Psychopharmacology in a Globalizing World: The Use of Antidepressants in Japan
Bibliographic record
Abstract
Despite the great popularity of selective serotonin-reuptake inhibitor (SSRI) antidepressants in North America and Europe, most of these medications have not yet been introduced in Japan. This reflects the difficulty in obtaining government approval for new drugs in Japan, as well as specific social and cultural issues. The majority of patients with depression or dysphoric mood in Japan are seen in specialty medical care, complain of physical symptoms, and are treated with anxiolytic medications. Sadness and depression may be given positive social meanings as yielding enhanced awareness of the transient nature of the world. This article explores the relevance for bioethics of cultural variations in the use of antidepressants at three different levels of analysis: (i) the varieties of depressive experience as they unfold in specific cultural worlds and value systems; (ii) the narrative construction of the self; and (iii) the political economic context of the pharmacological treatment of depression. The strong interconnections of values framed at one level with those at other levels means that there are likely to be unavoidable tradeoffs between different values or desirable short and long-term outcomes such as energy, efficiency, happiness, maturation, depth of personality, and responsiveness to social and moral predicaments. These tradeoffs challenge the assumption of universalism in biomedicine and raise questions about the consequences of our willingness to use medications to treat the myriad forms of distress that may signal fundamental problems with our way of life.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.002 | 0.003 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.000 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".