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Aim Intimate partner violence (IPV) is becoming a serious public health issue worldwide. This study sought to analyze factors affecting the help‐seeking behavior of male victims of IPV using a web survey. Methods Male IPV victims living in Japan were recruited to participate in a web‐based questionnaire survey conducted on February 25 and 26, 2021. A total of 1466 men were divided into two groups: Group 1 (43 men) consisted of victims who sought help and Group 2 consisted of victims (1423 men) who had not sought help. The Domestic Violence Screening Inventory, a 20‐item questionnaire regarding IPV exposure, and the Patient Health Questionnaire‐9 were used, along with the questions regarding help‐seeking behaviors for Group 1. Results Of the 43 victims, 28 victims (65.1%) used exclusively informal supports, eight victims (18.6%) used exclusively formal supports, and seven victims (16.3%) used both. Logistic regression analyses revealed that only physical violence was significantly associated with help‐seeking behaviors among types of abuse/violence (odds ratio [OR] = 4.51, confidence interval [CI] = 1.95–10.50, P < .001). Of past experiences, “foregoing divorce to avoid adverse childhood experiences in their offspring” (OR = 3.14, CI = 1.45–6.82, P = .003) was the most significantly associated with help‐seeking behaviors. Conclusion In Japan, male IPV victims tend to seek help following physical violence, but males are less are likely to seek help for nonphysical victimization, highlighting the need for targeted support for victims of nonphysical abuse. To provide comprehensive aid to male IPV victims, consultation centers designed for men will be needed. Help‐seeking behavior of male intimate partner violence (IPV) victims in Japan. Male IPV victims tend to seek help following physical violence, but males are less are likely to seek help for nonphysical victimization.

Abstract Background Cocaine (benzoylmethylecgonine) is one of the most widely used illegal psychostimulant drugs worldwide, and mortality from acute intoxication is increasing. Suppressing hyperthermia is effective in reducing cocaine-related mortality, but a definitive therapy has not yet been found. In this study, we assessed the ability of risperidone to attenuate acute cocaine-induced hyperthermia and delineated the mechanism of its action. Methods Rats were injected i.p. with saline, risperidone, ketanserin, ritanserin, haloperidol, or SCH 23 390 before and after injection of cocaine (30 mg/kg) or with WAY-00 635, SB 206 553, or sulpiride before cocaine injection; thereafter, the rectal temperature was measured every 30 minutes for up to 4 hours. In vivo microdialysis was used to reveal the effect of risperidone on cocaine-induced elevation of dopamine (DA), serotonin (5-HT), and noradrenaline concentrations in the anterior hypothalamus. For post-administration experiments, saline or risperidone (0.5 mg/kg) were injected into rats, and cocaine (30 mg/kg) was injected 15 minutes later. For every 30 minutes thereafter, DA, 5-HT, and noradrenaline levels were measured for up to 240 minutes after cocaine administration. Results Risperidone, 5-HT2A receptor antagonists, and D1 receptor antagonistic drugs prevented and reversed cocaine-induced hyperthermia. In contrast, receptor antagonists for 5-HT1A, 5-HT2B/2C, and D2 did not alter cocaine-induced hyperthermia. Risperidone treatment further attenuated cocaine-induced elevation of DA. Conclusions Our results indicate that risperidone attenuates cocaine-induced hyperthermia primarily by blocking the activities of the 5-HT2A and D1 receptors and may be potentially useful for treating cocaine-induced acute hyperthermia in humans.

Dementia, including Alzheimer's disease (AD), is a leading cause of mortality in Europe and the United States. Interestingly, while Japan is recognized for its high life expectancy, dementia-related diseases account for a comparatively lower proportion of recorded deaths. This study aimed to investigate the actual mortality attributed to clinically diagnosed AD in Japan, particularly in psychiatric hospital settings. Total 653 cases Death certificates and medical records from psychiatric hospitals in Japan were analyzed to investigate the actual death rate associated with dementia diseases. In total, 134 of the 653 cases (20.5%) were determined to have AD as the direct cause of death, a significant increase from the 34 cases initially identified from death certificates alone (P<0.01). And more, after reviewing the death certificates and medical records of 653 patients, 203 (134 with AD and 69 with other dementias) were identified as having dementia as the direct cause of death, representing 31.1% of all deaths. This rate was significantly higher than the rate identified before the medical record review (P<0.01). Dementia diagnoses were frequently omitted from death certificates, with complications often recorded as the primary cause of death. This suggests that the true incidence of dementia-related mortality in Japan may be approximately four times higher than reported. We found that the true incidence of dementia-related mortality in Japan may be higher than reported. These findings underscore the critical need to increase awareness about dementia as a cause of death and to educate the public and healthcare professionals on accurately documenting it on death certificates.

The purpose of this study was to examine factors affecting depression trait among male intimate partner violence (IPV) victims in Japan utilizing a multiple linear regression analysis. A web-based questionnaire survey was conducted. Male IPV victims living in Japan were recruited to answer the questionnaire on the website on February 25-26, 2021. A total of 16,414 subjects were enrolled, of whom 1466 respondents were included in the study. Other than IPV exposure, information about sociodemographic characteristics, past traumatic experiences and psychiatric history was collected. The Domestic Violence Screening Inventory (DVSI), a 20-item questionnaire regarding IPV exposure, and the Patient Health Questionnaire-9 (PHQ-9) were used to determine the intensity and the type of IPV harm and to screen for depression, respectively. The victims were more frequently subject to psychological abuse than to physical violence. Based on PHQ-9 scores, 10.7% of respondents exhibited moderate to severe depression. In the DVSI score, 79.2% of respondents required \"observation and support.\" The lowest level of academic attainment (junior high school), positive psychiatric history, foregoing divorce to avoid adverse childhood experiences of their offspring, childhood exposure to domestic violence, younger age, having no children, and experience of school bullying were shown to be significantly associated with depression trait. Male IPV harm has a multilayered complexity. The sociodemographic characteristics and experiences of victims' own have a greater impact on depression trait than direct violent harm, suggesting that the violence-focused support might be inadequate for male victims. Comprehensive supports are urgently needed.

Syndrome of inappropriate antidiuretic hormone release (SIADH) can sometimes be caused by an adverse effect of certain psychotropic drugs. However, suvorexant has never been reported to cause SIADH. A 77-year-old man with type 2 diabetes was admitted to the Jichi Medical University Hospital for the treatment of major depression. During the treatment, he was prescribed suvorexant for insomnia. Twelve days after the initiation of suvorexant, he developed hyponatremia, which met the diagnostic criteria of SIADH. We suspected the hyponatremia to be an adverse drug effect of suvorexant because no other cause for SIADH was detected. Accordingly, suvorexant was discontinued 15 days after the onset of SIADH, and hyponatremia improved in 6 days. Although suvorexant has fewer adverse drug reactions and is considered relatively safe, clinicians should be aware of the possibility of SIADH induced by suvorexant. Citation: Takano M, Okada T, Kobayashi T, Suda S. Syndrome of inappropriate antidiuretic hormone secretion induced by suvorexant: a case report. J Clin Sleep Med . 2021;17(3):593–594.

It has recently been hypothesized that hyperglutamatergia in the brain is involved in the pathophysiology of autism. However, there is no conclusive evidence of the validity of this hypothesis. As peripheral glutamate/glutamine levels have been reported to be correlated with those of the central nervous system, the authors examined whether the levels of 25 amino acids, including glutamate and glutamine, in the platelet-poor plasma of drug-naïve, male children with high-functioning autism (HFA) would be altered compared with those of normal controls. Plasma levels of 25 amino acids in male children (N = 23) with HFA and normally developed healthy male controls (N = 22) were determined using high-performance liquid chromatography. Multiple testing was allowed for in the analyses. Compared with the normal control group, the HFA group had higher levels of plasma glutamate and lower levels of plasma glutamine. No significant group difference was found in the remaining 23 amino acids. The effect size (Cohen's d) for glutamate and glutamine was large: 1.13 and 1.36, respectively. Using discriminant analysis with logistic regression, the two values of plasma glutamate and glutamine were shown to well-differentiate the HFA group from the control group; the rate of correct classification was 91%. The present study suggests that plasma glutamate and glutamine levels can serve as a diagnostic tool for the early detection of autism, especially normal IQ autism. These findings indicate that glutamatergic abnormalities in the brain may be associated with the pathobiology of autism.

Purpose There is no consensus regarding the optimal target weight for discharge during the hospitalization of children with eating disorders (EDs). We attempted to identify the ideal discharge weight for children receiving their first inpatient treatment for anorexia nervosa (AN) or avoidant/restrictive food intake disorder (ARFID). Patients and methods Sixty children (mean age: 12.8 years) diagnosed with either AN (49 children) or ARFID (11 children) were followed for 1 year after discharge from a psychiatric ward. We analyzed the percent of ideal body weight (%IBW) at discharge, along with physical and social factors, to predict weight outcomes and rehospitalization risk during the first year after discharge. Longitudinal weight trends were assessed, and Cox proportional hazards modeling was used to analyze the time to rehospitalization. Results Single and multiple regression analyses identified the %IBW at discharge as the sole significant predictor of %IBW at 1 year. A receiver operating characteristic curve determined that 86.4%IBW at discharge was the optimal predictor of achieving 90%IBW by 1-year post-discharge. Patients who had achieved ≥ 86.4%IBW at discharge showed better weight trajectories compared with those discharged at < 86.4%IBW. A higher discharge %IBW was associated with prolonged time to rehospitalization, indicating a reduced risk of readmission. Conclusions Discharging pediatric patients at a higher weight is associated with improved weight recovery and a reduced risk of rehospitalization. A target discharge weight of 86.4%IBW may serve as an effective criterion for children with EDs. Level of evidence III, case–control analytic studies.

To determine the clinical characteristics and course of severe avoidant/restrictive food intake disorder (ARFID) in hospitalized children and adolescents and compare them with those of patients with restricting-type anorexia nervosa (R-AN). We conducted a retrospective chart review of inpatients diagnosed with ARFID or R-AN based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, at Jichi Children's Medical Center Tochigi between April 1, 2007 and March 31, 2017. We compared the characteristics of the ARFID and R-AN patients at admission, during hospitalization, and after discharge. Both the ARFID (n=13) and R-AN (n=79) patients required hospitalization for their medically unstable state. The features of ARFID group included concern about the aversive consequences of eating and avoidance of eating due to sensory concerns. Significant differences were found at admission between ARFID and R-AN groups in age (10.7 vs 12.7 years), family history of mental disorders (46.2% vs 17.7%), comorbid developmental disorders (6 vs 3 cases), and the time from onset to admission (3.9 vs 6.3 months). The body weight status, % ideal body weight (%IBW), % expected body weight (%EBW), <75% IBW rate, and <75% EBW rate did not differ significantly between the two groups at admission or discharge. The duration of post-discharge outpatient follow-up treatment did not differ significantly between ARFID and R-AN groups (15.3 vs 18.4 months); however, ARFID group recovery rate was significantly higher than that of R-AN group (77% vs 43%). The reasons that the patients with ARFID had significantly better outcomes than the R-AN patients remain unclear. Compared to those in previous studies, the present patients were younger and demonstrated better outcomes. Our results indicate that the body weight status is similar between ARFID and R-AN patients, but the ARFID patients achieved better outcomes. These findings suggest that early onset in childhood, early disease recognition, and early intervention are important factors for achieving better outcomes for patients with ARFID.

Background Along with the improved prognosis of patients with congenital heart disease, the associated diverse complications are under scrutiny. Due to various medical restrictions on their upbringing, patients with congenital heart disease often have coexisting mental disorders. However, reports on patients with congenital heart disease and coexisting eating disorders are rare. Here, we report the case of a patient who developed anorexia nervosa (AN) following surgery for Ebstein's anomaly. Case Presentation A 21‐year‐old female with Ebstein's anomaly who underwent Fontan surgery was transferred to our institution with suspected AN after >2 years of intermittent stays at a medical hospital for decreased appetite. Initially, she did not desire to lose weight or fear obesity, and we suspected that she was suffering from appetite loss due to a physical condition associated with Fontan circulation. However, the eating disorder pathology gradually became more apparent. Conclusion Our experience suggests that patients with congenital heart disease are more likely to have a psychological background and physical problems that might contribute to eating disorders than the general population. Organic or psychogenic.