BACKGROUND:Computerized cognitive behaviour therapy (CCBT) programs can provide a useful self-help approach to the treatment of psychological problems. Previous studies have shown that CCBT has moderate effects on depression, insomnia, and anxiety. The present study investigated whether a supplement drink that includes L-carnosine enhances the effect of CCBT on psychological well-being.METHODS:Eighty-seven participants were randomly allocated to a control group, CCBT, or CCBT with supplement drink. The CCBT and CCBT with supplement drink groups received six weekly self-help CCBT program instalments, which consisted of psycho-education about stress management and coping, behaviour activation, and cognitive restructuring. The CCBT group consumed a bottle of the supplement soft drink every morning through the 6 weeks. This program was delivered by an e-learning system on demand and also included a self-help guidebook. Seventy-two participants completed the program or were assess at the end of the study.RESULTS:ANOVA revealed that there were significant interactions (times × groups) for POMS tension-anxiety and fatigue. The CCBT group showed significantly improved tension-anxiety scores, whereas the CCBT with drink group showed significant improvements on fatigue.CONCLUSION:The self-help CCBT program reduced the subjective experience of tension-anxiety in this group of workers. The addition of a supplement drink enhanced the effect of CCBT on fatigue, providing one possible approach to enhancement of such programs.TRIAL REGISTRATION:This study was registered on September 2, 2016 at UMIN. The registration number is UMIN000023903.

日本不安障害学会では，日本精神神経学会精神科用語検討委員会（日本精神神経学会，日本うつ病学会，日本精神科診断学会と連携した，精神科病名検討連絡会）からの依頼を受け，不安障害病名検討ワーキング・グループを組織し，DSM-5のドラフトから，不安障害に関連したカテゴリーの翻訳病名（案）を作成いたしました。ご存知のように，厚生労働省は，地域医療の基本方針となる医療計画に盛り込むべき疾病として指定してきた，がん，脳卒中，急性心筋梗塞，糖尿病の四大疾病に，新たに精神疾患を加えて「五大疾病」とする方針を決め，多くの都道府県で2013年度以降の医療計画に反映される予定です。精神疾患に関しては，「統合失調症」や「認知症」のように，common diseasesとして，人口に膾炙するような，馴染みやすい新病名への変更が行われてきております。うつ病も，「大うつ病性障害」という病名ではなく，「うつ病」という言葉で，社会に広く認知されております。そこで，DSM-5への変更を機に，従来の「不安障害」という旧病名を，「不安症」という新名称に変更したいと考えております。従来診断名である，「不安神経症」から，「神経」をとって，「不安症」となって短縮されているので，一般に馴染みやすいと考えます。ただし，日本精神神経学会での移行期間を考え，カッコ書きで，旧病名を併記する病名変更「不安症（不安障害）」とすることを検討しております。そのほかにもDSM-5になって変更追加された病名もあるため，翻訳病名（案）（PDFファイル）を作成しました。翻訳病名（案）については，今後も，日本精神神経学会精神科用語検討委員会の中での話し合いが進められていく予定です。どうぞよろしくお願い申し上げます。

内科系学会社会保険連合（略称：内保連）は，加盟する118の内科系学会から構成され，提示される学術的根拠に基づき， 社会保険医療の在り方を提言し，その診療報酬の適正化を促進することを目的とした組織です。日本不安障害学会は，平成25（2013）年5月，内保連への加盟が承認されました。また，不安障害の認知行動療法の医療保険点数化を目指し，内保連に，以下のような平成26年度診療報酬改定提案書を提出いたしました。6月には，内保連の精神科関連委員会，心身医学関連委員会のヒアリングを受けまして，8月には厚生労働省からのヒアリングが予定されております。日本総合病院精神医学会からも，趣旨にご賛同いただき，共同提案としていただきました。また，日本トラウマティックストレス学会にもご支援をお願いいたしております。平成26年度改定をめざし，不安障害の認知行動療法の医療保険点数化を推進していきたいと思いますので，会員の先生方におかれましては，ご支援のほど，どうぞよろしくお願い申し上げます。

AIMS:Sociocultural factors are thought to be important in the pathogenesis of eating disorders. However, there have been few studies comparing eating behavior among various cultural populations. The aim of the present study is to compare attitudes towards bodyweight and shape, and desire for thinness in Japanese male and female subjects with those in people from other countries and of different ethnic origin.METHODS:The subjects were 411 Japanese, 130 Indian, 135 Omani, 113 Euro-American and 196 Filipino adolescents. The Eating Attitude Test-26 and the Drive for Thinness subscale of the Eating Disorder Inventory-2 were used to assess eating attitudes and fat phobia.RESULTS:Subjects from India, Oman and the Philippines demonstrated eating attitudes that were similar to or worse than subjects from Western countries and Japan, although their desire for thinness was not as strong. The relationship between body mass index and eating attitudes or fat phobia in Indian, Omani and Filipino subjects differed from that in subjects from Western countries and Japan. In addition, both males and females showed disturbed eating attitudes in the Indian, Omani, and Filipino subjects.CONCLUSION:There are differences in eating attitudes and the drive for thinness among different cultural groups.

Dried-bonito broth is commonly employed as a soup and sauce base in Japanese cuisine and is considered to be a nutritional supplement that promotes recovery from fatigue. Previous human trials suggest that the ingestion of dried-bonito broth improves several mood states; however, its effect on fatigue has not yet been clarified. The aim of this study was to clarify the effects of daily ingestion of dried-bonito broth on fatigue and cognitive parameters by a placebo-controlled double blind crossover trial. Forty-eight subjects with fatigue symptoms ingested the dried-bonito broth or a placebo solution every day for 4 weeks. Mood states were evaluated by the Profile of Mood States (POMS), and mental task performance was evaluated by the Uchida-Kraepelin psychodiagnostic (UKP) test. Fatigue and total mood disturbance (TMD) scores on the POMS test decreased significantly during the dried-bonito broth ingestion (p<0.05), but did not change significantly during placebo ingestion. The change in vigor score during dried-bonito broth ingestion was significantly higher than that during placebo ingestion at 2 weeks (p<0.05). The results of the UKP test indicate that the numbers of both total answers and correct answers significantly increased during dried-bonito broth ingestion (p<0.05), while no significant changes were observed in the placebo ingestion. These results suggest that the daily ingestion of dried-bonito broth may improve the mood states, may reduce mental fatigue and may increase performance on a simple calculation task.

OBJECTIVE:To compare Omani and western teenagers attending schools in Muscat, Sultanate of Oman and Filipino teenagers residing in Manila, Philippines on indices of deliberate food restriction and dieting behavior. METHODS:The sample consisted of 444 students who were assessed using the cross-culturally valid measure, Eating Attitude Test-26, a subscale of Eating Disorder Inventory to gauge the presence of the drive for thinness or 'fat phobia' and the Bradford Somatic Inventory to elicit the presence of somatization. RESULT:Significant differences in attitudes to eating, body image and somatization between the western and non-western teenagers were found. CONCLUSION:This paper suggests that trajectories of eating disorder, such as body image disturbances as expressed in fat phobia and somatization, tend to vary from culture to culture and underscore the view that some of the health related behavior among adolescents need to be examined within socio-cultural contexts.

Serotonin (5-hydroxytryptamine; 5-HT) 2C receptors and the downstream melanocortin pathway are suggested to mediate the appetite-suppressing effects of 5-HT drugs such as m-chlorophenylpiperazine (mCPP) and fenfluramine. Here, we report that fluvoxamine (3-30 mg/kg), a selective serotonin reuptake inhibitor (SSRI), in the presence of SB 242084 (1-2 mg/kg), a selective 5-HT(2C) receptor antagonist, exerts appetite-suppressing effects while fluvoxamine or SB 242084 alone has no effect. The appetite-suppressing effects were attenuated in the presence of SB 224289 (5 mg/kg), a selective 5-HT(1B) receptor antagonist. Moreover, CP 94253 (5-10 mg/kg), a selective 5-HT(1B) receptor agonist, exerted appetite-suppressing effects and significantly increased hypothalamic pro-opiomelanocortin (POMC) and cocaine- and amphetamine-regulated transcript (CART) gene expression and decreased hypothalamic orexin gene expression. These results suggest that fluvoxamine and inactivation of 5-HT(2C) receptors exert feeding suppression through activation of 5-HT(1B) receptors, and that 5-HT(1B) receptors up-regulate hypothalamic POMC and CART gene expression and down-regulate hypothalamic orexin gene expression in mice.

Patients with chronic fatigue syndrome (CFS) report substantial symptom worsening after exercise. However, the time course over which this develops has not been explored. Therefore, the objective of this study was to investigate the influence of exercise on subjective symptoms and on cognitive function in CFS patients in natural settings using a computerized ecological momentary assessment method, which allowed us to track the effects of exercise within and across days. Subjects were 9 female patients with CFS and 9 healthy women. A watch-type computer was used to collect real-time data on physical and psychological symptoms and cognitive function for 1week before and 2weeks after a maximal exercise test. For each variable, we investigated temporal changes after exercise using multilevel modeling. Following exercise, physical symptoms did get worse but not until a five-day delay in CFS patients. Despite this, there was no difference in the temporal pattern of changes in psychological symptoms or in cognitive function after exercise between CFS patients and controls. In conclusion, physical symptoms worsened after several days delay in patients with CFS following exercise while psychological symptoms or cognitive function did not change after exercise.

There are various standpoints in psychosomatic medicine. The mind–body correlation matrix was presented from the standpoint of relational system theory. We can recognize various aspects of psychosomatic medicine and their interrelationship based on this matrix. Our study group at the University of Tokyo focused on the following: (1) cerebral glucose metabolism associated with a fear network in panic disorder (FDG–PET study of panic disorder); and (2) ecological momentary assessment (EMA): new method for psychosomatic medicine. The relevant issue to be tackled is to include psycho-behavioral variables in the matrix network and to investigate the relations among many kinds of variables.

Objective: To find differences in heart rate before and after refeeding and to identify which parameters of autonomic activity and endocrine function are associated with these differences.Methods: Before and after the start of refeeding, body weight, RR interval (RRI), heart rate variability, endocrine function, and energy expenditure were measured in nine female anorexia nervosa patients.Results: After short-term refeeding, mean daytime heart rate rose from 54.9 to 69.4 bpm (P < .05). The changes in sympathetic activity were correlated negatively with the changes in RRI (r = -.933, P < .001). Urine C-peptide, IGF-1, and fT3 increased significantly, and norepinephrine tended to increase.Conclusion: We demonstrated that autonomic nervous activity was relevant to changes in heart rate during refeeding, and it is speculated that the increases in insulin secretion, thyroid function, and IGF-I were responsible for the mechanisms. (c) 2006 Elsevier Inc. All rights reserved.

Recalled evaluation of headache intensity is often affected by several factors. Recently, computerized ecological momentary assessment (EMA) has been developed to avoid such problems as recall bias. Here, we compared recalled headache intensity with momentary headache intensity using EMA in tension-type headache (TTH). Forty patients with TTH wore watch-type computers for 1 week to record momentary headache intensity and also rated their headache intensities by recall. We calculated intraclass correlation coefficients between recalled headache intensity and indices from EMA recordings in the whole study population and in two subgroups divided by variability of momentary headache intensity. The results showed that consistency and agreement of momentary and recalled headache intensity were low, and this was especially marked in the subjects whose headache varied widely. These observations suggested that variability of headache intensity may affect recall of headache intensity and this should be taken into consideration in both clinical and research settings.

OBJECTIVEThe objective of this study was to investigate associations between accelerometer measurements of physical activity and psychosocial variables in older people.METHODSSubjects were 184 Japanese aged 65-85 years. An accelerometer provided step count and physical activity intensity data throughout each 24-hour period for 1 year. At the end of the year, anxiety, depression, and cognitive function were assessed.RESULTSControlling for age, the daily number of steps, and the daily duration of moderate-intensity physical activity showed significant negative correlations with depressive mood.CONCLUSIONA depressive mood is associated with the quantity and quality of habitual physical activity.

Several neuroanatomical hypotheses of panic disorder have been proposed focusing on the significant role of the amygdala and PAG-related "panic neurocircuitry." Although cognitive–behavioral therapy is effective in patients with panic disorder, its therapeutic mechanism of action in the brain remains unclear. The present study was performed to investigate regional brain glucose metabolic changes associated with successful completion of cognitive–behavioral therapy in panic disorder patients. The regional glucose utilization in patients with panic disorder was compared before and after cognitive–behavioral therapy using positron emission tomography with 18F-fluorodeoxyglucose. In 11 of 12 patients who showed improvement after cognitive–behavioral therapy, decreased glucose utilization was detected in the right hippocampus, left anterior cingulate, left cerebellum, and pons, whereas increased glucose utilization was seen in the bilateral medial prefrontal cortices. Significant correlations were found between the percent change relative to the pretreatment value of glucose utilization in the left medial prefrontal cortex and those of anxiety and agoraphobia-related subscale of the Panic Disorder Severity Scale, and between that of the midbrain and that of the number of panic attacks during the 4 weeks before each scan in all 12 patients. The completion of successful cognitive–behavioral therapy involved not only reduction of the baseline hyperactivity in several brain areas but also adaptive metabolic changes of the bilateral medial prefrontal cortices in panic disorder patients.

Resting energy expenditure (REE) increases in anorexia nervosa patients after refeeding; however, the associated mechanisms remain unclear. We hypothesized that changes in autonomic nervous activity are relevant to changes in REE during refeeding. The objectives of this study were (1) to confirm differences in REE during refeeding and (2) to identify the parameters associated with these differences. The subjects were 9 female inpatients with anorexia nervosa receiving cognitive-behavioral therapy. Both before and after the start of refeeding, which was defined as the first increase in food intake of 1675 kj or more per day, body composition, REE, endocrine function, R-R interval, autonomic nervous activity evaluated in terms of heart rate variability, and physical activity were measured and psychological tests completed. The differences in measurements before and after refeeding and specific associations between changes in REE and other factors were assessed. Resting energy expenditure increased significantly by 22.7% from 3190 to 3910 kj/d (P < .01) with the increase in energy intake. Fat-free mass and physical activity did not change. The increase in REE was accompanied by higher insulin-like growth factor-I, free triiodothyronine, and norepinephrine and decreases in parasympathetic activity and R-R interval. Some factors might be responsible for the increases in REE observed with refeeding. No previous study has simultaneously observed multiple variables related to energy metabolism during refeeding.