内藤 宏

Aims: The purpose of this study was to predict the outcome of cognitive behavior therapy (CBT) by trainees for major depressive disorder (MDD) based on the Parental Bonding Instrument (PBI). The hypothesis was that the higher level of care and/or lower level of overprotection score would predict a favorable outcome of CBT by trainees. Methods: The subjects were all outpatients with MDD treated with CBT as a training case. All the subjects were asked to fill out the Japanese version of the PBI before commencing the course of psychotherapy. The difference between the first and the last Beck Depression Inventory (BDI) score was used to represent the improvement of the intensity of depression by CBT. In order to predict improvement (the difference of the BDI scores) as the objective variable, multiple regression analysis was performed using maternal overprotection score and baseline BDI score as the explanatory variables. Results: The multiple regression model was significant (P=0.0026) and partial regression coefficient for the maternal overprotection score and the baseline BDI was -0.73 (P=0.0046) and 0.88 (P=0.0092), respectively. Therefore, when a patient's maternal overprotection score of the PBI was lower, a better outcome of CBT was expected. Conclusion: The hypothesis was partially supported. This result would be useful in determining indications for CBT by trainees for patients with MDD.

Recent GWAS demonstrated an association between candidate genes located at region 6p22.1 and schizophrenia. This region has been reported to house certain candidate SNPs, which may be associated with schizophrenia at HIST1H2BJ, PRSS16, and PGBD1. These genes may presumably be associated with pathophysiology in schizophrenia, namely epigenetics and psychoneuroimmunology. A three-step study was undertaken to focus on these genes with the following aims: (1) whether these genes may be associated in Japanese patients with schizophrenia by performing a 1st stage casecontrol study (514 cases and 706 controls) using Japanese tagging SNPs; (2) if the genetic regions of interest for the disease from the 1st stage of analyses were found, re-sequencing was performed to search for new mutations; (3) finally, a replication study was undertaken to confirm positive findings from the 1st stage were reconfirmed using a larger number of subjects (2,583 cases and 2,903 controls) during a 2nd stage multicenter replication study in Japan. Genotyping was performed using TaqMan PCR method for the selected nine tagging SNPs. Although three SNPs situated at the 3' side of PGBD1; rs3800324, rs3800327, and rs2142730, and two-window haplotypes between rs3800327 and rs2142730 showed positive associations with schizophrenia, these associations did not have enough power to sustain significance during the 2nd stage replication study. In addition, re-sequencing for exons 5 and 6 situated at this region did not express any new mutations for schizophrenia. Taken together these results indicate that the genes HIST1H2BJ, PRSS16, and PGBD1 were not associated with Japanese patients with schizophrenia. (C) 2012 Wiley Periodicals, Inc.