a b s t r a c t a r t i c l e i n f oIn Japan, schizophrenia was renamed in 2002 to reduce the stigma that people with schizophrenia are dangerous. However there has been little research on the potential anti-stigma effect of renaming. The present study aimed to examine whether portrayals of schizophrenia in newspapers as dangerous have been varied across renaming of the disease. To achieve this goal, newspaper articles containing the previous and new Japanese names for schizophrenia, published in the decades before and after the renaming, were identified through the database of the three largest Japanese national broadsheets. Identified articles were divided into two categories: a negative category, including a subcategory "danger"; and a positive category. Articles containing bipolar disorder were adopted as a control. The ratio of the number of articles on schizophrenia and danger to that of bipolar disorder was analysed as a variable of interest. The trend of this ratio was investigated to examine whether portrayals of schizophrenia changed after renaming. The search identified 4677 articles on schizophrenia, 53.0% of which were categorised as negative and 38.9% as danger. The search identified 525 articles on bipolar disorder, 24.6% of which were categorised as negative and 11.2% as danger. There was an increase of the ratio before schizophrenia was renamed (r = 0.54, p = 0.104), and a significant decrease after renaming (r = − 0.69, p = 0.028). Fisher's r-to-z transformation demonstrated a significant change in the trend of the ratio across renaming (Z = 2.72, p = 0.007). Renaming schizophrenia might be associated with mitigation in potentially stigmatised depiction of schizophrenia associated with violence in newspaper reports.
Structural and functional neuroimaging findings suggest that disturbance of the cortico–striato–thalamo–cortical (CSTC) circuits may underlie obsessive-compulsive disorder (OCD). However, some studies with 1H-magnetic resonance spectroscopy (1H-MRS) reported altered level of N-acetylaspartate (NAA), they yielded inconsistency in direction and location of abnormality within CSTC circuits. We conducted a comprehensive literature search and a meta-analysis of 1H-MRS studies in OCD. Seventeen met the inclusion criteria for a meta-analysis. Data were separated by frontal cortex region: medial prefrontal cortex (mPFC), dorsolateral prefrontal cortex, orbitofrontal cortex, basal ganglia and thalamus. The mean and s.d. of the NAA measure were calculated for each region. A random effects model integrating 16 separate datasets with 225 OCD patients and 233 healthy comparison subjects demonstrated that OCD patients exhibit decreased NAA levels in the frontal cortex (P=0.025), but no significant changes in the basal ganglia (P=0.770) or thalamus (P=0.466). Sensitivity analysis in an anatomically specified subgroup consisting of datasets examining the mPFC demonstrated marginally significant reduction of NAA (P=0.061). Meta-regression revealed that NAA reduction in the mPFC was positively correlated with symptom severity measured by Yale–Brown Obsessive Compulsive Scale (P=0.011). The specific reduction of NAA in the mPFC and significant relationship between neurochemical alteration in the mPFC and symptom severity indicate that the mPFC is one of the brain regions that directly related to abnormal behavior in the pathophysiology of OCD. The current meta-analysis indicates that cortices and sub-cortices contribute in different ways to the etiology of OCD.
Background Child and adolescent mental health problems are urgent health issues in low- and middle-income countries. To promote child and adolescent mental health services, simple validated screening tools are helpful. In Mongolia, the Strengths and Difficulties Questionnaire (SDQ), an internationally used child and adolescent mental health screening tool for children aged 4–17, was translated but not yet validated. To use the questionnaire appropriately, validation is necessary. Methods Children at 4th year at elementary school (community sample) and children visited psychiatric outpatient service (clinical sample) were recruited and their parental version of the SDQ was compared. The discriminating ability of the parental version of the SDQ was examined using Receiver Operating Characteristics (ROC) analysis on the SDQ total difficulties score. The area under the ROC curve (AUC) was used as a measure. Cut-off score was determined by normative banding that categorizes children with the highest 10% score range as abnormal and the second highest 10% as borderline following the original method; this cut-off score was compared with the cut-off score candidates with good balance between sensitivity and specificity using ROC analysis. Results We included 2301 children in the community sample, and 429 children in the clinical sample. Mean age was 9.7 years (SD 0.4, range 8.3–12.0) among the community sample and 10.4 years (SD 3.8, range 4.0–17.8) among the clinical sample. The mean total difficulties score was 12.9 (SD 4.8) among the community sample and 20.4 (SD 6.2) among the clinical sample. A total of 88.8% of the community sample and 98.8% of the clinical sample answered the SDQ. Using ROC analysis, the AUC was 0.82 (95% confident interval 0.80–0.85), which meant moderate discriminating ability. Using normative banding, the borderline cut-off score was 16/17 and abnormal cut-off score was 19/20. For cut-off scores of 16/17 and 19/20, sensitivity was 71.9 and 53.8% and specificity was 78.5 and 90.5%, respectively. The cut-off score candidates by ROC analysis were 16/17 and 17/18. Conclusions The parental version of the SDQ had moderate discriminating ability among Mongolian school-age children. For the screening of mental health problems among community children, cut-off score of 16/17 is recommended.
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