Showing papers by "Ryo Okubo published in 2023"

The prevalence and risk factors of suicidal ideation in pregnancy and postpartum under the COVID‐19 pandemic in Japan

Abstract: The perinatal period is a time of heightened vulnerability to mental health problems, including suicidal ideation (SI), a major risk factor of suicide. Meta-analytic studies have estimated that, whereas the prevalence of life-time SI in women is about 4.9%, 1 the prevalence during pregnancy and in postpartum increases to 10% and 7%, respectively. 2 The COVID-19 pandemic and accompanying social restrictions have been associated with increased maternal depression, a key risk factor of SI, in both pregnancy and postpartum. 3,4 Epidemiological surveys also suggest that during COVID-19, people spending more time on childrearing report higher depressive symptoms. 5 Thus, one may expect that pregnant and postpartum women may experience high levels of SI. However, to date, little research using large-scale nation-wide surveys has been conducted on this matter (but see, 6,7 also see Data S1 discussion for a description of community- and clinic-based surveys). Here, using Japanese nation-wide survey data, we investigated the prevalence and risk factors of SI in pregnancy and postpartum under the COVID-19 pandemic. The data was from the pregnant/postpartum mothers panel of the Japan COVID-19 and Society Internet Survey (JACSIS), in which the age and geographical distributions were nationally representative. 8 Data were collected in July and August 2021 and the fi nal sample consisted of 1639 pregnant and 5688 postpartum women. The study protocol was approved by the Research Ethics Committee of the Osaka International Cancer Institute (Approval No. 20084). Informed consent was obtained from all participants. We evaluated SI using the 10th item of the Edin-burgh Postnatal Depression Scale (EPDS, following previous studies, an answer of ‘ yes, quite often ’ , ‘ sometimes ’ or ‘ hardly ever ’ indicates the presence of SI. 2 ) Detailed methods are available in Data S1. The

Impact of loneliness on suicidal ideation during the COVID-19 pandemic: findings from a cross-sectional online survey in Japan

Abstract: Objectives We aim to reveal how loneliness relates to suicidal ideation following the onset of the COVID-19 pandemic. Design Cross-sectional online survey. Setting Community cohort study in Japan. Participants The second wave of a large web-based survey, Japan COVID-19 and Society Internet Survey, was conducted in February 2021, and we analysed the data of 6436 men and 5380 women who were aged 20–59 years. Main outcome measures The prevalence ratios (PRs) of suicidal ideation due to loneliness, depression, social isolation and decline in income during the pandemic and other sociodemographic and economic information were adjusted in the analysis. Statistical methods Estimations were conducted by separating a male and female sample. The survey weight (inverse probability weighting) was applied for analyses, and a Poisson regression model was used with all the potential confounders adjected. Results Overall, 15.1% of male and 16.3% of female participants were found to have had suicidal ideation during the COVID-19 pandemic. Among them, 23% of male and 20% of female participants experienced suicidal ideation for the first time. The results of the Poisson regression suggested that those who were feeling lonely had higher PRs for suicidal ideation (4.83 for men (95% CI, 3.87 to 6.16) and 6.19 for women (95% CI, 4.77 to 8.45)). The relationship between loneliness and suicidal ideation remained robust even after adjusting for depression, although there were declines in PRs. Additionally, the results showed that those who were lonely, and continued to feel lonely during the pandemic, had the highest PRs of suicidal ideation. Conclusion Loneliness had both direct and indirect effects on suicidal ideation mediated through depression. Those who felt lonelier during the pandemic had the highest risk of suicidal ideation. It is necessary to adopt national measures focused on providing psychological support to people who feel lonely to prevent them from taking their own lives.

Mental health care use and related factors in adolescents and young adults with cancer

Abstract: Abstract Purpose The actual state of mental health care use and related factors in adolescent and young adult (AYA) patients with cancer is not well understood in Japan. This study aimed to (1) examine the actual state of mental health care use among AYA patients with cancer and (2) describe socio-demographic and related factors associated with mental health care use. Methods We retrospectively reviewed the medical records of AYA patients with cancer aged 15–39 who first visited the National Cancer Center Hospital in Japan (NCCH) between January 2018 and December 2020. Logistic regression was used to analyze the association between social background characteristics and mental health care use. The association between the patient's course of cancer treatment and mental health care use was analyzed to help identify which patients might benefit from early mental health intervention. Results Among 1,556 patients, 945 AYA patients with cancer were registered. The median age at the time of the study was 33 years (range, 15–39 years). The prevalence of mental health care use was 18.0% (170/945). Age 15–19 years, female gender, urogenital cancer, gynecological cancer, bone or soft tissue cancer, head and neck cancer, and stage II–IV disease were associated with mental health care use. Regarding treatment, palliative treatment, chemotherapy, and hematopoietic stem cell transplantation were associated with mental health care use. Conclusion Factors associated with mental health care use were identified. Our findings potentially contribute to psychological support interventions for AYA patients with cancer.

Mediation Effects of Social Cognition on the Relationship between Neurocognition and Social Functioning in Major Depressive Disorder and Schizophrenia Spectrum Disorders

Abstract: Background: In schizophrenia spectrum disorders (SSD), social cognition mediates the relationship between neurocognition and social functioning. Although people with major depressive disorder (MDD) also exhibit cognitive impairments, which are often prolonged, little is known about the role of social cognition in MDD. Methods: Using data obtained through an internet survey, 210 patients with SSD or MDD were selected using propensity score matching based on their demographics and illness duration. Social cognition, neurocognition, and social functioning were evaluated using the Self-Assessment of Social Cognition Impairments, Perceived Deficits Questionnaire, and Social Functioning Scale, respectively. The mediation effects of social cognition on the relationship between neurocognition and social functioning were examined in each group. Invariances of the mediation model across the two groups were then analyzed. Results: The SSD and MDD groups had mean ages of 44.49 and 45.35 years, contained 42.0% and 42.8% women, and had mean illness durations of 10.76 and 10.45 years, respectively. In both groups, social cognition had significant mediation effects. Configural, measurement, and structural invariances across the groups were established. Conclusion: The role of social cognition in patients with MDD was similar to that in SSD. Social cognition could be a common endophenotype for various psychiatric disorders.

Effect modification by geographic area on the association between health literacy and self-rated health: a nationwide cross-sectional study in Japan

Abstract: Abstract Background Health literacy (HL) has gained increasing attention as a factor related to health behaviors and outcomes. This study aimed to investigate geographic differences in HL levels and effect modification by geographic area on their relationship with self-rated health in the Japanese population using a nationwide sample. Methods Data for this study were derived from a nationally representative cross-sectional survey on health information access for consumers in Japan using a mailed self-administered questionnaire in 2020 (INFORM Study 2020). Valid responses from 3,511 survey participants, selected using two-stage stratified random sampling, were analyzed in this study. HL was measured using the Communicative and Critical Health Literacy Scale (CCHL). Multiple regression and logistic regression analyses were conducted to examine the associations between geographic characteristics and HL and effect modification on the association between HL and self-rated health by geographic area, controlling for sociodemographic characteristics. Results The mean HL score was 3.45 (SD = 0.78), somewhat lower compared with previous studies on the Japanese general population. HL was higher in Kanto area than in Chubu area, after controlling for sociodemographic factors and municipality size. Furthermore, HL was positively associated with self-rated health after controlling for sociodemographic and geographic factors; however, this association was more evident in eastern areas than in western areas. Conclusion The findings indicate geographic differences in HL levels and effect modification by geographic area on the relationship between HL and self-rated health in the general Japanese population. HL was more strongly associated with self-rated health in eastern areas than in western areas. Further investigation is needed to explore the moderating effects of areal features, including the distribution of primary care physicians and social capital, when formulating strategies to improve HL in different contexts.