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Objectives@#This research probes into the characteristics of modern type depression (MTD) in South Korea, drawing parallels to Japan’s hikikomori state. It aims to bridge cultural value gaps and highlight its significance in South Korea, given the observed reclusive youth behaviors. @*Methods@#Participants undertook a semi-structured interview assessing hikikomori tendencies and MTD. Also, self-reports were done using the 25-item Hikikomori Questionnaire (HQ-25), 22-item Tarumi’s Modern-Type Depression Trait Scale: Avoidance of Social Roles, Complaint, and Low Self-Esteem (TACS-22), Patient Health Questionnaire-9 (PHQ-9), Beck Depression Inventory-II (BDI-II), Young’s Internet Addiction Test (YIAT), Smartphone Addiction ScaleShort form Version (SAS-SV), Revised UCLA Loneliness Scale (RULS), Lubben Social Network Scale (LSNS-6). Scores were analyzed by group (MTD, control) using and logistic regression was done. Additional analysis was done by group (modern type with hikikomori and modern type without hikikomori). @*Results@#Of 59 participants, 29 had MTD. In both groups, age and sex were matched with differences in education years. The MTD group contained 14 hikikomori individuals. Logistic regression identified the HQ-25 as a significant predictor for MTD. Notably, specific components like “low self-esteem” in TACS-22 and “isolation” in the HQ-25 significantly influenced MTD status. HQ-25 and RULS were significantly different between modern type with hikikomori and modern type without hikikomori. @*Conclusions@#Using Japanese diagnostic criteria, this study illuminated MTD in Korean patients. The findings underscore isolation and low self-esteem predicted diagnosis of MTD. As MTD shares common pathological traits with hikikomori, the therapeutic interventions are important in Korea.
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Objective@#Pharmacotherapy including mood stabilizers and antipsychotics are frequently used in bipolar disorder (BD); however, the lack of consensus regarding the definition of polypharmacy hinders conducting comparative studies across different settings and countries. Research on Asian Prescription Pattern (REAP) is the largest and the longest lasting international collaborative research in psychiatry in Asia. The objective of REAP BD was to investigate the prescription patterns of psychotropic medications across Asian countries. The rates of polypharmacy and psychotropic drug load were also analyzed. @*Methods@#The data collection was web-based. Prescription patterns were categorized as (1) mood stabilizer monotherapy: one mood stabilizer; (2) antipsychotic monotherapy: one antipsychotic; (3) simple polypharmacy: one mood stabilizer and one antipsychotic; and (4) complex polypharmacy: ≥ 2 mood stabilizers or/and antipsychotics. The psychotropic drug load in each patient was calculated using the defined daily dose method. @*Results@#Among 2003 patients with BD (52.1% female, 42.4 years) from 12 countries, 1,619 (80.8%) patients received mood stabilizers, 1,644 (82.14%) received antipsychotics, and 424 (21.2%) received antidepressants, with 14.7% mood stabilizer monotherapy, 13.4% antipsychotic monotherapy, 48.9% simple polypharmacy, 20.3% complex polypharmacy, and 2.6% other therapy. The average psychotropic drug load was 2.05 ± 1.40. Results varied widely between countries. @*Conclusion@#Over 70% of psychotropic regimens involved polypharmacy, which accords with the high prevalence of polypharmacy in BD under a permissive criterion (2 or more core psychotropic drugs) worldwide. Notably, ≥ 80% of our sample received antipsychotics, which may indicate an increasing trend in antipsychotic use for BD treatment.
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Objective@#Recently, rational polypharmacy approaches have been proposed, regardless of the lower risk and cost of monotherapy. Considering monotherapy as first-line treatment and polypharmacy as rational treatment, a balanced attitude toward polypharmacy is recommended. However, the high prevalence of polypharmacy led the Japanese government to establish a polypharmacy reduction policy. Based on this, the association between the policy and psychiatrists’ attitude toward polypharmacy has been under debate. @*Methods@#We developed an original questionnaire about Psychiatrists’ attitudes toward polypharmacy (PAP). We compared the PAP scores with the treatment decision-making in clinical case vignettes. Multiple regression analyses were performed to quantify associations of explanatory variables including policy factors and PAP scores. The anonymous questionnaires were administered to psychiatrists worldwide. @*Results@#The study included 347 psychiatrists from 34 countries. Decision-making toward polypharmacy was associated with high PAP scores. Multiple regression analysis revealed that low PAP scores were associated with the policy factor (β=-0.20, p=0.004). The culture in Korea was associated with high PAP scores (β=0.34, p<0.001), whereas the culture in India and Nepal were associated with low scores (β=-0.15, p=0.01, and β=-0.17, p=0.006, respectively). @*Conclusion@#Policy on polypharmacy may influence psychiatrists’ decision-making. Thus, policies considering rational polypharmacy should be established.
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OBJECTIVE@#Smartphone use is pervasive among youth in Japan, as with many other countries, and is associated with spending time online and on social media anywhere at any time. This study aimed to test a Japanese version of the Smartphone Addiction Scale-Short Version (SAS-SV) among Japanese college students.@*METHODS@#The subjects of this study were 602 college students in Japan. The study questionnaire consisted of questions about demographics (age, gender etc.), possession of a smartphone, internet use [length of internet use on weekdays and weekend, favorite social networking service (SNS) etc.], Young’s Internet Addiction Test (IAT), and the Smartphone Addiction Scale-Short Version (SAS-SV) translated into Japanese.@*RESULTS@#There was a total of 573 respondents (180 male, 393 female) who completed the questionnaire (mean 19.3±1.3 years). LINE was the most popular social media platform (52.0%) followed by Twitter (36.3%). The overall Internet Addiction Test (IAT) score was 45.3±13.2, with 4.5% classified as having severe addiction (IAT ≥70). The mean SAS-SV scores were 24.4±10.0 for males and 26.8±9.9 for females. Based on proposed cutoff scores, 22.8% of males and 28.0% of females screened positive for smartphone addiction. The total scores of the SAS-SV and the IAT was correlated significantly.@*CONCLUSION@#As the number of smartphone users becomes higher, problems related to smartphone use also become more serious. Our results suggest that the Japanese version of SAS-SV may assist in early detection of problematic use of smartphones.
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OBJECTIVES: Previous studies have reported that internet addiction (IA) is associated with attention-deficit/hyperactivity disorder (ADHD) consistently. However, in terms of gender, there are controversial findings. We aimed to investigate the relation between IA and self-acknowledged ADHD traits among female college students in Japan. METHODS: The study questionnaire consisted of questions about demographics, Adult ADHD Self-Report Scale-V1.1 Part A (ADHD screener) and Young's Internet Addiction Test (IAT). When four or more items are more frequent than the cut-off on ADHD screener, the subject was categorized into students with a positive ADHD screen. We defined students with total IAT score of 70 and higher as IA. RESULTS: A total number of respondents was 369 (mean age: 19.0±0.7 years). Seventy-seven subjects were screened positive on ADHD screener (20.9%). Students with a positive ADHD screen scored significantly higher on the IAT (54.2±14.2 vs. 42.5±11.3). The rates of IA in students with and without a positive ADHD screen were 18.2% and 1.0%, respectively. CONCLUSION: Results of this study demonstrated the relation between IA and self-evaluated ADHD traits among female college students in Japan. Appropriate education for students on how to use the internet properly will be necessary to prevent IA.