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About us
Overview
The Department of Neuropsychiatry, The University of Tokyo is Japan’s oldest psychiatric department that was established in 1886. “Anti-Psychiatry” movement for the last 3 decades had highly negative ef-
fects on the progress in all aspects of our activities. Since 1994, however, our department has been normalized and restarted to play a leading role in psychiatry in Japan. We are now dedicated to high quality clinical services, excellent training and education for students, and innovative research.
Department’s Perspective
Kiyoto Kasai
M.D., Ph.D., Professor and Chair
As one of the leading departments of psychiatry in Japan, we have been working on establish-ing a new concept of “value-based” psychiatry, which can be illustrated by a dynamic triangular conceptual model integrating the brain, real world, and life course.
Thinking of the brain in relation to the mind and body in a holistic approach to psychiatry, our clinical areas of focus or emphases include general hospital psychiatry and neuropsychiatry, where we provide consultation-liaison services and treatment of epilepsy and dementia. In addi-tion to our clinical work, we have consistently led research promoting biological psychiatry in Japan, exploring the very latest in neuroimaging and molecular genetics, among others.
What also makes us truly original as a leading neuroscience-based university department is that we have gained a real-world perspective on psychiatry, having driven the development of psy-
chiatric rehabilitation strategies from the forefront, including value-based psychotherapy, social skills training, and employment support for young people with schizophrenia. Recently, as well, we have dedicated ourselves to providing psychiatric care to survivors of the 2011 Great East Japan Earthquake through a range of acute- and chronic-phase community mental health activi-ties. Anticipating the future in neuroimaging within current psychiatric care contexts, we have developed a neuroimaging-aided differential diagnosis system for psychiatric disorders utilizing near-infrared spectroscopy (NIRS) that enables brain hemodynamic responses to be measured fully non-invasively and freely, without constraints. The application of NIRS to clinical settings would be an important endeavor of next-generation neuroimaging research integrating neuro-science and real world experiences and needs of an individual person.
We are also well aware that a life-course view of individuals and psychiatry is highly essential.Recognizing the importance of adolescence as a critical developmental stage for establishing one’ s sense of self and value/worth, we have recently started a large-scale longitudinal adoles-cent cohort study (Tokyo TEEN Cohort). Along with our integrative research on early interven-tion for psychosis (IN-STEP/3R), we look to deepening bi-directional understanding of well-be-ing in adolescence as well as recovery from psychosis.
Our dream as pioneers of cutting-edge psychiatry is to train the next generation of psychiatrists and mental health professionals who will be able to provide integrative approaches incorporat-ing biological psychiatry and person-centered community-based care to an individual with psy-chiatric disorders.
APA-TV: A Person-Centered Approach
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Staff
Associate Professor
Seiichiro Jinde
Associate Professor
Shuntaro Ando
Lecturer
Kayo Ichihashi
Lecturer
Eisuke Sakakibara
Assistant Professor
Shinya Fujikawa
Assistant Professor
Tempei Ikegame
Assistant Professor
Masashi Mizutani
Staff-Collaborative Divisions
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Patient Care
For outpatient services, we have more than 20 staff psychiatrists as well as medical staffs in-cluding clinical psychologists, psychiatric social workers, occupational therapists, and nurses. Approximately 1,000 new patients visit yearly, and the total visits per year was about 45,000(180 per day).
The secluded ward has 29 beds including 3 seclusion rooms. We also have 25 beds for the open ward. Approximately 500 patients with various psychiatric disorders were admitted in a year, and mean hospitalization is about 30 days long, and modified electro-convulsive therapy was performed for about 300 patients.
Occupational therapy, recreational therapy, and group therapy are performed. We established day care unit for outpatients with schizophrenia in 1974, and the patients are engaged in rehabil-itation and re-work programs. We also have Japan’s first child psychiatry day care unit in nation-al university hospitals since 1967, and mainly patients with pervasive developmental disorders are engaged in clinical and educational activities.
Education/Training
A significant mission of the Department of Neuropsychiatry at the Universi-ty of Tokyo is the training of next generation leaders in psychiatry. The fac-ulty of the Department of Psychiatry is actively involved in undergraduate and graduate medical education and participate in the training of psycholo-gists and the other medical staff of psychiatry.
Junior and Senior Residency Training
The University of Tokyo Psychiatry Residency Program offers a complete and balanced opportunity in general psychiatry training. The goal of our programs is to consolidate basic clinical skills in all areas of clinical psychiatry and to develop the Resident’s identity as a clinical psychiatrist.
Training occurs in a variety of settings including outpatient and inpatient department, ambulatory care, psychiatry day care unit and consultation-liaison settings in the Tokyo university Hospital. The residents have clinical meetings on patients (every morning), case conferences on inpatients (every week) and a series of lectures by teaching staffs on various aspects of psychiatry.
Undergraduate and Graduate Education
For undergraduates, we have provided neuropsychiatry comprehensive lectures (2nd year), clinical clerkship (bed-side learning; 3rd year), and elective clinical clerkship for 4th-year students). For post-graduate, currently about 20 Ph.D. students are studying in our department.
Research
The research mission of the Department of Neuropsychiatry at the University of Tokyo is to contribute to scientific advances in the understanding and treatment of psychiatric disorders. Our research en-compasses neuroimaging, basic molecular/cellular and genetic approaches, as well as clinical investiga-tions and population-based outcomes research.
Key research areas
Neuroimaging
Our research plays a leading role in psychiatric neuroimaging research in Japan and aims at multi-modality neuroimaging (structural and functional MRI, MR spectroscopy, EEG, MEG, and near-infrared spectroscopy [NIRS]) in schizophrenia, depression, bipolar disorder, and autism spectrum disorders.
Molecular/cellular
neuroscience
The goal of the molecular cellular neuroscience group is to build causal bridges among the mo-lecular, cellular, neural systems, and behavior on the rodent model of neuropsychiatric disorders. We employ integrated multidisciplinary tech-niques including genetics, cell biology, bio-chemistry, histology, electrophysiology, imaging and behavioral analysis for elucidating molecu-lar pathophysiology of rodent models of neuro-psychiatric disorders.
Genetic and Epidemiology research
The Genetic Research Group of the department is investigating genetic as well as environmental mechanism of psychiatric disorders. A major focus of the studies is exploration of suscepti-bility genes and clarification of the role of epi-genetics in neuropsychiatric disorders including schizophrenia, autism spectrum disorders, and bipolar disorder. We are also conducting a large-scale population-based cohort study in adolescence.
Near-infrared spectroscopy (NIRS)
Near-infrared spectroscopy (NIRS) as “next-generation” , “real-world” neuroimaging: Developing bio-markers to support early and accurate diagnosis of psychiatric disorders.
The overall disease burden of psychiatric and neurological disorders is equivalent to that of cancer or cardiovascular disease, and is particularly high in adolescence and young adulthood. Objective bio-markers allowing accurate, early diagnosis and treatment could help reduce this burden. However, cur-rent diagnostic methods rely on doctors’ examinations and patient and family reports. Even globally, there are very few examples of biomarkers being used to diagnose mental illness.
In our laboratory we currently focus on near-infrared spectroscopy (NIRS), a simple, non-invasive form of neuroimaging with minimal patient burden and suited to applications in psychiatric disorders. In a framework of academia-industry collaborations with other medical and research institutions including Gunma University and National Center of Neurology & Psychiatry (NCNP), and also with Hitachi Medical Corporation, we are working to be the first in the world to apply NIRS examination as an auxiliary means of diagnosis for psychiatric disorders.
We carried out a major multicenter study to investigate the accuracy of NIRS examination at the individ-ual level (Takizawa et al., Neuroimage, 2014). We attempted to differentiate three mental illnesses (de-pression, bipolar disorder and schizophrenia) that all have depressive symptoms in common. In seven facilities, the same NIRS examination of brain function was carried out of individuals engaged in the same simple verbal fluency test. Comparing this data with clinical diagnoses, we were able to accurate-ly distinguish major depression in 74.6% of cases and bipolar disorder and schizophrenia in 85.5% of cases at all seven facilities. This result indicates the potential for the development of biomarkers in the field of psychiatry, with potential applications in diagnosis, treatment, evaluation of therapeutic effect, prediction of prognosis, and as a tool for screening.