Do Individuals with Alcohol Dependence Show Higher Unfairness Sensitivity? The Relationship Between Impulsivity and Unfairness Sensitivity in Alcohol-Dependent Adults.

BACKGROUND: Alcohol-dependent patients are known to be generally more unfairness sensitive. The ultimatum game (UG) is an experimental task designed to provoke feelings of perceived unfairness. A previous study using the UG has reported more unfairness sensitivity in patients with alcohol dependence than in a nondependent control group; it has been speculated that this increased sensitivity might be due to a difficulty in impulse control. However, the mechanism of this relationship has not been clarified. Therefore, the relationship between unfairness sensitivity in interpersonal relationships and impulsivity was investigated using UG and delay discounting (DD) paradigms. METHODS: Subjects were 32 individuals with alcohol dependency and 36 healthy control individuals; both groups performed UG and DD tasks. RESULTS: Participants with alcohol dependence rejected monetary offers deemed unfair at a significantly higher rate than did control participants. Moreover, the proportion of accepting unfairness was negatively correlated with impulsivity in patients with alcohol dependence. CONCLUSIONS: Perceived unfairness is related to impulsivity in patients with alcohol dependence. These results provide insights concerning the psychopathology of alcohol dependence.

[Investigation of the validity of the algorithm for evaluating the degree of disability in those who are institutionalized in long-term psychiatric care facilities in Hiroshima].

The Disability Support Act is intended to integrate welfare services for those who are physically, intellectually, or mentally disabled and promote the independence and social participation. However, the Act has been the center of intense controversy since its implementation in 2005. A number of important issues on implementing the Act in psychiatric medicine have been raised, and the validity of the for evaluating algorithm the degree of disability in those who are mentally disabled is considered to be of the utmost importance. We investigated the validity of the algorithm for evaluating the degree of disability in 2,200 patients who were institutionalized in long-term psychiatric care facilities in Hiroshima. The discordance rate between the primary evaluation by computer program and secondary evaluation by specialists' review was 50.9%. A wide disparity in evaluating the degree of disability was observed between that by secondary evaluation by specialists' review and that by evaluation of IADL. This disparity was more prominent in those who were more severely disabled. Further studies are needed to develop a new evaluation method to address the psychiatric signs and symptoms, and cognitive deficit of the mentally disabled.