Most homeless individuals considered economic problems to be the cause of their homelessness; however, difficulties with human relationships were also important factors and were more difficult for participants to acknowledge. Furthermore, these difficulties were exacerbated among those individuals with mental problems.

BackgroundWhile the prevalence of mental illness or cognitive disability is higher among homeless people than the general population in Western countries, few studies have investigated its prevalence in Japan or other Asian countries. The present study conducted a survey to comprehensively assess prevalence of mental illness, cognitive disability, and their overlap among homeless individuals living in Nagoya, Japan.MethodsParticipants were 114 homeless individuals. Mental illness was diagnosed based on semi-structured interviews conducted by psychiatrists. The Wechsler Adult Intelligence Scale-III (WAIS-III, simplified version) was used to diagnose intellectual/ cognitive disability.ResultsAmong all participants, 42.1% (95% CI 33.4–51.3%) were diagnosed with a mental illness: 4.4% (95% CI 1.9–9.9%) with schizophrenia or other psychotic disorder, 17.5% (95% CI 11.6–25.6%) with a mood disorder, 2.6% (95% CI 0.9–7.5%) with an anxiety disorder, 14.0% (95% CI 8.8–21.6%) with a substance-related disorder, and 3.5% (95% CI 1.4–8.8%) with a personality disorder. Additionally, 34.2% (95% CI 26.1–43.3%) demonstrated cognitive disability: 20.2% (95% CI 13.8–28.5%) had mild and 14.0% (95% CI 8.8–21.6%) had moderate or severe disability. The percent overlap between mental illness and cognitive disability was 15.8% (95% CI 10.2–23.6%). Only 39.5% (95% CI 26.1–43.3%) of the participants were considered to have no psychological or cognitive dysfunction. Participants were divided into four groups based on the presence or absence of mental illness and/or cognitive disability. Only individuals with a cognitive disability reported a significant tendency toward not wanting to leave their homeless life.ConclusionThis is the first report showing that the prevalence of mental illness and/or cognitive disability among homeless individuals is much higher than in the general Japanese population. Appropriate support strategies should be devised and executed based on the specificities of an individual’s psychological and cognitive condition.

Aims/Introduction The diabetes status of homeless people has not been elucidated because of the limited access to this population. We carried out a survey of the prevalence of diabetes and prediabetes among homeless men in Nagoya, Japan, and assessed the associations between diabetes prevalence and sociodemographic characteristics. Materials and Methods Interviews relating to individuals’ sociodemographic background, mental illness and cognitive ability, and blood sampling were carried out for 106 homeless men (mean age 54.2 ± 12.7 years). Diabetes, prediabetes and normoglycemia were diagnosed according to the individual's hemoglobin A1c level: ≥6.5%, 6.4–6.0% and ≤5.9%, respectively. Mental illness and cognitive disability were diagnosed using the Mini‐International Neuropsychiatric Interview and Wechsler Adult Intelligence Scale‐ III , respectively. Associations between the prevalence of diabetes/prediabetes and mental illness/cognitive disability or sociodemographic background were analyzed using the χ 2 ‐test. Results Seven (6.6%) and 12 (11.3%) participants were diagnosed as having diabetes and prediabetes, respectively, which was a similar trend to that of general populations in Japan National Health and Nutrition Survey data. There was a significant difference in the prediabetes prevalence between groups with and without a history of having social support; however, no significant associations were found between the diabetes/prediabetes prevalence and mental illness/cognitive ability or participants’ sociodemographic background. Conclusions The incidence of diabetes in Japanese homeless men was similar to that in the general population, and the prediabetes incidence was lower in the group with social support than in that without. Early intervention for preventing diabetes and social support that focuses on diabetes management is important for homeless people.

There is currently no reliable and valid multidimensional instrument for measuring psychological symptoms among Japanese university students. The purpose of this pilot study was to translate the Counseling Center Assessment of Psychological Symptoms-62 (CCAPS-62) into Japanese and evaluate its validity and reliability. Following robust translation procedures, the CCAPS-Japanese was created. In the validation study, 2,758 undergraduate students from 11 universities (mean age = 19.08 ± 1.85 years) completed the CCAPS-Japanese. The results of confirmatory factor analysis supported the theoretical eight-factor structure model of the CCAPS-Japanese with the exclusion of seven items. The decision to retain/remove items was made by evaluating factor loadings and model fit indices while considering cultural equivalence and structural validity. Using the finalized 55-item CCAPS-Japanese, further analyses demonstrated that the eight subscales had acceptable to good internal consistencies (α = .61-.89). Thus, the tool's validity and reliability were established.The CCAPS-Japanese may be appropriate for assessing the psychological concerns of Japanese university students.

In this paper the 'analyst as a citizen in the world' is understood as the analyst interconnecting and harmonising with his or her environment, including not only society, but also nature and the universe. In this sense, Buddhism teaches the Oneness of Life and its Environment, and links are made between Mahayana Buddhism and Jung's understanding of the Self and individuation. The Logic of Lemma in the Flower Ornament Sutra indicates that all phenomena in the world can merge with each other without losing individuality; ten stages are described from the Lotus Sutra and links are made with the development in respect to the ego; Kenji Miyazawa and his work are given as examples to illustrate this. Causality and synchronicity are explored in terms of the interaction between the individual and the environment, and three examples are given where sometimes individual, egoic, causality is more of a feature and sometimes synchronicity has a greater prominence. The paper ends with an examination of tree drawings, made over a period of 50 years by junior high school students, which indicates the way that these individuals have portrayed themselves and their relation to their environment.

Objective To examine the degree of metabolic abnormalities and their association with the sociodemographic background or mental illness/cognitive disability among homeless men in Nagoya, Japan. Methods We interviewed 106 homeless men (aged 54.2±12.7 years) and measured their metabolic parameters. Mental illness and cognitive disability were diagnosed using the Mini-International Neuropsychiatric Interview and Wechsler Adult Intelligence Scale-III test, respectively. Associations between metabolic abnormalities and the sociodemographic background or mental illness/cognitive disability were analyzed. Results There were significant correlations of liver dysfunction (AST! 35 IU, ALT! 35 IU, γ-GTP! 75 IU), hypertension [systolic/diastolic blood pressure (BP) ! 140/90 mmHg], and dyslipidemia (HDL <40 mg/dL) with the history/duration of homelessness (over 2 times/year) and residence status (living on the streets). Although the mean body mass index (BMI), BP, HbA1c, and LDL in participants living in temporary residences were similar to those obtained from the general population data from National Health Nutrition Survey (NHNS) 2016, the systolic/diastolic BP in those living on the street was significantly higher than in the general population, and the HDL in those living in temporary residences was significantly lower than in those reported in the NHNS 2016 data. In the group with cognitive disability, the ALT, TG, and BMI values were significantly higher and the HDL level significantly lower in those living in temporary residences than in those living on the streets. Conclusion Stressful conditions while living on the streets may exacerbate hypertension and liver dysfunction, and unhealthy food habits when living in a temporary residence may exacerbate low HDL levels. In addition, an inability to self-manage due to cognitive disability may increase the ALT, TG, and BMI values. The provision of homeless people with the skills to sustain independent living conditions and ensure a healthy diet is required.

Background There are few reports that objectively show actual health conditions among the homeless or diagnoses of non-communicable diseases based on blood tests. This report discloses the actual data from blood tests and non-communicable diseases among the participants. Furthermore, associations between the test values for lifestyle-related disease and mental disorder/intellectual disability, as well as personal backgrounds of homeless people, were analyzed from the data gathered in the survey. Methods This study was performed in a rented meeting room close to Nagoya Station on November 2, 2014. Blood samples, physical measurements, blood pressure measurements intellectual faculties were measured. Physical/mental diseases were diagnosed by doctors. Fisher’s exact test was performed to compare between subgroups (by participants’ socio-demographic data or the presence of mental illness/cognitive disability) according to non-communicable disease test values, and to calculate the odds ratio. Results Abnormalities among participants in test values for non-communicable disease were as follows: hypoalbuminemia in one participant (0.9%), abnormalities in liver function in 22 participants (19.3%), decreased renal function in two participants (1.8%), dyslipidemia in 67 participants (58.8%), "a person whose impaired glucose tolerance cannot be ruled out" in 20 participants (17.5%), obesity in 33 participants (28.9%), thinness in five participants (4.3%), and hypertension in 60 participants (52.6%). Compared to the National health and nutrition survey 2015, non-communicable diseases of the homeless people were similar or slightly better than in the general population in Japan. Participants aged 20–39 years had a significant positive tendency of having liver function abnormality compared to ≥60 years old participants. There was no significant tendency with socio-demographic characteristics in dyslipidemia and “impaired glucose tolerance”. Conclusion It was found that the percentage of homeless people in Nagoya who showed abnormalities of lifestyle-related disease was similar or better than that of general population in Japan.

The cover image is based on the Case Report Development of the Counseling Center Assessment of Psychological Symptoms‐Japanese Version: Pilot Study by Ryo Horita, Benjamin Locke, Mayumi Yamamoto et al., https://doi.org/10.1002/cpp.2412.