We experienced a clinical case of a patient with psychotic depression who ingested the residual saponated cresol solution from a 500ml bottle of cresol, a disinfectant, with the intention of committing suicide. Through this experience, we felt it neccessary to investigate the present commercial situation of cresol for domestic use, and to come up with some safty measares.All the 128 drugstores and pharmacies in four cities located in the Tohno area of Gifu Pref. (Mizunami, Toki, Tajimi and Ena) were queried by telephone about the sale and stock of cresol.Almost 80% of the drugstores in these four cities, excluding pharmacies, were found to deal in saponated cresol solutions. They carried a little more than two 500ml bottles of cresol on average. This volume exceeds an estimated adult lethal dose of 250ml.Although it is unlikely that an ordinary household will use the whole of 500ml bottle of the disinfectant at a time, the residual saponated cresol solution could increase the risk of accidental cresol poisoning at home.So, it would be desirable not to sell 500ml bottles in ordinary drugstores. Furthermore, before selling a bottle of cresol, the pharmacists, who have a specialized knowledge about it, should kindly explain to the user about its toxicity and usage.
cresol ; Solutions ; Area ; Disinfectants ; Cancer patients and suicide and depression

Background: Paraquat has been a matter of grave concern around the world, including Japan, in light of high mortality rates and numerous fatalities.;Method: We undertook a cross-sectional survey of pesticide poisoning by collecting data for 6 years, from 1998 to 2003, from 102 hospitals affiliated with the Japanese Association of Rural Medicine. From these cases, we analyzed those with exposure to paraquat.;Results: There were 79 paraquat poisoning cases, including 71 cases of suicide. Of the suicide cases with 5% paraquat and 7% diquat products, more than 80% resulted in suicide deaths. All people who used 24% paraquat products completed suicide. The outcomes of these cases were related to age and volume of ingestion. The prognosis line proposed by Proudfoot in 1979 continues to explain the final outcome of almost all cases even though more than 25 years have passed since it was first proposed. More than 80% of fatalities died within the first three days of ingestion.;Conclusion: Numerous lifesaving methods have been proposed by physicians around the world. However, almost all of these methods treat pulmonary disorders in the sub-acute and subsequent periods and seem unable to effectively decrease mortality rates. It is necessary to take administrative measures to reduce paraquat concentrations in products and, furthermore, to impose strict restrictions on its distribution.
Paraquat ; Cancer patients and suicide and depression ; Surveys ; Japan ; seconds

One of the commonest psychological problems that a clinician would encounter in primary care is depression. The prevalence of depression is high in women, the elderly and those with underlying physical problems or during the postpartum period. The spectrum of clinical presentations is wide and somatic complaints are more common in primary care clinics. Depression may present as a primary disorder and co-morbidity with other psychological problems or physical illnesses is high. A good clinical interview is an important form of assessment and a quick screening of depression can be done with the administration of proper rating scales, such as the Patient Health Questionnaire, Hamilton Depression Rating Scale or Geriatric Depression Scale. Repeated use of the same scale in a patient would help the clinician to monitor the progress objectively.
Depression motion ; Primary Health Care ; Cancer patients and suicide and depression ; Scale <3> ; seconds

The management of depression in the primary care setting should ideally take a biological, psychological, and sociological approach. Antidepressants are the most commonly used biological agents in the treatment of depression. Psychological therapies and psychosocial interventions improve the outcome of treatment when combined with pharmacotherapy. Clinical depression is treatable and thus efforts should be made to alleviate the suffering of patients with depression.
Cancer patients and suicide and depression ; Primary Health Care ; Management ; Depression motion ; Part

Objective: Job satisfaction and mental distress may contribute to mental illness, particularly in regard to depression and even suicide. The aim of this study was to investigate the level of job satisfaction and its relationship to the level of mental distress among farmers in comparison to non-farming rural residents. Materials and Methods: A cross-sectional questionnaire survey of 7,000 rural residents was performed to assess the level of job satisfaction and mental distress. Mental distress was measured using the 12-item General Health Questionnaire (GHQ-12). The adjusted odds ratios and their 95% confidence intervals were calculated by means of multivariate logistic regression models. Results: A total of 5,364 rural residents (1,888 farmers and 3,476 non-farmers) responded, therefore yielding a response rate of 76.6%. Twenty-five percent of the farmers and 24 percent of non-farmers were either very dissatisfied or somewhat dissatisfied with their jobs. Twenty-five percent of the farmers and 29 percent of non-farmers had mental distress (GHQ score of 4 or above). The crude odds ratio of mental distress among dissatisfied farmers in comparison to satisfied farmers was 4.38 (95% CI = 3.49-5.51). Similarly, the crude odds ratio of mental distress among dissatisfied non-farmers in comparison to satisfied non-farmers was 5.01 (95% CI = 4.19-5.98). These statistically significant odds ratios remained even after controlling for age, gender and family structure. The most important cause of mental distress among farmers was related to family finances. Among non-farmers, however, the most important cause of mental distress tended to be human relations in the workplace. Conclusion: Although farmers experienced similar levels of job satisfaction and mental distress in comparison to non-farmers, the most important cause of mental distress differed between farmers and non-farmers. As the underlying risks for this level of job satisfaction, family finances are therefore considered to be a potentially hazardous factor in regard to mental distress for farmers.
Psyche, NOS ; Job Satisfaction ; percent ; Cancer patients and suicide and depression ; Cephalic index

We encountered a patient with intractable panic disorder who responded extremely well to Ryukotsuto, a Kampo preparation. Beginning in March 2003, a 55-year-old female began to lose vigor and concentration, while developing palpitations and experiencing a rise in blood pressure (systolic pressure≥190mmHg) accompanied by sudden anxiety. When these symptoms became intense, she was brought to a hospital by ambulance. Although close examination revealed no abnormalities, on clinical diagnosis, however, autonomic imbalance was recognized. Despite treatment with antidepressants and minor tranquilizers, including selective serotonin reuptake inhibitors (SSRI), no improvement was observed. A series of medicinal Kampo preparations, prescribed one after another, also had no effect. For further treatment, she was referred to our hospital on July 22, 2005. At the first consultation, a diagnosis of panic disorder was made, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Hon-Ton disease was suspected based on clinical findings, and Ryokeikansoto was prescribed as a decoction. However, no positive effects were observed after 1 week, while marked incompetence, forgetfulness, and depression were noted. Therefore, based on the results of a self-rating depression scale (SDS), a profile of mood states (POMS), and autonomic function tests, such as pupillary dynamics at the first consultation, panic disorder accompanied by extreme tension with depression was diagnosed. Consequently, her Kampo preparation was changed to Ryukotsuto. As a result, symptoms virtually disappeared and all western drugs were discontinued. Psychological tests, autonomic function tests, and her diagnostic scores for conditions of Ki, Ketsu, and Sui also improved. We conclude that Ryukotsuto may be an effective treatment for panic disorder accompanied by depression.
Panic Disorder ; Cancer patients and suicide and depression ; Medicine, Kampo ; therapeutic aspects ; symptoms <1>

I will illustrate our research, which elucidate the efficacy of Kampo medicines for “Ki”.In order to compare hangekobokuto with kososan, we assessed them by binocular infrared video pupillography. The results revealed that sympathetic nerve activity was inhibited by taking hangekobokuto in the patients belonging to sympathetic dominant group, while it was stimulated by taking kososan in the patients belonging to parasympathetic dominant group.Administration of hangekobokuto has decreased the value of brachial-ankle pulse wave velocity. This result suggests that hangekobokuto ameliorates the elasticity of vascular wall, which is closely related to autonomic nervous system.The gastric emptying rate, which was evaluated by ultrasonographic method in FD patients, showed its significant increase after administration of hangekobokuto.Global gene expression analysis using a DNA chip has shown the pharmacological actions of kososan.In the animal study using depression-like model mice, we have found that kososan decreased the suppression of neurogenesis.
Medicine, Kampo ; experience (practice) ; Clinical Research ; Cancer patients and suicide and depression ; Psychological suppression

Purpose: The present study aimed to determine the problems of the Japanese version of the Center for Epidemiologic Studies Depression (CES-D) scale when applied to Japanese independent community-dwelling elderly focusing on its factor structure. Methods: The subjects were 1791 community-dwelling independent elderly aged 60 and over (848 males and 943 females). This study used the Japanese version of the CES-D scale to assess depression in the elderly. Results: From the results of an exploratory factor analysis, the four factors of somatic symptoms, depression affect, positive affect and relation with others were interpreted. These factors were the same as those in the previous study, but the items making up each subscale differed. Therefore, the construct validity of each subscale was not necessarily assured. In the confirmatory factor analysis, goodness-of-fit was high for both the first and second-order factor models. In examining the validity by Akaike's information criterion (AIC), the second-order factor model assuming depression as a higher-order factor among the four factors was a better fit than the first-order factor model. Although the reliability of each subscale was not sufficient, adequate reliability was assured in the total scale. Conclusion: An assessment of depression using the Japanese version of the CES-D scale should be conducted using the total score, while a re-examination of items making up each subscale is needed.
Japanese language ; 2-Chloroethyl 2-(4-1,1-dimethylethyl) phenoxy-1 methylethyl ester ; Upper case dee ; Elderly ; Cancer patients and suicide and depression