論文 - 小林　由季

An evaluation of treatment response and remission definitions in adult obsessive-compulsive disorder: A systematic review and individual-patient data meta-analysis.

Divya Ramakrishnan, Luis C Farhat, Edoardo F Q Vattimo, Jessica L S Levine, Jessica A Johnson, Bekir B Artukoglu, Angeli Landeros-Weisenberger, Abraham Zangen, Antoine Pelissolo, Carlos A de B Pereira, Christian Rück, Daniel L C Costa, David Mataix-Cols, David Shannahoff-Khalsa, David F Tolin, Elham Zarean, Elisabeth Meyer, Emily R Hawken, Eric A Storch, Erik Andersson, Euripedes C Miguel, Giuseppe Maina, James F Leckman, Jerome Sarris, John S March, Juliana B Diniz, Kenneth Kobak, Luc Mallet, Nienke C C Vulink, Revital Amiaz, Rodrigo Yacubian Fernandes, Roseli G Shavitt, Sabine Wilhelm, Shahrokh Golshan, Sophie Tezenas du Montcel, Stefano Erzegovesi, Upasana Baruah, William M Greenberg, Yuki Kobayashi, Michael H Bloch

Journal of psychiatric research 173   387 - 397 2024年03月

筆頭著者, 責任著者

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INTRODUCTION: Expert consensus operationalized treatment response and remission in obsessive-compulsive disorder (OCD) as a Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) reduction ≥35% and score ≤12 with ≤2 on Clinical Global Impressions Improvement (CGI-I) and Severity (CGI-S) scales, respectively. However, there has been scant empirical evidence supporting these definitions. METHODS: We conducted a systematic review and an individual participant data meta-analysis of randomized-controlled trials (RCTs) in adults with OCD to determine optimal Y-BOCS thresholds for response and remission. We estimated pooled sensitivity/specificity for each percent reduction threshold (response) or posttreatment score (remission) to determine response and remission defined by a CGI-I and CGI-S ≤ 2, respectively. RESULTS: Individual participant data from 25 of 94 eligible RCTs (1235 participants) were included. The optimal threshold for response was ≥30% Y-BOCS reduction and for remission was ≤15 posttreatment Y-BOCS. However, differences in sensitivity and specificity between the optimal and nearby thresholds for response and remission were small with some uncertainty demonstrated by the confidence ellipses. CONCLUSION: While the empirically derived Y-BOCS thresholds in our meta-analysis differ from expert consensus, given the predominance of data from more recent trials of OCD, which involved more refractory participants and novel treatment modalities as opposed to first-line therapies, we recommend the continued use of the consensus definitions.

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Effect of Personality Traits on Sustained Remission Among Patients with Major Depression: A 12-Month Prospective Study

Waka Nogami, Atsuo Nakagawa, Nariko Katayama, Yuka Kudo, Mizuki Amano, Sakae Ihara, Chika Kurata, Yuki Kobayashi, Yohei Sasaki, Natsumi Ishikawa, Yasunori Sato, Masaru Mimura

Neuropsychiatric Disease and Treatment （Informa UK Limited）  Volume 18   2771 - 2781 2022年11月

筆頭著者, 責任著者, 査読有り

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Associations of Autism Traits With Obsessive Compulsive Symptoms and Well-Being in Patients With Obsessive Compulsive Disorder: A Cross-Sectional Study

Doi S., Kobayashi Y., Takebayashi Y., Mizokawa E., Nakagawa A., Mimura M., Horikoshi M.

Frontiers in Psychology （Frontiers in Psychology）  12   697717 - 697717 2021年07月

査読有り

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The aim of this study is to examine the association of autism traits with long-term obsessive compulsive disorder (OCD) symptoms and well-being levels in patient with OCD. Participants comprised 18 outpatients from a tertiary hospital and 100 adults who were registered in a large Japanese internet marketing research company and met OCD criteria by the Mini-International Neuropsychiatric Interview and were between the ages of 20 and 65 years. Clinical characteristics, autism trait assessed using the Autism Spectrum Quotient (AQ), OCD symptoms assessed using Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), and well-being assessed using the Flourishing Scale were assessed. Multiple regression analyses showed that a greater total score of AQ, a greater subscale score “imagination” was associated with a greater score of Y-BOCS. Greater total score of AQ, a greater subscale score “social skill,” and “imagination” were associated with lower well-being score. Autism traits, especially lack of imagination, were associated with more severe OCD symptoms. Further, autism traits, especially social skill problems and lack of imagination, were associated with lower levels of well-being. Assessment of autism traits before treatment and a strategy designed for OCD patients with autism traits may be warranted.

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Pseudo-continuous arterial spin labeling MRI study of patients with obsessive–compulsive disorder

Ota M., Kanie A., Kobayashi Y., Nakajima A., Sato N., Horikoshi M.

Psychiatry Research - Neuroimaging （Psychiatry Research - Neuroimaging）  303   111124 - 111124 2020年09月

査読有り,  ISSN  09254927

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© 2020 Elsevier B.V. Arterial spin labeling (ASL) magnetic resonance imaging is a novel technique that can measure regional cerebral blood flow (rCBF). Here we used pseudo-continuous ASL (pCASL) to examine the structural and functional imaging data in patients with obsessive-compulsive disorder (OCD). We estimated the gray matter volume imaging and pCASL imaging data by means of a voxel-by-voxel statistical analysis. We evaluated the differences of rCBF and gray matter volume between the OCD patients and healthy subjects. We detected a significant rCBF reduction in OCD patients in the right posterior cingulate extending to the lingual gyrus, thalamus, and hippocampus, and a significant increase in the left temporal gyrus and left frontal white matter region, compared with healthy subjects. We also observed a significant reduction in gray matter volume of OCD patients in the right hippocampus. We also estimated the correlation between the clinical severity of OCD and the rCBF and gray matter volumes, and found significant negative correlations between the severity of illness and the regional gray matter volume in the bilateral anterior cingulate corti. Our study demonstrated significant changes of rCBF in the cortico-striato-thalamo-cortical pathway around the hippocampus in OCD patients. These findings may help to elucidate the pathogenesis of OCD.

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An Evaluation of Family-Based Treatment for OCD in Japan: A Pilot Randomized Controlled Trial

Kobayashi Y., Kanie A., Nakagawa A., Takebayashi Y., Shinmei I., Nakayama N., Yamaguchi K., Nakayama C., Hirabayashi N., Mimura M., Horikoshi M.

Frontiers in Psychiatry （Frontiers in Psychiatry）  10   932 - 932 2020年01月

査読有り

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© Copyright © 2020 Kobayashi, Kanie, Nakagawa, Takebayashi, Shinmei, Nakayama, Yamaguchi, Nakayama, Hirabayashi, Mimura and Horikoshi. Objective: Although family involvement in the treatment of obsessive-compulsive disorder (OCD) produces a reduction in OCD symptoms and has significant effects on global functioning, few studies have focused on family intervention as part of OCD treatment in Japan. This study aims to examine the feasibility and efficacy of the family-based exposure and response prevention (FERP) program for adult patients with OCD and their family members. Design: Randomized controlled pilot study. Methods: A total of 18 outpatients aged 18–65 years with a primary diagnosis of OCD and one family member of each patient were randomized to an intervention group or a control group (1:1). The intervention group received the FERP program, which consisted of 16 weekly face-to-face cognitive behavioral therapy (CBT) sessions, including eight joint sessions with family members, in addition to treatment-as-usual (TAU). The control group received TAU alone. The primary outcome was the alleviation of OCD symptoms, as measured by changes in the total Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score from baseline to posttreatment. Analyses were provided on an intention-to-treat basis, and linear mixed models were used to test for significant group differences. Results: After 16 weeks, patients allocated to the FERP program showed improvement in OCD symptom severity, as measured by the total change score of the Y-BOCS (Hedges’ g = −1.58), as compared to the control group. Two patients (22.2%) in the FERP group reached remission, and five patients (55.6%) in the FERP group achieved treatment response. Clinical global improvement measured by the FAS-SR scores, K6 scores, and CGI-S scores was also observed (Hedges’ g = −1.35, −1.25, and −1.26, respectively) in the FERP group as compared to the control group. The dropout rate from the study was low (n = 2, 11.8%), and no adverse events were reported in the FERP group. Conclusion: Our results suggest that FERP may be an effective program for reducing patients’ OCD symptoms. Clinical Trial Registration: www.umin.ac.jp/ctr/, identifier UMIN000021763.

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The Japanese version of the Family Accommodation Scale for Obsessive-Compulsive Disorder: Psychometric properties and clinical correlates

Yuki Kobayashi, Hisato Matsunaga, Tomohiro Nakao, Yuka Kudo, Eisuke Sakakibara, Ayako Kanie, Noriko Nakayama, Issei Shinmei, Masaru Horikoshi

JOURNAL OF OBSESSIVE-COMPULSIVE AND RELATED DISORDERS （ELSEVIER SCIENCE BV）  15   27 - 33 2017年10月

筆頭著者, 責任著者, 査読有り,  ISSN  2211-3649

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Although a variety of obsessive-compulsive disorder (OCD)-related family pathologies, such as family accommodation, may exist in Japanese OCD patients, few studies on this topic have been conducted, and a validated assessment tool is not available in Japan. The Family Accommodation Scale (FAS) is the most widely used measure of accommodation behavior in OCD patients. The aims of this study were to develop a Japanese version of the FAS-Self-Rated Version (FAS-SR), to examine its reliability and validity, and to study the clinical correlates of family accommodation in OCD. We subsequently examined the psychometric properties of the Japanese version of the FAS-SR in a sample of 41 Japanese OCD patients and 41 relatives. The Japanese version of the FAS-SR demonstrated good internal consistency and test-retest reliability. It showed good convergent and divergent validity when concomitantly assessed with other measures, such as OCD symptom severity, functional impairment, family functioning, psychological distress, a variety of psychiatric symptoms and cognitive-reflection-impulsivity. Additionally, family psychopathology, especially somatization, obsessive-compulsive symptoms, depression, hostility and psychoticism, were significantly correlated with family accommodation in OCD. The Japanese version of the FAS-SR has acceptable psychometric properties for assessing family accommodation in Japanese patients with OCD in both research and clinical settings.

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Pilot study of exposure and response prevention for Japanese patients with obsessive-compulsive disorder

Issei Shinmei, Ayako Kanie, Yuki Kobayashi, Noriko Nakayama, Yuriko Takagishi, Sonoko Iijima, Yoshitake Takebayashi, Masaru Horikoshi

JOURNAL OF OBSESSIVE-COMPULSIVE AND RELATED DISORDERS （ELSEVIER SCIENCE BV）  15   19 - 26 2017年10月

筆頭著者, 責任著者, 査読有り,  ISSN  2211-3649

　概要を見る

This pilot study was conducted to evaluate the feasibility and efficacy of exposure and response prevention therapy in Japanese patients with obsessive-compulsive disorder. This study was the first to examine the effectiveness of exposure and response prevention therapy provided by Japanese clinical psychologists. The sample comprised 37 adults (male = 17, female = 20, mean age = 35.7 years, standard deviation [SD] = 10, mean Yale-Brown Obsessive Compulsive Scale score = 26.9, SD = 23.35) with a diagnosis of obsessive-compulsive disorder receiving treatment. Individually administrated exposure and response prevention was provided to the 37 patients with obsessive-compulsive disorder. We evaluated the feasibility and safety of the program using the dropout rate and adverse events. The primary outcome was the reduction of the Yale-Brown Obsessive Compulsive Scale score between the pre- and post-treatment periods. Secondary outcomes were depression, anxiety, and quality of life. Of the 37 patients, 5(14%) dropped out and 32(86%) completed the entire program. No severe adverse event was observed. The patients reported significant reductions in the Yale-Brown Obsessive Compulsive Scale score (obsession: Hedges' g = 2.11, 95% Cl [1.57, 2.68]; compulsion: Hedges' g = 2.05, 95% CI [1.41, 2.56]). Some secondary outcomes (depression and quality of life) also showed significant change. The results suggest that the exposure and response prevention program provided by Japanese clinical psychologists is an efficacious and feasible treatment approach for Japanese patients with obsessive-compulsive disorder.

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