Motohiro Ozone’s research while affiliated with Kurume University and other places

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Publications (68)


Inter‐rater reliability study of the Japanese version of the diagnostic clinical interview for drug withdrawal post SSRIs or SNRIs (DID‐W1‐J)
  • Article
  • Full-text available

January 2025

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8 Reads

Tomoyuki Nakamura

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Misari Oe

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Ken Uematsu

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Fig. 1. Study design. UHR, ultra-high risk state for psychosis; HC, healthy control.
Systematic reviews about cytokines levels and psychosis
Study schedules
Identification of Factors to Predict Transition to Schizophrenia in Subjects with Ultra-high risk for Psychosis: A Protocol for a Multicenter, Longitudinal Study of Sleep Parameters and Cytokine Levels

December 2024

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58 Reads

Clinical Psychopharmacology and Neuroscience

Objective: Schizophrenia is a major psychiatric illness which mostly begins in adolescence and leads to impairments of social functioning. Some patients with schizophrenia have been associated with ultra-high risk state for psychosis (UHR), a condition used to operationally represent the prodromal stage of the illness. In previous studies, the UHR and the progression to overt psychosis has been reported to be accompanied with alterations in the quality of sleep and the immune system, as represented by change of blood levels of cytokines. Currently, biomarkers to predict the development of psychosis in persons at UHR have not yet reached a steady consensus. Therefore, we present a study protocol to explore predictors of transitions to psychosis, in the realm of monitoring of sleep condition and cytokine measurement, in subjects with the UHR. Methods: This is a multicenter, longitudinal cohort study participated by 7 hospitals in Japan. We will recruit 50 UHR people and 30 healthy volunteers as a control group, and measure positive symptom, depressive symptoms, cognitive function, and social function. Blood cytokines levels and sleep indices, as well as actigraphy data will be monitored. After the baseline assessment, clinical symptoms, sleep indices, and cytokine levels will be measured every 12 weeks for 52 weeks. Actigraphy devices will continue to be worn for 52 weeks, while social function will be assessed over 104 weeks. The results of this study are expected to facilitate the development of novel intervention therapies to reduce the risk of psychosis and improve functional outcomes.




Preventive Effects of Ramelteon, Suvorexant, and Lemborexant on Delirium in Hospitalized Patients With Physical Disease: A Retrospective Cohort Study

June 2024

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119 Reads

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1 Citation

Journal of Clinical Psychopharmacology

Background New sleep-inducing drugs (eg, ramelteon, suvorexant, and lemborexant) have been shown to prevent delirium in high-risk groups. However, no single study has simultaneously evaluated the delirium-preventing effects of all novel sleep-inducing drugs in hospitalized patients. Therefore, this study aimed to clarify the relationship between sleep-inducing drugs and delirium prevention in patients hospitalized in general medical-surgical settings for nonpsychiatric conditions who underwent liaison interventions for insomnia. Methods This retrospective cohort study included patients treated in general medical-surgical settings for nonpsychiatric conditions with consultation-liaison psychiatry consult for insomnia. Delirium was diagnosed by fully certified psychiatrists using the Diagnostic and Statistical Manual of Mental Disorders 5 th edition. The following items were retrospectively examined from medical records as factors related to delirium development: type of sleep-inducing drugs, age, sex, and delirium risk factors. The risk factors of delirium development were calculated using adjusted odds ratios (aORs) via multivariate logistic regression analysis. Results Among the 710 patients analyzed, 257 (36.2%) developed delirium. Suvorexant (aOR, 0.61; 95% confidence interval [CI], 0.40–0.94; P = 0.02) and lemborexant (aOR, 0.23; 95% CI, 0.14–0.39; P < 0.0001) significantly reduced the risk of developing delirium. Benzodiazepines (aOR, 1.90; 95% CI, 1.15–3.13; P = 0.01) significantly increased this risk. Ramelteon (aOR, 1.30; 95% CI, 0.84–2.01; P = 0.24) and Z-drugs (aOR, 1.27; 95% CI, 0.81–1.98; P = 0.30) were not significantly associated with delirium development. Conclusions The use of suvorexant and lemborexant may prevent delirium in patients with a wide range of medical conditions.



An Exploratory Study of the Associations Between Sensory Processing Patterns and Emotional/Behavioral Problems in Children with Autism Spectrum Disorder

March 2024

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27 Reads

The Kurume Medical Journal

Aim: In autism spectrum disorder (ASD), abnormal sensory processing patterns are observed in various sensory modalities, including visual, auditory, touch, olfactory, taste, vestibular, and proprioceptive senses. Few studies have examined the relationship between sensory processing patterns and emotions, or their effects on daily life. We investigated the relationship between sensory processing patterns and emotional/behavioral problems in children with ASD. Participants and Methods: A retrospective chart review was conducted. Forty-three children with ASD (33 boys, 10 girls, median age 9 years) in the outpatient clinic of a psychiatric hospital participated; their parent (s) were invited to complete the Sensory Profile 2 (SP2) and the Child Behavior Checklist (CBCL) questionnaires. The participants’ teachers were invited to complete the Teacher’s Report Form (TRF). Results: In the correlation analyses, each of the four quadrants of the SP2 (low registration, sensory seeking, hypersensitivity, and sensory avoiding) had significant positive correlations with different types of emotional and behavioral problems measured by the CBCL. Focusing on emotion, ‘anxious/depressed’ was correlated with low registration (r = 0.41) and sensory avoiding (r = 0.60), while ‘withdrawal/depressed’ was correlated with sensory avoiding (r = 0.46). Only one significant correlation was revealed between the SP2 and the TRF. Conclusion: Our results suggest a link between sensory processing patterns and emotional/behavioral problems. In school settings, the relationship between sensory processing patterns and emotional/behavioral problems may be easily overlooked.


Fig. 2 Flow diagram of patients through the study. ADR adverse drug reaction, TEAE treatment-emergent adverse event, LEM lemborexant, RMT ramelteon, SUV suvorexant, Z-drug non-benzodiazepine sleeping pills
Patient background
Proportion of patients transitioning from pretreatment to LEM and retention rate
Efficacy and Safety of Transitioning to Lemborexant from Z-drug, Suvorexant, and Ramelteon in Japanese Insomnia Patients: An Open-label, Multicenter Study

March 2024

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11 Reads

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6 Citations

Advances in Therapy

Introduction: For patients with chronic insomnia, conventional therapy may not always provide satisfactory efficacy and safety. Thus, switching to an alternative therapeutic agent can be explored. However, there is a lack of prospective studies evaluating the effectiveness of such changes. This prospective, non-randomized, open-label, interventional, multicenter study assessed whether Japanese patients with chronic insomnia dissatisfied with treatment could transition directly to lemborexant (LEM) from four cohorts-non-benzodiazepine sedative-hypnotic (zolpidem, zopiclone, or eszopiclone) monotherapy, dual orexin receptor antagonist (suvorexant) monotherapy, suvorexant + benzodiazepine receptor agonists (BZRAs), and melatonin receptor agonist (ramelteon) combination. We evaluated whether transitioning to LEM improved patient satisfaction based on efficacy and safety. Methods: The primary endpoint was the proportion of successful transitions to LEM at 2 weeks (titration phase end), defined as the proportion of patients on LEM by the end of the 2-week titration phase who were willing to continue on LEM during the maintenance phase (Weeks 2-14). Patient satisfaction and safety (the incidence of treatment-emergent adverse events [TEAEs]) were assessed at 14 weeks (end of titration and maintenance phases). Results: Among the 90 patients enrolled, 95.6% (95% confidence interval: 89.0-98.8%) successfully transitioned to LEM at 2 weeks. The proportions of patients who successfully continued on LEM were 97.8% and 82.2% at the end of the titration and maintenance phases (Weeks 2 and 14), respectively. The overall incidence of TEAEs was 47.8%; no serious TEAEs occurred. In all cohorts, the proportions of patients with positive responses were higher than the proportions with negative responses on the three scales of the Patient Global Impression-Insomnia version. During the maintenance phase, Insomnia Severity Index scores generally improved at Weeks 2, 6, and 14 of LEM transition. Conclusions: Direct transition to LEM may be a valid treatment option for patients with insomnia who are dissatisfied with current treatment. Trial registration: ClinicalTrials.gov identifier, NCT04742699.




Citations (30)


... Two additional factors linked to prolonged BDZ use, as observed in recent studies, are the insufficient amelioration of insomnia and the increased hospitalization rates among patients with MDD. This highlights the need for alternative treatments and careful monitoring to address the potential risks of long-term BDZ therapy (22). Moreover, recent meta-analyses suggested that prolonged BDZ use is associated with an increased risk of cancer and a higher risk of mortality (23,24). ...

Reference:

Passiflora incarnata L., herba, in benzodiazepine tapering: long-term safety and efficacy in a real-world setting
Factors associated with the long-term use of benzodiazepine receptor agonists as hypnotics among patients with major depressive disorder and comorbid insomnia
  • Citing Article
  • August 2024

Journal of Psychiatric Research

... 3 When prescribing of benzodiazepines and other hypnotics, it would be prudent for medical practitioners to begin with an endpoint in mind as the Administrative Guidelines issued by MOH in 2008 suggested that patients who were already on high-dose and/or long-term benzodiazepines initiated by their specialists should be referred back to these specialists for further management. 17 Medical providers could consider facilitating patients' transition from sedative-hypnotics to other medications. A recent 2024 study has reported a significant number of successful transitions from Z-drugs and other hypnotics to lemborexant with no serious treatment-emergent adverse events, bearing in mind however that this was an openlabel multicentre study involving 90 patients. ...

Efficacy and Safety of Transitioning to Lemborexant from Z-drug, Suvorexant, and Ramelteon in Japanese Insomnia Patients: An Open-label, Multicenter Study

Advances in Therapy

... In addition to the use of psychoactive substances, another factor possibly affecting the risk of road crashes is attention deficit hyperactivity disorder (ADHD). The essential features of ADHD are a persistent pattern of attention deficit, hyperactivity, and/or impulsivity that interferes with functioning [9]. The prevalence of ADHD in the adult population is estimated to be 2.5 % [10]. ...

Sleep Structure in Untreated Adults With ADHD: A Retrospective Study

... 5 The existence of previous informational video can have beneficial effects on patients' motivation for dose reduction of hypnotics' medication use which was significantly strengthened after watching the video. 10 The objective of this research was to develop and test the IMBEHP video to motivate Chiang Mai University (CMU) personnel to embrace health promotion, to be aware of health risk factors for chronic illnesses, and to be aware of self-care for illness prevention and a healthy lifestyle during the COVID-19 pandemic. ...

Effect of a short video on patients’ motivation for dose reduction or cessation of hypnotics

Sleep and Biological Rhythms

... Of these, three are of a non-randomised or open design (Jernelöv et al., 2023;Philip et al., 2022;Stenberg et al., 2022). The remaining nine are randomised controlled trials (RCT) that, compared to passive or active control, also indicate promising results with reductions in primarily insomnia severity as outcome (Chung et al., 2023;Hinterberger et al., 2023;Horsch et al., 2017;Kuhn et al., 2021;Okajima et al., 2020;Reilly et al., 2021;Shimamoto et al., 2022;Watanabe et al., 2022;Zhang et al., 2023). Although all nine RCTs are relevant contributions to understanding the effect of CBT-I delivered exclusively through a smartphone app, some limitations prohibit a more thorough understanding of the potential benefits of smartphone appdelivered CBT-I. ...

Effect of Smartphone-based Cognitive Behavioral Therapy App on Insomnia: a Randomized, Double-blind Study
  • Citing Article
  • November 2022

Sleep

... This connection between medical factors and the risk of patient falls aligns with studies by Ghosh et al., Hashida et al., and Umina and Permanasari. [58][59][60] These studies indicate that patients with certain medications, especially those receiving benzodiazepine therapy, postsurgery patients, those under polypharmacy, and patients with balance disorders and visual impairments, are more susceptible to falls. Consequently, it is imperative to identify these medical factors for effective fall prevention. ...

Balance dysfunction the most significant cause of in-hospital falls in patients taking hypnotic drugs: A retrospective study

... Another GWAS to identify genetic variants that influence susceptibility to IH was conducted in the Japanese population, involving a total of 414 patients with IH and 6587 controls. The authors identified several candidate SNPs for IH, such as a common genetic variant (rs2250870) within a PDE9A intron, not only in whole blood but also in brain tissues [56]. ...

Genome-wide association study of idiopathic hypersomnia in a Japanese population
  • Citing Article
  • October 2021

Sleep and Biological Rhythms

... the abuse of BRAs have been widely documented over the years. 7,8 Consequently, health authorities in numerous countries, including Japan, have implemented guidelines advocating exclusively for short-term treatment when prescribing BRAs. 9,10 In recent years, hypnotics that do not involve benzodiazepine receptors, such as melatonin receptor agonists and orexin receptor antagonists (ORAs), have also begun to be used. ...

Current state of hypnotic use disorders: Results of a survey using the Japanese version of Benzodiazepine Dependence Self‐Report Questionnaire

... The effects of antidepressants and/or serotoninergic drugs on RBD are summarized in Table 6. The herbal medicine yokukansan or Yi-Gan San has led to improvements of RBD symptoms in a short case series [80] and two retrospective analyses of clinical records [81,82] (in one of them via a comparison with clonazepam [82]). ...

Efficacy of yokukansan compared with clonazepam for rapid eye movement sleep behaviour disorder: a preliminary retrospective study
  • Citing Article
  • June 2020

Psychogeriatrics

... Previous studies have shown that T 3D F used in mattresses could improve pressure dispersion, facilitate turning movements and blood flow [22], and reduce the risk of pressure ulcers in long-term bedridden groups [23,24]. Moreover, these types of mattresses were found to be effective in lowering the body temperature of subjects during sleep, allowing the body to enter deep sleep earlier [25]. These studies aimed to evaluate the performance of this mattress at the human-mattress interface, often by comparing it to mattresses made from other materials to quantify sleep comfort after using T 3D F. However, the results were far from conclusive, in part because they did not fully consider mattress performance, particularly the mattress firmness, which in turn affects the comfort of the human-bed interface. ...

High rebound mattress toppers facilitate core body temperature drop and enhance deep sleep in the initial phase of nocturnal sleep