論文 - 河西　千秋

Effects of a training workshop on suicide prevention among emergency room nurses

Yasuhiro Kishi, Kotaro Otsuka, Keiko Akiyama, Tomoki Yamada, Yumiko Sakamoto, Yaeko Yanagisawa, Hiroshi Morimura, Chiaki Kawanishi, Hiroaki Higashioka, Yasushi Miyake, Steven Thurber

Crisis ( Hogrefe Publishing )  35 ( 5 ) 357 - 361  2014年  [査読有り]

　概要を見る

Background: Suicide attempts are frequently encountered by emergency department nurses. Such encounters can potentially provide a foundation for secondary suicide prevention. Aims: The aim of the present investigation was to evaluate the effect of a 7-hr training program for emergency room nursing personnel in Japan. Method: In all, 52 nurses completed the questionnaires before the workshop and 1 month after the workshop. The nurses' understanding of and willingness to care for suicidal patients positively changed. Results: It is feasible to provide a 7-hr, relatively short, workshop on suicidal prevention aimed at emergency medical staff and to improve attitudes during a follow-up of 1 month. Conclusion: It is uncertain whether the positive attitudes of emergency nurses toward suicide and/or educational interventions could impact the outcomes of these interventions. Further studies are needed to address these important questions in this field.

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[Current topics of treatment for mental disease and suicide prevention in Japan].

K Cho, Shekhar Saxena, Yutaro Setoya, Masatoshi Takeda, Shigenobu Kanba, Kotaro Otsuka, Chiaki Kawanishi, S Takahashi, Tetsuo Omori, Shinichiro Tanaka

Seishin shinkeigaku zasshi = Psychiatria et neurologia Japonica   116 ( 11 ) 897 - 906  2014年  [国内誌]

PubMed

One-year follow up after admission to an emergency department for drug overdose in Japan

Shuntaro Ando, Toshihiko Matsumoto, Sho Kanata, Aya Hojo, Daisuke Yasugi, Nobuaki Eto, Chiaki Kawanishi, Nozomu Asukai, Kiyoto Kasai

Psychiatry and Clinical Neurosciences   67 ( 6 ) 441 - 450  2013年09月  [査読有り]

　概要を見る

Aim The aim of the study was to investigate the incidence of and risk factors for repetition of suicidal behavior within a year after admission for drug overdose in Japan. Methods Patients admitted to the emergency department of a general public hospital in Tokyo for drug overdose of prescribed medicine and/or over-the-counter drugs between March 2008 and February 2009 were followed up after 1 year. Demographic characteristics, previous suicide attempts, and mental health state were examined by self-report questionnaire and interview at recovery from the initial attempt. Information about suicidal behavior during the follow-up period was obtained from the outpatient psychiatrists by postal questionnaire 1 year after discharge. Results Of 190 patients admitted to the emergency department, 132 patients answered the questionnaire and had the interview. Information about thefollow-up period for 66 patients was obtained. Of the 66 patients, 28 patients attempted suicide again and two patients committed suicide during the 1-year follow-up period. Psychiatric diagnosis of personality disorder and denial of suicidal intent at the time of recovery were associated with increased risk for another suicide attempt. Lethality levels of suicidal behaviors before and after admission were associated with each other. Conclusion The rate of fatal and non-fatal suicide attempt within a year after admission for self-poisoning was substantial. Psychiatric diagnosis of personality disorder was a risk factor for repetition of suicide attempt. Clinicians should pay attention to the means of previous suicide attempts even though the patient denies suicidal intent at recovery. © 2013 The Authors. Psychiatry and Clinical Neurosciences © 2013 Japanese Society of Psychiatry and Neurology.

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横浜市立大学附属市民総合医療センターにおける、救命救急センターを拠点とした自殺未遂者への介入 現在の活動状況

伊藤 翼, 日野 耕介, 岡村 泰, 大山 寧寧, 高橋 雄一, 山田 朋樹, 河西 千秋, 小田原 俊成, 平安 良雄

日本社会精神医学会雑誌 ( (一社)日本社会精神医学会 )  22 ( 3 ) 391 - 391  2013年08月  [査読有り]

精神科救急と教育コース 救急医療における臨床心理士の役割

秋山 恵子, 三宅 康史, 東岡 宏明, 松月 みどり, 河西 千秋, 大塚 耕太郎, 岸 泰宏, 三上 克央, 柳澤 八重子, 河嶌 譲

日本臨床救急医学会雑誌 ( (一社)日本臨床救急医学会 )  16 ( 3 ) 298 - 298  2013年06月

精神科救急と教育コース 救急医療における精神症状評価と初期診療の標準化に向けて PEECコースの紹介

東岡 宏明, 三宅 康史, 松月 みどり, 河西 千秋, 大塚 耕太郎, 岸 泰宏, 三上 克央, 秋山 恵子, 柳澤 八重子, 坂本 由美子

日本臨床救急医学会雑誌 ( (一社)日本臨床救急医学会 )  16 ( 3 ) 298 - 298  2013年06月

Dose-dependent effect of antipsychotic drugs on autonomic nervous system activity in schizophrenia

Yohko Iwamoto, Chiaki Kawanishi, Ikuko Kishida, Taku Furuno, Mami Fujibayashi, Chie Ishii, Norio Ishii, Toshio Moritani, Masataka Taguri, Yoshio Hirayasu

BMC Psychiatry   12  2012年11月  [査読有り]

　概要を見る

Background: Antipsychotic drugs are considered a trigger factor for autonomic dysregulation, which has been shown to predict potentially fatal arrhythmias in schizophrenia. However, the dose-dependent effect of antipsychotic drugs and other psychotropic drugs on autonomic nervous system (ANS) activity remain unclear. The purpose of this study was to investigate the dose-dependent effect of antipsychotic drugs and other clinical factors on ANS activity in an adequate sample size of patients with schizophrenia.Methods: A total of 211 Japanese patients with schizophrenia and 44 healthy subjects participated in this study. ANS activity was assessed by means of heart rate variability (HRV) power spectral analysis. Antipsychotic drug treatment and various clinical factors were investigated for each participant. The patient group was categorized into three subgroups according to daily dose of antipsychotic drug, and HRV was compared between groups.Results: The results showed significantly decreased low-frequency and high-frequency components of HRV in the patient group compared to the control group. The high-dose group showed a significantly lower HRV than the medium-dose group and an even lower HRV than the low-dose group. In addition, a significant association between HRV and antipsychotic drug dose was identified by multiple regression analysis. HRV was not associated with age, sex, body mass index, duration of illness, or daily dose of other psychotropic drugs.Conclusion: These results suggest that antipsychotic drugs exert a significant dose-dependent effect on the extent of decline in ANS activity, and that optimal antipsychotic medication is required to avoid possible cardiovascular adverse events in patients with schizophrenia. © 2012 Iwamoto et al. licensee BioMed Central Ltd.

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Trait impulsivity in suicide attempters: Preliminary study

Chiho Doihara, Chiaki Kawanishi, Nene Ohyama, Tomoki Yamada, Makiko Nakagawa, Yohko Iwamoto, Toshinari Odawara, Yoshio Hirayasu

Psychiatry and Clinical Neurosciences   66 ( 6 ) 529 - 532  2012年10月  [査読有り]

　概要を見る

Suicide attempt is a risk factor for suicide. To investigate trait impulsivity among suicide attempters, 93 attempters admitted to an emergency department and 113 healthy controls were evaluated using the Japanese version of the Barratt Impulsiveness Scale (BIS-11J). Impulsivity was analyzed in relation to clinical data in the attempters. Total BIS-11J, attention impulsiveness, and motor impulsiveness scores were significantly higher in the attempters than in the controls. Both total BIS-11J and non-planning impulsiveness scores were significantly higher in attempters with schizophrenia and other psychotic disorders among the diagnostic groups. Control of impulsivity should be considered as one of the targets for suicide prevention. © 2012 The Authors. Psychiatry and Clinical Neurosciences.

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初期研修医を対象としたうつ病診療教育からみた精神医学教育の課題

河西 千秋, 大山 寧寧, 秋山 恵子, 須田 顕, 中川 牧子, 鈴木 志麻子, 平安 良雄, 白川 教人

精神神経学雑誌 ( (公社)日本精神神経学会 )  ( 2012特別 ) S - 430  2012年05月  [査読有り]

Effects of educating local government officers and healthcare and welfare professionals in suicide prevention

Isao Kaniwa, Chiaki Kawanishi, Akira Suda, Yoshio Hirayasu

International Journal of Environmental Research and Public Health   9 ( 3 ) 712 - 721  2012年03月  [査読有り]

　概要を見る

Suicide is a major public health issue. In Japan, local governments are responsible for suicide prevention, and local government officers are therefore expected to act as gatekeepers for suicide prevention. In this study, through a questionnaire survey, the authors examined the current knowledge and attitudes concerning suicide prevention among local government officers and healthcare and welfare professionals, and the effects of providing suicide prevention education on their knowledge of and attitudes toward suicide and its prevention. One hundred eighty-three local government officers and 432 healthcare/welfare professionals completed the survey before and after a single education session. Before the session, the local government officers and healthcare/welfare professionals showed mainly positive attitudes toward suicide prevention efforts, with little difference between the two groups. After the training, knowledge and attitudes were further improved for most questionnaire items. Respondents with one or more experiences of suicide prevention training showed significantly more knowledge and positive attitudes before the training than those with no such experience. Moreover, knowledge of depression and having a sympathetic attitude were found to be especially associated with the overall attitude that "suicide can be prevented". Training in suicide prevention was shown to be effective in promoting appropriate knowledge and attitudes among local government officers and healthcare/welfare professionals who are gatekeepers for preventing suicide. Our findings confirm the importance of suicide prevention education, and will contribute to creating a standard educational program on suicide prevention in Japan. © 2012 by the authors licensee MDPI, Basel, Switzerland.

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日本医療機能評価機構における「院内自殺の予防と事後対応プログラム」の構築と研修の着手

橋本 廸生, 河西 千秋, 大塚 耕太郎, 加藤 大慈, 蛸島 章子, 横山 容子, 菅原 浩幸

医療の質・安全学会誌 ( (一社)医療の質・安全学会 )  6 ( Suppl. ) 152 - 152  2011年10月

Comparison of characteristics of suicide attempters with schizophrenia spectrum disorders and those with mood disorders in Japan

Makiko Nakagawa, Chiaki Kawanishi, Tomoki Yamada, Kanna Sugiura, Yoko Iwamoto, Ryoko Sato, Satoshi Morita, Toshinari Odawara, Yoshio Hirayasu

Psychiatry Research   188 ( 1 ) 78 - 82  2011年06月  [査読有り]

　概要を見る

Suicidality in patients with schizophrenia is high. To clarify the characteristics of suicidal behavior in patients with schizophrenia, we investigated suicide attempters with schizophrenia spectrum disorders in comparison with patients with mood disorders. One hundred patients with schizophrenia spectrum disorders and 155 patients with mood disorders admitted to an emergency department after a suicide attempt were interviewed in detail on items concerning 1) demographic characteristics, 2) previous suicidal behavior, and 3) index suicidal behavior. Differences between the two groups were subsequently analyzed. Patients with schizophrenia spectrum disorders showed a lower incidence of previous deliberate self-harm, and a higher incidence of a subsequent suicide attempt more than 1 year after the previous suicide attempt as well as a higher lethality of index suicide attempt compared to patients with mood disorders. Furthermore, the most common motive for making a suicide attempt in patients with schizophrenia spectrum disorders was having a mental problem. This study revealed the factors associated with suicide attempts among Japanese patients with schizophrenia spectrum disorders, and the nature of these factors makes it difficult to predict future attempts. This makes clear the importance of continuous long-term follow-up with careful attention to the mental symptoms and psychological burden for such patients. © 2010 Elsevier Ireland Ltd.

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救急関連training courseの現状と展望 救急医療における精神科的評価PEECコースについて

三宅 康史, 有賀 徹, 大塚 耕太郎, 大橋 寛子, 河西 千秋, 岸 泰宏, 坂本 由美子, 守村 洋, 柳澤 八恵子, 山田 朋樹, 日本臨床救急医学会自殺企図者のケアに関する検討委員会

日本臨床救急医学会雑誌 ( (一社)日本臨床救急医学会 )  14 ( 2 ) 214 - 214  2011年04月

Diagnosis and treatment of akathisia in a cancer patient who cannot stand up or sit down, because of poor performance status: Factors that make the diagnosis of akathisia difficult, and diagnosis clues

Hideki Onishi, Makoto Wada, Tomomi Wada, Mei Wada, Mayumi Ishida, Chiaki Kawanishi, Keiko Mizuno, Hiroshi Ito, Masaru Narabayashi, Yasutsuna Sasaki

Palliative and Supportive Care   8 ( 4 ) 477 - 480  2010年12月  [査読有り]

　概要を見る

Objective: Akathisia is a common adverse effect of antipsychotics and, less commonly, antidepressants. Akathisia can cause great discomfort and is often described by the patient as a most distressing sensation however, the condition is often underdiagnosed or misdiagnosed. In oncological settings, neuroleptics and antidepressants that induce akathisia are also administered. However, reports of akathisia in oncology settings are few and a case of akathisia in a bedridden patient has not been reported as far as we know.Case report: A 72-year-old man with esophageal cancer who could not sit down or stand up was administered 5mg/day haloperidol to relieve agitation as a symptom of major depressive disorder. Three days after the administration of haloperidol, the agitation had become worse. Careful observation revealed that the patient sometimes showed slight rubbing movement of the lower extremities and slight twisting movements of the body, which were not observed before the administration of haloperidol. The patient moved his body and lower extremities to relieve restlessness, which had developed after the administration of haloperidol. Although symptoms were atypical, akathisia was suspected and discontinuation of haloperidol resolved the symptoms.Results and significance of results: In patients with poor performance status, clues leading to the correct diagnosis of akathisia might be absent, which would not be the case in patients who were able to walk, stand up, or sit down. Careful observations of patients before and after the administration of drugs that may cause akathisia may be required to ensure correct diagnosis. Copyright © Cambridge University Press 2010.

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Dopamine D2 receptor gene polymorphisms are associated with suicide attempt in the Japanese population

Akira Suda, Chiaki Kawanishi, Ikuko Kishida, Ryoko Sato, Tomoki Yamada, Makiko Nakagawa, Hana Hasegawa, Daiji Kato, Taku Furuno, Yoshio Hirayasu

Neuropsychobiology   59 ( 2 ) 130 - 134  2009年05月  [査読有り]

　概要を見る

Background: Some reports have suggested the involvement of the D 2 dopaminergic function in the expression of suicidal behavior. Here, we examined associations between suicide attempts and two kinds of functional polymorphisms in the dopamine D2 receptor (DRD2) gene, namely, TaqIA and -141C Ins/Del. Methods: Subjects included 120 suicide attempters and 123 unrelated volunteers. Those who attempted suicide were severely injured and were transferred to the emergency unit in our university hospital. To determine each genotype, we performed polymerase chain reaction and restriction fragment length polymorphism analyses. Results: We found significant differences in genotypic and allelic frequencies of -141C Ins/Del and TaqIA polymorphisms between suicide attempters and healthy controls (-141C Ins/Del, p = 0.01 TaqIA,p = 0.036). The Ins allele of -141C Ins/Del was significantly more frequent in suicide attempters (p = 0.011), as well as the A2 allele of TaqIA (p = 0.017). Haplotype analysis revealed no significant linkage disequilibrium between -141C Ins/Del and TaqIA polymorphisms (D′ = 0.226, r2 = 0.016, p = 0.10). Conclusions: These findings suggest that DRD2 gene polymorphisms may be involved in the biological susceptibility to suicide. Copyright © 2009 S. Karger AG, Basel.

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「自殺企図者に対する救急外来(ER)・救急科・救命救急センターにおける手引き」作成の意義

三宅 康史, 大塚 耕太郎, 岸 泰宏, 坂本 由美子, 守村 洋, 柳澤 八重子, 山田 朋樹, 河西 千秋, 伊藤 弘人, 有賀 徹

日本臨床救急医学会雑誌 ( (一社)日本臨床救急医学会 )  12 ( 2 ) 259 - 259  2009年04月

自殺予防と救急看護 自殺企図患者に対する救急外来(ER)・救急科・救命救急センターにおける手引き 日本臨床救急医学会「自殺未遂者のケアに関する委員会」の取り組み

三宅 康史, 有賀 徹, 伊藤 弘人, 大塚 耕太郎, 河西 千秋, 岸 泰宏, 坂本 由美子, 守村 洋, 山田 朋樹, 柳澤 八恵子

日本救急看護学会雑誌 ( (一社)日本救急看護学会 )  10 ( 3 ) 59 - 63  2009年03月

Responses to patients with suicidal ideation among different specialties in general hospitals

Hiroto Ito, Kenji Kawano, Daisuke Kawashima, Chiaki Kawanishi

General Hospital Psychiatry   30 ( 6 ) 578 - 580  2008年11月  [査読有り]

　概要を見る

Objective: The purpose of this study was to examine whether there were any differences in responses to patients with suicidal ideation among specialties in general hospitals. Methods: A cross-sectional questionnaire study was conducted in 2007. The subjects of the study were chief physicians at 75 emergency departments, 69 internal medicine departments and 154 psychiatry departments in 161 general hospitals with psychiatric beds in Japan. Results: The physicians in internal and emergency medicine reported making arrangements for needed counseling services and recommending to patients that they talk to the people around them, whereas those in psychiatric departments reported asking patients to promise not to commit suicide (no-suicide contract) and making a next appointment for them. Conclusions: Internists and emergency physicians are likely to take different approaches when responding to patients with suicidal ideation than psychiatrists. © 2008 Elsevier Inc. All rights reserved.

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Trait aggression in suicide attempters: A pilot study

Chiho Doihara, Chiaki Kawanishi, Tomoki Yamada, Ryoko Sato, Hana Hasegawa, Taku Furuno, Makiko Nakagawa, Yoshio Hirayasu

Psychiatry and Clinical Neurosciences   62 ( 3 ) 352 - 354  2008年06月  [査読有り]

　概要を見る

Suicide attempt is a potent risk factor of subsequent suicide. Understanding the characteristics of suicide attempters is important for preventing suicide. The authors investigated aggression in medically serious suicide attempters at an emergency department. Trait aggression was evaluated in 55 suicide attempters and 71 healthy individuals as a control group using the Japanese version of the Buss-Perry Aggression Questionnaire (BAQ). Total BAQ scores (t = 2.782, P = 0.006) and the hostility scores (t = 3.735, P < 0.001) were significantly higher in the suicide attempters than the controls. It suggested that to focus on aggression and its management is one of the key components for preventing suicide. © 2008 The Authors.

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首都圏の高度救命救急センターで入院治療を受けた重症自殺未遂者の特徴

中川 牧子, 山田 朋樹, 岩本 洋子, 河西 千秋, 小田原 俊成, 佐藤 玲子, 長谷川 花, 須田 顕, 平安 良雄

精神神経学雑誌 ( (公社)日本精神神経学会 )  ( 2008特別 ) S - 374  2008年05月