Aim: This study aimed to investigate factors associated with depression in a sample of elderly Japanese individuals in a rural community and to examine differences among factors associated with individuals living alone or living with others. Methods: Using a population-based sample from rural Japan, we assessed a total of 1552 participants aged 65 years or older by mailing a survey and evaluating responses based on the Geriatric Depression Scale. Factors associated with depression were also examined. Results: We received 964 valid responses. Depressed subjects comprised 20.5% of the sample. Living alone was significantly related to depression. In individuals living alone, depression was associated with loss of appetite, suicidal ideation, financial strain, and worries in life. However, multiple linear regression analyses revealed that the influence of living alone was negated by having a good social support system. Conclusion: These findings confirm that living alone is an important factor in depression among the elderly in a rural part of Japan. Results also confirm what others have found in Western cultures: high levels of social support, awareness of receiving social support, and willingness to receive assistance may reduce the risk of depression.

Although factors related to depression did not differ markedly between urban and rural elderly people, some risk factors differed between the two areas. Effective intervention programs for elderly depression should pay more attention to regional differences.

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Purpose: Relatively few ADHD drugs are available in Japan, but psychotropics are often used for the comorbidity of ADHD. We aimed to compare juvenile and adult patients in terms of drugs used for ADHD. Methods: We retrospectively surveyed the circumstances of prescriptions for atomoxetine and concurrent medications for ADHD patients (36 men, 39 women) using electronic medical records from a single-department psychiatric hospital in rural Japan. Mean dosage, period and rate of administration continuation, side effects, reasons for cessation, comorbid diagnoses, and use of concurrent medication were statistically compared between juvenile (<18 years old) and adult (! 18 years old) groups using the t-test and χ 2 test. Results: Continuation rate was significantly higher in the adult group (43.5%) than in the juvenile group (20.7%; p= 0.043). In the juvenile group, 65.5% received monotherapy and 34.5% received combination therapy, compared to monotherapy for 37.0% and combination therapy for 63.0% in the adult group. Combination therapy was significantly more frequent in the adult group (p=0.015). Discussion: These findings were attributed to differences in motivations for medical treatment and care-receiving patterns between groups. Since juvenile people often start treatment for ADHD as a primary condition, rather than as a comorbidity, concomitant medications are less frequent. Juvenile patients tend to drop out because of poor subjective symptoms. Among adults, treatment for ADHD often begins as treatment of comorbidity, so concomitant medications and maintenance therapy are more frequent than among juvenile patients.