Nobuo Anzai

Graduate School of Clinical Psychology,Professional Degree Program in Clinical PsychologyProfessor
Graduate School of Health Sciences,Doctoral Program in Clinical PsychologyProfessor
Last Updated :2026/07/28

■Researcher basic information

Research Keyword

  • social psychiatry
  • social skills training
  • coguitive behavior therapy
  • Psychiatric rehabilitation

Field Of Study

  • Life sciences, Psychiatry

■Career

Career

  • Apr. 2020 - Present
  • Apr. 2014 - Mar. 2020
  • 2002 - 2003
    Director of Social Psychiatry,
  • 1992 - 2002
  • 1992 - 2002
    Direction of Psychiary, Tokyo Mentropolitan
  • 1977 - 1992
    The University of Tokyo, Faculty of Medicine
  • 1977 - 1992
    Research Associate, Department of Psychiatry,
  • National Center of Neurology and Psychikatry.
  • National Institute of Mental Health,
  • Matsuzawa Hospital.
  • University of Tokyo.

Member History

  • 1992

■Research activity information

Paper

  • Pre-disaster family visits and post-evacuation return to Fukushima among psychiatric inpatients evacuated to out-of-area hospitals after the nuclear accident.
    Yuko Suzuki; Toshihiro Terui; Yasuto Kunii; Takeyasu Kakamu; Tomoo Hidaka; Daisuke Gotoh; Nobuo Anzai; Shin-Ichi Niwa; Hirooki Yabe
    The International journal of social psychiatry, May 2025
    OBJECTIVE: This study aimed to elucidate the effects of pre-evacuation family hospital visits on post-evacuation returns to Fukushima Prefecture (hometown) among psychiatric inpatients who mandatorily evacuated to hospitals outside the prefecture because of the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident. METHOD: Of the inpatients in Fukushima, 44 were admitted to a hospital in the nearby Soso district on March 11, 2011, and were therefore included in the current analysis. We collected information on their discharge after the evacuation and family visits before the evacuation by reviewing the medical records of both the evacuation destination and former hospitals. RESULTS: The average durations from the accident to post-evacuation return among patients with and those without former family visits were 681.8 days (standard error [SE] = 163.3) and 1,027.8 days (SE = 152.0), respectively. The log-rank test showed a tendency of earlier return to Fukushima among inpatients who had received family visits to the hospital before evacuation (p = .073). CONCLUSIONS: The results highlight the critical need for close collaboration between psychiatric medical practitioners and families, to not only support patients' community reintegration into daily life but also facilitate a timely return to their hometowns following long-distance evacuation caused by an unforeseen large-scale disaster.
    DOI URL
  • Examining the content validity of the Comprehensive Assessment of Functioning for Mental Illness-Subjective Version (CAMI-S) with reference to the framework of the International Classification of Functioning, Disability, and Health (ICF).
    Takashi Amagasa; Akiko Inagaki; Wataru Suzuki; Yoshimi Suzukamo; Kuniyoshi Nagai; Kingo Sawada; Hiroyuki Inadomi; Ikuyoshi Mukaiyachi; Nobuo Anzai; Emi Ikebuchi; Shinichi Niwa
    PCN reports : psychiatry and clinical neurosciences, Sep. 2024
    AIM: To support the achievement of life goals and social participation of persons with mental illness, based on the World Health Organization's International Classification of Functioning, Disability, and Health (ICF), we generated items, identified domains, and examined the content validity of the Comprehensive Assessment of Functioning for Mental Illness-Subjective Version (CAMI-S). The purpose was to assess patients' strengths and weaknesses by incorporating the patient and public involvement perspective. METHODS: Focus group interviews on the items to be included were conducted with Group A. A draft scale was constructed by extracting articles mentioning factors for social participation and recovery for each ICF component from PubMed. Group B participants rated themselves using the draft and highlighted items they considered inappropriate. Experts then rated the importance of the items through the Delphi method. Lastly, Group C participants evaluated whether the draft scale would help in understanding their strengths and weaknesses. RESULTS: The interviews revealed subjective experience items. The draft scale had 81 items (physical and mental functions, 10; activities, 23; participation, 24; environment, 12; individuals, six; and subjective experience, six). Through the Delphi method, the number of items was reduced to 34 in six domains. Most participants (N = 50) indicated that it helped them ascertain patients' strengths and weaknesses (mean = 2.11 ± .714). Completion time for the scale was 56 min, including the 60-item face sheet (20-110 min). CONCLUSION: The CAMI-S helped participants ascertain patients' strengths and weaknesses. Its reliability and validity will be verified through a large-scale survey in the future.
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  • Post-Disaster Community Transition of Psychiatric Inpatients: Lessons from the Fukushima Nuclear Accident.
    Toshihiro Terui; Yasuto Kunii; Hiroshi Hoshino; Takeyasu Kakamu; Tomoo Hidaka; Tetsuhito Fukushima; Nobuo Anzai; Daisuke Gotoh; Itaru Miura; Hirooki Yabe
    Community mental health journal, May 2024
    This study sought to explore factors related to community transition after the mandatory evacuation of psychiatric inpatients to other hospitals owing to the Fukushima Daiichi Nuclear Power Plant accident. A retrospective cohort design was adopted and 391 psychiatric patients were examined. Univariate and multivariate analyses were conducted to confirm the association between the achievement or non-achievement of discharge to community living and their backgrounds (age, gender, evacuation destination, psychiatric diagnoses, and physical complications). Multivariate analysis indicated that patients with psychiatric diagnoses of schizophrenia, schizotypal, and delusional disorders (International Statistical Classification of Diseases and Related Health Problems 10th revision, F20-29), and those with physical diagnoses of the circulatory (I00-95) and digestive (K00-93) systems showed a significant association with the non-attainment of community transition. From these results, we hypothesized that difficulties in the management of medication during and immediately after the extremely chaotic settings of evacuation could have negative effects on the community transitions. Furthermore, another possible concern was that individuals' persistent psychotic status before the accident had been carried over to the destination hospitals. Therefore, pre-disaster daily cooperation across hospitals and challenges for vulnerable psychiatric patients' future community lives are also essential.
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  • 精神疾患を持つ人々の社会生活目標達成のために ICF(国際生活機能分類)モデル準拠「強みと弱さ評価尺度」のパイロット調査から　　　　　　　　　　　　　　　
    Dec. 2023
  • Post-evacuation return of psychiatric hospital inpatients evacuated to hospitals outside the Fukushima prefecture after the nuclear accident: A Retrospective Cohort Study.
    Toshihiro Terui; Yasuto Kunii; Hiroshi Hoshino; Takeyasu Kakamu; Tomoo Hidaka; Tetsuhito Fukushima; Nobuo Anzai; Daisuke Gotoh; Itaru Miura; Hirooki Yabe
    The International journal of social psychiatry, Jun. 2023
    BACKGROUND: Post-evacuation return after mandatory hospital evacuation due to complicated disasters is often overlooked and not well-discussed. AIMS: In this study, we explored the factors which are related to the ease or difficulty of the post-evacuation return to Fukushima prefecture of psychiatric inpatients who had been evacuated to hospitals outside the prefecture because of the Great East Japan Earthquake (GEJE) and subsequent Fukushima Daiichi Nuclear Power Plant (FDNPP) accident. METHOD: This retrospective cohort study included evacuated psychiatric hospital inpatients who were registered in the Matching Project for Community Transition (MPCT) and had been traced until July 31, 2019. A total of 531 patients were included for the analyses. Univariable and multivariable analysis were conducted to detect the patients' traits including their psychiatric/physical backgrounds which were associated with their outcome - the time from GEJE to the date of return to Fukushima. RESULTS: Over half of the patients returned to Fukushima. In the multivariable analysis, the patients' gender (male), age (older), and psychiatric diagnoses of schizophrenia, schizotypal and delusional disorders (ICD-10, F20-29) showed lower hazard ratio (HR) and statistically significant association with the difficulties of post-evacuation return. Meanwhile, disorders of psychological development (F80-89), diseases of the nervous (G00-99, except G40-41) and genitourinary (N00-99) systems showed higher HR and statistically significant association with the ease of return. CONCLUSIONS: The specific characteristics of the psychiatric inpatients including their psychiatric and physical status are associated with their post-evacuation return to their hometown. These results indicated that the evacuated hospitals' practitioners and staffs from the MPCT understood the necessity of the earlier return of inpatients to their hometown. Moreover, clinicians should pay more attention to some symptoms unique to psychiatric patients which contributed to their difficulties in returning safely or expressing their hope to return.
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  • 精神科デイケアを利用した統合失調症患者のリカバリーに関する縦断的観察研究　　　　　　　　　　　　　　　
    Apr. 2022
  • Long-term observation of mortality among inpatients evacuated from psychiatric hospitals in Fukushima prefecture following the Fukushima nuclear disaster.
    Toshihiro Terui; Yasuto Kunii; Hiroshi Hoshino; Takeyasu Kakamu; Tomoo Hidaka; Tetsuhito Fukushima; Nobuo Anzai; Daisuke Gotoh; Itaru Miura; Hirooki Yabe
    Scientific reports, 19 Jul. 2021
    The debate regarding the need for hospital evacuation and the evacuation distance remains rather chaotic. Furthermore, the relationship between hospital evacuation and the prognoses of psychiatric inpatients has not yet been investigated. We aimed to reveal the association between the long-term prognosis of psychiatric inpatients evacuated immediately following the Fukushima Daiichi Nuclear Power Plant accident and their backgrounds. In this retrospective cohort study, 777 psychiatric inpatients who were immediately evacuated from their hospitals following the accident were included for analysis. Survival time was the primary outcome. We conducted univariable and multivariable analyses to examine the associations between mortality and linear distance of evacuation and different backgrounds, including psychiatric/physical traits. Univariable analysis showed that the estimated survival time among patients was significantly associated with their evacuation distance. A multivariable analysis showed that a longer evacuation distance had a significantly lower hazard ratio (HR) and resulted in lower mortality. In contrast, older patients with physical complications of respiratory disease (International Statistical Classification of Diseases and Related Health Problems 10th revision, J00-99) and genitourinary disease (N00-99) showed a significantly higher HR and had a higher mortality than patients without these complications. To prevent death among elderly psychiatric inpatients with physical comorbidities during disasters, the evacuation destination should be determined taking into consideration the evacuees' tolerance for long-distance transportation and the availability of post-evacuation care in the destination hospitals.
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  • 福島第一原子力発電所事故による精神科避難転院患者の転院後死亡に関する検討　　　　　　　　　　　　　　　
    Jan. 2021
  • 精神科入院治療再考-「重度かつ慢性」患者への包括支援実践ガイドをもとに 統括調整班の立場から実践ガイドの根拠と病院としての取組の重要性　　　　　　　　　　　　　　　
    Sep. 2020
  • 大学生における慢性疼痛に失感情症と被養育体験が及ぼす影響
    May 2020
    URL
  • 【Clozapineによる臨床の新たな展開】長期在院者の退院促進実績を有する日本の「好事例病院」におけるclozapine使用状況
    Jan. 2020
    URL
  • 精神障害リハビリテーションの研究と実践を展望する これまでの研究の成果と実践への広がりの現状『精神障害リハビリテーション学』(学会テキスト2000年)再考 病院臨床の役割と課題を中心に
    Jun. 2019
    URL
  • 【統合失調症の治療ゴールをめぐって】心理社会的治療の視点から
    Apr. 2019
    URL
  • 「家族会におけるSST研修の効果検証」 レリジエンス尺度からみた統合失調症当事者家族の変化　　　　　　　　　　　　　　　
    Nov. 2018
  • 対応困難な患者の回復を促す「個別支援SST出前講座」の効果の検討 参加した病棟スタッフの変化と病棟実践への導入　　　　　　　　　　　　　　　
    Nov. 2018
  • 発達障害児とその親を対象としたSSTプログラムの有用性 親子SSTプログラム開発のための予備的研究
    Oct. 2018
  • 治療抵抗性統合失調症への包括的支援を考える 急性期からの治療法の再検討 長期入院を作らないためのクロザピン、mECT、LAIを含めた治療戦略　　　　　　　　　　　　　　　
    Jun. 2018
  • 発達障害児とその親を対象としたコミュニケーション向上のための親子SSTプログラム HWの提示方法と実行率を中心に　　　　　　　　　　　　　　　
    Sep. 2017
  • コミュニケーション促進のための親子SSTプログラム プログラムを通した発達障害児の保護者の経験　　　　　　　　　　　　　　　
    Sep. 2017
  • 失感情症と両親の養育態度が疼痛に与える影響 大学生のアンケートから
    Jul. 2017
  • いわゆる「重度かつ慢性」の患者に対する医療をどう行っていくか 「重度かつ慢性」研究から見えてきた退院困難患者への入院治療の現状と課題　　　　　　　　　　　　　　　
    Jun. 2017
  • 【精神医学症候群(第2版)-発達障害・統合失調症・双極性障害・抑うつ障害-】統合失調症スペクトラム障害および他の精神病性障害群 薬物療法以外の治療法 統合失調症患者の心理社会的治療法
    Mar. 2017
  • [The Report of the Survey to the Members of the Society about the Functional Dissociation of the Psychiatric Hospital beds].
    Saburo Matsubara; Nobuo Anzai; Junichiro Ota; Tetsuro Ohmori; Akira Kodaka; Shigeki Sato; Iwao Sano; Kunitoshi Hatou; Masahiko Mikuni; Yoshio Yamanouchi; Akira Yoshizumi; Yoshifumi Watanabe
    Seishin shinkeigaku zasshi = Psychiatria et neurologia Japonica, 2016
    In 2014, Japanese Ministry of Health, Labour and Welfare published the guideline on the policy of the psychiatric hospitals. We executed a survey to the members of "The Japanese Society of Psychiatry and Neurology" about the impression of this guideline, especially about "The functional differentiation of psychiatric hospital beds". Nine questions were notified on the home page of the society. 862 answers (5.3% of the members) were corrected by website from 1st to 30th of May in 2015. Attribution of the answers : doctors working at the psychiatric hospitals (70.9%), the psychiatric clinics (20%), the others (9.1%). The questions which more than 80% of the answers agreed were "The reduction of the psychiatric beds should be stepwise under the rule of check & balance in the improvement of the psychiatric community treatment", "Improve the function of the recovery phase treatment" and "The adequate treat- ment for the patients of the severe and chronic phases". The questions more than 55% of the answers agreed were "The reduction of the chronic phase beds for the improvement of the function of the acute phase beds". The questions which opposites exceeded (almost 47%) were "The assessment of the psychiatric symptoms in the patients of the chronic phase should be done by the third party" and "The facility for social skill treatment should be placed in the community". We could know the mind of the members about the revolution of the psychiatric.
  • 【精神障害者へのケアマネジメント】精神科医の立場からみたケアマネジメント　　　　　　　　　　　　　　　
    Jun. 2014
  • Effects of risperidone and aripiprazole on neurocognitive rehabilitation for schizophrenia.
    Yasuhiro Matsuda; Sayaka Sato; Kazuhiko Iwata; Shunichi Furukawa; Norifumi Hatsuse; Yukako Watanabe; Nobuo Anzai; Toshifumi Kishimoto; Emi Ikebuchi
    Psychiatry and clinical neurosciences, Jun. 2014
    AIM: Methods to improve neurocognitive impairments are of important research interest. This study sought to examine the synergistic effects of neurocognitive rehabilitation and antipsychotics for schizophrenia. METHODS: Subjects were 43 patients diagnosed with schizophrenia or schizoaffective disorder in a randomized trial of the effects of neurocognitive rehabilitation or a quasi-randomized experimental trial of supported employment with neurocognitive rehabilitation. We compared the effects of risperidone and aripiprazole in neurocognitive rehabilitation for schizophrenia. Subjects were divided into the following groups: (i) the control-risperidone group (CR group) (n = 13); (ii) the rehabilitation-risperidone group (RR group) (n = 9); (iii) the control-aripiprazole group (CA group) (n = 10); and (iv) the rehabilitation-aripiprazole group (RA group) (n = 11). Subjects in the rehabilitation group were engaged in computer-based cognitive exercises (24 sessions) with bridging group (12 sessions) over 12 weeks. Psychiatric symptoms, neurocognitive functioning and social functioning assessments were evaluated at baseline and at 12 weeks. RESULTS: A two-way anova with neurocognitive rehabilitation and antipsychotic medication as factors revealed a significant interaction effect on motor speed. Working memory and motor speed significantly improved in the RA group compared with the CA group. We found no significant improvements between the CR group and the RR group. CONCLUSION: A synergistic effect of neurocognitive rehabilitation and aripiprazole was observed as improvement of motor speed. In patients treated with aripiprazole, neurocognitive rehabilitation appeared to improve working memory and motor speed. Further studies of synergistic effects of neurocognitive rehabilitation and antipsychotic medication are necessary to verify these findings.
    DOI URL
  • Effects of psychosocial program for preparing long-term hospitalized patients with schizophrenia for discharge from hospital: randomized controlled trial.
    Sayaka Sato; Emi Ikebuchi; Nobuo Anzai; Shimpei Inoue
    Psychiatry and clinical neurosciences, Oct. 2012
    AIM: The aims of the present study were to revise the Community Re-entry Program-Japanese version and to review the effectiveness of the revised Program, named the Discharge Preparation Program. METHODS: This study was a randomized controlled trial. The Discharge Preparation Program (DPP) was the intervention condition (n = 26), and the usual rehabilitation program was the control condition (n = 23). Outcome indicators included factors that make patient discharge difficult (which nurses evaluated), psychiatric symptom, knowledge about the illness or medication, and the number of patients who were discharged within 6 months after the end of a program. RESULTS: Significant improvements were found in the score of the 'Issues on treatment compliance' factor and the score of the 'Autistic life' factor, which are subscales of the Discharge Difficulty Scale, for the DPP group, on two-way ANOVA ('Issues on treatment compliance': F = 3.818, P < 0.10; 'Autistic life': F = 4.155, P < 0.05) These factors affected discharge outcome. Thus, the program may be capable of promoting discharge of long-term hospitalized psychiatric patients. With regard to the number of patients discharged in 6 months after the end of a program, there was no significant difference between both groups. CONCLUSION: The present result is in agreement with past studies, and the DPP is useful in discharge support for patients with schizophrenia in Japan.
    DOI URL
  • Development of a clinical pathway for long-term inpatients with schizophrenia.
    Miharu Nakanishi; Kanae Sawamura; Sayaka Sato; Yutaro Setoya; Nobuo Anzai
    Psychiatry and clinical neurosciences, Feb. 2010
    Clinical pathways have been defined as an optimal sequencing and timing of interventions by staff for a particular diagnosis or procedure, designed to better utilize resources, maximize quality of care and minimize delays. The aim of the present study was to develop a clinical pathway for long-term inpatients with schizophrenia. A review of clinical records was conducted for 17 patients with schizophrenia who had stayed in one psychiatric hospital for >1 year, and who remained in the community >3 months after hospital discharge. A review of clinical routine records was conducted. The discharge process of each patient was expressed in a clinical pathway around phases and care components. They were integrated into one clinical pathway. The discharge process was divided into assessment and goalsetting, preparation, and discharge phases. Care components included discharge planning, daily activity, living environment, health management, and basic life skills. Discharge planning was an important care component that was combined with all three phases. A clinical pathway was developed from reviewing past patient records, and discharge planning was found to be an important care component, which was combined with all three phases: assessment and goalsetting, preparation, and discharge. Further study is needed to examine the validity of the pathway for use in other hospitals.
    DOI URL
  • 賀茂精神医療センターにおける統合失調症在院患者への「退院準備プログラム」の効果検討
    大森 寛; 高見 浩; 大森 信忠; 佐藤 さやか; 安西 信雄; 池淵 恵美
    精神医学, Sep. 2008, [Reviewed]
  • [What impedes discharge support for persons with schizophrenia in psychiatric hospitals?].
    Emi Ikebuchi; Sayaka Satoh; Nobuo Anzai
    Seishin shinkeigaku zasshi = Psychiatria et neurologia Japonica, 2008
    OBJECTIVE: This study examines the factors that may impede discharge support for persons with schizophrenia who are receiving standard psychiatric services in Japan. SUBJECTS: Two hundred and ninety-two in-patients from nine psychiatric hospitals diagnosed with schizophrenia agreed to participate in this study. The mean duration of hospitalization at the time of the survey was approximately 10 years. METHODS: Variables that were evaluated in the baseline assessment were as follows: demographic features such as age and duration of hospitalization, primary psychiatrist's evaluation (the Brief Psychiatric Rating Scale, Global Assessment of Functioning, Assessing List of Patients' Needs of Psychiatric Rehabilitation, and so on), ward nurses' evaluation (the Discharge Difficulty Scale and the Hall and Baker's Rehabilitation Evaluation), and self administered questionnaires (the Self-Efficacy for Community Life Scale, Client Satisfaction Questionnaire, MOS Short-Form 36-Item Health Survey, and Drug Attitude Inventory Short Form). In the follow-up one year later, the subjects were divided into two groups: patients discharged and patients still hospitalized. RESULTS: Eight factors were identified by factor analysis of the Discharge Difficulty Scale. They were insight and treatment compliances, anxieties over discharge, activities of daily living (ADL), problem behaviors, autistic behaviors, medical complications, suicidal behaviors, and family problems. Five clusters were found on cluster analysis; cluster 1 (multiple factors of discharge difficulty), cluster 2 (insight, adherence, and autistic behavior factors of discharge difficulty), cluster 3 (few factors of discharge difficulty), cluster 4 (anxiety and autistic behavior of discharge difficulty), and cluster 5 (insight and adherence, anxiety, and deviant behavior factors of discharge difficulty). In the follow-up one year later, 60 and 157 subjects were divided into the discharge and continued-hospitalization groups, respectively. Six factors were detected by factor analysis that examined the variables which showed significant differences between the two groups in the baseline assessment: 1) discharge difficulties observed by ward nurses, 2) interpersonal difficulties attributed to negative symptoms, 3) hostility, excitement, and suspiciousness, 4) self-efficacy of patients in the community, 5) possible exacerbation of medical diseases, and 6) physical complaints related to the adverse effects of medication. On logistic regression analysis, the hostility, excitement, and suspiciousness and self-efficacy of patients in the community were found to be the two significant contributing factors to the outcome. DISCUSSION: Effective treatments promoting discharge support for long-term in-patients with schizophrenia are discussed according to the five clusters found. By clustering discharge difficulties, the treatment team will be provided with the necessary medical and social resources. In conclusion, a desirable supportive relation between patients and the team, basic skills to motivate the patients, and cooperative relations among the members of the treatment team are crucial in order to improve the outcomes of patients with discharge difficulties.
  • Symptom dimensions and needs of care among patients with schizophrenia in hospital and the community.
    Miharu Nakanishi; Yutaro Setoya; Manami Kodaka; Hazuki Makino; Akio Nishimura; Keita Yamauchi; Masaru Mimura; Hisao Sato; Hiroshi Arata; Hidefumi Yukumi; Takashi Amagasa; Hideki Ueno; Yuki Miyamoto; Takuya Sugie; Nobuo Anzai
    Psychiatry and clinical neurosciences, Oct. 2007
    The purpose of the present paper was to examine the psychiatric symptom dimensions related to needs of care among patients with schizophrenia in hospital and in the community. Subjects were 217 patients with F2 ICD-10 diagnoses. Hospital patients included 102 inpatients (47.0%) in psychiatric long-term care units. Community patients included 115 outpatients (53.0%) living in their homes or residential facilities. Psychiatrists used the Brief Psychiatric Rating Scale (BPRS) to assess patients' psychiatric symptoms. Formal care providers assessed needs of care using a scale developed by the Committee on Case Management Guidelines for People with Mental Disabilities in Japan. Instrumental Activities of Daily Living (IADL) self-performance and difficulty were also measured using a scale from the Minimum Data Set-Home Care (MDS-HC). Multiple regression analyses were applied, using the symptom dimensions as dependent variables and needs of care as independent variables. Patient group (hospital or community) was also used as an independent variable. Hospital patients demonstrated more severe psychiatric symptoms and greater needs of care than community patients. Multiple regression analyses showed that the total needs of care were greater among male patients (B = 0.142, P = 0.005), hospital patients (B = 0.310, P < 0.001), patients with poor IADL self-performance (B = 0.217, P = 0.047), and patients with severe negative symptoms (B = 0.240, P = 0.002; R(2) = 0.515). The present results suggested an association between negative symptoms and needs of care in schizophrenia. Hospital patients had greater needs of care, even though their psychiatric symptoms were controlled for. Further research should examine the relationships between psychiatric symptoms and needs of care in a cohort study following patients when hospitalized and when living in the community.
  • [Development of SST in Japan and the role of the SST Dissemination Association].
    Nobuo Anzai; Masahisa Nishizono
    Seishin shinkeigaku zasshi = Psychiatria et neurologia Japonica, 2006
  • [Psychiatric rehabilitation for patients with schizophrenia].
    Nobuo Anzai; Emi Ikebuchi
    Ryoikibetsu shokogun shirizu, 2003
  • [Randomized controlled trial on effectiveness of the community re-entry program to inpatients with schizophrenia spectrum disorder, centering around acquisition of illness self-management knowledge].
    Kumagai Naoki; Anzai Nobuo; Ikebuchi Emi
    Seishin shinkeigaku zasshi = Psychiatria et neurologia Japonica, 2003
    OBJECTIVE: The objective of this study was to examine by randomized controlled trial the effectiveness and safety of the Japanese version of the Community Re-Entry Program, a manualized psycho-educational program with cognitive-behavioral therapy techniques, in discharge preparation for inpatients with schizophrenia. Our hypotheses are that firstly the program is effective for patients in acquiring illness self-management knowledge, that secondly the program shows positive effects on objective behavior and symptoms, and that thirdly the program has no adverse effects on subjective quality of life (QOL). METHOD: The subjects were 32 psychiatric inpatients, 24 male and 8 female, hospitalized in psychiatric rehabilitation wards, who gave written informed consent to participate in this study. The Community Re-Entry Program consists of 16 small-group sessions of one hour each that teach illness self-management knowledge and related skills to prepare patients for discharge from hospital and re-entry to the community with cognitive-behavioral techniques such as demonstration, roleplay, feedback, behavioral modeling and homework assignments. A specialized trainer's manual, demonstration videotape and patient workbook are utilized in the program. The program content includes defining discharge readiness, identifying symptoms and medication effects, assisting with discharge planning, connecting with community care, medication self-management, monitoring relapse warning signs, and preparing for emergencies. Except for considerations of the sex ratio in both groups, subjects were randomly allocated to the program (the program group) or ordinary occupational therapy (the control group). Of 32 patients, 31 were diagnosed with schizophrenia and 1 with schizotypal disorder. For the patients in the program group, we administered the program of 16 sessions as well as introductory and closing sessions, twice a week for 9 successive weeks. Nursing staffs in the wards took the roles of trainers with careful fidelity to the manual and supervision by psychiatrists with extensive experience in cognitive-behavioral therapy. The subjects were assessed concerning psychopathology with PANSS by psychiatrists, objective behavior with REHAB by nurses, subjective QOL with subjects' self-reports on WHO/QOL-26 and illness self-management knowledge also by self-report questionnaire attached to the trainers' manual of the program, before and after the whole program. RESULTS: Before the program, no significant differences were observed between groups concerning age, illness duration, education, length of current hospitalization, amount of antipsychotic medication, psychopathology, objective behavior, subjective QOL and illness self-management knowledge. One patient dropped out of the program because of transient ischemic attack. After the program, the patients in the program group significantly improved in illness self-management knowledge, as well as in speech skills and social activity score, factors of REHAB concerned with objective behavior evaluation, compared with those in the control group. Positive symptoms thus seemed to improve in the patients in the program group compared with those in the control group. No significant changes were observed in other items, including subjective QOL, in the patients of both groups. No patients experienced psychotic relapse in the observation term. DISCUSSION: We consider that the results supported most of our hypotheses, as they showed positive effects of the program in learning illness self-management knowledge, objective behavior and possible positive effect on positive symptoms, and no adverse effects were observed in psychopathology, behavior or subjective QOL. Further study is necessary on illness self-management behavior acquisition and the effects on long-term clinical outcomes. Study on whether the program is effective for younger patients with shorter hospitalization are expected, because the subjects in this study were rather older (45.9 +/- 11.5 years in the program group) and hospitalized longer (37.8 +/- 36.7 months in the program group). CONCLUSION: The Japanese version of the program was effective and relatively safe for schizophrenia spectrum disorder inpatients for learning illness self-management knowledge in preparation for discharge and planning community re-entry.
  • Training persons with schizophrenia in illness self-management: a randomized controlled trial in Japan.
    Nobuo Anzai; Shusuke Yoneda; Naoki Kumagai; Yukako Nakamura; Emi Ikebuchi; Robert Paul Liberman
    Psychiatric services (Washington, D.C.), May 2002
    Despite the worldwide shift from inpatient to community-based treatment for individuals with severe mental illness, Japanese psychiatric services remain hospital based. In 1998, Japan had 29 psychiatric beds per 10,000 persons, twice as many as in most European countries and five times as many as in the United States (1). The reasons for Japan's slow transition to a community-based mental health system are both economic and cultural. For instance, 90 percent of psychiatric beds are in private for-profit hospitals. There is little incentive for inpatient facilities to discharge patients promptly, because the Japanese health care system provides universal coverage with virtually unlimited reimbursement for inpatient services, and the government does not have a mechanism for financing the relocation of resources from hospitals to communities (2). In addition, the stigma associated with mental illness in Japanese families is high (3). Thus a patient's primary residence is the psychiatric hospital, and opportunities are provided for periodic visits from the family.However, psychiatric rehabilitation principles and practices are beginning to take root in Japan. Anzai and his colleagues at the Matsuzawa Psychiatric Hospital in Tokyo have adapted an empirically validated skills training program to prepare patients with schizophrenia for life in the community after discharge from the hospital. In this column, they report the results of a randomized controlled trial of this approach in an inpatient facility serving a large urban center.
  • Training persons with schizophrenia in illness self-management: A randomized controlled trial in Japan
    N Anzai; S Yoneda; N Kumagai; Y Nakamura; E Ikebuchi; RP Liberman
    PSYCHIATRIC SERVICES, May 2002, [Reviewed]
    DOI URL
  • 「心理社会的治療・リハビリテーションモデルの開発研究」のプロセスについて　　　　　　　　　　　　　　　
    Mar. 2001
  • 心理社会的援助プログラムのニーズアセスメントと効果評価に関する全国試行調査 調査デザインと評価尺度の開発・評価　　　　　　　　　　　　　　　
    Mar. 2001
  • 分裂病入院患者への退院準備プログラム(3) 再発徴候の認識と対処技能の改善　　　　　　　　　　　　　　　
    Mar. 2001
  • 精神分裂病の病態,治療・リハビリテーションに関する研究 心理社会的援助プログラムのニーズアセスメントと効果評価に関する全国試行調査 調査デザインと評価尺度の開発・評価　　　　　　　　　　　　　　　
    Dec. 2000
  • 精神分裂病の病態,治療・リハビリテーションに関する研究 分裂病入院患者への退院準備の心理教育プログラム(2) 無作為割付臨床試験(RCT)による1年後までの退院促進効果の検討　　　　　　　　　　　　　　　
    Dec. 2000
  • 精神分裂病の病識に影響を与える要因について
    Nov. 2000
  • 精神分裂病の病識に影響を与える要因について
    Jul. 2000
  • 分裂病入院患者への退院準備の心理教育プログラム 無作為割付臨床試験(RCT)による疾病理解に及ぼす効果の検討　　　　　　　　　　　　　　　
    Dec. 1999
  • 分裂病入院患者の退院準備のための心理教育 無作為割付臨床試験による「地域生活への再参加プログラム」の有効性の検討　　　　　　　　　　　　　　　
    Oct. 1999
  • 分裂病入院患者の疾病理解と行動改善 無作為割付臨床試験による「地域生活への再参加プログラム」の効果の検討
    Jul. 1999
  • 精神分裂病患者の臨床症状と抗精神病薬の選択　　　　　　　　　　　　　　　
    安西 信雄; 染矢 俊幸; 宮内 勝
    精神薬療基金研究年報, Mar. 1986
    東大病院精神科デイ・ホスピタル(DH)を終了した41例の精神分裂病患者を対象に,投与薬物と臨床症状との関連を検討した.薬物については,投与薬物のCP換算量を求め,また行動薬理学的データに基づき投与薬物の薬理作用の指標(抗DA作用値,抗NA作用値,抗5HT作用値)を求めた.症状はSCLと陰性症状評価尺度(SANS)を用いて評価した.DH終了時について,投与薬物のCP換算量を従属変数とし症状を独立変数とした重回帰分析で,「思考滅裂」や「情動の平板化・情動鈍麻」などの症状の強さとCP換算量の多さが有意な関連を示し,投与薬物の各薬理作用の指標間の相関は高かったが,各薬理作用値と症状との正準相関で,「思考滅裂」や「焦燥」が強く「被害妄想」や「抑うつの特殊な病像」の弱い患者群では,投与薬物の抗NA作用値や抗DA作用値が大きく抗5HT作用値が小さいとの有意な関連が示された

MISC

Books and other publications

  • Training long-term schizophnenic inpatients in illness self-management: A randmized coutrolled trial.　　　　　　　　　　　　　　　
    Kashima H, Falloon IRH, Mizuno M, etal(Eds): Comprehensive treatment of schizophnevio-Linking Neuro behavioral finding to psychisocial Approaches, 2002
  • Training persons with schizophrenia in illness self- management: A randomized contlolled trial in Japan　　　　　　　　　　　　　　　
    Psychiatr Serv, 2002
  • 分裂病の認知行動療法－社会生活技能訓練（SST）を中心に　　　　　　　　　　　　　　　
    1997

Research Themes

  • 精神障害者の退院促進と、地域生活の自立・ＱＯＬ向上　　　　　　　　　　　　　　　
    1998
  • Engaged in research on the psychiatric rehabilitation of persons with schizophrenia　　　　　　　　　　　　　　　

■Achievement List

Research Seeds

■University education and qualification information

Qualifications, licenses

  • 01 Dec. 1973
  • 01 Jun. 1988
  • 01 Jun. 1995
  • 01 Apr. 2008
  • 01 Mar. 2011