Kurihama Medical and Addiction Center

Alcohol dependence (AD) is often comorbid with other mental disorders. We assessed how comorbidities are associated with the clinical features of AD. Information on the history of mental comorbidities, hazardous drug use, suicide attempts, and drinking milestones was collected on a semi-structured medical history form from 4116 Japanese male AD inpatients (2007-2018); the subjects' ADH1B and ALDH2 genotypes (rs1229984/rs671) were also determined. Of the total, 889 (21.60%) patients reported a history of mental comorbidities, including mood disorders (15.48%) and insomnia (2.89%); 202 (4.91%) reported a history of hazardous drug use, and 614 (14.92%) reported suicide attempts. Comorbidities were most commonly diagnosed around the time of onset of advanced alcohol use disorder (aAUD). Patients with comorbidities who began drinking regularly showed more rapid progression to aAUD and to the start of treatment for AD. Multivariate odds ratios (MORs [95%CI]) for the fast-metabolizing ADH1B*1/*2 and ADH1B*2/*2, protective against AD, were higher in patients with comorbidities [1.43 (1.16-1.76) and 1.35 (1.11-1.66)], drug use [1.64 (1.09-2.46) and 1.60 (1.07-2.38)], and suicide attempts [1.45 (1.13-1.85) and 1.49 (1.17-1.88)] compared with the ADH1B*1/*1. MORs for the inactive protective ALDH2*1/*2 were increased only in patients with insomnia [2.65 (1.75-4.02)] compared with the ALDH2*1/*1. MORs for smoking [0.74 (0.58-0.94)] and for age ≤15 years at first drink [0.66 (0.54-0.81)] were lower in patients with comorbidities. MORs for suicide attempts were 2.87 (2.36-3.48) in patients with comorbidities and 3.38 (2.47-4.62) in patients with drug use. Mental comorbidities and a history of suicide attempts were frequent in Japanese patients with AD. Risk factors for AD (ADH1B*1/*1, smoking, early initiation of drinking) were negatively associated with the risk of comorbidities, suggesting interactions between comorbidities and AD risk factors. Insomnia was positively associated with the inactive ALDH2*1/*2. AD patients with mental comorbidities require multifaceted interventions, including suicide prevention.

The aim of this study is to estimate the rate of patients who screened positive for gaming disorder (GD) in ICD-11 among adolescents with psychiatric and/or developmental disorders by using two screening tests: a nine-item screening test for GD, GAMing Engagement Screening test (GAMES Test), and the Ten-Item Internet Gaming Disorder Test (IGDT-10). Subjects were 257 adolescent patients attending a psychiatric clinic in Sapporo, Japan. They were asked to complete two questionnaires. The total score on the IGDT-10 was calculated by two different scoring methods, original version (OV) and modified version (MV). The three groups were also compared on the basis of their clinical diagnoses. Of the 203 respondents, 42 (20.7%) screened positive using the GAMES Test. With respect to the IGDT-10, only eight (3.9%) screened positive using the IGDT-10 OV scoring, while 55 (27.1%) screened positive using the IGDT-10 MV. The most notable finding was that the mean total scores on the GAMES Test and the IGDT-10 MV were significantly higher in the attention deficit hyperactivity disorder group than in the other two groups (depression and autism spectrum disorder). The results of this study showed that adolescents with mental health problems had a higher rate of screening positivity on self-rated screening tools for GD than the general population. Because excessive gaming has a wide range of adverse effects on adolescents' mental health, early detection of probable GD is crucial. Screening for GD should be part of routine clinical practice.

Abstract Relationships with close relatives, friends, and future generations should be critical in a collective society; therefore, the fear of separation from others, and care for others, must be core components of attitudes concerning death. However, such relational attitudes toward death have been insufficiently investigated. This study develops a new psychological scale for assessing death attitudes considering relationships with loved ones and future generations. In Study 1, we conducted an exploratory factor analysis using data from 477 Japanese adults. The results revealed a five‐factor structure of the Death Attitudes in Relationships Scale (DARS) and confirmed its internal consistency, convergent validity, and test–retest reliability. In Study 2 (N = 380), we demonstrated the goodness‐of‐fit indices for the factor structure and further verified the construct validity, considering relationships with other variables. As such, we confirmed the validity and reliability of the DARS. The DARS can be used to reexamine the previous, accumulated findings using the existing scale.

Parents' emotions towards a child are extremely important. The Scale of Parent-to-Child Emotions (SPCE) consists of five basic and four self-conscious emotion domains for assessment of parental emotional states. Abridgement of the SPCE is needed for research and clinical settings. Our previous investigational data for SPCE development were used in this study. The sample of 2336 fathers and 2264 mothers, whose eldest child's age was up to 12 years old, was analyzed. Total information for each pair (form) of items corresponding to a latent trait (θ) was calculated. The form with the greatest amount of total information was selected as the best for each domain. In addition, relative efficiency for each form and correlations of raw sum scores in classical test theory (CTT) for short forms with factor scores in item response theory (IRT) were calculated. The SPCE was shortened to 18 items by selecting two items each for nine domains. Correlations of raw sum scores in CTT for short forms with factor scores in IRT were correlated strongly and significantly. This abridged form of the scale, the SPCE-18, may be applicable in a busy clinical setting or research works to investigate the trajectory of parent-to-child emotions across a long span of time.

The Edinburgh Postnatal Depression Scale (EPDS) is a widely used screening tool for perinatal depression. Its factor structure is still a debatable topic. Our study aimed to examine the factor structure and measurement invariances of the Japanese version of the EPDS from late pregnancy to early postpartum. A total of 633 women were followed with the EPDS at three times over the perinatal period: late pregnancy (n = 633), 5 days after childbirth (n = 445), and 1 month after childbirth (n = 392). We randomly divided the participants into two groups: one for exploratory factor analyses (EFAs) and another for confirmatory factor analyses (CFAs). The result of the EFAs indicated different factor models at each time point. Hence, CFAs were performed using the second sample set to compare different models including the ones previously reported. A 3-factor model consisting of depression (items 7, 9), anxiety (items 4, 5), and anhedonia (items 1, 2) (Kubota et al., 2018) was consistently stable during the whole perinatal period. Kubota's 3-factor model showed invariance across the perinatal period.

Background: Many pregnant women experience impairments in social, occupational, or other important functioning. Aim: This study aimed to confirm measurement and structural invariance of the Sheehan Disability Scale (SDS) and its validity during early pregnancy. Design: Longitudinal study with two observations. Methods: Questionnaires were distributed to pregnant women attending antenatal clinics at gestational weeks 10-13. Of 382 respondents, 129 responded to the SDS again 1 week later. Results: Confirmatory factor analysis shows good fit with the data: χ2/df = 0, comparative fit index (CFI) = 1.000, standardized root mean square residual (SRMR) = 0, and root mean square error of approximation (RMSEA) = 0.718. There is acceptable configural, measurement, and structural invariance of the factor structure between primiparas and multiparas as well as between two observation occasions. The Pregnancy-Unique Quantification of Emesis and Nausea, Patient Health Questionnaire-9, and Insomnia Severity Index subscales explain 47% of the variance in SDS scores. Conclusion: Perinatal health care professionals should pay more attention to the difficulties and disabilities that pregnant women face.

ABSTRACT This paper reports a qualitative survey of experts in problem gaming and/or problem gambling from 19 countries worldwide on the impact of the COVID-19 pandemic on problematic gaming and gambling. Twenty-seven problem gaming experts reported (i) no licensing changes, (ii) few existing or newly introduced policies or regulations, (iii) overall increases in gaming, (iv) adverse health-related outcomes, (v) media coverage of gaming and eSports, (vi) limited health service capacity for treatment and prevention, (vii) difficulty in connecting with patients, and (viii) adaptations including transition to telemedicine. Twenty-eight problem gambling experts reported (i) no changes in policies or regulation, (ii) increased activity of off-shore betting companies, and (iii) increases in online gambling, though (iv) decreased expenditure due to closure of land-based gambling venues, (v) adverse health-related outcomes, (vi) some financial benefits from savings, (vii) few and poorly accessible treatment facilities and (viii) transition to telemedicine. There is a need for: guidelines on the prevention and management of excessive gaming and gambling; studies examining the public health consequences of eSports viewing and participation and closure of land-based gambling venues on other forms of gambling; and longitudinal studies in a number of different areas described herein.

The Nausea and Vomiting of Pregnancy Quality of Life (NVP QOL) Questionnaire is a self-report measure of health-related QOL for nausea and vomiting during pregnancy. This study determines the best fitting factor structure for the NVP QOL Questionnaire and explores its measurement invariance in terms of observation time and parity. A test-retest study of pregnant women was conducted at Gestational Weeks (GWs) 10-13 (T1: N = 381) and 1 week later (T2: n = 128) at one hospital and five clinics with the NVP QOL and the Pregnancy-Unique Quantification of Emesis and Nausea (PUQE). Exploratory and confirmatory factor analyses were performed to compare different factor structure models and evaluate measurement invariance of the best fitting model between two time points and between primiparas and multiparas. Concurrent validity of the NVP QOL was clarified by correlations with the PUQE, Sheehan Disability Scale, and other scales. The one-factor model had the best fit. This factor structure model was acceptable up to the factor invariance level for two time points and up to the factor mean level for primiparas versus multiparas. Correlations between NVP QOL, PUQE, and Sheehan Disability Scale scores were strong. Women with higher NVP QOL scores were more likely to lose weight, have lower daily fluid intake, have reduced fluid and food intake since pregnancy began, and receive outpatient or inpatient treatment. The one-factor structure and measurement invariance of the NVP QOL at different times and parities were demonstrated, suggesting that the NVP QOL can be used to evaluate primiparas and multiparas in a longitudinal study.