PCN reports : psychiatry and clinical neurosciences最新文献

{"title":"Awareness of premenstrual dysphoric disorder, attitudes toward premenstrual symptoms, and probability of suspected premenstrual dysphoric disorder among Japanese university students.","authors":"Yasuko Fuse-Nagase, Yoshie Kono, Takashi Takeda","doi":"10.1002/pcn5.70298","DOIUrl":"10.1002/pcn5.70298","url":null,"abstract":"<p><strong>Aim: </strong>Premenstrual dysphoric disorder (PMDD) interferes with patients' work, school, social activities, or relationships with others. For female students with PMDD to be active in society, both the patients and the surrounding population should be familiar with PMDD, be positive for treatment, and be aware that its disruptions can negatively impact society. Hence, this study aimed to determine PMDD awareness and attitudes toward premenstrual symptoms among male and female university students in Japan and to investigate the probability of suspected PMDD.</p><p><strong>Methods: </strong>Through a survey, we asked all participants about their awareness of PMDD and their attitudes toward premenstrual symptoms. Female participants were also screened for premenstrual symptoms using the Premenstrual Symptoms Questionnaire (PSQ). Those who met certain criteria were classified into the \"PMDD\" group.</p><p><strong>Results: </strong>A total of 1846 students (949 females, 892 males, and 5 unspecified) completed the survey on awareness and attitude. Only 20.6% of them were familiar with PMDD. Some believed that premenstrual symptoms should be endured. Only 36.2% had the idea that the disruptions caused by these symptoms were a loss to society. The PSQ was completed by 920 females. We found that 3.7% were classified into the \"PMDD\" group. Some participants in the \"PMDD\" group were not familiar with PMDD, while some perceived that premenstrual symptoms should be endured.</p><p><strong>Conclusion: </strong>Despite having suspected PMDD, a certain percentage of women remain unaware of their condition and endure their symptoms. PMDD awareness through education is crucial to achieving an active life for females of menstruating age.</p>","PeriodicalId":74405,"journal":{"name":"PCN reports : psychiatry and clinical neurosciences","volume":"5 1","pages":"e70298"},"PeriodicalIF":1.3,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12887689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146168309","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 diverse psychiatric and functional impairments following immune checkpoint inhibitor therapy.","authors":"Takako Ikegami, Ryoichi Sadahiro, Junji Yamaguchi, Eri Nishikawa, Saho Wada, Tatsuto Terada, Rika Nakahara, Hiromichi Matsuoka","doi":"10.1002/pcn5.70297","DOIUrl":"10.1002/pcn5.70297","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitors (ICIs) can cause a range of immune-related adverse events (irAEs), including rare neuropsychiatric complications. However, these events often present with diverse and non-specific symptoms, making diagnosis difficult.</p><p><strong>Case presentation: </strong>A 64-year-old man with Stage IV gastric cancer receiving nivolumab developed impaired consciousness, delusions, and dissociative behavior, and reduced instrumental activities of daily living during and after ICI therapy. During chemotherapy, the patient was suspected of having dementia and was referred to a psychiatrist. However, the possibility of irAE was not mentioned at that time. Despite normal magnetic resonance imaging (MRI) and cerebrospinal fluid findings, a multidisciplinary assessment due to clinical features and exclusion of other etiologies led to the clinical suspicion of an immune-related encephalopathy. Steroid pulse therapy and antipsychotics (risperidone, later olanzapine) improved symptoms. Psychiatric relapse occurred after discontinuing risperidone and resolved with olanzapine.</p><p><strong>Conclusion: </strong>In patients undergoing ICI therapy, new-onset psychiatric symptoms should raise suspicion for irAEs. Timely multidisciplinary intervention is essential for accurate diagnosis and effective symptom management.</p>","PeriodicalId":74405,"journal":{"name":"PCN reports : psychiatry and clinical neurosciences","volume":"5 1","pages":"e70297"},"PeriodicalIF":1.3,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12874490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146144869","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":"Embedding virtual reality social skills training into return-to-work care for depression: A single-arm feasibility pilot with exploratory autistic-trait moderation.","authors":"Yutaro Akaki, Yasuhisa Nakamura, Yuko Nakanishi, Yuji Okuyama, Kiyoshi Fujita","doi":"10.1002/pcn5.70289","DOIUrl":"10.1002/pcn5.70289","url":null,"abstract":"<p><strong>Aim: </strong>To assess the feasibility of embedding virtual reality-based social skills training (SST-VR) into a return-to-work day-care program for major depressive disorder (MDD) and to estimate pre-post change in self-reported social skills, with exploratory moderation by autistic traits.</p><p><strong>Methods: </strong>In this single-arm, add-on pilot at a Japanese psychiatric day-care Re-Work center, 20 adults with MDD (18 men) received six 90-min SST-VR sessions every 2 weeks over approximately 3 months plus the standard Re-Work program. The primary outcome was Kikuchi's Social Skills Scale-18 (KiSS-18); secondary outcomes were social adaptation, social anxiety, and depressive symptoms (self-report). A linear mixed-effects model tested the effects of Time (pre vs post), baseline Autism-Spectrum Quotient (AQ; mean-centered), and their interaction. Feasibility was assessed via attendance and attrition.</p><p><strong>Results: </strong>Attendance was 94.2% with no attrition. KiSS-18 increased from 49.7 ± 10.6 to 53.5 ± 12.4 (<i>p</i> = 0.028; <i>r</i> = 0.56). The model showed significant effects of Time (<i>χ</i>²(1) = 8.11, <i>p</i> = 0.004) and Time × AQ (<i>χ</i>²(1) = 4.46, <i>p</i> = 0.035), suggesting smaller gains at higher AQ (exploratory; restricted AQ range). Emotional processing and stress management subscales improved; secondary outcomes showed no significant change. Bootstrap analyses were consistent with the mixed-model findings.</p><p><strong>Conclusion: </strong>SST-VR was feasible. Because the single-arm add-on design cannot isolate SST-VR-specific effects from concurrent care and nonspecific influences, the KiSS-18 change is hypothesis-generating. Controlled comparisons with Re-Work alone in larger, more diverse samples should test efficacy, include objective behavioral and vocational outcomes, and prospectively evaluate moderation.</p>","PeriodicalId":74405,"journal":{"name":"PCN reports : psychiatry and clinical neurosciences","volume":"5 1","pages":"e70289"},"PeriodicalIF":1.3,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12862656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146115282","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":"Efficacy of a video-viewing intervention of smartphone-based positive word stimulation on depressive symptoms in individuals with subthreshold depression: Protocol for a randomized controlled trial.","authors":"Hiroyuki Uchida, Takumi Igusa, Chihaya Machida, Tomohiro Shimada, Kazuki Hirao","doi":"10.1002/pcn5.70284","DOIUrl":"10.1002/pcn5.70284","url":null,"abstract":"<p><strong>Background: </strong>Interventions targeting subthreshold depression (StD) are critically important for preventing major depressive disorder's onset. Our smartphone-based, video-viewing website (SPSRS), which presents positive word stimulation in videos, is a novel intervention for improving StD's depressive symptoms. Because no rigorous evidence exists for SPSRS's efficacy, this trial aims to evaluate the SPSRS intervention's efficacy on depressive symptoms.</p><p><strong>Methods: </strong>The trial will be an evaluator-blinded, randomized, 5-week, parallel-group superiority trial designed to assess whether the SPSRS intervention (experimental group) is effective compared to no intervention (waiting-list control group). In a 1:1 ratio, 400 participants with StD will be randomly assigned to an experimental group (<i>n</i> = 200) or a waiting-list control group (<i>n</i> = 200). The experimental group will receive a 10-min SPSRS video-viewing intervention once daily for 5 weeks; when the intervention ends, the waiting-list control group will receive the treatment upon request. The intervention's primary outcome will be the mean change from baseline on the Center for Epidemiologic Studies Depression Scale; secondary outcomes will include the mean change from baseline on the Kessler Psychological Distress Scale and the Generalized Anxiety Disorder seven-item scale.</p><p><strong>Result: </strong>The results are presented according to the protocol.</p><p><strong>Discussion: </strong>This trial's confirmation of SPSRS's efficacy could lead to new StD intervention strategies and provide interventions tailored to patient needs.</p>","PeriodicalId":74405,"journal":{"name":"PCN reports : psychiatry and clinical neurosciences","volume":"5 1","pages":"e70284"},"PeriodicalIF":1.3,"publicationDate":"2026-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12859689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108955","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":"Acute mania and psychosis potentially triggered by St John's wort.","authors":"Daisuke Yoshioka, Takehiko Yamanashi, Masaaki Iwata","doi":"10.1002/pcn5.70292","DOIUrl":"10.1002/pcn5.70292","url":null,"abstract":"<p><strong>Background: </strong>St John's wort (SJW) is widely used as an herbal supplement for depressive symptoms and is generally regarded as safe. However, although extremely rare, manic and psychotic reactions have been reported, typically in individuals taking high doses, using psychotropic agents, or having a psychiatric history.</p><p><strong>Case presentation: </strong>We report a case of a Japanese male in his early twenties with only one prior psychiatric visit for interpersonal stress, who developed acute manic and psychotic symptoms while taking standard doses of SJW. Shortly after returning to a university training program following COVID-19 infection, he developed emotional instability, prominent grandiose and persecutory delusions, reduced sleep, and dangerous behavior. Blood tests, cerebrospinal fluid analysis, brain imaging, and cerebrospinal fluid antibody testing were normal. Upon admission, we provisionally diagnosed him with schizoaffective disorder and initiated treatment with aripiprazole, which led to rapid improvement and near remission within 1 week. During pre-discharge psychoeducation, he reported taking SJW for several months, suggesting a possible association between SJW use and symptom onset. SJW was discontinued, and aripiprazole long-acting injectable treatment was initiated after discharge. After 2 months of sustained clinical stability, antipsychotic treatment was discontinued based on shared decision-making with the patient. Outpatient follow-up is ongoing to monitor for any recurrence of symptoms.</p><p><strong>Conclusion: </strong>This case demonstrates that acute manic and psychotic symptoms may occur even in young adults with no notable psychiatric history who take standard doses of SJW. Although SJW is regarded as safe, this case highlights that severe psychiatric reactions may still arise.</p>","PeriodicalId":74405,"journal":{"name":"PCN reports : psychiatry and clinical neurosciences","volume":"5 1","pages":"e70292"},"PeriodicalIF":1.3,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12828271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146055274","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":"Effect of a dual-boarded emergency-psychiatry physician on psychiatric consultations in the emergency department: A pre-post study in Japan.","authors":"Takero Terayama, Shogo Takeshita, Nobuhisa Kobayashi, Hiroaki Toda, Takehito Sawamura","doi":"10.1002/pcn5.70291","DOIUrl":"10.1002/pcn5.70291","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the impact of assigning a dual-boarded emergency-psychiatry physician to the emergency department (ED) on the frequency, timing, and nature of psychiatric consultations. Access to psychiatric evaluations in EDs is often limited, particularly in Japan, where general hospitals with psychiatric services are declining. Integrating dual-boarded physicians in emergency medicine and psychiatry may address unmet psychiatric needs.</p><p><strong>Methods: </strong>This retrospective, single-center, pre-post study was conducted at a secondary emergency hospital in Tokyo, Japan. All patients transported by ambulance between October 2020 and September 2024 were included in this study. An a priori sample size calculation was not performed; instead, the study size was determined by all consecutive eligible patients during this predefined observation period. The intervention involved the continuous assignment of a dual-boarded physician in October 2022. The primary outcome was the number of psychiatric consultations initiated by emergency physicians. Secondary outcomes included reasons for consultation, patient characteristics, physiological indicators at ED presentation, emergency procedures at admission, consultation setting, time from admission to consultation, and clinical outcomes; for patients with multiple consultations during the same hospitalization, only the initial consultation was analyzed.</p><p><strong>Results: </strong>Among 23,916 patients, 137 psychiatric consultations were analyzed. Consultations increased 3.41-fold post-intervention (31 vs. 106), with the consultation rate increasing from 0.29% to 0.81%. High-risk psychiatric presentations, including suicidal ideation (40.6% vs. 12.9%, <i>p</i> = 0.005), self-harm (42.5% vs. 19.4%, <i>p</i> = 0.019), and overdose (33.0% vs. 12.9%, <i>p</i> = 0.040), were significantly more common post-intervention, whereas delirium was less frequent (2.8% vs. 25.8%, <i>p</i> < 0.001). Vital signs at ED presentation and emergency procedures at admission were comparable between groups. Time from admission to consultation was shorter post-intervention (median 1 vs. 3 days, <i>p</i> = 0.007). The median hospital stay was also shorter from 22 to 8 days (<i>p</i> = 0.001). There was no significant change in the psychiatric hospital transfer rates.</p><p><strong>Conclusion: </strong>This study demonstrated that the 2-year assignment of one dual-boarded emergency-psychiatry physician was associated with an increased acceptance of more complex psychiatric cases in the ED, particularly those involving self-harm and suicidal ideation.</p>","PeriodicalId":74405,"journal":{"name":"PCN reports : psychiatry and clinical neurosciences","volume":"5 1","pages":"e70291"},"PeriodicalIF":1.3,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12828264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047433","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":"Improvement in avoidance in major depressive disorder: A 10-month prospective study of depressive symptoms and personality traits.","authors":"Ryotaro Higuchi, Atsuo Nakagawa, Dai Mitsuda, Waka Nogami, Mizuki Amano, Sakae Ihara, Aoi Ito, Sachiko Noda, Nariko Katayama, Hiroki Kocha","doi":"10.1002/pcn5.70288","DOIUrl":"10.1002/pcn5.70288","url":null,"abstract":"<p><strong>Aim: </strong>Avoidance is a key maintaining factor in major depressive disorder (MDD); however, longitudinal evidence remains limited, and its association with personality traits is not fully understood. This study aimed to (1) examine the longitudinal associations among avoidance, depressive symptoms, and rumination and (2) explore the relationship between avoidance and personality traits in outpatients with MDD.</p><p><strong>Methods: </strong>In this 10-month prospective study, 53 adult outpatients diagnosed with MDD were assessed while receiving routine outpatient psychiatric care. Avoidance, depressive symptoms, and rumination were measured at baseline and follow-up using the Cognitive Behavioral Avoidance Scale (CBAS), 17-item GRID-Hamilton Depression Rating Scale (GRID-HAMD-17), and Ruminative Responses Scale (RRS), respectively. Personality traits were assessed at baseline using the Temperament and Personality Questionnaire (T&P). Patients were dichotomized into an Avoidance Improvement (AI) group (≥9-point reduction in CBAS scores) or a Non-Avoidance Improvement (NON-AI) group based on a median split. Univariate and multivariate regression analyses were conducted to identify factors associated with Avoidance Improvement.</p><p><strong>Results: </strong>The AI group demonstrated greater reductions in depressive symptoms (<i>p</i> = 0.001) and rumination (<i>p</i> = 0.031) than the NON-AI group. In multivariate analysis, greater improvement in depressive symptoms (odds ratio [OR] = 1.130, 95% confidence interval [CI] = 1.016-1.257) and lower baseline Personal Reserve (OR = 0.848, 95% CI = 0.724-0.968) were independently associated with improvement in avoidance.</p><p><strong>Conclusion: </strong>Reductions in depressive symptoms and lower Personal Reserve may contribute to decreased avoidance in MDD. These findings highlight the importance of targeting depressive symptoms not only for direct relief but also to disrupt maladaptive avoidance cycles.</p>","PeriodicalId":74405,"journal":{"name":"PCN reports : psychiatry and clinical neurosciences","volume":"5 1","pages":"e70288"},"PeriodicalIF":1.3,"publicationDate":"2026-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12812285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146004840","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":"Differential working memory changes following methylphenidate in medication-naive and medication-experienced adults with ADHD.","authors":"Masaaki Shimizu, Shunsuke Takagi, Ryuta Aoki, Takashi Itahashi, Yumi Shikauchi, Hironobu Nakamura, Genichi Sugihara, Hidehiko Takahashi, Motoaki Nakamura","doi":"10.1002/pcn5.70286","DOIUrl":"10.1002/pcn5.70286","url":null,"abstract":"<p><strong>Aim: </strong>The long-term impact of pharmacological treatment on cognitive function in adults with attention-deficit/hyperactivity disorder (ADHD), particularly whether benefits persist after treatment discontinuation, is not well understood. This study aimed to investigate whether prior medication history is associated with different patterns of cognitive change following methylphenidate (MPH) administration.</p><p><strong>Methods: </strong>Thirty-six adults with ADHD (17 medication-naive, 19 medication-experienced) were assessed on five cognitive tasks, the multitasking test (MTT), reaction time (RTI), rapid visual processing (RVP), stop signal task (SST), and spatial working memory (SWM), from the Cambridge Neuropsychological Test Automated Battery baseline and following a period of clinically stable MPH treatment (Post). We used mixed-design ancovas to test for Time × Medication history interactions.</p><p><strong>Results: </strong>We found a significant interaction in the SWM task (6-box condition; <i>q</i> = 0.044). A sensitivity analysis excluding atomoxetine-experienced participants showed a preserved effect size but trend-level significance (<i>q</i> = 0.061). Post hoc analyses revealed that the medication-naive group's SWM performance significantly improved from baseline to Post, whereas the medication-experienced group, who exhibited a significantly better baseline performance, showed no change. Exploratory analyses suggested similar trends across the other SWM difficulty levels. No significant interactions were found for other tasks.</p><p><strong>Conclusion: </strong>Two groups showed differential trajectories of change in the SWM task. Rather than reflecting a purely pharmacological effect, these patterns may involve a combination of baseline cognitive differences, learned cognitive strategies, and pre-existing individual characteristics. These preliminary findings highlight the importance of considering treatment history in clinical practice and research.</p>","PeriodicalId":74405,"journal":{"name":"PCN reports : psychiatry and clinical neurosciences","volume":"5 1","pages":"e70286"},"PeriodicalIF":1.3,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12800564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145991977","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":"Restoring decision-making capacity through ECT to enable clozapine initiation in treatment-resistant schizophrenia: An ethical and clinical case report.","authors":"Shimpei Hanaoka, Hiroki Suzuki, Akira Sugeno","doi":"10.1002/pcn5.70281","DOIUrl":"10.1002/pcn5.70281","url":null,"abstract":"<p><strong>Background: </strong>Treatment-resistant schizophrenia (TRS) is often accompanied by poor insight and impaired decision-making capacity (DMC), complicating the initiation of clozapine (CLZ) despite clear clinical indications. In Japan, CLZ utilization is markedly lower than in many foreign countries, partly due to concerns about adverse effects, mandatory blood monitoring, and difficulties in obtaining informed consent from patients with impaired DMC. Although CLZ can legally be initiated only with family consent, sustained treatment generally requires the patient's own agreement. Electroconvulsive therapy (ECT) may alleviate acute psychotic symptoms and temporarily improve DMC, thereby enabling informed participation in treatment decisions.</p><p><strong>Case presentation: </strong>A woman in her late thirties with TRS persistently refused CLZ. On readmission, her Clinical Global Impression-Severity (CGI-S) score was 7. Pseudo-TRS was partly ruled out using a long-acting injectable antipsychotic (LAI). Following a multidisciplinary case conference in the psychiatric department and family proxy consent, ECT was initiated during involuntary hospitalization for medical care and protection in accordance with clinical practice recommendations for ECT endorsed by the Japanese Society of Psychiatry and Neurology (JSPN). After three ECT sessions, the patient's DMC improved sufficiently to allow voluntary consent to CLZ initiation. Twelve ECT sessions were administered while CLZ was titrated to 225 mg/day. The CGI-S score improved to 3, no serious adverse events occurred, and she was discharged approximately 120 days after admission with stable outpatient follow-up.</p><p><strong>Conclusion: </strong>This case demonstrates that ECT can function as a capacity-restoring intervention enabling voluntary CLZ initiation in selected TRS patients who initially lack DMC. In the context of low CLZ utilization in Japan, a staged approach combining acute stabilization and pharmacological consolidation may provide a clinically and ethically acceptable pathway when supported by multidisciplinary review and procedural safeguards.</p>","PeriodicalId":74405,"journal":{"name":"PCN reports : psychiatry and clinical neurosciences","volume":"5 1","pages":"e70281"},"PeriodicalIF":1.3,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12789935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953514","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":"Valbenazine induced acute parkinsonism in a patient with alcohol use disorder and central pontine myelinolysis.","authors":"Yasuhito Nagai, Miyata Mamiko, Koichi Miyakawa","doi":"10.1002/pcn5.70282","DOIUrl":"10.1002/pcn5.70282","url":null,"abstract":"<p><strong>Background: </strong>Valbenazine is used to treat dyskinesia and is generally associated with limited side effects; however, a few cases with the adverse effect of parkinsonism are reported in the literature. In this study, we report a case of valbenazine-induced acute parkinsonism.</p><p><strong>Case presentation: </strong>The patient was a 60-year-old male who suffered from depression and alcohol use disorder. When he was 50 years old, he was diagnosed with Wernicke's encephalopathy, central pontine myelinolysis-induced parkinsonism, and dyskinesia. After remission, dyskinesia persisted and was diagnosed as tardive dyskinesia. The patient was treated with tetrabenazine and valbenazine at different times, and only valbenazine treatment induced acute parkinsonism.</p><p><strong>Conclusion: </strong>Valbenazine can cause acute parkinsonism, even in patients who have previously tolerated tetrabenazine, and especially in those with underlying basal ganglia lesions.</p>","PeriodicalId":74405,"journal":{"name":"PCN reports : psychiatry and clinical neurosciences","volume":"5 1","pages":"e70282"},"PeriodicalIF":1.3,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12789971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953673","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}