Key wordsThe purpose of the present study is to test interrater reliability of the Japanese version of the Positive and Negative Syndrome Scale (PANSS) and to examine factors possibly affecting the reliability. The study group conducted the PANSS rating on 20 patients with DSM-IV schizophrenia. For the analysis of interrater reliability, intraclass correlation coefficient (ICC) was calculated. The ICC for individual items of the PANSS ranged from 0.26 to 0.92, and those for the positive, negative, and general psychopathology subscales were 0.85, 0.83 and 0.75, respectively. The Cronbach's alpha coefficient for the subscales were 0.84, 0.87 and 0.76, respectively. The interrater reliability and the internal consistency were satisfactory and similar to those obtained in the antecedent studies. No salient training effect was found in a sequential analysis of the concordance rate. It is concluded that the Japanese version of the PANSS is a reliable and efficient tool for comprehensive assessment of the schizophrenic syndrome.interrater reliability, intraclass coefficient, Positive and Negative Syndrome Scale (PANSS), schizophrenia.

The objective of the present study was to examine the efficacy of group musical therapy for inpatients with DSM-IV schizophrenia or schizoaffective psychosis. Thirty-four therapy group subjects in a ward for long-stay female patients received 15 group musical therapy sessions over 4 months, while 32 waiting group subjects from another ward with the same function were to wait for the sessions until the studied course was completed. The assessment included measures of psychotic symptoms, objective quality of life and subjective musical experiences. Comparison of the groups indicated that significant advantages in the therapy group subjects were detected in some measures concerning personal relations and a subjective sense of participation in a chorus activity. However, the follow-up evaluation suggested that the improvement might not be durable. These findings suggested that the musical therapy had some, but possibly only shortlived, effects on personal relations and musical experiences of chronic psychotic patients.

The purpose of the present study was to examine the role of occupation and social experience as factors determining the attitude of psychiatric care workers and other workers from various backgrounds toward people with schizophrenia. To measure the attitude of 786 subjects from six occupational groups toward people with schizophrenia, the evaluation scale applying semantic differential technique and the modified Social Rejection Scale were used, which assess two aspects of the attitude: affective acceptance and social distancing, respectively. The results of the two scales from the six groups were similar on the whole. Public health nurses showed the most accepting attitude in both scales. Psychiatric nurses and local welfare commissioners were the second and the third groups in affective acceptance, and the third and the second in socially accepting behavior, respectively. There was no significant difference in attitude among the rest of the groups (nonpsychiatric care workers, professional probation officers and non-care workers). These results can be understood in terms of the workers' experience of contact with people with schizophrenia, and education and other support opportunities. The importance of positive contact experiences and the means for facilitation of an accepting attitude in psychiatric care workers and other workers need to be stressed. Key wordsattitude toward the mentally ill, measurement of attitude, occupational factor, schizophrenia.

BackgroundPatients admitted to a psychiatric hospital with suicidal behavior (SB) are considered to be especially at high risk of suicide. However, the number of studies that have addressed this patient population remains insufficient compared to that of studies on suicidal patients in emergency or medical settings. The purpose of this study is to seek features of a sample of newly admitted suicidal psychiatric patients in a metropolitan area of Japan.Method155 suicidal patients consecutively admitted to a large psychiatric center during a 20-month period, admission styles of whom were mostly involuntary, were assessed using Structured Clinical Interviews for DSM-IV Axis I and II Disorders (SCID-I CV and SCID-II) and SB-related psychiatric measures. Associations of the psychiatric diagnoses and SB-related characteristics with gender and age were examined.ResultsThe common DSM-IV axis I diagnoses were affective disorders 62%, anxiety disorders 56% and substance-related disorders 38%. 56% of the subjects were diagnosed as having borderline PD, and 87% of them, at least one type of personality disorder (PD). SB methods used prior to admission were self-cutting 41%, overdosing 32%, self-strangulation 15%, jumping from a height 12% and attempting traffic death 10%, the first two of which were frequent among young females. The median (range) of the total number of SBs in the lifetime history was 7 (1-141). Severity of depressive symptomatology, suicidal intent and other symptoms, proportions of the subjects who reported SB-preceding life events and life problems, and childhood and adolescent abuse were comparable to those of the previous studies conducted in medical or emergency service settings. Gender and age-relevant life-problems and life events were identified.ConclusionsFeatures of the studied sample were the high prevalence of affective disorders, anxiety disorders and borderline PD, a variety of SB methods used prior to admission and frequent SB repetition in the lifetime history. Gender and age appeared to have an influence on SB method selection and SB-preceding processes. The findings have important implications for assessment and treatment of psychiatric suicidal patients.

It is acknowledged that a considerable proportion of patients who have an episode of acute and transient psychotic disorder (ATPD), will develop schizophrenia after the episode is remitted. If features discriminating the patients who later developed schizophrenia from those who underwent a monomorphous ATPD-only course are discerned, they may be useful for predicting the prognosis. The authors performed a chart review study of those who were hospitalized with the diagnosis of ATPD and followed up thereafter for >5 years and compared two subject groups: 10 later-schizophrenia-developing (SD) patients and 15 non-schizophrenia-developing (non-SD) patients. Assessment of the subjects, conducted by two psychiatrist raters blind to the subject groups, included frequency of ATPD episodes, adaptation levels and life events before admission, and psychiatric symptoms before and after admission. The interrater reliability of the assessment proved to be favorable. As a result, early recurrence of psychotic episodes in the follow-up period, lack of acute upsurge of insomnia in an early phase of the episode and poor premorbid heterosexual relations characterized the SD patients. The result indicated heterogeneity of ATPD episodes.

Synaptotagmin XI (Syt11) is a member of the synaptotagmin family, which is localized in cells either in synaptic vesicles or the cellular membrane, and is known to act as a calcium sensor. The Syt11 gene is located on chromosome locus 1q21-q22, which was previously reported as a major susceptibility locus of familial schizophrenia. Here, we present evidence for an association between the number of 33-bp repeats in the promoter region of the Syt11 gene and schizophrenia. We found that the transcriptional activity of the gene is affected by the number of 33-bp repeats, which include an Sp1 binding site, suggesting that the excessive expression of Syt11 can be associated with schizophrenia. Another (single nucleotide) polymorphism in the Syt11 5'UTR region, where the potent transcription factor YY1 can bind, also affects the transcriptional activity of Syt11.

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