2022.04.01

Possible form of cooperation：Cooperative Research Type of joint or funded research proposed：Joint research with other research organizations such as universities.

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Wiley  

Introduction

The recent COVID‐19 pandemic has introduced considerable societal turmoil, which could impose a psychological burden on junior residents but has not been adequately reported in the literature.

Methods

Junior (PGY 1–2) residents at the University of Yamanashi Hospital in Japan during 2021–2022 were recruited to complete the Brief Job Stress Questionnaire (BJSQ), Center for Epidemiologic Studies Depression Scale (CES‐D), and Athens Insomnia Scale (AIS) at the exit of each clinical department. The data collected were compared to our previous study conducted in 2017–2018 in order to assess the impact of the pandemic.

Results

There were 80 residents in each period who completed the CES‐D. During the pandemic, a total of 70 residents (87.5%) were involved in COVID‐19–related work for 1.4 ± 1.8 h per month. The pandemic period saw a significant reduction in quantitative overload ( p = 0.003, Cohen’s d  = −0.5, 95% CI − 0.8 to − 0.1), a finding that was mainly driven by male residents. Further, the maximum–minimum difference in the CES‐D scores tended to be lower during the pandemic ( p = 0.06, d  = −0.3, 95% CI − 0.6 to 0.04). Additionally, the residents engaged in COVID‐19–related work at or above the median (0.92 (0.33–1.92) hours/month) exhibited significantly higher coworker support ( p = 0.01) and sense of reward ( p = 0.02). Reproducibly, insomnia significantly influenced the CES‐D scores in each period.

Conclusion

Depression levels among the residents did not worsen during the pandemic, which may sound somewhat unexpected and needs replication elsewhere. This outcome may be attributable to physicians’ work reform in Japan and protective factors that may enhance the psychological resilience of junior residents.

DOI： 10.1155/ppc/2902116

Other Link： https://onlinelibrary.wiley.com/doi/full-xml/10.1155/ppc/2902116

Authorship：Lead author   Language：Japanese  

J-GLOBAL

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

Hyponatremia due to water intoxication is frequently observed in patients with chronic schizophrenia. We herein present a 49-year-old man who developed schizophrenia at the age of 23 and had been admitted to the closed ward of our hospital for 7 years. He was found by a round nurse standing at the bedside, covering both ears with his hands and making groaning noises. He was disoriented and immediately after being returned to bed, a general tonic-clonic seizure occurred. Severe hyponatremia (Na 104 mEq/L) was noted and intravenous sodium correction was started. A few hours later, due to glossoptosis and massive vomiting, ventilation got worse to the point where he had to be put on a ventilator. On the following day, he developed aspiration pneumonia and antimicrobial treatment was started. In addition, a blood sample taken 36 hours later revealed an extensive elevation of creatine kinase (41,286 U/L), pointing to a possibility of rhabdomyolysis as a complication. Subsequently, the general condition gradually improved with antimicrobial therapy and sodium correction. He eventually recovered without any complications including central pontine myelinolysis. He had no history of polydipsia before this event but it was later found that esophageal stricture triggered complusive fluid intake, resulting in acute hyponatremia, seizure, aspiration pneumonia and rhabdomyolysis. A brief discussion will be provided on the issues surrounding hyponatremia, rhabdomyolysis and schizophrenia.

PubMed

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.comppsych.2023.152425

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

Evidence on electroconvulsive therapy (ECT) for people receiving chronic hemodialysis has been rather scarce in the literature. We report the case of a 74-year-old male patient with major depressive disorder on chronic hemodialysis for 14 years with numerous physical complications including abdominal aortic aneurysm, ossification of the posterior longitudinal ligament, and cerebral stroke. Several antidepressant drugs failed to improve the patient, but judicious implementation of a total of 6 ECT sessions under a close liaison with medical experts brought him into remission without any notable adverse effects. In particular, flumazenil, as well as rocuronium and sugammadex, was used together with a strict control of blood pressure. We thoroughly discuss the case and provide a literature review on such topics as assessment of physical complications, medications used for anesthesia, electrode placement, and timing of hemodialysis during ECT sessions, which identified a clear need for more research on this medically challenging issue.

DOI： 10.1097/YCT.0000000000000860

PubMed

Language：Japanese   Book type：Textbook, survey, introduction

Language：Japanese   Presentation type：Poster presentation