Anxiety Disorders: Kaiya H

Bandelow B, Zohar J, Hollander E, Kasper S, Möller HJ, Anonymous00037, Zohar J, Hollander E, Kasper S, Möller HJ, Bandelow B, Allgulander C, Ayuso-Gutierrez J, Baldwin DS, Buenvicius R, Cassano G, Fineberg N, Gabriels L, Hindmarch I, Kaiya H, Klein DF, Lader M, Lecrubier Y, Lépine JP, Liebowitz MR, Lopez-Ibor JJ, Marazziti D, Miguel EC, Oh KS, Preter M, Rupprecht R, Sato M, Starcevic V, Stein DJ, van Ameringen M, Vega J. · Department of Psychiatry and Psychotherapy, University of Gottingen, Gottingen, Germany. · World J Biol Psychiatry. · Pubmed #18949648 No free full text.

Abstract: In this report, which is an update of a guideline published in 2002 (Bandelow et al. 2002, World J Biol Psychiatry 3:171), recommendations for the pharmacological treatment of anxiety disorder, obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD) are presented. Since the publication of the first version of this guideline, a substantial number of new randomized controlled studies of anxiolytics have been published. In particular, more relapse prevention studies are now available that show sustained efficacy of anxiolytic drugs. The recommendations, developed by the World Federation of Societies of Biological Psychiatry (WFSBP) Task Force for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-traumatic Stress Disorders, a consensus panel of 30 international experts, are now based on 510 published randomized, placebo- or comparator-controlled clinical studies (RCTs) and 130 open studies and case reports. First-line treatments for these disorders are selective serotonin reuptake inhibitors (SSRIs), serotonin-noradrenaline reuptake inhibitors (SNRIs) and the calcium channel modulator pregabalin. Tricyclic antidepressants (TCAs) are equally effective for some disorders, but many are less well tolerated than the SSRIs/SNRIs. In treatment-resistant cases, benzodiazepines may be used when the patient does not have a history of substance abuse disorders. Potential treatment options for patients unresponsive to standard treatments are described in this overview. Although these guidelines focus on medications, non-pharmacological were also considered. Cognitive behavioural therapy (CBT) and other variants of behaviour therapy have been sufficiently investigated in controlled studies in patients with anxiety disorders, OCD, and PTSD to support them being recommended either alone or in combination with the above medicines.

Sakai Y, Kumano H, Nishikawa M, Sakano Y, Kaiya H, Imabayashi E, Ohnishi T, Matsuda H, Yasuda A, Sato A, Diksic M, Kuboki T. · Department of Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Tokyo 113-8655, Japan. · Neuroimage. · Pubmed #16889985 No free full text.

Abstract: Several neuroanatomical hypotheses of panic disorder have been proposed focusing on the significant role of the amygdala and PAG-related "panic neurocircuitry." Although cognitive-behavioral therapy is effective in patients with panic disorder, its therapeutic mechanism of action in the brain remains unclear. The present study was performed to investigate regional brain glucose metabolic changes associated with successful completion of cognitive-behavioral therapy in panic disorder patients. The regional glucose utilization in patients with panic disorder was compared before and after cognitive-behavioral therapy using positron emission tomography with (18)F-fluorodeoxyglucose. In 11 of 12 patients who showed improvement after cognitive-behavioral therapy, decreased glucose utilization was detected in the right hippocampus, left anterior cingulate, left cerebellum, and pons, whereas increased glucose utilization was seen in the bilateral medial prefrontal cortices. Significant correlations were found between the percent change relative to the pretreatment value of glucose utilization in the left medial prefrontal cortex and those of anxiety and agoraphobia-related subscale of the Panic Disorder Severity Scale, and between that of the midbrain and that of the number of panic attacks during the 4 weeks before each scan in all 12 patients. The completion of successful cognitive-behavioral therapy involved not only reduction of the baseline hyperactivity in several brain areas but also adaptive metabolic changes of the bilateral medial prefrontal cortices in panic disorder patients.

Tanii H, Nishimura Y, Inoue K, Koshimizu H, Matsumoto R, Takami T, Hara N, Nishida A, Okada M, Kaiya H, Okazaki Y. · Department of Psychiatry, Mie University Graduate School of Medicine, Tsu, Mie 514-8507, Japan. · Neurosci Lett. · Pubmed #19429001 No free full text.

Abstract: We examined the relationship between the catechol-O-methyltransferase (COMT) Val158Met genotype and frontal lobe function by using multi-channel near-infrared spectroscopy (NIRS). The present study investigated oxygenated ([oxy-Hb]) and deoxygenated ([deoxy-Hb]) hemoglobin concentration changes during the performance of a verbal fluency task in the frontal region of 71 patients with panic disorder (PD). The activation of [oxy-Hb] on the right lateral prefrontal cortex was observed in the Met/Met genotype of the COMT gene polymorphism of PD patient groups in the analysis of NIRS, which seems to be related to the autonomic dysfunction in the pathogenesis of PD.

Nishimura Y, Tanii H, Hara N, Inoue K, Kaiya H, Nishida A, Okada M, Okazaki Y. · Department of Psychiatry, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan. · Psychiatry Res. · Pubmed #19324535 No free full text.

Abstract: To investigate whether prefrontal function during a cognitive task reflects the severity of panic disorder, the prefrontal function during a word fluency task in 109 panic disorder patients with or without agoraphobia was measured by multi-channel near-infrared spectroscopy (NIRS). [Oxy-Hb] changes in the left inferior prefrontal cortex were significantly associated with the frequency of panic attacks, and, in addition, [deoxy-Hb] changes in the anterior area of the right prefrontal cortex were significantly associated with the severity of agoraphobia. These results suggest that the prefrontal function in patients with panic disorder is associated with the disease state of disease in patients with panic disorder.

Sakamoto N, Yoshiuchi K, Kikuchi H, Takimoto Y, Kaiya H, Kumano H, Yamamoto Y, Akabayashi A. · Department of Stress Sciences and Psychosomatic Medicine, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan. · Biopsychosoc Med. · Pubmed #19017383 links to  free full text

Abstract: ABSTRACT: BACKGROUND: Panic disorder is one of the anxiety disorders, and anxiety is associated with some locomotor activity changes such as "restlessness". However, there have been few studies on locomotor activity in panic disorder using actigraphy, although many studies on other psychiatric disorders have been reported using actigraphy. Therefore, the aim of the present study was to investigate the relationship between panic disorder and locomotor activity pattern using a wrist-worn activity monitor. In addition, an ecological momentary assessment technique was used to record panic attacks in natural settings. METHODS: Sixteen patients with panic disorder were asked to wear a watch-type computer as an electronic diary for recording panic attacks for two weeks. In addition, locomotor activity was measured and recorded continuously in an accelerometer equipped in the watch-type computer. Locomotor activity data were analyzed using double cosinor analysis to calculate mesor and the amplitude and acrophase of each of the circadian rhythm and 12-hour harmonic component. Correlations between panic disorder symptoms and locomotor activity were investigated. RESULTS: There were significant positive correlations between the frequency of panic attacks and mesor calculated from double cosinor analysis of locomotor activity (r = 0.55) and between HAM-A scores and mesor calculated from double cosinor analysis of locomotor activity (r = 0.62). CONCLUSION: Panic disorder patients with more panic attacks and more anxiety have greater objectively assessed locomotor activity, which may reflect the "restlessness" of anxiety disorders.

Sugaya N, Kaiya H, Kumano H, Nomura S. · Graduate School of Human Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, JP-359-1192 Saitama, Japan. · Scand J Gastroenterol. · Pubmed #18569984 No free full text.

Abstract: OBJECTIVE: To investigate the relationship between subtypes of irritable bowel syndrome (IBS) and severity of symptoms associated with panic disorder (PD). MATERIAL AND METHODS: The study comprised 178 consecutive new PD outpatients. Sixty-four patients met the Rome-II criteria for IBS (IBS[+]; 29 diarrhea-predominant IBS (IBSD), 14 constipation-predominant IBS (IBSC), 21 other types of IBS). RESULTS: IBSD patients with agoraphobia avoided a greater number of scenes owing to fear of panic attack than did PD patients without IBS (IBS[-]) and with agoraphobia. IBS[+] patients with avoidant behavior due to fear of IBS symptoms had significantly higher Beck Depression Inventory (BDI) scores and avoided a larger number of scenes owing to fear of panic attack than IBS[+] patients with agoraphobia and without avoidant behavior due to fear of IBS symptoms or IBS[-] patients with agoraphobia. CONCLUSIONS: The results suggest that the presence of IBSD or avoidant behavior because of fear of IBS symptoms may be associated with a more severe form of agoraphobia, and the latter may also be associated with depression.

Kaiya H, Sugaya N, Iwasa R, Tochigi M. · Outpatient Clinic for Anxiety Disorders, Akasaka Mental Clinic, Tokyo, Japan. · Psychiatry Clin Neurosci. · Pubmed #18412848 No free full text.

Abstract: It was suggested that fatigue is one of characteristics of panic disorder. Fatigue was assessed in 360 patients with panic disorder using the Japanese version of the Multidimensional Fatigue Inventory (MFI-J). The scores for general fatigue and reduced activity were significantly higher in the patients than in the controls. These tendencies were also observed in men when the subject group was differentiated according to sex, but not in women. In contrast, the trend for higher score for physical fatigue was observed only in the female patients. Thus, the present study suggests that the characteristics of fatigue vary with sex in panic disorder.

Nishimura Y, Tanii H, Fukuda M, Kajiki N, Inoue K, Kaiya H, Nishida A, Okada M, Okazaki Y. · Department of Psychiatry, Division of Neuroscience, Mie University, Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, Japan. · Neurosci Res. · Pubmed #17628733 No free full text.

Abstract: The present study investigated oxygenated ([oxy-Hb]) and deoxygenated ([deoxy-Hb]) hemoglobin concentration changes during the performance of a word fluency task in the frontal region of five drug-naive patients with panic disorder with or without agoraphobia and in 33 age-, sex-, and task performance-matched healthy volunteers by using multi-channel near-infrared spectroscopy (NIRS). The left inferior frontal [oxy-Hb] changes during performance of the task in patients with panic disorder were significantly smaller than those of healthy controls. This pilot study suggests the possibility that the left frontal lobe, required for cognitive function, is impaired in patients with panic disorder.

Eames D, Kaiya H, Yoshida E, Iwasa R. · Tokyo Cyber Clinic. · Seishin Shinkeigaku Zasshi. · Pubmed #16761695 No free full text.

This publication has no abstract.

Ohtani T, Kaiya H, Utsumi T, Inoue K, Kato N, Sasaki T. · Research Center for Panic Disorder, Nagoya Nental Clinic, Nagoya, and Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Japan. · Psychiatry Clin Neurosci. · Pubmed #16732757 No free full text.

Abstract: It has been suggested that symptoms of panic disorder may be significantly affected by seasonal factors including weather changes, although few studies have explored the issue. The purpose of the present paper was to investigate clinical data to examine sensitivity of panic disorder patients to seasonal changes and seasonal fluctuation of panic disorder symptoms. A self-rating questionnaire consisting of the Seasonal Pattern Assessment Questionnaire (SPAQ) and additional self-rating questions were analyzed in 146 Japanese patients (50 male, 96 female) with panic disorder (DSM-IV) at an outpatient clinic for anxiety disorder. The average of the Global Seasonality Scores (GSS) was 12.5+/-4.7 and 25.3% of the patients were suggested to suffer from seasonal affective disorder, according to the GSS. Frequency of the panic attack was found to fluctuate seasonally, with peaks in August and December (P=0.005 and 0.01, chi2 test). The present results indicate that panic disorder patients may be more sensitive to seasonal and meteorological factors than the general population and become more fragile in a specific season or months. This might assist in the development of preventive measures for the frequent recurrence of symptoms in panic disorder.

Sakai Y, Kumano H, Nishikawa M, Sakano Y, Kaiya H, Imabayashi E, Ohnishi T, Matsuda H, Yasuda A, Sato A, Diksic M, Kuboki T. · Department of Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655. · Neuroreport. · Pubmed #15931063 No free full text.

Abstract: The present study was performed to assess cerebral glucose metabolism in patients with panic disorder using positron emission tomography. F-fluorodeoxyglucose positron emission tomography with voxel-based analysis was used to compare regional brain glucose utilization in 12 nonmedicated panic disorder patients, without their experiencing panic attacks during positron emission tomography acquisition, with that in 22 healthy controls. Panic disorder patients showed appreciably high state anxiety before scanning, and exhibited significantly higher levels of glucose uptake in the bilateral amygdala, hippocampus, and thalamus, and in the midbrain, caudal pons, medulla, and cerebellum than controls. These results provided the first functional neuroimaging support in human patients for the neuroanatomical hypothesis of panic disorder focusing on the amygdala-based fear network.

Kaiya H, Umekage T, Harada S, Okazaki Y, Sasaki T. · Research Center for Panic Disorder, Nagoya Mental Clinic, Nagoya, Japan. · Psychiatry Clin Neurosci. · Pubmed #15823164 No free full text.

Abstract: Environmental factors, in addition to genetic factors, may be related to the development of panic attack (PA) and panic disorder (PD). Previous studies suggested that there may be seasonal variation in the onset of PA/PD and possibly a higher prevalence of PA/PD in colder areas. Also observed were lactate-induced PA and elevated serum cholesterol in PD patients. These suggest that living environment and lifestyle, such as weather conditions, preference of food and physical exercise, might play a role in the occurrence of PA and PD. The present study explored the association of such candidate factors with the development of PA and PD in 4000 Japanese subjects, using a questionnaire. The subjects were recruited from the general population of Japan, using stratified random sampling. Logistic regression with stepwise selection of variables was employed for statistical analysis. Variables including "dislike of physical exercise", mostly in female subjects, and "living in areas with longer winter", in male subjects, were suggested for associations with PA and PD among the candidate factors. The result is preliminary but indicates that lifestyle such as like/dislike of physical exercise and environmental factors including weather conditions could play a partial role in the development of PA and PD. Further investigations are required before firm conclusions can be reached.

Kumano H, Kaiya H, Yoshiuchi K, Yamanaka G, Sasaki T, Kuboki T. · Department of Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo, Japan. · Am J Gastroenterol. · Pubmed #15046231 No free full text.

Abstract: OBJECTIVES: Irritable bowel syndrome (IBS) is considered to be a transcultural functional bowel disorder with high comorbidity and psychiatric disorders; but well-designed epidemiologic studies have never been performed in Japan. The purpose of this study was to establish the prevalence of IBS, together with the comorbidity rates of panic disorder (PD) and agoraphobia, employing a large-scale survey based on stratified random sampling. METHODS: A total of 4,000 subjects aged 20-69 years completed a questionnaire and the results were weighted to ensure representativeness of the Japanese general population. The questionnaire covered key symptoms of IBS, PD, and agoraphobia. The prevalence of IBS and its subtypes was calculated by gender. The comorbidity of PD and agoraphobia with IBS was compared with morbidity in non-IBS subjects; and comorbidity in IBS subjects who had consulted medical practitioners regarding their symptoms and in those who had not was also compared. RESULTS: The prevalence of IBS was 6.1% in total. It was significantly higher in females than in males. Diarrhea-predominant IBS was more prevalent in males and constipation-predominant IBS in females. The morbidity rates of PD and agoraphobia were significantly higher in IBS than in non-IBS subjects. Comorbidity did not differ between female and male IBS subjects, while morbidity was significantly higher in female than in male non-IBS subjects; and comorbidity did not differ between consulter and nonconsulter subjects. CONCLUSIONS: The prevalence of IBS and its comorbidity with PD and agoraphobia in Japan were demonstrated to be similar to those reported in Western industrialized countries.

Someya T, Kitamura H, Uehara T, Sakado K, Kaiya H, Tang SW, Takahashi S. · Department of Psychiatry, Niigata University School of Medicine, Japan. · Depress Anxiety. · Pubmed #10945135 No free full text.

Abstract: Although recent studies have found dysfunctional parental rearing behaviour is associated with certain aspects of psychopathology of panic disorder (PD), the results are not in complete agreement. By using a translated Japanese version of the EMBU (Egna Minnen Beträffande Uppfostran), we investigated the parental rearing behavior perceived by 103 normal subjects, 71 PD patients with agoraphobia, and 32 PD patients without agoraphobia. The PD patients scored both parents as more rejecting and overprotective than did the controls. However, subgroup analysis showed that the patients with agoraphobia reported significantly more rejection from both parents and less emotional warmth from mothers, while the patients without agoraphobia, by contrast, reported more overprotection from both parents and more favouring subject from fathers than did the controls. Interestingly, these results were consistent with those documented in the Western literature, which reported "affectionless control" as a parenting style in PD, and, furthermore, indicated a cross-cultural similarity of parental rearing factor. In addition, it was suggested that a lack of care might be associated with the development of agoraphobia in Japan.

Kato T, Yamanaka G, Kaiya H. · Department of Neuropsychiatry, Faculty of Medicine, University of Tokyo, Panic Disorder Research Center (Akasaka Clinic), Japan. · Psychiatry Clin Neurosci. · Pubmed #10498236 No free full text.

Abstract: In 97 patients who visited Akasaka Clinic, their chief complaints, the form of media which motivated patients to visit the clinic, and their DSM-IV diagnoses were examined. The media which most frequently motivated the patients were books (35%), TV programs (23%), and the Internet (16%). While many of patients complained of panic attacks, 74.2% were diagnosed as having anxiety disorder, 12% had somatoform disorder and 8% did not have any mental illness. The rate of panic disorder tended to be higher in patients motivated by TV programs (70%) and significantly lower in those motivated by the reading of books (48%). These results suggest that enlightenment of panic disorder using the media, especially that by TV programs, effectively motivates patients with panic disorder.

Nishimura Y, Tanii H, Hara N, Inoue K, Nishida A, Okada M, Kaiya H, Okazaki Y. · No affiliation provided · Psychiatry Clin Neurosci. · Pubmed #19335399 No free full text.

This publication has no abstract.

Inoue K, Tanii H, Fukunaga T, Abe S, Nishimura Y, Kajiki N, Yokoyama C, Nishida A, Tawara J, Kaiya H, Nata M, Okazaki Y. · No affiliation provided · Psychiatry Clin Neurosci. · Pubmed #16958953 No free full text.

This publication has no abstract.