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Psychiatry & Sleep Medicine
Based on accumulated knowledge and clinical experience in psychiatry and sleep medicine, this work summarizes the underlying concepts and research perspectives that inform clinical practice. It presents theoretical frameworks for understanding psychiatric disorders and sleep disturbances, as well as approaches to diagnosis and treatment.
In addition, it offers reflections on the broader social and cultural contexts surrounding mental health care and psychiatric practice. This work is intended as a resource for developing a multifaceted understanding of the interconnected issues of mind and sleep.
Medicine and Society
Psychiatric medicine and sleep medicine have developed not only through biomedical advances but also under the influence of social and cultural contexts. This section features articles addressing themes related to the relationship between society and medicine.
Psychiatric Care in Film
Cinema as a Window into Psychiatric Care
Film is a useful medium for visually understanding psychiatric symptoms and mental health care. This article analyzes films depicting depression, schizophrenia, anxiety disorders, autism spectrum disorder, and addiction, examining the accuracy of symptom representation as well as portrayals of medical and social support, while also considering the risk of reinforcing stigma. Through cinematic narratives, audiences can vicariously experience the perspectives of others and gain insight into the lives of patients and their families, including the importance of daily functioning, rehabilitation, and social reintegration. The paper also discusses the potential application of film in psychiatric education and mental health awareness.
Contributing Author: Yuhei Kayukawa
Source: Journal of the Japanese Psychiatric Hospital Association, Vol. 27, No. 4
Film is a useful medium for visually understanding psychiatric symptoms and mental health care. This article analyzes films depicting depression, schizophrenia, anxiety disorders, autism spectrum disorder, and addiction, examining the accuracy of symptom representation as well as portrayals of medical and social support, while also considering the risk of reinforcing stigma. Through cinematic narratives, audiences can vicariously experience the perspectives of others and gain insight into the lives of patients and their families, including the importance of daily functioning, rehabilitation, and social reintegration. The paper also discusses the potential application of film in psychiatric education and mental health awareness.
Contributing Author: Yuhei Kayukawa
Source: Journal of the Japanese Psychiatric Hospital Association, Vol. 27, No. 4
Special Feature: Work Styles in the Era of the 100-Year Lifespan and Suicide Prevention among Young People
This paper provides a multifaceted analysis of the factors underlying the increasing rates of suicide among young people, from social, economic, and psychological perspectives. It examines structural issues in contemporary society, including deteriorating employment conditions, the expansion of non-regular employment, long working hours, and workplace harassment, as well as mental health challenges and psychiatric disorders commonly seen in adolescence and young adulthood.
Drawing also on experience in university student support, the paper emphasizes the importance of early mental health intervention and the development of supportive environments in workplaces and educational settings. It argues for concrete social measures aimed at preventing suicide among young people.
Drawing also on experience in university student support, the paper emphasizes the importance of early mental health intervention and the development of supportive environments in workplaces and educational settings. It argues for concrete social measures aimed at preventing suicide among young people.
Psychological Distress among Japanese University Students as Seen in the White Paper on Health 2005, and Challenges in Mental Health Support during the Employment Ice Age
This study analyzes the mental health status of Japanese national university undergraduate and graduate students based on the White Paper on Health 2005. It examines the number of counseling cases among undergraduate and graduate students, gender differences, psychiatric diagnoses, and maladjustment outcomes such as leave of absence, withdrawal, and academic delay. In particular, it addresses issues such as “job-hunting depression” during the employment ice age, as well as the higher prevalence of depression, anxiety disorders, and adjustment disorders among female students. This pioneering report highlights the importance of mental health support for university students and the enhancement of campus life environments.
Suicide Prevention Among Young People
Based on a keynote abstract presented at a special symposium of the Society for the Prevention of Karoshi (death from overwork), this paper examines the increasing incidence of suicide among young people and the challenges of prevention.
It discusses structural social factors such as deteriorating employment conditions, long working hours, and workplace harassment, as well as the role of psychiatric disorders that are common in adolescence and young adulthood. The analysis highlights broader systemic issues within Japanese society that contribute to vulnerability among young people.
The paper emphasizes the importance of early intervention and the reform of social systems in order to create an environment in which young people can maintain hope and continue living with a sense of security.
Yuhei Kayukawa
6th Special Symposium of the Society for the Prevention of Karoshi
It discusses structural social factors such as deteriorating employment conditions, long working hours, and workplace harassment, as well as the role of psychiatric disorders that are common in adolescence and young adulthood. The analysis highlights broader systemic issues within Japanese society that contribute to vulnerability among young people.
The paper emphasizes the importance of early intervention and the reform of social systems in order to create an environment in which young people can maintain hope and continue living with a sense of security.
Yuhei Kayukawa
6th Special Symposium of the Society for the Prevention of Karoshi
Sleep Disorders in Contemporary Society
In contemporary society, sleep disorders such as insomnia, snoring, and hypersomnia are widely observed and have a significant impact on both physical and mental health as well as social functioning. Based on epidemiological studies of the general population, this article reviews the prevalence and characteristics of insomnia, obstructive sleep apnea syndrome, and circadian rhythm sleep disorders. It also outlines age and gender differences, associations with psychiatric disorders, and broader social consequences such as traffic accidents and occupational injuries. This work presents sleep disorders as an important public health issue in modern society.
Contributing author: Yuhei Kayukawa
Source: Clinical Psychiatry, Vol. 34, No. 1
Contributing author: Yuhei Kayukawa
Source: Clinical Psychiatry, Vol. 34, No. 1
Academic Performance and Sleep
This paper examines the relationship between sleep and academic performance across developmental stages ranging from adolescence to graduate school.
It highlights that the reduction of slow-wave sleep during adolescence is associated with brain reorganization and increased daytime sleepiness, and that sleep duration and bedtime timing are related to academic achievement. The study also points to the growing problem of sleep deprivation among young people due to excessive use of smartphones and the internet, as well as an increase in students reporting hypersomnia.
Overall, the paper emphasizes the importance of sleep management and its significant impact on academic performance and cognitive functioning (Feinberg, 2009; Wolfson, 1998; Power, 2004).
Contributing Author: Yuhei Kayukawa
Source: Progress in Medicine, Vol. 35, No. 1
It highlights that the reduction of slow-wave sleep during adolescence is associated with brain reorganization and increased daytime sleepiness, and that sleep duration and bedtime timing are related to academic achievement. The study also points to the growing problem of sleep deprivation among young people due to excessive use of smartphones and the internet, as well as an increase in students reporting hypersomnia.
Overall, the paper emphasizes the importance of sleep management and its significant impact on academic performance and cognitive functioning (Feinberg, 2009; Wolfson, 1998; Power, 2004).
Contributing Author: Yuhei Kayukawa
Source: Progress in Medicine, Vol. 35, No. 1
The Significance of Work in the Social Participation of Individuals with Mental Disorders
This paper examines the significance of “working” in the social participation of individuals with mental disorders from the perspective of psychiatric rehabilitation. In the context of Japan’s psychiatric care shifting from inpatient-centered treatment to community-based care, employment is positioned not merely as a means of income, but as an essential component of regaining social roles, self-esteem, and facilitating social reintegration.
Through practices such as sheltered workshops and community work facilities, the paper highlights the reality that many individuals with mental disorders seek opportunities for work as well as social connection. It further discusses the need for comprehensive community support systems that integrate medical care, employment, and housing, and emphasizes the role of work in improving long-term social outcomes.
Contributing author: Yuhei Kayukawa
Source: Mind and Society, No. 68
Through practices such as sheltered workshops and community work facilities, the paper highlights the reality that many individuals with mental disorders seek opportunities for work as well as social connection. It further discusses the need for comprehensive community support systems that integrate medical care, employment, and housing, and emphasizes the role of work in improving long-term social outcomes.
Contributing author: Yuhei Kayukawa
Source: Mind and Society, No. 68
Psychiatry and the Issue of Mentally Disordered Offenders
This special feature provides a detailed overview of mentally disordered offenders, covering their historical background, current legal and medical systems, crime statistics, and recidivism rates. It also examines the realities of prejudice and discrimination against individuals with mental disorders, as well as the structural challenges within both healthcare and judicial systems.
In addition, drawing on cases such as the Ikeda Elementary School massacre, the paper discusses the need for system reform and the promotion of social participation for individuals with mental disorders. It aims to deepen understanding of the relationship between psychiatric care and legal frameworks, and serves as an essential resource for comprehending issues related to mentally disordered offenders.
Contributing author: Yuhei Kayukawa
Source: Horitsu Jiho (The Jurist), Vol. 74, No. 2
In addition, drawing on cases such as the Ikeda Elementary School massacre, the paper discusses the need for system reform and the promotion of social participation for individuals with mental disorders. It aims to deepen understanding of the relationship between psychiatric care and legal frameworks, and serves as an essential resource for comprehending issues related to mentally disordered offenders.
Contributing author: Yuhei Kayukawa
Source: Horitsu Jiho (The Jurist), Vol. 74, No. 2
Fallacy of the Average Worker Theory
This paper examines the problems inherent in the evaluative frameworks long used in workers’ compensation determinations for overwork-related deaths and suicides in Japan, particularly the “average worker theory” and the concept of the “same-type worker,” from the perspectives of psychiatry, judicial decision-making, and labor policy.
While the number of claims for occupational mental disorders has been increasing, the approval rate remains low. Against this backdrop, the paper focuses on structural factors within the system, particularly the framework for assessing psychological burden, which insufficiently reflects individual variability. It points out that evaluation methods based on an assumed “average worker” may diverge significantly from the actual diversity of workers, thereby influencing determinations of work-related causation.
Furthermore, the paper considers the fact that psychiatric diagnosis is fundamentally based on an “individual-centered” framework, and that judicial decisions also tend to emphasize individual circumstances, and examines the consistency of these approaches with current compensation standards.
In addition, against the backdrop of the advancement of neurodiversity and the expansion of disability employment policies, the paper discusses the importance of designing systems that assume diversity among workers, and calls for a reconsideration of the evaluative axes used in workers’ compensation determinations.
This study provides a foundational examination aimed at improving compensation systems, with the dual goals of preventing overwork-related deaths and suicides and ensuring appropriate compensation.
Contributing author: Yuhei Kayukawa
Source: Journal of Karoshi Prevention Studies, No. 5 (FY2024)
While the number of claims for occupational mental disorders has been increasing, the approval rate remains low. Against this backdrop, the paper focuses on structural factors within the system, particularly the framework for assessing psychological burden, which insufficiently reflects individual variability. It points out that evaluation methods based on an assumed “average worker” may diverge significantly from the actual diversity of workers, thereby influencing determinations of work-related causation.
Furthermore, the paper considers the fact that psychiatric diagnosis is fundamentally based on an “individual-centered” framework, and that judicial decisions also tend to emphasize individual circumstances, and examines the consistency of these approaches with current compensation standards.
In addition, against the backdrop of the advancement of neurodiversity and the expansion of disability employment policies, the paper discusses the importance of designing systems that assume diversity among workers, and calls for a reconsideration of the evaluative axes used in workers’ compensation determinations.
This study provides a foundational examination aimed at improving compensation systems, with the dual goals of preventing overwork-related deaths and suicides and ensuring appropriate compensation.
Contributing author: Yuhei Kayukawa
Source: Journal of Karoshi Prevention Studies, No. 5 (FY2024)
Suicide, Depression, and Sleep
This paper examines the problems of the “average worker theory” and the “similarly situated worker” framework used in workers’ compensation determinations for overwork-related death and suicide, from the perspectives of psychiatry, law, and labor policy.
Although the number of workers’ compensation claims for mental disorders has increased, approval rates remain low. The paper argues that this is partly due to a structure of psychological burden assessment that insufficiently reflects individual variability. In particular, evaluation based on the “average worker” standard may create a gap between the model and the actual diversity of workers, potentially influencing judgments of work-related causation.
It further highlights inconsistencies between current compensation criteria and psychiatric practice, where diagnosis is inherently individualized, as well as legal practice, which increasingly considers case-specific circumstances. From this perspective, the paper points to structural issues in the alignment of psychiatric, judicial, and administrative frameworks.
In addition, drawing on the perspectives of neurodiversity and the development of disability employment policies, it emphasizes the need for a system design that assumes diversity among workers, and calls for a reassessment of evaluation criteria in workers’ compensation decisions.
Overall, the paper proposes a foundational examination toward improving compensation systems that balance prevention of overwork-related death and suicide with fair and appropriate compensation.
Contributing Author: Yuhei Kayukawa
Source: Yobō Jihō, No. 228
Although the number of workers’ compensation claims for mental disorders has increased, approval rates remain low. The paper argues that this is partly due to a structure of psychological burden assessment that insufficiently reflects individual variability. In particular, evaluation based on the “average worker” standard may create a gap between the model and the actual diversity of workers, potentially influencing judgments of work-related causation.
It further highlights inconsistencies between current compensation criteria and psychiatric practice, where diagnosis is inherently individualized, as well as legal practice, which increasingly considers case-specific circumstances. From this perspective, the paper points to structural issues in the alignment of psychiatric, judicial, and administrative frameworks.
In addition, drawing on the perspectives of neurodiversity and the development of disability employment policies, it emphasizes the need for a system design that assumes diversity among workers, and calls for a reassessment of evaluation criteria in workers’ compensation decisions.
Overall, the paper proposes a foundational examination toward improving compensation systems that balance prevention of overwork-related death and suicide with fair and appropriate compensation.
Contributing Author: Yuhei Kayukawa
Source: Yobō Jihō, No. 228
Harvard’s Student Support System (Part I)
This report presents the findings of a field study on the student support system and mental health care framework at Harvard University. It focuses in particular on the activities of the Bureau of Study Counsel (BSC), a student counseling organization, and introduces its counseling services as well as peer-based tutoring systems in which students support one another in academic and daily life.
Through these initiatives, the report highlights an advanced model that organically integrates academic support with mental health care, and discusses implications for student support systems in Japanese universities.
Contributing author: Yuhei Kayukawa
Source: Japan Student Services Organization (JASSO)-related journal
Through these initiatives, the report highlights an advanced model that organically integrates academic support with mental health care, and discusses implications for student support systems in Japanese universities.
Contributing author: Yuhei Kayukawa
Source: Japan Student Services Organization (JASSO)-related journal
Harvard’s Student Support System (Part II)
This report presents the findings of a field study on the student mental health support system at the Massachusetts Institute of Technology (MIT). It introduces a comprehensive framework of mental health care provided through on-campus medical services, residential life support utilizing student dormitories, and mental health education for faculty and staff.
Through the case of MIT, the report discusses the importance of building a university-wide system in which the entire academic community participates in supporting student well-being.
Contributing author: Yuhei Kayukawa
Source: Japan Student Services Organization (JASSO)-related journal
Through the case of MIT, the report discusses the importance of building a university-wide system in which the entire academic community participates in supporting student well-being.
Contributing author: Yuhei Kayukawa
Source: Japan Student Services Organization (JASSO)-related journal
Harvard Student Support System, Part III
This paper summarizes findings from an investigation into student support and mental health systems at Harvard University and the Massachusetts Institute of Technology (MIT).
It describes an integrated support framework in which student counseling services, medical departments, faculty members, and student communities collaborate to provide comprehensive care. The paper also examines challenges faced by Japanese universities in comparison.
It further discusses the importance of creating environments that support students’ mental well-being and offers perspectives on the future of mental health support within higher education institutions.
Contributing Author: Yuhei Kayukawa
Source: Japan Student Services Organization (JASSO) related publication
It describes an integrated support framework in which student counseling services, medical departments, faculty members, and student communities collaborate to provide comprehensive care. The paper also examines challenges faced by Japanese universities in comparison.
It further discusses the importance of creating environments that support students’ mental well-being and offers perspectives on the future of mental health support within higher education institutions.
Contributing Author: Yuhei Kayukawa
Source: Japan Student Services Organization (JASSO) related publication
Clinical Practice and Assessment
In the diagnosis and treatment of psychiatric disorders and sleep disorders, careful evaluation of patients’ subjective symptoms and daily functioning is essential. This section features articles on diagnostic and assessment methods used in clinical practice, including clinical interviews and standardized rating scales.
Various Types of Insomnia and Sleep Patterns
This article reviews the prevalence and historical concepts of insomnia and organizes various types of insomnia along with characteristic sleep patterns, providing a comprehensive framework for diagnosis and treatment. It explains different insomnia subtypes—sleep-onset insomnia, sleep-maintenance insomnia, and early-morning awakening insomnia—in relation to psychiatric disorders, physical illnesses, medications, psychological factors, and circadian rhythm influences.
It further emphasizes that non-pharmacological interventions such as sleep hygiene education, sleep restriction therapy, and relaxation techniques are effective, and that pharmacological treatment should be carefully selected according to symptoms and underlying causes.
Contributing author: Yuhei Kayukawa
Source: Pathophysiology, Vol. 14, No. 11
It further emphasizes that non-pharmacological interventions such as sleep hygiene education, sleep restriction therapy, and relaxation techniques are effective, and that pharmacological treatment should be carefully selected according to symptoms and underlying causes.
Contributing author: Yuhei Kayukawa
Source: Pathophysiology, Vol. 14, No. 11
Special Feature: ICSD-3 and Sleep Medicine in Japan – Foreword
This article reviews the historical development of sleep disorder classification systems and outlines the features of the latest international classification, ICSD-3. It traces the evolution of sleep disorder categories, including insomnia disorders, hypersomnia disorders, and circadian rhythm sleep-wake disorders, and explains the background behind ICSD-3’s effort to align with ICD and DSM frameworks.
The paper further discusses the impact of diagnostic classifications on clinical practice and treatment, the relationship between ICSD-3 and sleep medicine in Japan, and the challenges of relying on international standards. It concludes by emphasizing the importance of classification systems for the future development of sleep medicine.
Contributing author: Yuhei Kayukawa
Source: Sleep Medicine, Vol. 9, No. 2
The paper further discusses the impact of diagnostic classifications on clinical practice and treatment, the relationship between ICSD-3 and sleep medicine in Japan, and the challenges of relying on international standards. It concludes by emphasizing the importance of classification systems for the future development of sleep medicine.
Contributing author: Yuhei Kayukawa
Source: Sleep Medicine, Vol. 9, No. 2
A detailed clinical interview focusing on underlying physical and psychiatric conditions that present with insomnia is a key point in the diagnosis of insomnia disorder.
Contributing author: Yuhei Kayukawa
A detailed clinical interview is essential for the diagnosis of insomnia disorder, including assessment of physical illnesses, psychiatric conditions, lifestyle factors, and medication use. This article reviews the approach to differential diagnosis based on insomnia type, sleep patterns, circadian rhythm, and psychosocial factors, and outlines key clinical evaluation points for guiding appropriate treatment.
A detailed clinical interview is essential for the diagnosis of insomnia disorder, including assessment of physical illnesses, psychiatric conditions, lifestyle factors, and medication use. This article reviews the approach to differential diagnosis based on insomnia type, sleep patterns, circadian rhythm, and psychosocial factors, and outlines key clinical evaluation points for guiding appropriate treatment.
Is Excessive Daytime Sleepiness a Result of Nocturnal Sleep Disturbance, or a Primary Disorder of the Daytime Arousal Maintenance System?
In the diagnosis of hypersomnia, it is important to distinguish between excessive daytime sleepiness caused by insufficient nocturnal sleep and hypersomnia resulting from impairment of the central arousal-maintaining systems.
This article reviews key points in clinical interviewing for hypersomnia, a diagnostic flowchart, and major causative disorders such as sleep apnea syndrome and narcolepsy. It also discusses severity assessment using the Multiple Sleep Latency Test (MSLT) and approaches to clinical management.
Contributing author: Yuhei Kayukawa
Source: Tips and Pitfalls in the Clinical Practice of Sleep Disorders
This article reviews key points in clinical interviewing for hypersomnia, a diagnostic flowchart, and major causative disorders such as sleep apnea syndrome and narcolepsy. It also discusses severity assessment using the Multiple Sleep Latency Test (MSLT) and approaches to clinical management.
Contributing author: Yuhei Kayukawa
Source: Tips and Pitfalls in the Clinical Practice of Sleep Disorders
Key Points in the Diagnosis of Disorders Causing Insomnia
This article explains key diagnostic points for disorders that cause insomnia. Insomnia is not a single disease entity, but rather a symptom arising from multiple factors, including psychiatric disorders, physical illnesses, lifestyle habits, medications, and circadian rhythm disturbances.
Accurate diagnosis requires a detailed clinical interview grounded in empathy for the patient’s distress, along with a comprehensive assessment of sleep patterns, lifestyle factors, psychosocial stressors, and medication use.
The article outlines a framework for the differential diagnosis of insomnia and highlights key points in clinical evaluation, emphasizing the importance of sleep medicine in improving treatment selection and quality of life (QOL).
Contributing author: Yuhei Kayukawa
Source: New Approaches to Psychiatric Practice 8
Accurate diagnosis requires a detailed clinical interview grounded in empathy for the patient’s distress, along with a comprehensive assessment of sleep patterns, lifestyle factors, psychosocial stressors, and medication use.
The article outlines a framework for the differential diagnosis of insomnia and highlights key points in clinical evaluation, emphasizing the importance of sleep medicine in improving treatment selection and quality of life (QOL).
Contributing author: Yuhei Kayukawa
Source: New Approaches to Psychiatric Practice 8
Key Points in the Diagnosis of Disorders Causing Hypersomnia
Contributing author: Yuhei Kayukawa
This article discusses diagnostic key points for disorders causing hypersomnia, characterized primarily by excessive daytime sleepiness. It organizes various etiologies such as insufficient sleep syndrome, sleep apnea syndrome, and narcolepsy, and emphasizes that a detailed clinical interview is essential for accurate differential diagnosis. Careful assessment of sleep duration, lifestyle habits, snoring, and symptoms such as cataplexy improves diagnostic accuracy. When necessary, sleep studies should be combined with clinical evaluation, which contributes to appropriate treatment and reduction of social impairment caused by hypersomnia.
Source: New Approaches to Psychiatric Practice 8
This article discusses diagnostic key points for disorders causing hypersomnia, characterized primarily by excessive daytime sleepiness. It organizes various etiologies such as insufficient sleep syndrome, sleep apnea syndrome, and narcolepsy, and emphasizes that a detailed clinical interview is essential for accurate differential diagnosis. Careful assessment of sleep duration, lifestyle habits, snoring, and symptoms such as cataplexy improves diagnostic accuracy. When necessary, sleep studies should be combined with clinical evaluation, which contributes to appropriate treatment and reduction of social impairment caused by hypersomnia.
Source: New Approaches to Psychiatric Practice 8
Focusing on Subjective Symptoms and Questionnaires such as the Epworth Sleepiness Scale (ESS)
Contributing author: Yuhei Kayukawa
This article explains the diagnosis and pathophysiology of obstructive sleep apnea syndrome (OSAS), with emphasis on subjective symptoms and the Epworth Sleepiness Scale (ESS). Key clinical features include loud snoring, witnessed apnea during sleep, frequent arousals, excessive daytime sleepiness, difficulty concentrating, and a lack of restorative sleep.
Physiological consequences such as oxygen desaturation (SpO₂ reduction), bradycardia, and tachycardia are also important for clinical evaluation. The article highlights the classification of symptoms into insomnia-type and hypersomnia-type presentations. It further emphasizes that a combination of detailed clinical interview and polysomnography is essential for accurate severity assessment and treatment planning.
This article explains the diagnosis and pathophysiology of obstructive sleep apnea syndrome (OSAS), with emphasis on subjective symptoms and the Epworth Sleepiness Scale (ESS). Key clinical features include loud snoring, witnessed apnea during sleep, frequent arousals, excessive daytime sleepiness, difficulty concentrating, and a lack of restorative sleep.
Physiological consequences such as oxygen desaturation (SpO₂ reduction), bradycardia, and tachycardia are also important for clinical evaluation. The article highlights the classification of symptoms into insomnia-type and hypersomnia-type presentations. It further emphasizes that a combination of detailed clinical interview and polysomnography is essential for accurate severity assessment and treatment planning.
Depression and Sleep Disorders in University Students
Contributing author: Yuhei Kayukawa
Depression among university students is often triggered by factors such as fatigue soon after admission, dissatisfaction with the chosen field of study, disrupted daily rhythms, and excessive academic or part-time work demands. It is frequently accompanied by sleep disturbances such as hypersomnia or insomnia.
In particularly demanding fields such as medical schools, decreased motivation and apathy can lead to academic delay or even leave of absence. Early diagnosis, adjustment of sleep–wake rhythms, and, when necessary, pharmacotherapy, light therapy, and lifestyle modification are key to supporting academic continuity and return to studies.
Depression among university students is often triggered by factors such as fatigue soon after admission, dissatisfaction with the chosen field of study, disrupted daily rhythms, and excessive academic or part-time work demands. It is frequently accompanied by sleep disturbances such as hypersomnia or insomnia.
In particularly demanding fields such as medical schools, decreased motivation and apathy can lead to academic delay or even leave of absence. Early diagnosis, adjustment of sleep–wake rhythms, and, when necessary, pharmacotherapy, light therapy, and lifestyle modification are key to supporting academic continuity and return to studies.
Understanding Pathophysiology and Treatment Theory
A comprehensive understanding of psychiatric disorders and sleep disorders requires an integrated consideration of underlying pathophysiological mechanisms as well as lifestyle and environmental factors that contribute to symptom development. This section features articles on disease mechanisms and therapeutic approaches, based on clinical research and accumulated medical knowledge, focusing on conceptual frameworks for understanding and treating these conditions.
Panic Disorder: Its Biological Aspects
This paper examines the biological aspects of panic disorder (PD) by organizing its pathophysiology into four domains: etiological factors, integrative models, daytime pathology during wakefulness, and nocturnal pathology during sleep. Genetic and familial influences are considered relatively limited, with environmental factors and the formation of cognitive patterns playing a more central role. Neurochemical models involving the locus coeruleus, raphe nuclei, and the GABAergic system, as well as interactions with the limbic system and prefrontal cortex, are discussed in relation to panic attacks (PA), anticipatory anxiety (AA), and phobic anxiety (PhA). The paper highlights the biological basis of PD from the perspective of integrating pharmacotherapy and psychotherapy.
Contributing Author: Yuhei Kayukawa
Source: Psychiatric Treatment Studies, Vol. 8, No. 7
Contributing Author: Yuhei Kayukawa
Source: Psychiatric Treatment Studies, Vol. 8, No. 7
Shear’s Biopsychological Model and an Integrative Model Combining Cognitive and Behavioral Approaches
Panic disorder (PD) is an anxiety disorder characterized by sudden episodes of palpitations, shortness of breath, and other somatic symptoms, along with anticipatory anxiety and avoidance behavior. This article focuses on Shear’s integrative model, which synthesizes biological vulnerability with cognitive-behavioral factors as well as psychodynamic aspects to explain the pathophysiology of the disorder. It describes psychological changes following the initial panic attack and the formation of a vicious cycle, discusses implications for treatment, and considers the significance of combining pharmacotherapy and psychotherapy.
Contributing Author: Yuhei Kayukawa
Source: 100 Hypotheses in Psychiatric Disorders
Contributing Author: Yuhei Kayukawa
Source: 100 Hypotheses in Psychiatric Disorders
Psychostimulants
This article provides an overview of the pharmacological effects and clinical applications of psychostimulants. Psychostimulants act on the central nervous system and primarily enhance wakefulness, attention, and motivation through dopaminergic and noradrenergic pathways. Clinical benefits have been reported in conditions such as ADHD, narcolepsy, hypersomnia, depressive symptoms, and obesity, with agents such as methylphenidate and modafinil being used in practice. This paper reviews their mechanisms of action, indications, adverse effects, and clinical significance, and provides a comprehensive discussion of the utility of psychostimulants.
Contributing Author: Yuhei Kayukawa
Source: Theories and Techniques in Psychiatric Treatment
Contributing Author: Yuhei Kayukawa
Source: Theories and Techniques in Psychiatric Treatment
Circadian Rhythms and Psychiatric Disorders
An Article Explaining the Relationship Between Biological Rhythms and Psychiatric Disorders: Using examples such as circadian rhythm sleep–wake disorders, depression, seasonal affective disorder, and age-related changes in sleep, this paper discusses the association between the internal biological clock and psychiatric symptoms, as well as treatments such as light therapy.
Contributing Author: Yuhei Kayukawa
Source: Gendai Igaku (Modern Medicine), Vol. 46, No. 3
Contributing Author: Yuhei Kayukawa
Source: Gendai Igaku (Modern Medicine), Vol. 46, No. 3
Characteristics and Issues of Sleep Disorders Associated with Depressive Symptoms and Stress
Depressive symptoms and stress are closely associated with sleep disorders, and disruptions in sleep–wake rhythms—such as insomnia, early morning awakening, and hypersomnia—can exacerbate depressive states. This article explains how stress-induced hyperactivation of the arousal system, disturbances in the sleep–wake cycle, and reduced sleep quality contribute to the amplification of depressive symptoms. It also summarizes the impact of sleep disorders on daily life and occupational functioning, and emphasizes the importance of therapeutic intervention.
Contributing Author: Yuhei Kayukawa
Source: New Strategies for the Treatment of Sleep Disorders
Contributing Author: Yuhei Kayukawa
Source: New Strategies for the Treatment of Sleep Disorders
Mind & Sleep
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Mind & Brain Basics
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