Distribution of Total Depressive Symptoms Scores and Each Depressive Symptom Item in a Sample of Japanese Employees.

BACKGROUND: In a previous study, we reported that the distribution of total depressive symptoms scores according to the Center for Epidemiologic Studies Depression Scale (CES-D) in a general population is stable throughout middle adulthood and follows an exponential pattern except for at the lowest end of the symptom score. Furthermore, the individual distributions of 16 negative symptom items of the CES-D exhibit a common mathematical pattern. To confirm the reproducibility of these findings, we investigated the distribution of total depressive symptoms scores and 16 negative symptom items in a sample of Japanese employees. METHODS: We analyzed 7624 employees aged 20-59 years who had participated in the Northern Japan Occupational Health Promotion Centers Collaboration Study for Mental Health. Depressive symptoms were assessed using the CES-D. The CES-D contains 20 items, each of which is scored in four grades: "rarely," "some," "much," and "most of the time." The descriptive statistics and frequency curves of the distributions were then compared according to age group. RESULTS: The distribution of total depressive symptoms scores appeared to be stable from 30-59 years. The right tail of the distribution for ages 30-59 years exhibited a linear pattern with a log-normal scale. The distributions of the 16 individual negative symptom items of the CES-D exhibited a common mathematical pattern which displayed different distributions with a boundary at "some." The distributions of the 16 negative symptom items from "some" to "most" followed a linear pattern with a log-normal scale. CONCLUSIONS: The distributions of the total depressive symptoms scores and individual negative symptom items in a Japanese occupational setting show the same patterns as those observed in a general population. These results show that the specific mathematical patterns of the distributions of total depressive symptoms scores and individual negative symptom items can be reproduced in an occupational population.

The effect of sleep restriction and psychological load on the diurnal metabolic changes in tryptamine-related compounds in human urine.

OBJECTIVE: The effect of a severely stressful situation (sleep restriction and psychological load) on the diurnal changes in novel tryptamine-related compounds (hydroxydiacetyltryptamine, sulphatoxymelatonin, and dihydromelatonin) was evaluated in human subjects for 16 days. METHODS: The subjects were allowed to sleep for 5 h on days three through 12 and for 8 h on the other days. On days three through 12, the subjects were asked to perform a psychological task. The first two and the last 4 days were viewed as control days. A performance test was administered to evaluate the extent of the subjects' fatigue. Total urine was sampled by collecting it into bottles three times a day [(1) during the sleeping period, (2) in the morning, and (3) in the afternoon]. Seven tryptamine-related compounds in urine were assayed using HPLC-fluorometry. RESULTS: The urine melatonin level was high at night and low during the day. In contrast, urinary levels of hydroxydiacetyltryptamine and sulphatoxydiacetyltryptamine were low at night and high during the day. Dihydromelatonin was undetectable in urine during the sleeping period. Sleep restriction and psychological load did not affect diurnal changes in urinary melatonin, hydroxydiacetyltryptamine, sulphatoxydiacetyltryptamine, or N-acetylserotonin levels. The concentrations of hydroxymelatonin and sulphatoxymelatonin in urine did not show diurnal changes and decreased gradually during the experimental days. A principal component analysis confirmed the diurnal changes and suggested two novel metabolic pathways: (1) N-acetylserotonin to sulphtoxydiacetyltryptamine via hydroxydiacetyltryptamine, and (2) melatonin to dihydromelatonin. CONCLUSION: Severely stressful situations did not affect diurnal changes in melatonin, hydroxydiacetyltryptamine, sulphatoxydiacetyltryptamine, or N-acetylserotonin levels in urine.

[Study of influences of social support and social networks on participation in periodic health examination of the elderly at home comparison of three regions with different social backgrounds].

PURPOSE: Periodic health examination are presumed to be important with respect to the well-being of aged individuals. The purpose of this study was to analyze the relationships between elderly at home accepting periodic health examination and their social support and social networks. METHOD: The survey was performed targeting so-called young elderly persons living at home in 3 regions in Hokkaido Prefecture, a large city (Sapporo), an ex-coalmining town (Yuubari) and a small farming town (Takasu). The study populations were asked about social support and social networks, and the Mantel-Haenszel method was applied to analyze the data. RESULTS: 1) Both males and females who received periodic health examination within the last one year (participants) were members of various groups, such as neighborhood societies, clubs for the elderly and so on, and were more interested in public magazines and political issues than those who had never received periodic health examination (non-participants). Elderly males who accepted periodic health examination were those who were interested in elections, who had a hobby, and who thought that life was worthwhile. 2) Both elderly males and females who accepted periodic health examination were those who had friends, and elderly males who accepted periodic health examination were those who had close relatives and who lived in a friendly neighborhood. 3) Elderly males who accepted periodic health examination were more likely to both receive and supply instrumental and emotional support in interaction with others.

Urinary catecholamines and salivary cortisol on workdays and days off in relation to job strain among female health care providers.

OBJECTIVES: This study examined the effects of psychosocial job strain on the excretion of neuroendocrine stress hormones (adrenaline, noradrenaline, and cortisol) on workdays and days off. METHODS: Japanese female health care providers (N=16) filled out Karasek's job content questionnaire and had their neuroendocrine excretions (ie, urinary catecholamines and salivary cortisol) measured on a day off and on two workdays (one day shift and one night shift). After control for age and job experience as covariates, a repeated-measures analysis of variance was carried out. RESULTS: Noradrenaline excretion was significantly greater over time in the high-strain group than in the low-strain group, and that of the high-demand group was significantly greater over time than that of the low-demand group. Adrenaline excretion did not significantly differ between the groups. The group with high supervisory support had significantly higher adrenaline excretion than the group with low supervisory support. The concentration of salivary cortisol on a dayshift was significantly lower, but marginally, in the high-strain group than in the low-strain group. CONCLUSIONS: Psychosocial job strain is associated with greater noradrenaline excretion over time. This finding suggests unwinding sympathetic nervous activity. The low cortisol levels of the high-strain group may indicate circadian rhythm disturbance induced by job strain. Supervisory relationships may have a particular influence for the studied occupation because the participants had more administrative contact with supervisors than support at the worksite; therefore, supervisory support may increase adrenaline excretion.

Leisure time physical activity as a determinant of self-perceived health and fitness in middle-aged male employees.

Self-perceived health and fitness are epidemiological predictors of subsequent mortality and/or functional limitation. The present study was designed to analyze which lifestyle factors contribute to good status of self-perceived health and fitness in middle-aged male employees. Participants (n=401) aged 50-59 were assessed as to the status of self-perceived health and fitness, and various lifestyle factors including nutrition, smoking, drinking, physical activity, psychological stress, sleeping and relaxation. Logistic regression analysis revealed that among the lifestyle factors surveyed in the present study, doing exercise/sports at a medium level (either > or =4.5METs/1-2 times per week or <4.5METs/> or =3-4 times per week) of physical activity index (PAI) was the only predictor of good self-perceived health. Similarly, doing exercise/sports at or above the medium level of PAI was identified as the only independent predictor of good self-perceived fitness. In addition, maintaining the habit of doing exercise/sports at or above the medium level of PAI throughout the year, and having this habit through the 4th and 5th decades of life or starting to have it from the age of 50 through 59 were important to obtain a good status of self-perceived health and fitness. These findings suggest that leisure time physical activity level is a determinant of good health and fitness in the middle-aged male employees in the present study.

[Factors associated with participation in medical checkups of the elderly at home comparison of 3 regions with different social backgrounds].

PURPOSE: Annual medical checkups are presumed to be important with the well-being of aged individuals. The purpose of this study was to investigate factors related to participation in medical checkups of elderly persons at home. METHODS: A survey was performed targeting so-called young elderly persons living at home in 3 regions in Hokkaido Prefecture, a large city (Sapporo), an ex-coalmining town (Yubari) and a small farming town (Takasu). The study populations were asked about medical checkups, economic status, self-rated health status, activities of daily living (ADL) and basic characteristics such as age, sex and occupation. We used the Mantel-Haenszel method for statistical analysis. RESULTS: 1) Elderly males who received medical checkups within the last 1 year (participants) had a shorter period of education, were less likely to have or to have had the smoking habit, undertook more physical activity, had better eating habit, more often rated their own health as good or normal, and had a better physical ADL & instrumental ADL, than those who had never received medical checkups (non-participants). Regionally, the items that showed significant differences included: "live with the spouse", "do not smoke" and "do not have physical pain or disabilities" in Sapporo; "enjoy physical activity", "have good eating habit" and "have good instrumental ADL" in Yubari; and "engaged in agriculture/fishery work" and "had outpatient visits in the last three months" in Takasu. 2) Elderly female participants who had outpatient visits in the last three months had anxiety about their own health, significantly different from non-participants. Regionally, the items that showed significant differences included: "often drink alcohol" in Sapporo; "still working right now", "was engaged in agriculture/fishery work in the past" and "had outpatient visits in the last three months" in Yubari; and "have own house", "do not smoke" and "pay attention to eating habit" in Takasu. 3) The item which showed a significantly high rate both for male and female participants was "still working right now". CONCLUSIONS: This study indicates that medical checkups should be recommended to the elderly, taking into account not only their basic characteristics such as sex and occupation, but also lifestyle, self-rated health status and ADL, which are associated with medical checkup participation.

Familial aggregation of uterine myomas in Japanese women.

To assess the familial aggregation of uterine myomas in Japanese women with myomas, one hundred forty four women requiring surgery for myomas and 288 age-matched healthy controls were studied in Hokkaido, Japan. The incidence of positive first-degree family history of myomas among women aged 45-54 years with myomas was greater than that among controls (31.5% versus 15.2%, respectively, p < 0.01). Analyses categorized by the status of parity and familiality among subjects showed that the risk for myomas was the greatest in women who had both fewer births (parity = 0 or 1) and the positive family history of myomas as compared with those who had both more births (parity > or = 2) and the negative familiality of myomas (odds ratio = 5.8, 95% confidence interval = 2.3 - 14.6). The results of this study suggest that Japanese middle-aged women with myomas have the familial predisposition of uterine myomas. Furthermore, nulliparous women with the familial aggregation of myomas may be at increased risk of the disease.