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附属病院 精神科 |
学会（学術団体）・委員会 【 表示 ／ 非表示 】
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2016年04月-継続中
日本国
日本精神神経学会
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2017年07月-継続中
日本国
日本睡眠学会
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2017年07月-継続中
日本国
日本臨床精神神経薬理学会
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2018年10月-継続中
日本国
日本認知症学会
学位論文 【 表示 ／ 非表示 】
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Severity of depressive symptoms is associated with venous thromboembolism in hospitalized patients with a major depressive episode
Kazuhisa Yoshizawa, Masahiro Takeshima, Sayaka Ishino, Masaya Ogasawara, Dai Fujiwara, Yu Itoh, Aya Imanishi, Hidenobu Ohta, Kazuo Mishima
Neuropsychiatric Disease and Treatment 17 2955 - 2963 2022年09月 [査読有り]
国内共著
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Association between sleep state misperception and bedtime behavior in patients with chronic insomnia
Kudo M.
Scientific Reports ( Scientific Reports ) 14 ( 1 ) 13991 - 13991 2024年12月
研究論文（学術雑誌）
Previous studies on sleep state misperception have objectively evaluated sleep status in special environments using polysomnography. There is a paucity of data from studies that evaluated habitual sleep status in home environments. The present study aimed to investigate sleep state misperception in the home environment of patients with chronic insomnia using a lumbar-worn actigraphy to identify sleep habits associated with sleep state misperception severity. Thirty-one patients and 42 healthy volunteers were included in the insomnia and non-insomnia group, respectively. Participants recorded subjective assessments in sleep diaries, objective assessments with an actigraphy worn for 14 days, and self-assessments using questionnaires. Both groups had similar objective sleep ratings; however, insomnia group had significantly worse subjective ratings (total sleep time, wake after sleep onset, and sleep onset latency). A significant correlation was found between subjective and objective total sleep time scores in non-insomnia group but not in insomnia group. Insomnia group had earlier bedtimes, significantly longer bedtimes, and impaired daytime functioning (Sheehan Disability Scale score); additionally, they underestimated their total sleep time, particularly with earlier bedtimes and longer laying durations. Monitoring the sleep status and habits of individuals in home environments could be instrumental in identifying key points for targeted interventions on sleep hygiene and cognitive behavioral therapy for insomnia.
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Irinaka K.
Clinical Psychopharmacology and Neuroscience ( Clinical Psychopharmacology and Neuroscience ) 22 ( 4 ) 688 - 696 2024年11月
研究論文（学術雑誌）
Tardive dyskinesia and dystonia are intractable extrapyramidal symptoms caused by the blockade of dopamine receptors by antipsychotic drugs. In addition to the reduction or discontinuation of the causative drug, valbenazine for tardive dyskinesia and botulinum toxin for tardive dystonia have been reported to be effective. However, their efficacy has not been fully demonstrated. In this study, we report the case of a female patient with bipolar disorder, valbenazine-resistant tardive dystonia, and tardive dyskinesia who achieved improvement in extrapyramidal symptoms with electroconvulsive therapy. Additionally, we conducted a narrative literature review on the safety and efficacy of electroconvulsive therapy for tardive dyskinesia and dystonia.
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Takeshima M.
Psychopharmacology ( Psychopharmacology ) 241 ( 8 ) 1555 - 1563 2024年08月
研究論文（学術雑誌）
RATIONALE: The efficacy and safety of antidepressant augmentation therapy with aripiprazole (AATA) has been established; however, the ongoing effects of continuing aripiprazole after remission remain unclear because no studies have examined this issue. OBJECTIVES: We aimed to explore the effect of AATA discontinuation on the major depressive disorder (MDD) recurrence risk in patients with remitted MDD after AATA. METHODS: This 24-week, multicenter, placebo-controlled, double-blind, randomized trial evaluated recurrence risk in patients with MDD who achieved remission with AATA. Differences in MDD recurrence, as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, between the two groups were compared using survival analysis. The differences in depressive symptom severity and social functioning between the two groups were compared using a mixed model with repeated measures. Extrapyramidal symptoms and akathisia were also assessed. RESULTS: Twenty-three participants were randomized and treated. Two patients in each group experienced recurrence during the study. Kaplan-Meier analysis with Log-rank comparison showed no difference in recurrence between groups (p = 0.642). No significant difference in interactions between group and period was observed in the 17-item Hamilton depression rating scale (p = 0.492) or the Social and Occupational Functioning Assessment Scale (p = 0.638). No patients developed extrapyramidal symptoms or akathisia. CONCLUSIONS: Definitive conclusions could not be drawn owing to the small sample size. This study represents a starting point for investigating the safety of aripiprazole discontinuation on recurrence in patients with MDD who have achieved remission with AATA. Future studies with appropriate sample sizes calculated based on this study are needed.
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Treatment Failure and Long-Term Prescription Risk for Guideline-Recommended Hypnotics in Japan
Takeshima M.
JAMA Network Open ( JAMA Network Open ) 7 ( 4 ) e246865 2024年04月
研究論文（学術雑誌）
IMPORTANCE: Although insomnia guidelines recommend the use of several individual hypnotics, the most useful hypnotic for treating insomnia in a clinical setting remains unclear. OBJECTIVE: To determine which guideline-recommended hypnotics have lower risks of monotherapy failure and which hypnotics have a higher risk of long-term prescription for insomnia treatment. DESIGN, SETTING, AND PARTICIPANTS: This retrospective observational cohort study used data from the Japan Medical Data Center Claims Database from April 1, 2005, to March 31, 2021. Participants included adults whose first prescribed pharmaceutical treatment for insomnia was guideline-recommended hypnotic monotherapy. Data were analyzed from December 24, 2022, to September 26, 2023. EXPOSURES: Suvorexant, ramelteon, eszopiclone, zolpidem, and triazolam monotherapy. MAIN OUTCOMES AND MEASURES: The primary outcome was monotherapy failure, defined as a change in hypnotic or having an additional hypnotic prescribed for insomnia within 6 months of the first prescription of a guideline-recommended hypnotic monotherapy. The secondary outcome was monotherapy discontinuation, defined as no prescription of any hypnotic for 2 consecutive months within 6 months after prescribing a guideline-recommended hypnotic in patients for whom monotherapy did not fail. Monotherapy failure and discontinuation were compared using Cox proportional hazards and logistic regression models, respectively. RESULTS: The study included 239 568 adults (median age, 45 [IQR, 34-55] years; 50.2% women) whose first prescription for insomnia was guideline-recommended hypnotic monotherapy. During the 6-month follow-up period, 24 778 patients (10.3%) experienced failure of monotherapy with a guideline-recommended hypnotic. In comparison with eszopiclone, there were more cases of monotherapy failure for ramelteon (adjusted hazard ratio [AHR], 1.23 [95% CI], 1.17-1.30; P < .001), fewer cases for zolpidem (AHR, 0.84 [95% CI, 0.81-0.87]; P < .001) and triazolam (AHR, 0.82 [95% CI, 0.78-0.87]; P < .001), and no significant difference between suvorexant and eszopiclone. Among those without monotherapy failure, monotherapy was discontinued in 84.6% of patients, with more discontinuations for ramelteon (adjusted odds ratio [AOR], 1.31 [95% CI, 1.24-1.40]; P < .001) and suvorexant (AOR, 1.20 [95% CI, 1.15-1.26]; P < .001) than for eszopiclone and no significant difference between zolpidem or triazolam and eszopiclone. CONCLUSIONS AND RELEVANCE: Due to uncontrolled confounding factors in this cohort study, no conclusions regarding the pharmacologic properties of guideline-recommended hypnotics can be drawn based on these results. Further studies accounting for confounding factors, including diagnoses of chronic vs acute insomnia disorder, insomnia and psychiatric symptom severity, and physician attitudes toward hypnotic prescription, are needed.
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Takeshima M.
Frontiers in Psychiatry ( Frontiers in Psychiatry ) 15 1405049 - 1405049 2024年
研究論文（学術雑誌）
INTRODUCTION: Guidelines for various psychiatric disorders recommend short-term use of benzodiazepine anxiolytic monotherapy in few cases. Contrarily, benzodiazepine anxiolytic polypharmacy (BAP) is not recommended in any case. However, BAP is often used in real world. Therefore, this study aimed to determine the association between BAP and concomitant use of psychotropic medications. METHOD: This retrospective cross-sectional study used claims data from the Japan Medical Data Center. Medical information of health insurance subscribers treated with benzodiazepine anxiolytics in June 2019 was extracted. Prescription of two or more benzodiazepine anxiolytics was defined as BAP. Binary logistic regression analysis was performed to investigate the factors associated with BAP, using age group, sex, type of subscriber, and number of concomitant hypnotics, antidepressants, and antipsychotics (none, one, and two or more) as covariates. RESULT: The eligible participants were 104,796 adults who were prescribed benzodiazepine anxiolytics. Among them, 12.6% were prescribed two or more drugs. Logistic regression analysis revealed that BAP was significantly associated with those who received hypnotic monotherapy (adjusted odds ratio [aOR]: 1.04, 95% confidence interval [CI]: 1.001-1.09, p=0.04), antidepressant monotherapy and polypharmacy (aOR: 1.57, 95% CI: 1.51-1.63, p<0.001 and aOR: 1.98, 95% CI: 1.88-2.09, p<0.001, respectively), and antipsychotic monotherapy and polypharmacy (aOR: 1.12, 95% CI: 1.07-1.19, p<0.001 and aOR: 1.41, 95% CI: 1.30-1.54, p<0.001, respectively). Conversely, lower BAP was associated with those who received hypnotic polypharmacy (aOR: 0.86, 95% CI: 0.81-0.91, p<0.001). DISCUSSION: This study showed that the greater the number of concomitant antidepressants and antipsychotics, the greater the association with BAP. Since combination therapy with antidepressants or antipsychotics is generally not recommended, patients receiving combination therapy with these medications may be resistant to pharmacotherapy. Therefore, implementing the recommended non-pharmacological treatments may reduce BAP.
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Maruki T.
Psychiatry and Clinical Neurosciences ( Psychiatry and Clinical Neurosciences ) 2025年
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急性期精神科作業療法による抑うつ状態と運動機能に対する効果とその関連性の検証
林 正喜, 千田 聡明, 久米 裕, 吉沢 和久, 三島 和夫
日本作業療法学会抄録集 ( (一社)日本作業療法士協会 ) 58回 PH - 5 2024年11月
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Effects of policy interventions on psychotropic polypharmacy in Japanese older adults
Takeshima M.
Psychogeriatrics ( Psychogeriatrics ) 24 ( 5 ) 1176 - 1179 2024年09月
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ガイドラインで推奨された睡眠薬における治療の失敗と長期処方リスクの比較
竹島 正浩, 吉沢 和久, 小笠原 正弥, 三島 和夫
精神神経学雑誌 ( (公社)日本精神神経学会 ) ( 2024特別号 ) S538 - S538 2024年06月
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寛解した大うつ病性障害の患者においてアリピプラゾールの増強療法は中止できるか? プラセボ対照二重盲検比較試験
竹島 正浩, 馬越 秋瀬, 吉沢 和久, 小笠原 正弥, 伊藤 結生, 三島 和夫
日本臨床精神神経薬理学会・日本神経精神薬理学会合同年会プログラム・抄録集 ( 日本臨床精神神経薬理学会・日本神経精神薬理学会 ) 34回・54回 JP9 - 2 2024年05月
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せん妄とベンゾジアゼピン系薬剤
吉沢 和久, 三島 和夫
第33回日本臨床精神神経薬理学会学術集会 2023年09月 - 2023年09月
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抗うつ薬の使用と脂質異常症の発症リスク：日本の大規模データベースを用いたコホート研究
吉沢 和久, 竹島 正浩, 三島 和夫
第119回日本精神神経学会学術総会 2023年06月 - 2023年06月
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睡眠薬の長期処方に対する診療報酬改定と新規睡眠薬の効果
竹島 正浩, 吉沢 和久, 小笠原 正弥, 伊藤 結生, 三島 和夫
第119回日本精神神経学会学術総会 2023年06月 - 2023年06月
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大規模診療報酬データを用いた睡眠薬の処方実態調査
竹島 正浩, 吉沢 和久, 小笠原 正弥, 三島 和夫
第47回日本睡眠学会学術総会 2022年06月 - 2022年07月
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精神科外来患者における便秘症治療薬の処方状況
吉沢 和久, 菊池 結花, 佐藤 優真, 神林 崇, 三島 和夫, 清水 徹男
第28回日本臨床精神神経薬理学会 第48回日本神経精神薬理学会 合同年会 2018年11月 - 2018年11月
学外の社会活動（高大・地域連携等） 【 表示 ／ 非表示 】
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平鹿総合病院主催 緩和ケア研修会 2023 コミュニケーション
2023年11月 -
平鹿総合病院主催 緩和ケア研修会 2022 コミュニケーション
2022年10月