Top

Child and Adolescent Psychiatry and Mental Health

Published in:

Open Access 01-12-2009 | Research

The practice of child and adolescent psychiatry: a survey of early-career psychiatrists in Japan

Authors: Masaru Tateno, Naoki Uchida, Saya Kikuchi, Ryosaku Kawada, Seiju Kobayashi, Wakako Nakano, Ryuji Sasaki, Keisuke Shibata, Tomohiro Shirasaka, Muneyuki Suzuki, Kumi Uehara, Toshikazu Saito

Published in: Child and Adolescent Psychiatry and Mental Health | Issue 1/2009

Abstract

Background

Child and adolescent psychiatry (CAP), a subspecialty of psychiatry in Japan, is facing a serious workforce shortage. To resolve this situation, the Japanese government has organized a task force and has been working to increase psychiatrists' clinical skills to improve care for children and adolescents with mental health problems. Using an online questionnaire system, the authors have conducted a survey to investigate the perceptions, experiences, and interests of early-career psychiatrists in CAP.

Methods

The subjects of this study were 182 psychiatrists in Japan whose individual clinical experiences did not exceed 15 years. The authors of this study created an online questionnaire system and e-mailed the URL and login password to all subjects. Respondents anonymously answered the questions. Most questions required an answer indicating a level of agreement scored on a nine-point scale. Responding to the questionnaire was considered to constitute consent, and all respondents' privacy was carefully protected.

Results

The mean age and clinical psychiatric experience of the subjects were found to be 33.1 ± 4.5 years and 5.43 ± 3.5 years, respectively. On a nine-point scale (with nine being the highest), experience and interest in CAP measured 3.05 ± 1.9 and 5.34 ± 2.5, respectively; further, these two factors showed significant correlation (r = 0.437, p < 0.0001). The mean score for the early-career psychiatrists' confidence in their ability to diagnose and appropriately treat was notably low, at 3.13 ± 1.9.

Conclusion

Our results demonstrated that early-career psychiatrists self-evaluated their CAP clinical experience as insufficient, and these clinicians' CAP experiences and interests correlated significantly. Therefore, in order to improve child and adolescent medical care, we need to expose young psychiatrists to sufficient CAP cases and explore the factors that could attract them to this field.

Available only for authorised users

Tsuchiya KJ, Takei N: Focus on psychiatry in Japan. Br J Psychiatry. 2004, 184: 88-92. 10.1192/bjp.184.1.88.CrossRefPubMed

Hayashi M, Yamazaki K: Surveys on the pregraduate and postgraduate education on child and adolescent psychiatry in Japan. Psychiatry Clin Neurosci. 1998, 52 (Suppl): S281-284.CrossRefPubMed

Crump A: Suicide in Japan. Lancet. 2006, 367 (9517): 1143-10.1016/S0140-6736(06)68502-4.CrossRefPubMed

Naito A: Internet suicide in Japan: implications for child and adolescent mental health. Clin Child Psychol Psychiatry. 2007, 12 (4): 583-597. 10.1177/1359104507080990.CrossRefPubMed

Honjo S, Sasaki Y, Kaneko H, Tachibana K, Murase S, Ishii T, Nishide Y, Nishide T: Study on feelings of school avoidance, depression, and character tendencies among general junior high and high school students. Psychiatry Clin Neurosci. 2003, 57 (5): 464-471. 10.1046/j.1440-1819.2003.01149.x.CrossRefPubMed

McClure M, Shirataki S: Child psychiatry in Japan. J Am Acad Child Adolesc Psychiatry. 1989, 28 (4): 488-492. 10.1097/00004583-198907000-00003.CrossRefPubMed

Borovoy A: Japan's hidden youths: mainstreaming the emotionally distressed in Japan. Cult Med Psychiatry. 2008, 32 (4): 552-576. 10.1007/s11013-008-9106-2.CrossRefPubMed

Herrmann N, Shulman KI, Silver IL: Intensive early exposure to geriatric psychiatry in residency training: impact on career choice and practice. Can J Psychiatry. 1992, 37 (8): 549-552.PubMed

Thomas T: Factors affecting career choice in psychiatry: a survey of RANZCP trainees. Australas Psychiatry. 2008, 16 (3): 179-182.CrossRefPubMed

10.

Miyajima K, Fujisawa D, Nakagawa A, Kato T: [Psychiatric training at university hospitals--a viewpoint of the first psychiatrists who were trained at the latter part of the new system]. Seishin Shinkeigaku Zasshi. 2007, 109 (11): 1039-1044.PubMed

11.

Mowbray RM, Davies BM, Biddle N: Psychiatry as a career choice. Aust N Z J Psychiatry. 1990, 24 (1): 57-64. 10.3109/00048679009062886.CrossRefPubMed

12.

Shelley RK, Webb MG: Does clinical clerkship alter students' attitudes to a career choice of psychiatry?. Med Educ. 1986, 20 (4): 330-334. 10.1111/j.1365-2923.1986.tb01375.x.CrossRefPubMed

13.

Sierles FS, Yager J, Weissman SH: Recruitment of U.S. medical graduates into psychiatry: reasons for optimism, sources of concern. Acad Psychiatry. 2003, 27 (4): 252-259. 10.1176/appi.ap.27.4.252.CrossRefPubMed

14.

Martin VL, Bennett DS, Pitale M: Medical students' interest in child psychiatry: a clerkship intervention. Acad Psychiatry. 2007, 31 (3): 225-227. 10.1176/appi.ap.31.3.225.CrossRefPubMed

15.

Cutler JL, Alspector SL, Harding KJ, Wright LL, Graham MJ: Medical students' perceptions of psychiatry as a career choice. Acad Psychiatry. 2006, 30 (2): 144-149. 10.1176/appi.ap.30.2.144.CrossRefPubMed

16.

Likert R: "A Technique for the Measurement of Attitudes". Archives of Psychology. 1932, 140: 1-55.

17.

Brook RH, Chassin MR, Fink A, Solomon DH, Kosecoff J, Park RE: A method for the detailed assessment of the appropriateness of medical technologies. Int J Technol Assess Health Care. 1986, 2 (1): 53-63. 10.1017/S0266462300002774.CrossRefPubMed

18.

Keating NL, Zaslavsky AM, Ayanian JZ: Physicians' experiences and beliefs regarding informal consultation. JAMA. 1998, 280 (10): 900-904. 10.1001/jama.280.10.900.CrossRefPubMed

19.

Allen MH, Currier GW, Hughes DH, Reyes-Harde M, Docherty JP: The Expert Consensus Guideline Series. Treatment of behavioral emergencies. Postgrad Med. 2001, 1-88. quiz 89-90, Spec No

20.

Kurita H: Clinical studies of pervasive developmental disorders in Japan. Psychiatry Clin Neurosci. 1996, 50 (4): 165-170. 10.1111/j.1440-1819.1996.tb02737.x.CrossRefPubMed

21.

Kurita H: Disorders of the autism spectrum. Lancet. 2006, 368 (9531): 179-181. 10.1016/S0140-6736(06)69015-6.CrossRefPubMed

22.

Kawamura Y, Takahashi O, Ishii T: Reevaluating the incidence of pervasive developmental disorders: impact of elevated rates of detection through implementation of an integrated system of screening in Toyota, Japan. Psychiatry Clin Neurosci. 2008, 62 (2): 152-159. 10.1111/j.1440-1819.2008.01748.x.CrossRefPubMed

23.

Teshirogi H, Tateno M, Yoneta M, Kunishige M, Maegaki Y, Takeyama Y, Tsutsumi H, Saito T: WISC-III profiles of subjects with high-functioning pervasive developmental disorders who visited child and adolescent psychiatry clinics at a university hospital. 2009.

24.

Sadakata T, Washida M, Iwayama Y, Shoji S, Sato Y, Ohkura T, Katoh-Semba R, Nakajima M, Sekine Y, Tanaka M, Nakamura K, Iwata Y, Tsuchiya KJ, Mori N, Detera-Wadleigh SD, Ichikawa H, Itohara S, Yoshikawa T, Furuichi T: Autistic-like phenotypes in Cadps2-knockout mice and aberrant CADPS2 splicing in autistic patients. J Clin Invest. 2007, 117 (4): 931-943. 10.1172/JCI29031.PubMedCentralCrossRefPubMed

25.

Nishimura K, Nakamura K, Anitha A, Yamada K, Tsujii M, Iwayama Y, Hattori E, Toyota T, Takei N, Miyachi T, Iwata Y, Suzuki K, Matsuzaki H, Kawai M, Sekine Y, Tsuchiya K, Sugihara G, Suda S, Ouchi Y, Sugiyama T, Yoshikawa T, Mori N: Genetic analyses of the brain-derived neurotrophic factor (BDNF) gene in autism. Biochem Biophys Res Commun. 2007, 356 (1): 200-206. 10.1016/j.bbrc.2007.02.135.CrossRefPubMed

26.

Durand CM, Betancur C, Boeckers TM, Bockmann J, Chaste P, Fauchereau F, Nygren G, Rastam M, Gillberg IC, Anckarsater H, Sponheim E, Goubran-Botros H, Delorme R, Chabane N, Mouren-Simeoni MC, de Mas P, Bieth E, Roge B, Heron D, Burglen L, Gillberg C, Leboyer M, Bourgeron T: Mutations in the gene encoding the synaptic scaffolding protein SHANK3 are associated with autism spectrum disorders. Nat Genet. 2007, 39 (1): 25-27. 10.1038/ng1933.PubMedCentralCrossRefPubMed

27.

Nakashima N, Yamagata T, Mori M, Kuwajima M, Suwa K, Momoi MY: Expression analysis and mutation detection of DLX5 and DLX6 in autism. Brain Dev. 2009.

Title: The practice of child and adolescent psychiatry: a survey of early-career psychiatrists in Japan
Authors: Masaru Tateno
Naoki Uchida
Saya Kikuchi
Ryosaku Kawada
Seiju Kobayashi
Wakako Nakano
Ryuji Sasaki
Keisuke Shibata
Tomohiro Shirasaka
Muneyuki Suzuki
Kumi Uehara
Toshikazu Saito
Publication date: 01-12-2009
Publisher: BioMed Central
Published in: Child and Adolescent Psychiatry and Mental Health / Issue 1/2009
Electronic ISSN: 1753-2000
DOI: https://doi.org/10.1186/1753-2000-3-30

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The practice of child and adolescent psychiatry: a survey of early-career psychiatrists in Japan

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2009

Children with disrupted attachment histories: Interventions and psychophysiological indices of effects

Conventional intramuscular sedatives versus ziprasidone for severe agitation in adolescents: case-control study

Better mental health in children of Vietnamese refugees compared with their Norwegian peers - a matter of cultural difference?

Atomoxetine treatment and ADHD-related difficulties as assessed by adolescent patients, their parents and physicians

A pilot study on peritraumatic dissociation and coping styles as risk factors for posttraumatic stress, anxiety and depression in parents after their child's unexpected admission to a Pediatric Intensive Care Unit

Depressive symptoms from kindergarten to early school age: longitudinal associations with social skills deficits and peer victimization