We are conducting an open pre- and post-trial to evaluate the feasibility, safety, and efficacy of STAIR/NST, a cognitive-behavioral therapy for complex PTSD, in Japan. A translation of the STAIR/NST treatment principles and manual has also been published. In addition, we have prepared a Japanese version of the latest edition of the International Trauma Interview. （Kim, Niwa, Otaki)

We will conduct gene analysis and expression analysis, endocrine and immune marker measurement, autonomic function analysis, brain MRI, cognitive function measurement, and psychological and clinical evaluation in trauma survivors (PTSD group and non-exposed group) and healthy subjects. We aim to develop an objective method of predicting treatment efficacy based on the index. The study is being conducted in collaboration with the Department of Psychiatry, Nagoya City University, and is ongoing with data collected on 248 patients so far. (Hori, Sekiguchi, Ito, Hayashi, Niwa, Kim, Otsuka, Narita, Kawanishi)

To evaluate the efficacy of memantine, an anti-dementia drug, in patients with PTSD. The purpose of this study is to develop a protocol for RCTs by conducting an open clinical trial as a preliminary study to determine effect size and safety. A total of 10 patients were completed during this fiscal year, and the interim analysis results were published in a paper. Gene expression analysis, endocrine and immune system measurements, and brain MRI measurements will be conducted before and after memantine treatment to elucidate the mechanism of therapeutic effect and to develop a surrogate marker for therapeutic effect. (Hori, Sekiguchi, Ito, Narita, Kim)

Blood samples are collected from patients and healthy subjects, and proteins, mRNA, metabolites, etc. are quantified to identify molecules that are useful for diagnosis, classification, and progress indicators of schizophrenia and mood disorders. The study is being conducted in collaboration with the Third Department of Disease Research at the Institute of Neurology, and samples from approximately 440 subjects have already been collected. Using these blood samples, the above measurements are being performed to search for candidate biomarkers of psychiatric disorders. (Hori, Ogawa)

The aim of this project is to identify biomarkers for psychiatric disorders such as mood disorders, psychotic disorders, and PTSD by measuring the concentrations of steroid hormones and other substances in hair. The study is being conducted in collaboration with the Third Department of Disease Research of the Institute of Neurology, the Center Hospital, and the MGC Bioresource Department, and recruitment of subjects is underway. (Hori)

An ongoing literature review on post-disaster mental health is being conducted as a WHO research project in collaboration with the University of Curtin and others. Focusing on peer-reviewed literature on disaster mental health care published within the past 10 years, we summarized and scrutinized the contents of the collected literature, especially those that were subjected to systematic reviews. (Kim, Nakashima, Shimazu, Ishida, Shimomura)

We investigated the effects of stress on memory performance, physiological responses to stress, and personality traits during transient stressful experiences. Noise stress task (white noise) or social stress task (speech and mental arithmetic) were used as stress load. Experiments were conducted on healthy university students to examine the effects of words and images on memory. (Rin, Kim)

In collaboration with Kitasato University, the National Institute for Occupational Safety and Health, and others, we are now examining the efficacy of a new CBM that also acts on memory regions and its neural mechanisms of action from a comprehensive perspective using fMRI, genes (including expression), and endocrine and immunoinflammatory indices in subjects at risk for stress-related mental disorders. （Hakamada, Hori)

A study was conducted to contribute to the establishment of a support system model for eating disorders by collecting and accumulating consultation and support cases at eating disorder treatment and support centers (support centers) and analyzing their contents. In FY2020, a total of 1,388 consultation cases from April 2020 to November 2020 at four support centers in Japan were analyzed and compiled into a report. (Ohara, Ando)

Participated in an international consortium on genome-wide association analysis of neurogenic emaciation, and the results of the study were published in Addiction Bioloby (Ando)

A multicenter, randomized, placebo-controlled trial of enhanced cognitive behavior therapy (CBT-E) for eating disorders in Japanese patients with bulimia nervosa was conducted at the University of Tokyo, Tohoku University, Kyushu University, Kokubudai Hospital of the National Center for Global Health and Medicine (NICHe), and our TMC. A joint randomized controlled trial was conducted. In addition, intervention providers were trained through case supervision by the original author of CBT-E. (Ogawa, Ohara, Sekiguchi, Sugawara, Ayako, Funaba, Kawanishi, Tomita, Ando)

We have developed a Japanese version of CBT using internal sensory exposure for irritable bowel syndrome (IBS) (CBT-IE), and a feasibility study of 17 patients in a single group showed improvement in abdominal symptoms and quality of life with a high effect size (paper under submission). To reduce the cost of the CBT-IE program, we developed a program in which video materials are viewed before the face-to-face session, and conducted a feasibility study in collaboration with the Departments of Psychosomatic Medicine and Gastroenterology at the Center Hospital, comparing 17 cases before and after the face-to-face session. The results are in preparation for submission for publication. (Funaba, Kawanishi, Fujii, Tomita, Ando)

A multicenter randomized controlled trial was conducted to evaluate the effectiveness of a CBT program combined with video materials for irritable bowel syndrome (IBS) at the University of Tokyo, Tohoku University, National Center for Global Health and Medicine Hospital, Kohnodai Hospital, and TMC Hospital, with a total of 31 IBS patients enrolled in both groups at all centers. The study is ongoing. (Funaba, Kawanishi, Sekiguchi, Fujii, Ohara, Tomita, Ando)

Although fear of self odor has received attention as an Olfactory Reference Syndrome (ORS), little is known about its pathogenesis or effective treatment. ORS is often comorbid with irritable bowel syndrome (IBS). 203 people with IBS-like symptoms and fear of self odor were surveyed, analyzed, and published in a preprint in English (Kawanishi H et al., 2020 JMIR Preprint). (Kawanishi, Sekiguchi, Funaba, Tomita, Ohara, Sugawara, Ando)

The aim of this study is to clarify the cognitive-scientific treatment structure of psychotherapy by conducting cognitive psychological tests before and after psychotherapy at the Department of Psychosomatic Medicine, Kokubudai Hospital, National Center for Global Medicine (NCGM). Using data from 37 patients with eating disorders, we examined differences in the pattern of introsensory perception by eating disorder type, but were unable to detect differences between groups. We will continue to examine the relationship with clinical symptoms. (Sekiguchi, Ayako Sugawara, Terasawa)

We conducted a study to standardize the Japanese version of the Functional Bowel Syndrome-related Cognitive Rating Scale and IBS-related Behavioral Response Rating Scale, which are cognitive and behavioral assessment scales specifically for IBS, with Assistant Professor Nagisa Sugaya of the Health and Social Medicine Unit, Yokohama City University, and collected data from 20 cases. (Funaba, Kawanishi, Ohara, Sekiguchi, Ariga, Tomita, Ando)

To identify causative mutations and genes contributing to the development of eating disorders, we conducted exome sequencing of 38 patients (20 affected and 18 unaffected) from 10 families affected with eating disorders in collaboration with Akira Oka, a lecturer at Tokai University. Mutations that matched with affected siblings were extracted for all modes of inheritance, and those predicted to alter protein structure were narrowed down. (In preparation for submission for publication) (Ando)

We conducted a survey on the actual conditions of treatment and support for eating disorders in eating disorder clinics nationwide, and investigated the actual conditions of treatment, the status of the additional fee for inpatient medical management of eating disorders, cooperation with related organizations, training needs, the possibility of being listed on the list of clinics, and the evaluation of the guidelines for cooperation and treatment of eating disorders. The Shizuoka model and the Chiba model were surveyed as good examples of the establishment of medical and administrative cooperation after the establishment of the Eating Disorders Treatment Support Center, and presented as a collection of good examples. (Ando, Sekiguchi, Ayako Sugawara, Funaba, Kawanishi)

We aim to develop new diagnostic methods for stress-related disorders with diverse phenotypes by examining the effects of trauma history and stress load on brain information processing and neurocircuit dynamics across diseases. Data were collected from a total of 80 patients with PTSD, IBS, and healthy subjects. (Sekiguchi, Sugawara, Katsunuma, Ito, Lin, Niwa, Hori, Kim)

Internal receptive sensory training using biofeedback techniques is being conducted to examine the effects of cognitive neuroscience. In collaboration with Associate Professor Yuri Terasawa of the Faculty of Letters at Keio University (visiting researcher), training intervention data were collected on a total of 22 healthy university students. It was found that training of the sense of internal receptivity made the behavior style more adaptive. (Sekiguchi, Sugawara Ayako, Katsunuma, Terasawa)

We conducted a longitudinal observational study before and after cognitive behavioral therapy (CBT) for eating disorders, and collected brain MRI, clinical data, and gene expression data before and after CBT, aiming to generate neuroscientific evidence of CBT effectiveness for early detection and intervention of eating disorders. Data collection began as a multicenter collaborative study with Tohoku University, Chiba University, the University of Tokyo, Kyoto University, the University of Occupational and Environmental Health, and Kyushu University, and data were collected from a total of 28 patients with eating disorders and healthy subjects. We also published a protocol article (Hamatani et al., 2020 BMJ Open). In parallel, a database of brain MRI images of a total of 400 patients with eating disorders and healthy subjects collected at the collaborating institutions is being constructed and analyzed. (Sekiguchi, Ando, Hori, Kawanishi, Sugawara, Takamura, Narita, Ohara, Moriguchi, Tomita, Kim)

The purpose of this study is to elucidate and organize the support needs of patients with eating disorders and their families who do not visit hospitals. A web-based survey was conducted using information on support needs collected in the past and opinions from professionals who have been involved in the treatment of eating disorders, and data was collected from 379 patients and family members in total. (Ayako Sugawara, Sekiguchi, Ohara, Nishizono)

We are conducting a joint research project in collaboration with the NCNP Hospital and Mood Disorders Center and the NCNP Biobank. It has been reported that the risk of developing many mental disorders such as depression increases with the rate of childhood trauma (childhood adversity experiences). The purpose of this project is to search for biological markers that are associated with the development of psychiatric symptoms such as depression. (Ogawa, Hori, Kim)

The purpose of this study is to verify the reliability of the method for conducting web surveys and experiments on the Internet. Questionnaire scales for the survey and PC tasks for the experiment were developed and compared with the results of a conventional paper survey and an in-laboratory experiment. (Lin, Kim)