Neuropsychiatry services in Japan

This chapter deals with the neuropsychiatric service provision, training, career opportunities, particular issues in aged society, and scientific activities for understanding the situation of neuropsychiatry in Japan. The proportion of people aged 65 years and older in Japan reached the world’s highest at 21.0% in 2006. The elderly population has since increased persistently and is estimated at 27.1% of the total population. In addition to this, the ratios of people aged 75 years and over and those aged 85 years and over are estimated at 13.2% and 4.1%, respectively. The ‘oldest old ’ group has contributed to the increasing prevalence of dementia. According to the governmental survey, the estimated number of elderly persons with dementia was 2.80 million in 2010 and 3.45 million in 2015. It is predicted to increase to 4.1 million by 2020 and 4.7 million by 2035. The number of patients with major neuropsychiatric disorders, especially Alzheimer’s disease, vascular dementia, and Parkinson’s disease, has been increasing for the last two decades, and the needs for neuropsychiatric services are also rapidly increasing. Neuropsychiatric services consist mainly of provision of clinical diagnosis, based on clinical examination, and medical treatment for neuropsychiatric symptoms, i.e. psychiatric symptoms of neurological disorders. Neuropsychiatric services should be provided by neuropsychiatry specialists. There are approximately 13,000 psychiatrists and 8000 neurologists working in psychiatric hospitals, general hospitals, medical schools, and private clinics. However, the number of neuropsychiatry specialists is quite limited. Therefore, there is urgency for the Japanese Neuropsychiatric Association (JNA) to set up an appropriate training system for clinicians in order to remediate the shortage of neuropsychiatrists.