequate psychiatric services to acute patients; thereby possibly preventing suicide attempters from later actually dying by suicide.

DOI PubMed

【自殺の現状をどう理解するのか】自殺企図の最前線、救急現場から精神科医療へどうつなげるか 自殺未遂者ケアに関わる教育研修プログラム

大塚 耕太郎, 河西 千秋

日本精神科病院協会雑誌 ( (公社)日本精神科病院協会 )  37 ( 6 ) 543 - 547  2018年06月  [査読有り]

日本自殺予防学会の歴史と法人化後の展望 学会による地域貢献 学会法人化後の教育・研修事業

河西 千秋, 大塚 耕太郎

自殺予防と危機介入 ( (一社)日本自殺予防学会 )  38 ( 1 ) 21 - 21  2018年03月

Antipsychotics promote GABAergic interneuron genesis in the adult rat brain: Role of heat-shock protein production

Hiroo Kaneta, Wataru Ukai, Hanako Tsujino, Kengo Furuse, Yoshiyasu Kigawa, Masaya Tayama, Takao Ishii, Eri Hashimoto, Chiaki Kawanishi

Journal of Psychiatric Research ( Elsevier Ltd )  92   108 - 118  2017年09月  [査読有り]

　概要を見る

Current antipsychotics reduce positive symptoms and reverse negative symptoms in conjunction with cognitive behavioral issues with the goal of restoring impaired occupational and social functioning. However, limited information is available on their influence on gliogenesis or their neurogenic properties in adult schizophrenia brains, particularly on GABAergic interneuron production. In the present study, we used young adult subventricular zone (SVZ)-derived progenitor cells expressing proteoglycan NG2 cultures to examine the oligodendrocyte and GABAergic interneuron genesis effects of several kinds of antipsychotics on changes in differentiation function induced by exposure to the NMDA receptor antagonist MK-801. We herein demonstrated that antipsychotics promoted or restored changes in the oligodendrocyte/GABAergic interneuron differentiation functions of NG2(+) cells induced by the exposure to MK-801, which was considered to be one of the drug-induced schizophrenia model. We also demonstrated that antipsychotics restored heat-shock protein (HSP) production in NG2(+) cells with differentiation impairment. The antipsychotics olanzapine, aripiprazole, and blonanserin, but not haloperidol increased HSP90 levels, which were reduced by the exposure to MK-801. Our results showed that antipsychotics, particularly those recently synthesized, exerted similar GABAergic interneuron genesis effects on NG2(+) neuronal/glial progenitor cells in the adult rat brain by increasing cellular HSP production, and also suggest that HSP90 may play a crucial role in the pathophysiology of schizophrenia and is a key target for next drug development.

DOI PubMed

The usefulness of combined brain perfusion single-photon emission computed tomography, Dopamine-transporter single-photon emission computed tomography, and 123I-metaiodobenzylguanidine myocardial scintigraphy for the diagnosis of dementia with Lewy bodies

Seiju Kobayashi, Kanae Makino, Shigeki Hatakeyama, Takao Ishii, Masaru Tateno, Tomo Iwamoto, Hanako Tsujino, Kazuhito Kawasaki, Kouhei Mikuni, Wataru Ukai, Tomonori Murayama, Eri Hashimoto, Kumiko Utsumi, Chiaki Kawanishi

Psychogeriatrics ( Blackwell Publishing Ltd )  17 ( 4 ) 247 - 255  2017年07月  [査読有り]

　概要を見る

Background: Current diagnostic criteria recommend neuroimaging as a diagnostic support tool for the clinical diagnosis of dementia with Lewy bodies (DLB). Because DLB causes characteristic impairments and disabilities, such as neuroleptic hypersensitivity, which may significantly increase morbidity and mortality, its prompt and correct diagnosis is very important. The aim of this study was to evaluate the extent to which diagnostic accuracy can be increased by using different combinations of brain perfusion single-photon emission computed tomography (bp-SPECT), 123 I-metaiodobenzylguanidine myocardial scintigraphy (MIBG scintigraphy), and DAT-SPECT. Taking finances and patient burden into consideration, we compared the tests to determine priority. Methods: Thirty-four patients with probable DLB (75.0 ± 8.3 years old 14 men, 20 women) underwent bp-SPECT, MIBG scintigraphy, and DAT-SPECT. Results: Our comparison of three functional imaging techniques indicated that MIBG scintigraphy (79%) and Dopamine-transporter (DAT) SPECT (79%) had better sensitivity for characteristic abnormalities in DLB than bp-SPECT (53%). The combination of the three modalities could increase sensitivity for diagnosis of DLB to 100%. Additionally, the ratio of patients with rapid eye movement sleep behaviour disorder was significantly higher in the positive finding group on MIBG scintigraphy than in the negative finding group. Conclusions: In terms of stand-alone diagnostic means, priority should be placed on MIBG scintigraphy or DAT-SPECT for the diagnosis of DLB. However, our results suggest that the combination of bp-SPECT, MIBG scintigraphy, and DAT-SPECT increased the accuracy of the clinical diagnosis of DLB.

DOI PubMed

大学生を対象とした日本の自殺予防研究に関する系統的レビュー

太刀川 弘和, 川島 義高, 小田原 俊成, 衛藤 暢明, 河西 千秋, 山田 光彦

CAMPUS HEALTH ( (公社)全国大学保健管理協会 )  54 ( 2 ) 186 - 191  2017年05月

　概要を見る

近年の自殺対策の発展に伴い、国内外を問わず、大学では様々な自殺予防の取り組みが行われている。しかし、これらのプログラムの有効性に関するエビデンスはほとんど検討されていない。そこで我々は、大学における自殺予防対策のエビデンスを得ることを目的として、国内の大学生の自殺予防研究に関する系統的レビューを実施した。方法は、まず2つの文献データベース(CiNii、医中誌)を用い、大学、学生、自殺関連事象をキーワードとする検索式検索を行った。次に検索された597編の論文から、(1)研究デザインが無作為化対照試験(RCT)、非無作為化対照試験(nRCT)、分割時系列試験(ITS)、前後比較試験(CBA)のいずれか、(2)研究対象者が大学生、(3)何らかの介入が行われている、(4)アウトカムが記載されている、という適格基準を満たす論文を抽出した。最後に適格論文の内容を吟味してエビデンスを検討した。結果、抽出された適格論文は、12編(内容重複5編)と少なかった。研究デザインはRCTが1編もなく、自殺リスク、アウトカムの評価は不十分であった。結果から、我が国の大学生の自殺予防対策には、現時点では十分なエビデンスがないことが示された。(著者抄録)

大学生を対象とした国内外の自殺予防研究に関する系統的レビュー

太刀川 弘和, 川島 義高, 小田原 俊成, 衛藤 暢明, 河西 千秋, 山田 光彦

CAMPUS HEALTH ( 全国大学保健管理協会 )  54 ( 1 ) 342 - 342  2017年03月  [査読有り]

大学生を対象とした国内外の自殺予防研究に関する系統的レビュー

太刀川 弘和, 川島 義高, 小田原 俊成, 衛藤 暢明, 河西 千秋, 山田 光彦

CAMPUS HEALTH ( (公社)全国大学保健管理協会 )  54 ( 1 ) 342 - 342  2017年03月  [査読有り]