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Muacevic A, Adler JR, Pei-Chen Chang J, P J Tan M, Kayano R, Okumura Y, Horinouchi T, Ii T, Kuroki T, Akiyama T. Gender Biases Toward People With Difficulty in Balancing Work and Family Due to ADHD: Two Case Vignette Randomized Studies Featuring Japanese Laypersons and Psychiatrists. Cureus 2023; 15:e34243. [PMID: 36852366 PMCID: PMC9965895 DOI: 10.7759/cureus.34243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2022] [Indexed: 01/28/2023] Open
Abstract
Objective The gender gap in labor force participation is likely larger in adults with attention deficit hyperactivity disorder (ADHD) than that in the general population. Thus, we investigated whether gender affected the perception toward persons displaying ADHD symptoms and experiencing difficulty in balancing work and family. Methods Both Japanese laypersons and psychiatrists were recruited for web-based surveys in March and October 2020 via an online survey company, Cross Marketing Inc., and the secretariat of the Japanese Society of Psychiatry and Neurology, respectively. The participants were randomly assigned to read either a male or female case vignette. The vignettes were identical, except for the gender of the patient in the case. The primary and secondary outcomes were the respondents' opinions on the seriousness of the case and the degree to which the case's wish should be maintained, using sliding scales of 0-100. Results We included 560 laypersons and 585 psychiatrists. Neither cohort differed in most outcomes between the groups assigned to the male and female case vignettes. Among laypersons, the average score of seriousness was 58.8 in the female-vignette group and 58.6 in the male-vignette group (mean difference, 0.15; 95% confidence interval, -4.9 to 5.2). Among psychiatrists, the average score of seriousness was 53.9 in the female-vignette group and 53.7 in the male-vignette group (mean difference, 0.18; 95% confidence interval, -3.1 to 3.4). Similarly, between-group differences in the opinions on the degree to which the case's wish should be maintained were 1.2 in laypersons and 0.63 in psychiatrists. We found no significant interaction between the gender of the case and the respondent's gender in any of the outcomes. Conclusion Our results did not support the hypothesis that women were more likely to be pressured to prioritize family over work than men were when there was difficulty balancing work and family due to ADHD symptoms.
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Affiliation(s)
| | | | - Jane Pei-Chen Chang
- Department of Psychiatry, China Medical University Hospital, Taichung, TWN.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, GBR
| | - Marcus P J Tan
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, GBR.,Department of Child and Adolescent Psychiatry, South London and Maudsley NHS Foundation Trust, London, GBR
| | - Ryoma Kayano
- Center for International Collaborative Research, Nagasaki University, Nagasaki, JPN
| | - Yasuyuki Okumura
- Epidemiology, Initiative for Clinical Epidemiological Research, Tokyo, JPN
| | - Toru Horinouchi
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Hokkaido, JPN
| | - Toshitaka Ii
- Department of Psychiatry, Aichi Medical University, Nagoya, JPN
| | - Toshihide Kuroki
- Graduate School of Human-Environment Studies, Kyushu University, Fukuoka, JPN
| | - Tsuyoshi Akiyama
- Department of Neuropsychiatry, NTT Medical Center Tokyo, Tokyo, JPN
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Pereira-Sanchez V, Alvarez-Mon MA, Horinouchi T, Kawagishi R, Tan MPJ, Hooker ER, Alvarez-Mon M, Teo AR. Examining Tweet Content and Engagement of Users With Tweets About Hikikomori in Japanese: Mixed Methods Study of Social Withdrawal. J Med Internet Res 2022; 24:e31175. [PMID: 35014971 PMCID: PMC8925292 DOI: 10.2196/31175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 10/22/2021] [Accepted: 10/29/2021] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Hikikomori is a form of severe social withdrawal that is particularly prevalent in Japan. Social media posts offer insight into public perceptions of mental health conditions and may also inform strategies to identify, engage, and support hard-to-reach patient populations such as individuals affected by hikikomori. OBJECTIVE In this study, we seek to identify the types of content on Twitter related to hikikomori in the Japanese language and to assess Twitter users' engagement with that content. METHODS We conducted a mixed methods analysis of a random sample of 4940 Japanese tweets from February to August 2018 using a hashtag (#hikikomori). Qualitative content analysis included examination of the text of each tweet, development of a codebook, and categorization of tweets into relevant codes. For quantitative analysis (n=4859 tweets), we used bivariate and multivariate logistic regression models, adjusted for multiple comparisons, and estimated the predicted probabilities of tweets receiving engagement (likes or retweets). RESULTS Our content analysis identified 9 codes relevant to tweets about hikikomori: personal anecdotes, social support, marketing, advice, stigma, educational opportunities, refuge (ibasho), employment opportunities, and medicine and science. Tweets about personal anecdotes were the most common (present in 2747/4859, 56.53% of the tweets), followed by social support (902/4859, 18.56%) and marketing (624/4859, 12.84%). In the adjusted models, tweets coded as stigma had a lower predicted probability of likes (-33 percentage points, 95% CI -42 to -23 percentage points; P<.001) and retweets (-11 percentage points, 95% CI -18 to -4 percentage points; P<.001), personal anecdotes had a lower predicted probability of retweets (-8 percentage points, 95% CI -14 to -3 percentage points; P=.002), marketing had a lower predicted probability of likes (-13 percentage points, 95% CI -21 to -6 percentage points; P<.001), and social support had a higher predicted probability of retweets (+15 percentage points, 95% CI 6-24 percentage points; P=.001), compared with all tweets without each of these codes. CONCLUSIONS Japanese tweets about hikikomori reflect a unique array of topics, many of which have not been identified in prior research and vary in their likelihood of receiving engagement. Tweets often contain personal stories of hikikomori, suggesting the potential to identify individuals with hikikomori through Twitter.
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Affiliation(s)
- Victor Pereira-Sanchez
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York, NY, United States
- Department of Psychiatry, Columbia University, New York, NY, United States
- Division of Translational Epidemiology, New York State Psychiatric Institute, New York, NY, United States
- Department of Psychiatry and Clinical Psychology, Clinica Universidad de Navarra, Pamplona, Spain
| | - Miguel Angel Alvarez-Mon
- Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcala, Alcala de Henares, Spain
- Department of Psychiatry and Mental Health, Hospital Infanta Leonor, Madrid, Spain
| | - Toru Horinouchi
- Department of Psychiatry and Neurology, Hokkaido University Graduate School of Medicine, Hokkaido, Japan
| | - Ryo Kawagishi
- Department of Psychiatry, Chiba Psychiatric Medical Center, Chiba, Japan
| | - Marcus P J Tan
- Department of Child and Adolescent Psychiatry, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Elizabeth R Hooker
- VA Portland Health Care System, Health Services Research & Development Center to Improve Veteran Involvement in Care, Portland, OR, United States
| | - Melchor Alvarez-Mon
- Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcala, Alcala de Henares, Spain
- Immune System Diseases-Rheumatology, Oncology Service and Internal Medicine, Hospital Universitario Principe de Asturias, Alcalá de Henares, Spain
| | - Alan R Teo
- VA Portland Health Care System, Health Services Research & Development Center to Improve Veteran Involvement in Care, Portland, OR, United States
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, United States
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Nakagami Y, Hayakawa K, Horinouchi T, Pereira-Sanchez V, Tan MPJ, Park SC, Park YC, Moon SW, Choi TY, Avasthi A, Grover S, Kallivayalil RA, Rai Y, Shalbafan M, Chongsuksiri P, Udomratn P, Kathriarachchi ST, Xiang YT, Sim K, Javed A, Chong MY, Tan CH, Lin SK, Inada T, Murai T, Kanba S, Sartorius N, Shinfuku N, Kato TA. A Call for a Rational Polypharmacy Policy: International Insights From Psychiatrists. Psychiatry Investig 2021; 18:1058-1067. [PMID: 34732030 PMCID: PMC8600221 DOI: 10.30773/pi.2021.0169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 07/02/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE Recently, rational polypharmacy approaches have been proposed, regardless of the lower risk and cost of monotherapy. Considering monotherapy as first-line treatment and polypharmacy as rational treatment, a balanced attitude toward polypharmacy is recommended. However, the high prevalence of polypharmacy led the Japanese government to establish a polypharmacy reduction policy. Based on this, the association between the policy and psychiatrists' attitude toward polypharmacy has been under debate. METHODS We developed an original questionnaire about Psychiatrists' attitudes toward polypharmacy (PAP). We compared the PAP scores with the treatment decision-making in clinical case vignettes. Multiple regression analyses were performed to quantify associations of explanatory variables including policy factors and PAP scores. The anonymous questionnaires were administered to psychiatrists worldwide. RESULTS The study included 347 psychiatrists from 34 countries. Decision-making toward polypharmacy was associated with high PAP scores. Multiple regression analysis revealed that low PAP scores were associated with the policy factor (β=-0.20, p=0.004). The culture in Korea was associated with high PAP scores (β=0.34, p<0.001), whereas the culture in India and Nepal were associated with low scores (β=-0.15, p=0.01, and β=-0.17, p=0.006, respectively). CONCLUSION Policy on polypharmacy may influence psychiatrists' decision-making. Thus, policies considering rational polypharmacy should be established.
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Affiliation(s)
- Yukako Nakagami
- Department of Psychiatry, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Department of Preventive Services, School of Public Health/Medicine and Medical Science, Kyoto University, Kyoto, Japan
| | - Kohei Hayakawa
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toru Horinouchi
- Department of Neuroscience, Trafford Centre for Medical Research, Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Victor Pereira-Sanchez
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York, USA
| | - Marcus P J Tan
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Seon-Cheol Park
- Department of Psychiatry, Hanyang University Guri Hospital, Guri, Republic of Korea
| | - Yong Chon Park
- Department of Psychiatry, Hanyang University Guri Hospital, Guri, Republic of Korea
| | - Seok Woo Moon
- Department of Psychiatry, Konkuk University Chungju Hospital, Institute of Medical Science, Chungju, Republic of Korea
| | - Tae Young Choi
- Department of Psychiatry, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea
| | - Ajit Avasthi
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sandeep Grover
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Yugesh Rai
- Essex Partnership University Trust, Colchester, UK
| | | | | | - Pichet Udomratn
- Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Samudra T Kathriarachchi
- Department of Psychiatry, Faculty of Medical Sciences, University of Sri Jayewardenepura, Sri Lanka
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, University of Macau, Macao SAR, China
| | - Kang Sim
- Institute of Mental Health, Buangkok Green Medical Park, Singapore
| | - Afzal Javed
- Pakistan Psychiatric Research Centre, Fountain House, Lahore, Pakistan
| | - Mian-Yoon Chong
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung & Chang Gung University School of Medicine, Taoyuan, Taiwan
| | - Chay-Hoon Tan
- Department of Pharmacology, National University of Singapore, Singapore
| | - Shih-Ku Lin
- Department of Psychiatry, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Toshiya Inada
- Department of Psychiatry, Nagoya University, Graduate School of Medicine, Nagoya, Japan
| | - Toshiya Murai
- Department of Psychiatry, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shigenobu Kanba
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Norman Sartorius
- Association for the Improvement of Mental Health Programmes, Geneva, Switzerland
| | - Naotaka Shinfuku
- Department of Social Welfare, School of Human Sciences, Seinan Gakuin University, Fukuoka, Japan
| | - Takahiro A Kato
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Tan MPJ, Lee W, Kato TA. International experience of hikikomori (prolonged social withdrawal) and its relevance to psychiatric research. BJPsych Int 2020; 18:34-37. [PMID: 34287404 PMCID: PMC8274427 DOI: 10.1192/bji.2020.20] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 03/08/2020] [Accepted: 03/24/2020] [Indexed: 12/15/2022] Open
Abstract
When prolonged social withdrawal was first described in Japan as ‘hikikomori’, many studies examining its etiology suggested it to be related to factors unique to Japan and thus a culture-bound syndrome. However, existing research has suffered from a lack of standardised definitions, impeding comparability between studies. We summarise existing research and discuss its relevance to psychiatric practice today.
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Affiliation(s)
- Marcus P J Tan
- ST5 Trainee in Child and Adolescent Psychiatry, South London and Maudsley NHS Foundation Trust, UK.
| | - William Lee
- Consultant Liaison Psychiatrist, Devon Partnership NHS Trust, Exeter, UK
| | - Takahiro A Kato
- Associate Professor, Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Japan
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