治癒不能がん患者の心的外傷後成長を目指した集団精神療法プログラムの開発と普及

• Project/Area Number: 18K13327
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 10030:Clinical psychology-related
• Research Institution: Saitama Medical University
• Principal Investigator: 石田 真弓 埼玉医科大学, 医学部, 准教授 (80636465)
• Project Period (FY): 2018-04-01 – 2024-03-31
• Project Status: Granted (Fiscal Year 2022)
• Budget Amount: ¥2,730,000 (Direct Cost: ¥2,100,000、Indirect Cost: ¥630,000); Fiscal Year 2020: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000); Fiscal Year 2019: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000); Fiscal Year 2018: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000)
• Keywords: 心的外傷後成長 / 治癒不能がん / がん / 集団精神療法 / 治癒不能

Outline of Annual Research Achievements

本研究は、がんの進行・再発に伴い治癒不能と告知されたがん患者の精神的問題に焦点を当て、その心的外傷後成長（Posttraumatic Growth）を目指した集団精神療法プログラムの開発と、研修会等の開催による普及を目指す実践的研究である。
がん患者にとって進行・再発は「治癒不能」を意味し、その破局的な心理的打撃から精神的健康の悪化が指摘されている。しかし、研究者のこれまでの研究から、治癒不能がん患者を対象とした集団精神療法によって、精神状態の維持・改善がはかられ、心的外傷後成長に至る可能性が示唆された。本研究では、心的外傷後成長を生起させる集団精神療法の具体的な要因を明らかにし、①治癒不能がん患者の心的外傷後成長を目指した集団精神療法プログラム（GP）を治療法として確立させ、②がん医療に携わる臨床心理士や精神科医などを対象に研修会を開催し、精神医学的治療の選択肢としてがん医療に普及させることを目的としている。
本年度は、GPに参加することで、心理的苦悩を緩和し、話す Speak、聴くListen、考える Thinkのスキルを獲得する過程について、参加者の発言を中心に質的な分析を継続的に実施している。1年間を通して11回開催することができた。
各回で取り上げられた話題や関連する事項から、発言の中に心的外傷後成長が確認されることが多く、参加者らにそれをフィードバックすることで新たな視点を提供している。
また、前年度のビタミンB1欠乏に引き続き、参加者の中に身体症状のコントロールに使用していた薬剤による副作用が精神的な苦悩となって表出されたケースを経験した。症状の鑑別を行い、薬物療法の中止によってその苦悩に対応したことをケースレポートとして報告した。身体症状に常に注意を払いながら、精神症状へのケアを継続することの重要性を改めて認識した。

Current Status of Research Progress

2: Research has progressed on the whole more than it was originally planned.

Reason

Covid19によって患者を多く集められなかったが、数名の参加者は継続させることができた。

Strategy for Future Research Activity

初回から終了まで参加した患者がいるため、患者の分析を継続的に実施している。

Research Products

• [Journal Article] Can depressed cancer patients with a borderline thiamine concentration develop deficiency within a short time period? (2023)
  • Author(s): Uchida Nozomu、Ishida Mayumi、Yoshioka Akira、Sato Izumi、Ito Hiroshi、Onizawa Nobuyuki、Sato Ryota、Mizunuma Naoki、Onishi Hideki
  • Journal Title: Palliative and Supportive Care Volume: - Issue: 4 Pages: 768-771
  • DOI: 10.1017/s1478951522001808
  • Peer Reviewed
• [Journal Article] The prevalence of thiamine deficiency among elderly nursing home residents: A cross‐sectional study (2023)
  • Author(s): Uchida Nozomu、Ishida Mayumi、Sato Izumi、Yoshioka Akira、Takahashi Takao、Furuya Daisuke、Ebihara Yasuhiro、Ito Hiroshi、Onishi Hideki
  • Journal Title: Journal of General and Family Medicine Volume: - Issue: 3 Pages: 148-153
  • DOI: 10.1002/jgf2.609
  • Peer Reviewed
• [Journal Article] Opioid withdrawal syndrome developing after long-term administration of naldemedine (2022)
  • Author(s): Ishida Mayumi、Uchida Nozomu、Yabuno Akira、Hasegawa Kosei、Mizunuma Naoki、Takahashi Takao、Onishi Hideki
  • Journal Title: Palliative and Supportive Care Volume: 20 Issue: 6 Pages: 897-899
  • DOI: 10.1017/s147895152200044x
  • Peer Reviewed
• [Journal Article] Clinical diagnosis, outcomes and treatment of thiamine deficiency in a tertiary hospital (2022)
  • Author(s): Onishi Hideki、Uchida Nozomu、Yoshioka Akira、Sato Izumi、Ishida Mayumi
  • Journal Title: Clinical Nutrition Volume: 41 Issue: 9 Pages: 2052-2053
  • DOI: 10.1016/j.clnu.2022.07.009
  • Peer Reviewed
• [Journal Article] A case of Wernicke encephalopathy in a dementia caregiver: The need for nutritional evaluation in family caregivers (2021)
  • Author(s): Ishida Mayumi、Uchida Nozomu、Itami Kumi、Sato Izumi、Yoshioka Akira、Onishi Hideki
  • Journal Title: Journal of General and Family Medicine Volume: 23 Issue: 2 Pages: 104-106
  • DOI: 10.1002/jgf2.494
• [Journal Article] Naldemedine-induced opioid withdrawal syndrome with severe psychiatric symptoms in an advanced cervical cancer patient without brain metastasis (2021)
  • Author(s): Ishida Mayumi、Hiraoka Mie、Yaguchi Ayako、Sugano Koji、Adachi Nasako、Itoga Tomoko、Ishiguro Tomohito、Onishi Hideki
  • Journal Title: Palliative and Supportive Care Volume: Online ahead of print. Issue: 3 Pages: 1-3
  • DOI: 10.1017/s1478951521001917
• [Journal Article] What are the clinical signs of thiamine deficiency in elderly patients? (2021)
  • Author(s): Onishi Hideki、Ishida Mayumi
  • Journal Title: Journal of General and Family Medicine Volume: 23 Issue: 1 Pages: 71-71
  • DOI: 10.1002/jgf2.479
• [Journal Article] Thiamine deficiency unrelated to alcohol consumption in high‐income countries: a literature review (2021)
  • Author(s): Onishi Hideki、Ishida Mayumi、Uchida Nozomu、Yoshioka Akira、Sato Izumi
  • Journal Title: Annals of the New York Academy of Sciences Volume: 1505 Issue: 1 Pages: 5-6
  • DOI: 10.1111/nyas.14693
• [Journal Article] Wernicke encephalopathy in a caregiver: A serious physical issue resulting from stress in a family member caring for an advanced cancer patient (2021)
  • Author(s): Ishida Mayumi、Uchida Nozomu、Yoshioka Akira、Sato Izumi、Hamaguchi Tetsuya、Horita Yosuke、Mihara Yoshiaki、Onishi Hideki
  • Journal Title: Palliative and Supportive Care Volume: 2021 Issue: 4 Pages: 1-3
  • DOI: 10.1017/s1478951521001784
• [Journal Article] Reversible dementia due to vitamin B12 deficiency in a lung cancer patient: relevance of preoperative evaluation. (2021)
  • Author(s): Ishida M, Taguchi R, Sakaguchi H, Itami K, Yoshioka A, Sato I, Uchida N, and Onishi H.
  • Journal Title: Palliative & Supportive Care Volume: Online ahead of print. Issue: 3 Pages: 377-379
  • DOI: 10.1017/s1478951521000481
  • Peer Reviewed
• [Journal Article] Insufficiency of B vitamins with its possible clinical implications (2021)
  • Author(s): Onishi Hideki、Ishida Mayumi
  • Journal Title: Journal of Clinical Biochemistry and Nutrition Volume: 68 Issue: 1 Pages: 1-1
  • DOI: 10.3164/jcbn.20-158
  • NAID: 130007965348
  • ISSN: 0912-0009, 1880-5086
  • Peer Reviewed
• [Journal Article] High proportion of thiamine deficiency in referred cancer patients with delirium: a retrospective descriptive study (2021)
  • Author(s): Onishi Hideki、Sato Izumi、Uchida Nozomu、Takahashi Takao、Furuya Daisuke、Ebihara Yasuhiro、Yoshioka Akira、Ito Hiroshi、Ishida Mayumi
  • Journal Title: European Journal of Clinical Nutrition Volume: Online ahead of print. Issue: 10 Pages: 1499-1505
  • DOI: 10.1038/s41430-021-00859-9
  • Peer Reviewed / Open Access
• [Journal Article] Exacerbation of psychotic symptoms as clinical presentation of (2020)
  • Author(s): Nozomu Uchida, Mayumi Ishida, Izumi Sato, Takao Takahashi, Daisuke Furuya, Yasuhiro Ebihara, Hiroshi Ito, Akira Yoshioka, Hideki Onishi
  • Journal Title: Journal of Genaral and Family Medicine Volume: - Issue: 5 Pages: 185-187
  • DOI: 10.1002/jgf2.330
  • Peer Reviewed / Open Access
• [Journal Article] Subclinical thiamine deficiency identified by pretreatment evaluation in an esophageal cancer patient (2020)
  • Author(s): Yoshioka Akira、Sato Izumi、Onishi Hideki、Ishida Mayumi
  • Journal Title: European Journal of Clinical Nutrition Volume: 75 Issue: 3 Pages: 564-566
  • DOI: 10.1038/s41430-020-00735-y
  • Peer Reviewed / Open Access
• [Journal Article] Neuroleptic malignant syndrome in patients with cancer: a systematic review. (2020)
  • Author(s): Sato I, Onishi H, Kawanishi C, Yamada S, Ishida M, Kawakami K
  • Journal Title: BMJ Support Palliat Care Volume: 10 Issue: 3 Pages: 265-270
  • DOI: 10.1136/bmjspcare-2020-002200
  • Peer Reviewed / Open Access
• [Journal Article] “Phantom akathisia” in an amputated leg of a sarcoma patient: a case report (2020)
  • Author(s): Ishida Mayumi、Imanishi Jungo、Yazawa Yasuo、Sunakawa Yu、Torigoe Tomoaki、Onishi Hideki
  • Journal Title: BioPsychoSocial Medicine Volume: 14 Issue: 1
  • DOI: 10.1186/s13030-020-00178-8
  • Peer Reviewed / Open Access
• [Journal Article] Thiamine deficiency in the bereaved after cancer-related spousal loss (2019)
  • Author(s): Onishi Hideki、Uchida Nozomu、Takahashi Takao、Furuya Daisuke、Ebihara Yasuhiro、Sato Izumi、Ito Hiroshi、Ishida Mayumi
  • Journal Title: Palliative and Supportive Care Volume: 17 Issue: 6 Pages: 738-740
  • DOI: 10.1017/s147895151900018x
  • Peer Reviewed
• [Journal Article] Thiamine deficiency observed in a cancer patient’s caregiver. (2019)
  • Author(s): ONISHI, H., ISHIDA, M., UCHIDA, N., TAKAHASHI, T., FURUYA, D., EBIHARA Y., SATO I. & AKECHI, T.
  • Journal Title: Palliative & Support Care Volume: in press Issue: 5 Pages: 611-613
  • DOI: 10.1017/s1478951518001001
  • Peer Reviewed
• [Journal Article] Thiamine deficiency in a patient with recurrent renal cell carcinoma who developed weight loss with normal appetite and loss of energy soon after nivolumab treatment (2019)
  • Author(s): Onishi Hideki、Okabe Takashi、Uchida Nozomu、Shirotake Suguru、Todo Maki、Oyama Masafumi、Ishida Mayumi
  • Journal Title: Palliative and Supportive Care Volume: 18 Issue: 2 Pages: 241-243
  • DOI: 10.1017/s1478951519000658
  • Peer Reviewed
• [Journal Article] Thiamine deficiency in the bereaved after cancer-related spousal loss. (2019)
  • Author(s): ONISHI, H., UCHIDA, N., TAKAHASHI, T., FURUYA D., EBIHARA, Y., SATO, I., HIROSHI I. & ISHIDA, M.
  • Journal Title: Palliative & Support Care Volume: in press
  • Peer Reviewed
• [Journal Article] Subclinical thiamine deficiency identified by preoperative evaluation in a patient with rapidly growing ovarian cancer: Diagnosis and the need for preoperative thiamine measurement. (2019)
  • Author(s): ONISHI, H., ISHIDA, M., UCHIDA, N., SHINTANI, D., NISHIKAWA, T., HASEGAWA, K., FUJIWARA, K. & AKECHI, T.
  • Journal Title: Palliative & Support Care Volume: in press Issue: 2 Pages: 245-247
  • DOI: 10.1017/s1478951518000469
  • Peer Reviewed
• [Journal Article] Wernicke encephalopathy without delirium that appeared as agitation in a patient with lung cancer. (2018)
  • Author(s): ONISHI, H., ISHIDA, M., KAGAMU, H., MURAYAMA, Y., KOBAYASHI, K., SATO, I., UCHIDA, N. & AKECHI, T.
  • Journal Title: Palliative & Support Care Volume: 16 Issue: 6 Pages: 800-802
  • DOI: 10.1017/s1478951518000226
  • Peer Reviewed
• [Journal Article] Early detection and successful treatment of Wernicke's encephalopathy in outpatients without the complete classic triad of symptoms who attended a psycho-oncology clinic. (2018)
  • Author(s): Onishi H, Ishida M, Tanahashi I, Takahashi T, Ikebuchi K, Taji Y, Kato H, Akechi T.
  • Journal Title: Palliative and Supportive Care. Volume: Epub ahead of print Issue: 5 Pages: 633-636
  • DOI: 10.1017/s1478951518000032
  • Peer Reviewed
• [Presentation] Subclinical thiamine deficiency in a cancer patient-bereaved family member induced by anniversary reaction (2021)
  • Author(s): Mayumi Ishida, Nozomu Uchida, Naoki Mizunuma, Nobuyuki Onizawa, Kumi Itami, Hideki Onishi.
  • Organizer: American Psychosocial Oncology Society
  • Int'l Joint Research
• [Presentation] Construction of the mental support system to the patient who receives cancer genomic medicine. (2020)
  • Author(s): Hisayo Fukushima, Mayumi Ishida, Takao Takahashi, Hideki Onishi, Tetsuya Hamaguchi.
  • Organizer: the European Human Genetics Virtual Conference.
  • Int'l Joint Research
• [Presentation] Thiamine Deficiency as a Misdiagnosed and Unrecognized Cause of Delirium in Referred Patients with Cancer. (2020)
  • Author(s): Hideki Onishi, Izumi Sato, Mayumi Ishida.
  • Organizer: International Society for Pharmacoepiology Annual Conference
  • Int'l Joint Research
• [Presentation] Thiamine deficiency in the cancer-bereaved after the death of a spouse (2019)
  • Author(s): Onishi H, Ishida M
  • Organizer: The 25th World Congress of the International College of Psychosomatic Medicine
  • Int'l Joint Research
• [Presentation] Exploratory research on post-traumatic growth observed in group psychotherapy for advanced cancer patients (2019)
  • Author(s): Ishida M, Takahashi T, Onishi H
  • Organizer: The 25th World Congress of the International College of Psychosomatic Medicine
  • Int'l Joint Research
• [Presentation] Communication with the Cancer Bereaved - Avoiding further distress. (2018)
  • Author(s): Mayumi Ishida, Hideki Onishi
  • Organizer: World Congress of Psycho‐Oncology
  • Int'l Joint Research
• [Presentation] The rate and treatment outcome of thiamine deficiency in cancer patients diagnosed with delirium: A preliminary study. (2018)
  • Author(s): Hideki Onishi, Mayumi Ishida, Nozomu Uchida, Izumi Sato, Takao Takahashi.
  • Organizer: Palliative and Supportive Care in Oncology Symposium
  • Int'l Joint Research