The purpose of the present study is to examine the current situation of sedative-related disorders (mainly benzodiazepines) in Japan and the clinical characteristics of Japanese patients with this disorder. Subjects were 671 drug-related disorder patients diagnosed according to the ICD-10 classification as "F1: mental and behavioural disorders due to psychoactive substance use," who abused psychoactive substances other than alcohol. Of all the psychiatric hospitals in Japan between September and October 2010, these drug-related disorder patients had consecutively consulted or were admitted to 153 psychiatric hospitals. The present study was conducted by means of a mail survey. Subjects' clinical information, including history of psychoactive substance use, means of access to the primary drug of abuse, other ICD-10 diagnoses including F1 subcategory and comorbid psychiatric disorders, and recent history of self-destructive behavior, were collected from the attending psychiatrists of each subject. The data thus gathered concerning sedative-related disorder patients were compared with those patients with methamphetamine-related disorder, which has been the most serious drug-related problem in Japan since the 1950s. Out of the 671 subjects, 119 patients mainly abusing sedatives (the SRD group) were identified, while 361 patients were identified as mainly abusing methamphetamine (the MRD group). The MRD group was the largest population (53.8% of the total subjects), followed by the SRD group (17.7%), the inhalant-related disorder group with 56 patients (8.3%), and so on. Compared with the MRD group, the SRD group was younger, contained more female patients, and had a lower incidence of history of involvement with anti-social societies and anti-social behavior. Patients of the SRD group were more likely to have started abusing drugs with the intention of reducing the unpleasant symptoms of insomnia (42.9%), anxiety (26.1%), and depression (16.0%), and to acquire the drugs they abused from medical institutions such as psychiatric or primary care clinics (82.1%), while patients of the MRD group were more likely to have started out of curiosity (35.1%) or in response to peer pressure (47.1%), and to acquire their drugs from a "pusher" (32.8%). Additionally, in the SRD group, the ICD-10 Neurology and Psychiatry,4-1-1 OgawaHigashi, Kodaira, Tokyo 187-8553, Japan; Tel: +81-42-341-2711; Fax: +81-42-346-1944; email: tmatsu@ncnp.go.jp [Translated with permission from Seishinshinkeigaku-zasshi (Psychiatria et Neurologia Japonica), vol. 113, 1184-1198, 2011] Received May 16, 2013 accepted September 15, 2014; Act Nerv Super 57(1), 12-28; ISSN-1802-9698 F1 subcategory diagnoses that were clinically most important were "dependence syndrome" (64.0%), "harmful use" (16.2%) and "acute intoxication" (16.2%), while the most important subcategory diagnosis in the MRD group was "psychotic disorder" (34.3%) and "residual disorder and late-onset psychotic disorder" (32.9%). Further, comorbid psychiatric disorders were more fr...
Aim:The aim of this study was to evaluate the effect of a relapse-prevention program for methamphetamine (MAP)-dependent inmates in a prison.Methods: Participants were 251 male inmates with MAP-abuse problems. We compared scores on the Self-efficacy Scale for Drug Dependence (SSDD) and the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES) before and after intervention with a self-teaching workbook and group therapy.Results: For all participants, only SSDD scores increased during the pre-intervention period. SOCRATES-8D scores increased after the start of the intervention using the self-teaching workbook, and both SSDD and SOCRATES-8D scores increased when group therapy was implemented. Changes in scores in participants with moderate and high MAP dependence were considerably different from the scores of those with low dependence during the preintervention and the self-teaching workbook periods. Conclusion:Intervention using a self-teaching workbook and group therapy in prisons might be effective for inmates with more than moderate severity of MAP abuse.Key words: dependence, evaluation, methamphetamine, prison, relapse-prevention. M ETHAMPHETAMINE (MAP) ABUSE has been a social problem in Japan ever since the end of World War II.1 Very few medical institutions in Japan have specialized treatments for drug dependency until now, and many MAP-dependent individuals have little opportunity to receive medical treatment before being incarcerated for drug abuse. Furthermore, they do not receive adequate drug dependency treatment in prison, and often relapse after being released.2 To improve this situation, the 'Act on Penal Detention Facilities and Treatment of Inmates and Detainees', which codified an educational and therapeutic approach for imprisoned criminals to promote their social remediation and rehabilitation, came into force in 2007. Prisons operated by the Private Finance Initiative (PFI), which uses private capital and expertise in the construction, maintenance, and operation of public institutions, are expected to provide drug-dependent inmates with multidisciplinary treatment by obtaining the cooperation of extramural experts.The Harima Rehabilitation Program Center (HRPC) is one of the four PFI prisons in Japan. Since its establishment, the HRPC has provided a relapseprevention program (the Program) specifically 3 a self-teaching workbook developed to promote recovery from drug dependence. This was used in conjunction with group therapy as it was in the SMARPP, 4 to assist the recovery of addicts from drug dependence. Although the intervention effect of such a progressive effort naturally needs to be verified, conducting a randomized controlled trial (RCT) at penal detention facilities has various problems from a legal and human rights standpoint. Moreover, little evidence is available regarding the effectiveness of treatment programs for drug dependence in Japan. To the best of our knowledge, no RCT have been conducted in Japan and there is only one case-control study of a small population...
Aims: To identify profiles associated with treatment retention in Japanese patients with methamphetamine use disorder. Methods: The study used a retrospective design based on clinical records. The subjects were 101 patients at the Kanagawa Psychiatric Center, Serigaya Hospital, who were diagnosed as having methamphetamine use disorder. They were divided in two groups, namely those who remained in treatment 3 months after the initial assessment, and those who did not. The primary analysis compared patient profiles between the two groups to detect discriminating variables, which were then submitted for secondary analysis using logistic regression to determine the most relevant predictor of retention. Results: Primary analysis indicated that older age, having psychotic symptoms, receiving public assistance, and history of incarceration were associated with treatment retention after 3 months. Secondary analysis showed that positive history of incarceration was the most significant predictor of the outcome. Conclusions: History of incarceration had the most significant treatment‐retention effect on Japanese patients with methamphetamine use disorder. The development and introduction of integrated programs that link methamphetamine‐dependent offenders to drug treatment is recommended in outpatient treatment for Japanese patients with methamphetamine user disorder.
Aims:The purpose of the present study was to examine whether the possible effectiveness of the juvenile version of the Serigaya Methamphetamine Relapse Prevention Program (SMARPP-Jr.) selfteaching workbook we developed for relapse prevention of drug abuse depends on the severity of the subject's drug-related problems.Methods: Subjects were 85 adolescent drug abusers who were detained in a juvenile classification home. We compared changes between the subjects' scores on rating scales administered both before and after interventions with the self-teaching workbook, and we examined associations between the effectiveness of the intervention and the severity of the subjects' drug-related problems.Results: Regardless of the severity of their drugrelated problems, the subjects' rating scale scores were significantly different after the intervention, which suggests that use of the workbook increased their awareness of the problems caused by drug dependence and their motivation to obtain treatment. However, use of the workbook did not significantly change their confidence in their capacity to resist drug craving. Conclusion:Although the self-teaching workbook is a convenient intervention tool that can increase subject awareness and motivation for treatment, it is likely that continuous community-based support systems are required to prevent relapse.
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