Internet survey on the provision of complementary and alternative medicine in Japanese private clinics: a cross-sectional study / 中西医结合学报

OBJECTIVE@#Although the use of complementary and alternative medicine (CAM) by the general population has been surveyed previously, the provision of CAM by Japanese physicians in private clinics has not been studied. Universal health insurance system was established in Japan in 1961, and most CAMs are not on the drug tariff. We aimed to clarify the current status of CAM provided by physicians at private clinics in Japan.@*METHODS@#We conducted an internet survey on 400 directors/physicians of private clinics nationwide on the provision of CAM from February 6 to February 10, 2017. Survey items included attributes of subjects, presence/absence of sections or facilities for provision of CAM, proportions of health insurance coverage for medical practices, and source of information. Private clinic was defined as a clinic run by one physician, with less than 20 beds.@*RESULTS@#Commonly provided CAMs were Kampo (traditional Japanese herbal) medicines (34.8%) and supplements/health foods (19.3%). CAMs on the drug tariff were provided in 46.5% of cases at the clinics, but only 16.5% of cases were provided CAMs which were not on the drug tariff, at different neighboring facilities. Among different specialties, Kampo medicines were prescribed at obstetrics/gynecology (54.0%), orthopedics (44.4%), and dermatology (43.0%). Clinics not providing any CAM accounted for 53.5%. With regard to health insurance coverage, 96.8% of the clinics provided only or mainly health services on the universal national health insurance tariff (29.8% and 67.0%, respectively).@*CONCLUSION@#Kampo medicines represent the most commonly used CAM in private clinics in Japan, and universal national health insurance coverage is considered to be the reason for the high rate of their use.

The Current Status of Palliative Care for Non-cancer Patients in Japan: Field Survey on the Representatives of the Japanese Society for Palliative Medicine

Purpose: The field survey was conducted to evince the current status of palliative care for non-cancer patients. Methods: The on-line questionnaire survey was conducted covering 196 representatives of the Japanese Society for Palliative Medicine. Multiple-choice questions were asked about their medical experiences with non-cancerous diseases, their attitudes towards palliative care, their feelings of bewilderment upon providing palliative care, and what they thought would be required for future education in this field. Results: One-hundred and eleven (111) representatives (57%) responded the survey. Ninety-nine (99)% of the respondents experienced providing non-cancer patients with palliative care, but 63% of them experienced less than 50 patients in the terminal phases even in cumulative total. Eighty (80)% of them said they were feeling insecure about providing non-cancer patients with palliative care, and 83% of them were feeling difficulty when they had to do so. The reasons listed included that prognostic prediction for such cases wouldn’t be easy and that it wouldn’t be covered by public health insurances. What they felt necessary about future education included communication and multi-disciplinary team medicine, in this order. Conclusions: The representatives of the Japanese Society for Palliative Medicine are well-aware of the demands for palliative care for non-cancer patients, but not many of them have experienced such cases and more than 80% of them are feeling insecure and difficulty about providing it.

Trypophobia: an investigation of clinical features

Objective: Trypophobia refers to the fear of, or aversion to, clusters of holes. We assessed clinical features of trypophobia and investigated whether it most resembled a specific phobia or obsessive-compulsive disorder. Methods: An online survey was conducted to gather information on sociodemographic variables, course and duration, severity, associated features, comorbid psychiatric diagnoses, and levels of psychological distress and impairment in individuals with trypophobia. The survey also explored whether such individuals experienced more fear or disgust, and whether symptoms showed more resemblance to a specific phobia or to obsessive-compulsive disorder. Associations of symptom severity and duration with degree of impairment were investigated. Results: One hundred and ninety-five individuals completed the questionnaire. Symptoms were chronic and persistent. The most common associated comorbidities were major depressive disorder and generalized anxiety disorder. Trypophobia was associated with significant psychological distress and impairment. The majority of individuals experienced disgust rather than fear when confronted with clusters of holes, but were more likely to meet DSM-5 criteria for specific phobia than for obsessive-compulsive disorder. Symptom severity and duration were associated with functional impairment. Conclusions: Given that individuals with trypophobia suffer clinically significant morbidity and comorbidity, this condition deserves further attention from clinicians and researchers.

Factors Affecting Quality of Life of Family Caregivers of Cancer Patients: Study Using the Japanese Version CQOLC (The Caregiver Quality of Life Index-Cancer)

<p>Purpose: To clarify the factors that affect the family caregiver’s quality of life (QOL) of cancer patients. Methods: We conducted an internet survey including 21 items of the Japanese version CQOLC for 400 families of cancer patients in March 2012. Results: Factors that increased psychological burden were that caregivers were women, other family needed long-term care, and the patient had higher need for care. Factors that increased the family caregiver’s difficulty in their daily activities due to long-term care were caregivers are women, other family needed long-term care, caregivers did not think they had a good relationship with the patient, and the patient had higher need for care. Factors that increased financial burden were that the age of caregivers was less than 60 years, decreased of income after the patient’s diagnosis, and patients were men. Factors that increase the positive feeling for caregiving were that caregivers thought they had good relationship with the patient, and the patient’s need for care was higher. Conclusions: To reduce the burden in family caregiver of cancer patients without losing the positive feeling for caregiving would be important for both improving the family caregiver’s QOL, and to continue the care for patient in long term. </p>

Prevalence Of Sleep Problems Among Those With Internet Gaming Disorder In Singapore

Internet gaming disorder (IGD) involves the excessive use of Internet games that can cause negative consequences like sleep problems, psychological distress, depression and anxiety. It is widely assumed that IGD is closely related with sleep problems, but studies on the topic are scant. Our study aims to explore the association between IGD and sleep problems. Methods: A total of 1085 participants, aged 13-40 years old reported playing Internet games in this self-administered, web-based survey. The instruments used for the study were socio-demographic questions, IGD Questionnaire, Life Satisfaction Scale, General Health Questionnaire-12 and Insomnia Severity Index. The cut-off point of 10 and above was used to establish the prevalence of sleep problems in this study. Logistic regression analysis was used to explore the association between socio-demographic factors, IGD and sleep problems. Results: The prevalence of sleep problems among those with IGD was 28.2%. Female online gamers (adjusted odds ratio, OR=0.7, 95% confidence interval (CI) = 0.5-0.9) were more likely to have sleep problems than males. Participants with secondary education (adjusted OR=1.9, 95% CI=1.2-3.0) and post- secondary education (adjusted OR=2.7, 95% CI= 1.2-6.0) were more likely to have sleep problems than those who had completed university. Participants with DSM-5 IGD were more likely to have sleep problems. Psychological distress (adjusted OR 4.8, 95% CI=3.6-6.7) and life satisfaction (B = -3.1, 95% CI= -4.0 to -2.2) was associated with sleep problems. Conclusion: Prevalence of sleep problems with IGD is higher among female gamers and is associated with increased psychological distress and decreased life satisfaction. Integrated health management is needed to promote good sleep hygiene among those diagnosed with IGD. ASEAN Journal of Psychiatry, Vol. 17 (1): July – December 2016: XX XX.

Reliability and Validity of the Korean Version of Beck Depression Inventory-II via the Internet : Results from a University Student Sample / 신경정신의학

OBJECTIVES: The purpose of this study was to evaluate the properties of the Beck Depression Inventory-II (BDI-2) via the internet. METHODS: Participants included 1967 students of a university. A confirmatory factor analysis was performed to test whether the factor structure of the BDI-2. Convergent validity was assessed by correlating the scores on the BDI-2 with those on other scales. RESULTS: Two-week test-retest reliability was high (r=0.84) and internal consistency was good (Cronbach's alpha=0.882). The BDI-2 showed a good criterion validity with strong correlation with Patient health questionnaire 9 (PHQ-9). Factor structure of the BDI-2 was established using the three-factor structure, which explained 43% of the total variance. CONCLUSION: The results of the current study indicate that the BDI-2 is an effective and valid scale for evaluation of depression among Korean university students. The findings suggest that the BDI-2 is a promising assessment tool for use in depression and study of depression via the internet.