Progress in Social Psychiatry in Japan

Progress in Social Psychiatry in Japan

Yoshibumi Nakane Progress in Social Psychiatry in Japan An Approach to Psychiatric Epidemiology

Yoshibumi Nakane Department of Neuropsychiatry Nagasaki University Nagasaki Japan This English translation is based on the Japanese original SYAKAISEISHINIGAKU NO IMA Yoshibumi Nakane, 2010 Originally published in Japan in 2010 by Nakayama Shoten Co., Ltd. ISBN 978-4-431-54102-8 ISBN 978-4-431-54103-5 (ebook) DOI 10.1007/978-4-431-54103-5 Springer Tokyo Heidelberg New York Dordrecht London Library of Congress Control Number: 2012951285 Springer Japan 2012 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, speci fi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on micro fi lms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. Exempted from this legal reservation are brief excerpts in connection with reviews or scholarly analysis or material supplied speci fi cally for the purpose of being entered and executed on a computer system, for exclusive use by the purchaser of the work. Duplication of this publication or parts thereof is permitted only under the provisions of the Copyright Law of the Publisher s location, in its current version, and permission for use must always be obtained from Springer. Permissions for use may be obtained through RightsLink at the Copyright Clearance Center. Violations are liable to prosecution under the respective Copyright Law. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a speci fi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com)

Preface When I became involved in several international joint studies related to psychiatry and psychiatric treatments, the experiences often made me think of psychiatry in Japan, which is the foundation of my study, and made me want, even in a small way, to show data unique to Japan and introduce them in other countries. At the same time, I found it dif fi cult to establish a broad-based understanding of the term EBM (evidence-based medicine). I frequently quoted foreign data in research presentations and lectures, and I thought that the existing data unique to Japan were not exactly suf fi cient. As a result, I started specializing in social psychiatry and later in psychiatric epidemiology, and I have continued efforts to obtain speci fi c psychiatric fi ndings in the area where I live and about events that have occurred. I gained the cooperation of more than 40 psychiatrists in Japan to compile data related to psychiatric treatments and psychiatry in this country and published them in 1969. Titled Images in Psychiatry: Japan, the book introduced the historical progress of psychiatry and the actual situation of various fi elds in Japan, including psychiatric health care and education, biological psychiatry, psychopathology, psychoanalysis, and transcultural psychiatry. Although books describing the Morita Therapy (a unique treatment form developed in Japan), anthrophobia ( Taijin-kyofu-sho ), and some other speci fi c fi elds have been published in English to date, I believe my book was the fi rst one to provide an extensive description of psychiatry in Japan. However, the English edition of the book was published by a French publisher, and I do not know how much impact the book had on research outside of Japan. In addition, in 2011 I published the Japanese edition of Progress in Social Psychiatry in Japan, based on fi ndings shared with colleagues mainly in my fi eld of specialization. When I told my Western friends about the publication of the book, I was encouraged to publish it also in English. That is how this book came to be published. I will be very happy if this book can be of any help for the psychiatrists in the world to gain information and understand the situation in Japan. Nagasaki, Japan Yoshibumi Nakane v

Contents 1 Introduction... 1 Part I Social Psychiatry and Psychiatric Epidemiology 2 De fi nition and Historical Review of Social Psychiatry and Psychiatric Epidemiology... 5 2.1 Social Psychiatry and the Japanese Society of Social Psychiatry... 5 2.2 Psychiatric Epidemiology... 10 References... 10 3 The Foundation of Psychiatric Epidemiology Research... 11 3.1 Methodological Foundation... 11 3.2 Ethics in Study Methods... 14 3.3 Subjects of Epidemiological Studies in Psychiatry... 17 References... 19 Part II Findings on Social Psychiatry and Psychiatric Epidemiology in Japan 4 Activities of the Department of Neuropsychiatry Nagasaki University School of Medicine, as a World Health Organization Collaborating Center... 23 References... 31 vii

viii Contents 5 Studies on Schizophrenia... 33 5.1 Incidence Rates, Prevalence Rates, and Other Statistics... 33 5.2 Findings of the WHO Collaborating Center in Nagasaki... 39 5.3 Outline of Scales Used in the First Assessment or WHO/DOSMeD... 48 5.4 Help-Seeking Patterns and Recognition by Family Members (Key Persons) in New Schizophrenia Cases in Nagasaki... 52 5.5 Clinical Psychiatric Characteristics of New Schizophrenia in Nagasaki... 56 5.5.1 Subtypes of Schizophrenia... 56 5.5.2 Psychiatric Symptoms Schizophrenia... 60 5.5.3 Life Events and the Development of Schizophrenia... 65 5.5.4 Natural History and Outcome (in the Short and Long Term), and Associated Factors... 72 References... 82 6 Studies on Affective Disorders... 85 6.1 WHO World Mental Health Survey in Japan... 85 6.2 Summary of the Study on the Standardized Assessment of Depressive Disorder... 89 References... 92 7 Studies on Patient with Affective Disorders in General Practice... 93 7.1 Studies on Referral Rates in Patients with Depression in the General Health Care Setting... 95 7.2 Studies of Medical Care in Patients with Psychological Problems in the General Health Care Setting... 96 References... 108 8 Development from Atomic Bomb Diseases to Survivors Mental Health Support: Findings on Disaster Psychiatry... 109 References... 128 Epilogue... 131 Further Developments in Social Psychiatry and Psychiatric Epidemiology... 131 Appendix... 135 Medical Office ( Ikyoku )... 135

Contents ix Bibliography... 137 Mental Health Research for A-Bomb Survivors (Hibakusha)... 139 Mental Health in the Nuclear Power Plant Accident... 140 Psychiatric Problems Among Evacuees of Volcanic Eruption... 141 Index... 143