PCN reports : psychiatry and clinical neurosciences最新文献

{"title":"Treatment discontinuation in a post-disaster outpatient clinic: A retrospective cohort study of post-traumatic stress disorder and complex post-traumatic stress disorder in Fukushima, Japan.","authors":"Arinobu Hori, Emiko Ando, Naomi Ito, Michio Murakami, Masaharu Tsubokura","doi":"10.1002/pcn5.70416","DOIUrl":"https://doi.org/10.1002/pcn5.70416","url":null,"abstract":"<p><strong>Aim: </strong>Trauma-focused psychotherapies are recommended as first-line treatments for post-traumatic stress disorder (PTSD); however, treatment discontinuation remains a major challenge in routine clinical practice. This study examined treatment discontinuation and structured psychotherapy implementation among patients with PTSD and complex PTSD (CPTSD) in a post-disaster outpatient setting.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed anonymized clinical records from April 2016 to March 2021 at a psychiatric outpatient clinic in Minamisoma City, Fukushima, Japan. Patients with ICD-11 PTSD or CPTSD as a primary or secondary diagnosis were included (<i>n</i> = 170), with an analytic cohort (<i>n</i> = 144, excluding transfers, deaths, and undetermined outcomes) for structured psychotherapy analyses. To address immortal time bias arising from delayed trauma-focused psychotherapy initiation (median 327 days from initial visit), structured psychotherapy was modeled as a time-varying covariate in Cox regression.</p><p><strong>Results: </strong>Treatment discontinuation occurred in 33.5% (57/170) of patients within 1 year, with 64.9% of events occurring within the first 90 days. Structured psychotherapy was delivered to 17.6% (30/170) of patients. Although crude discontinuation rates differed markedly by trauma-focused psychotherapy receipt (7.1% vs. 47.4%), the association was substantially attenuated and non-significant in the time-varying analysis (hazard ratio = 0.482, 95% CI 0.113-2.050), indicating that the crude association largely reflected immortal time bias.</p><p><strong>Conclusion: </strong>In this post-disaster outpatient setting, discontinuation was concentrated in the early phase of care that precedes structured psychotherapy, and most patients never reached trauma-focused treatment. Early treatment engagement, rather than structured psychotherapy delivery alone, may represent the critical bottleneck in real-world PTSD care.</p>","PeriodicalId":74405,"journal":{"name":"PCN reports : psychiatry and clinical neurosciences","volume":"5 3","pages":"e70416"},"PeriodicalIF":1.3,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13598934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peer support and 2-year abstinence in alcohol use disorder: A nationwide prospective cohort study in recovery-support facilities.","authors":"Satoshi Inoura, Takuya Shimane, Satomi Mizuno, Toshihiko Matsumoto","doi":"10.1002/pcn5.70418","DOIUrl":"10.1002/pcn5.70418","url":null,"abstract":"<p><strong>Aim: </strong>Peer support is considered an important component of recovery for individuals with alcohol use disorder (AUD); however, peer-support factors associated with sustained long-term abstinence remain unclear. Therefore, we examined the association between 2-year complete abstinence and peer-support factors among individuals with AUD at Drug Addiction Rehabilitation Centers (DARCs) nationwide in Japan.</p><p><strong>Methods: </strong>This secondary analysis utilized data from a nationwide prospective cohort study of DARC users with AUD. Eligible participants were individuals with AUD, and trainee staff were excluded. Baseline data were collected via self-administered questionnaires; follow-up assessments were conducted at 6-month intervals over 2 years. Peer-support variables included program participation, relationships with peers and staff, and exposure to recovery role models. Multivariable analyses were performed using generalized estimating equations.</p><p><strong>Results: </strong>This study included 159 individuals with AUD from 36 facilities (mean age: 51.0 ± 11.1 years; 96.2% male). The 2-year complete abstinence rate was 45.9%, with 55.3% abstinent at 1 year. Positive relationships with other users (adjusted odds ratio [aOR]: 3.35, 95% confidence interval [CI]: 1.63-6.88) and exposure to recovery role models (aOR: 2.12, 95% CI: 1.26-3.54) were significantly associated with 2-year complete abstinence. Sensitivity analyses yielded consistent findings.</p><p><strong>Conclusion: </strong>Among individuals with AUD utilizing recovery-support facilities, positive peer relationships and exposure to recovery role models were strongly associated with maintaining abstinence over 2 years. These findings highlight the importance of peer-oriented recovery-support within community-based treatment systems.</p>","PeriodicalId":74405,"journal":{"name":"PCN reports : psychiatry and clinical neurosciences","volume":"5 3","pages":"e70418"},"PeriodicalIF":1.3,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protocol of a single-arm open-label pilot study of extended rTMS therapy for treatment-resistant depression (ExTMS study).","authors":"Shun Takahashi, Mitsuhiro Eto, Masahiro Hata, Kazuhiro Shinosaki, Manabu Ikeda","doi":"10.1002/pcn5.70404","DOIUrl":"10.1002/pcn5.70404","url":null,"abstract":"<p><strong>Background: </strong>Repetitive transcranial magnetic stimulation (rTMS) for treatment-resistant depression (TRD) has been covered by the Japanese public health insurance system. Standard public insurance-covered treatment is limited to a 30-session course delivered over 8 weeks. While rTMS therapy is effective for TRD, residual depressive symptoms frequently persist after treatment completion. This pilot study aims to prospectively evaluate whether extended rTMS therapy can further improve depressive symptoms and be safely administered in patients with TRD who have shown insufficient improvement after completion of the standard treatment course.</p><p><strong>Methods: </strong>This is a 4-week single-arm open-label pilot study. Participants will be recruited from patients receiving standard public health insurance-covered rTMS therapy. Eligible participants are adults who achieved at least 20% improvement following the standard 30-session course but continue to experience residual depressive symptoms, defined as a 17-item Hamilton Depression Rating Scale (HAMD-17) total score of 5 or higher. Extended rTMS therapy will consist of 12 additional sessions administered over 4 weeks using the same stimulation protocol as the standard rTMS therapy.</p><p><strong>Outcomes: </strong>The primary outcome is the change in HAMD-17 total score from baseline, defined as completion of the standard 30-session course, to completion of extended treatment. Secondary outcomes include remission and minimal residual symptom rates, changes in depressive symptoms and patient-reported outcomes during treatment, and adverse events.</p><p><strong>Conclusions: </strong>This study will provide preliminary evidence regarding the potential clinical benefit of extended rTMS therapy for patients with residual depressive symptoms after completion of the standard treatment course.</p>","PeriodicalId":74405,"journal":{"name":"PCN reports : psychiatry and clinical neurosciences","volume":"5 3","pages":"e70404"},"PeriodicalIF":1.3,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13594764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Large language models as psychometric laboratories? Maybe not yet. Cautionary evidence from synthetic personality data.","authors":"Matteo Carpi, Conny De Vincenzo","doi":"10.1002/pcn5.70417","DOIUrl":"10.1002/pcn5.70417","url":null,"abstract":"","PeriodicalId":74405,"journal":{"name":"PCN reports : psychiatry and clinical neurosciences","volume":"5 3","pages":"e70417"},"PeriodicalIF":1.3,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suicide mortality and associated factors among university students in Japan: A 5-year nationwide epidemiological study (FY 2020-2024).","authors":"Katsuhiro Yasumi, Takehiro Ibaraki, Yasuko Fuse-Nagase, Toshiyuki Marutani, Hirokazu Tachikawa, Asumi Takahashi, Terumi Ishii, Toshinari Odawara, Chiaki Kawanishi","doi":"10.1002/pcn5.70413","DOIUrl":"10.1002/pcn5.70413","url":null,"abstract":"<p><strong>Aim: </strong>Suicide is the leading cause of death among Japanese youth; however, nationwide data focusing specifically on university students remain limited. This study aimed to elucidate suicide mortality rates, sociodemographic characteristics, and presumed motives among university students in Japan during FY 2020-2024, following the onset of the COVID-19 pandemic.</p><p><strong>Methods: </strong>Data were collected annually through the student affairs divisions of participating universities, covering a cumulative total of 13.5 million students, representing more than 90% of Japan's total university enrollment. We analyzed demographic characteristics, academic history, presumed motives, and campus health service utilization among identified suicide cases.</p><p><strong>Results: </strong>A total of 1526 suicide deaths or suspected suicides were identified. The male suicide rate (13.90 per 100,000) was significantly higher than the female rate (8.16), although the sex difference narrowed over the study period. Undergraduate and master's programs exhibited significantly higher suicide mortality rates compared with doctoral programs. Suicide deaths peaked in September and March, aligning with critical transitions in the Japanese academic calendar. The most common presumed motive was academic failure, followed by career concerns. Approximately 19% of cases involved a history of leave of absence or grade retention, whereas only 13.6% had prior contact with campus health services.</p><p><strong>Conclusion: </strong>Although suicide rates remained higher among men, the sex difference is narrowing. Academic failure and career concerns were prominent risk factors, and the low utilization of campus health services underscores the need for proactive outreach and a socioecological prevention model to enhance campus-wide coordination.</p>","PeriodicalId":74405,"journal":{"name":"PCN reports : psychiatry and clinical neurosciences","volume":"5 3","pages":"e70413"},"PeriodicalIF":1.3,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of tic improvement following tipepidine administration in a boy with Tourette syndrome comorbid with attention-deficit/hyperactivity disorder and autism spectrum disorder.","authors":"Masumi Tachibana, Tsuyoshi Sasaki","doi":"10.1002/pcn5.70415","DOIUrl":"10.1002/pcn5.70415","url":null,"abstract":"<p><strong>Background: </strong>Tourette Syndrome (TS) is defined by motor and vocal tics that begin in childhood and persist for over a year. TS causes difficulties in daily life and lowers self-esteem, yet pharmacological treatment options for TS remain limited. Tipepidine, administered in this case report, is generally used as a safe and inexpensive cough suppressant. Recent studies have suggested that tipepidine may improve symptoms of attention-deficit/hyperactivity disorder (ADHD) and depression.</p><p><strong>Case presentation: </strong>We report the clinical course of a boy with TS, ADHD, and autism spectrum disorder (ASD), in whom the addition of tipepidine to aripiprazole was associated with improvement in both motor and vocal tics. The patient had tried several antipsychotics before he was prescribed tipepidine. However, the effectiveness of those drugs was temporary, and the patient experienced tolerability issues such as drowsiness. The addition of tipepidine was well tolerated, and the improvement in tic symptoms was maintained during long-term follow-up.</p><p><strong>Conclusion: </strong>This case suggests that adjunctive tipepidine may be well tolerated and associated with sustained improvement in motor and vocal tics during long-term follow-up in a patient with TS receiving aripiprazole.</p>","PeriodicalId":74405,"journal":{"name":"PCN reports : psychiatry and clinical neurosciences","volume":"5 3","pages":"e70415"},"PeriodicalIF":1.3,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13584892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anxious-depressive attack-A clinical state with intrusive rumination.","authors":"Hisanobu Kaiya, Takeshi Otowa, Tsukasa Sasaki, Shota Noda, Naomi Matsuda, Yojiro Sakai, Fusaka Minami","doi":"10.1002/pcn5.70396","DOIUrl":"https://doi.org/10.1002/pcn5.70396","url":null,"abstract":"<p><strong>Aim: </strong>The present study aimed to examine anxious-depressive attack (ADA) regarding its characteristics and the circumstances of onset, thereby clarifying why ADA has remained underrecognized.</p><p><strong>Methods: </strong>In this cross-sectional study, 286 psychiatric outpatients were assessed using structured clinical interviews. ADA was diagnosed according to predefined criteria, characterized by sudden and recurrent episodes beginning with intense anxious-depressive distress, followed by prolonged intrusive rumination involving negative memories or future worries and prominent negative emotions. Data on prevalence, onset, temporal patterns, phenomenology, and coping behaviors were systematically collected.</p><p><strong>Results: </strong>The lifetime prevalence of ADA was 21.7%, with onset typically during adolescence or early adulthood. Episodes most commonly occurred during periods of mental disengagement, particularly in the evening or at night, and typically lasted 2-3 h. Detailed intrusive thoughts were predominantly autobiographical, emotionally intense, and often related to temporally distant experiences. While most patients could recall the onset, offset, and content of their episodes, 43.5% regarded ADA as a mental state that anyone might experience and 29.0% had never disclosed their experiences. Maladaptive coping behaviors, including suicidal behavior or sexual derailment, were observed in 40.3% of cases.</p><p><strong>Conclusion: </strong>ADA represents a distinctive mental state preserving consciousness and memory coexist with reduced self-reflective awareness of the pathological nature of the episode. Its ego-syntonic, covert nature, prolonged duration, and relative lack of prominent somatic symptoms may contribute to underrecognition of ADA. Recognizing ADA in clinical practice should facilitate more accurate clinical assessment suggesting an appropriate treatment strategy.</p>","PeriodicalId":74405,"journal":{"name":"PCN reports : psychiatry and clinical neurosciences","volume":"5 3","pages":"e70396"},"PeriodicalIF":1.3,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe anorexia nervosa in an adolescent girl with Turner syndrome: A case report with psychosocial implications.","authors":"Kohei Kamikawa, Ryohei Takada, Yuya Honda, Yasumitsu Hamano, Harue Goto, Takashi Okada","doi":"10.1002/pcn5.70412","DOIUrl":"10.1002/pcn5.70412","url":null,"abstract":"<p><strong>Background: </strong>Adolescence is a critical period for the development of body image and self-evaluation. Turner syndrome (TS) is characterized by short stature and delayed or absent secondary sexual development, which may become particularly salient during adolescence. However, the association between TS and anorexia nervosa (AN) remains unclear. We report a case of severe AN in an adolescent girl with TS.</p><p><strong>Case presentation: </strong>A 16-year-old girl diagnosed with TS in early childhood had received regular pediatric follow-up. During junior high school, she became increasingly conscious of physical and pubertal differences between herself and her peers and experienced confusion and distress regarding bodily changes after initiation of Kaufmann therapy. After entering high school, she began restricting her dietary intake following a peer's comment that her neck appeared thick. Over 6 months, her weight decreased by approximately 10-28.5 kg (body mass index, 13.6 kg/m²). Despite severe underweight, she expressed an intense fear of weight gain and persistently perceived herself as overweight. She was diagnosed with AN. Nutritional rehabilitation, psychoeducation, and cognitive interventions targeting body-related concerns and negative automatic thoughts were provided. Her body weight increased to 33.6 kg (body mass index, 16.0 kg/m²), and she was discharged on day 91. Her weight remained stable for 18 months.</p><p><strong>Conclusion: </strong>This case illustrates that AN in an adolescent with TS may present with typical AN psychopathology, while experiences related to physical and pubertal development may constitute an important part of the individual psychosocial context. Clinicians should assess these experiences alongside core AN psychopathology and incorporate them into standard treatment and individualized psychosocial support.</p>","PeriodicalId":74405,"journal":{"name":"PCN reports : psychiatry and clinical neurosciences","volume":"5 3","pages":"e70412"},"PeriodicalIF":1.3,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13574210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contact experience with people living with dementia and dementia-related stigma domains among old-old adults: A cross-sectional study.","authors":"Suguru Shimokihara, Kosuke Yama, Kazuki Yokoyama, Hikaru Ihira, Keitaro Makino, Atsushi Mizumoto, Hideyuki Tashiro, Ryo Miyajima, Kiyotaka Shimada, Nozomu Ikeda","doi":"10.1002/pcn5.70399","DOIUrl":"10.1002/pcn5.70399","url":null,"abstract":"","PeriodicalId":74405,"journal":{"name":"PCN reports : psychiatry and clinical neurosciences","volume":"5 3","pages":"e70399"},"PeriodicalIF":1.3,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13551591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing a taxonomy of supportive psychotherapy techniques: Protocol for a systematic review and qualitative content analysis.","authors":"Yuki Omiya, Chong Chen, Hissei Imai, Masahiro Hishiyama, Mariko Nakau, Takeshi Matsuda, Sadayuki Hashioka","doi":"10.1002/pcn5.70408","DOIUrl":"10.1002/pcn5.70408","url":null,"abstract":"<p><strong>Background: </strong>Supportive psychotherapy (SP) is widely practiced, yet its constituent techniques have never been systematically identified or classified. Authors and manuals describe overlapping but non-identical sets in varying terminology, and the boundary between SP and supportive-expressive psychotherapy (SEP) remains unclear, impeding training, research, and comparison. This review aims to identify and classify supportive techniques across the SP and SEP literature and develop a consolidated taxonomy, mapping SEP-specific expressive techniques separately to clarify the supportive-expressive boundary.</p><p><strong>Methods: </strong>This systematic review protocol, applying qualitative content analysis across study designs, follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P). We will search MEDLINE (PubMed), APA PsycINFO, the Cochrane Central Register of Controlled Trials (CENTRAL), and Embase from inception, with backward and forward citation searches. Eligible sources are peer-reviewed publications of any design describing at least one specific SP or SEP technique, plus prespecified key texts and manuals. Two reviewers will independently screen, extract data at source and technique levels (verbatim), and appraise quality with the Joanna Briggs Institute (JBI) Critical Appraisal Tools. Qualitative content analysis will consolidate synonymous descriptions and build the taxonomy through a hybrid inductive-deductive approach.</p><p><strong>Results: </strong>We expect to produce a consolidated, hierarchically organized taxonomy of supportive techniques, with a boundary mapping of SEP-specific expressive techniques and a characterization of consensus and divergence across both literatures.</p><p><strong>Conclusions: </strong>Such a taxonomy would provide a common language for clinicians and researchers, support precise specification of SP in trials, and facilitate structured training.</p>","PeriodicalId":74405,"journal":{"name":"PCN reports : psychiatry and clinical neurosciences","volume":"5 3","pages":"e70408"},"PeriodicalIF":1.3,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13549220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148908035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}