Analyzing changes in help-seeking from mental and physical health professionals during COVID-19 in Japan.

Japan witnessed the outbreak of coronavirus disease (COVID-19) in March - May 2020. We examined whether the impact of COVID-19 on people seeking help from mental and physical health professionals varied with changes in employment (from full-time employment to unemployment or leave of absence) and psychological predisposition to new-type depression (Interpersonal Sensitivity [IS]/Privileged Self [PS]) associated with the pandemic. An online survey was conducted in June 2020 (after the outbreak of COVID-19) among people who were full-time employees as of April 2019. Data from 1,053 individuals were analyzed. The survey asked about regular visits to health professionals one year prior to the survey (June 2019) and at the time of the survey. Employment status, personality traits, and demographic characteristics were also examined. We found that consultation rates changed little before and after the pandemic. Logistic regression analysis showed that after controlling for age and gender, being unemployed or absent from work after the pandemic and having higher scores for IS/PS were positively associated with regular visits to health professionals. Considering that COVID-19 has been shown to increase the incidence of physical and mental illness, the finding that the rate of consultations remained unchanged implies that consultations were withheld. Joblessness/absence from work and IS/PS had negative effects on physical and mental health, leading to fewer visits.

Risk factors of hikikomori among office workers during the COVID-19 pandemic: A prospective online survey.

The global pandemic of COVID-19 has forced people to restrict their outings. In Japan, self-restraint behavior (SRB) has been requested by the government, and some of those decreasing their outings may shift to pathological social withdrawal; hikikomori. The purpose of this study was to examine the risk factors of hikikomori conducting an online prospective survey. An online survey was conducted in June 2020 and December 2020; (1) SRB-related indicators (degree of SRB, motivation for SRB, stigma and self-stigma toward COVID-19, anxiety and depressive feelings toward COVID-19) and (2) general mental health (hikikomori tendency, depressive symptoms, modern type depression (MTD) tendency, internet addiction) were collected. A cross-lagged effects model was performed to examine the association between these variables. Lack of emotional support and lack of socialization in June 2020 increased isolation in December 2020. Besides, MTD and hikikomori interacted with each other. Interestingly, although hikikomori tendency increased depressive tendencies, SRB itself did not have a significant path on any mental health-related variables. Poor interpersonal relationships, rather than SRB per se, are suggested to be a risk factor for increased isolation among office workers in the COVID-19 pandemic. Appropriate early interventions such as interpersonal or emotional support may prevent the transition to pathological hikikomori. The association between MTD and hikikomori seems to reveal the interesting possibility that MTD is a gateway to increased risk of hikikomori, and that hikikomori is a gateway to MTD as well. Future research is required to elucidate the relationship between hikikomori and MTD.

Perceptions of traditional and modern types of depression: A cross-cultural vignette survey comparing Japanese and American undergraduate students.

AIM: Depression is a heterogeneous disorder that has various subtypes. In Japan, however, a prevailing misunderstanding is that the term utsu-byo (clinical depression) indicates only the melancholic type. Consequently, a subtype called 'modern-type depression' (MTD), which has contrasting features to those of melancholic or traditional-type depression (TTD), is severely stigmatized in Japan these days. The present study conducted a cross-cultural comparison of perceptions of TTD and MTD between Japan and the USA to examine how the Japanese collectivistic culture contributes to negative biases toward MTD. METHODS: Undergraduate students in Japan (N = 303) and the Midwestern USA (N = 272) completed the survey. They read two vignettes that described the conditions of fictional individuals with either TTD or MTD, and then reported their perceptions of each vignette. RESULTS: Mixed analyses of variance revealed significant interactions between nation (Japan or the USA) and vignette (TTD or MTD) on most perception items. These interactions and subsequent analyses with Bonferroni corrections mainly indicate the following: (i) Japanese are more likely to suppose that conditions of MTD are milder compared with TTD; and (ii) Japanese are more likely to hold stronger aversive attitudes and weaker willingness to provide support toward people with MTD than toward those with TTD. CONCLUSION: These results indicate that people with MTD are more likely to be accepted in the US independent culture than in the Japanese collectivistic culture. Discussion highlights that cultural diversity education potentially reduces stigma of MTD in Japan.

[Development of the Interpersonal Sensitivity/Privileged Self Scale: The measurement of a psychological characteristic related to "Modern-type Depression"].

We developed the Interpersonal Sensitivity/Privileged Self Scale (IPS) to measure personality traits related to "modern-type depression," and assessed its validity and reliability through three surveys completed by 804 undergraduates. Factors for validity were examined by confirmatory factor analysis. As predicted, the scale comprised two superordinate factors: interpersonal sensitivity (IS) and privileged self (PS). Criterion-related validity for the IPS scale was assessed by examining its relationship with depressive symptoms and typus melancholicus, and by comparing subscale scores regarding depression types (i.e., melancholic, atypical). All subscale scores were positively correlated with depressive symptoms. Correlations between typus melancholicus and subscales showed that the interpersonal sensitivity subscale was positively correlated with typus melancholicus, while the privileged self subscale was not correlated. An analysis of variance revealed that the "self-righteousness" score was significantly higher for the atypical depression group compared to the melancholic depression group. The test-retest correlation indicated good test-retest reliability for all subscales. Overall, the findings indicated that the IPS has high validity and reliability.

A comparison of perceptions of 'modern-type' and melancholic depression in Japan.

BACKGROUND: In Japan, psychiatrists have noted two different types of depression, traditional/melancholic depression and 'modern-type' depression (MTD). Although both the modern and the traditional types of depression overlap in regard to symptoms, these are two distinct syndromes, which can lead to confusion for Japanese people. AIMS: This study aims to examine impressions of two types of depression using vignettes and clarify the differences in perceptions of the two types. METHODS: The participants, 206 Japanese undergraduates, were presented with two vignettes, one describing a patient with traditional-type depression and the other describing a patient with MTD, and then were asked to answer questions regarding their perceptions of the patient. In order to control covariates (i.e. perceived severity and dysfunction of depression), analyses of covariance with repeated measures were administered. RESULTS: People generally had more negative perceptions of the patient with MTD. For example, when the protagonist was the patient with MTD, people were more likely to avoid and less motivated to support the patient. Large differences were also found in causal attribution to internal and controllable causes. CONCLUSION: Negative impressions of the patient with MTD may be partly explained by causal attribution to internal and controllable factors.