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Article History

Received: 11 October 2025

Accepted: 27 March 2026

First Online: 24 April 2026

Declarations

:

: Katsunaka Mikami has received honoraria from Shionogi & Co., Ltd., Sumitomo Pharma Co., Ltd., and Takeda Pharmaceutical Co., Ltd., Lundbeck Japan K.K., and Otsuka Phar-maceutical Co., Ltd.; and a consulting fee from Shionogi & Co., Ltd, EA Pharma Co., Ltd., Sumi-tomo Pharma Co., Ltd., and Otsuka Pharmaceutical Co., Ltd. Yuichi Onishi has received research honoraria from Takeda Pharmaceutical Co., Ltd. Yuki Takahashi has received financial support from Shionogi & Co. Noa Tsujii has held the position of endowed chair founded by Toyama Prefecture. He reports procuring personal fees from Otsuka, Takeda, Janssen, and Nobelpharma. Natsuru Watanabe has received honoraria from and Takeda Pharmaceutical Co., Ltd., and Viatris Inc.Masahide Usami has received a financial support from Health and Labour Sciences Research Grant Number 23GC1013 and Japan Institute for Health Security Grants 24A1014 and 24ri005. He has a consulting fee from Shionogi & Co., Ltd, Takeda Pharma Co., Ltd., and Otsuka Pharmaceutical Co., Ltd.Kenji Yamamoto has received JSPS KAKENHI Grant Number 22K07588,Kanagawa Prefecture Suicide Attempt Support Project Research Fund 2025, Grants from Nakajima Educational Films Publishing Inc., personal fees from Eisai Co., Ltd., personal fees from Otsuka Pharmaceutical Co., Ltd., personal fees from Shionogi & Co., Ltd., personal fees from Meiji Seika Pharma Co., Ltd., personal fees from Sumitomo Pharma Co., Ltd., personal fees from Merck Sharp & Dohme, personal fees from Viatris Inc., personal fees from Takeda Pharma Co., Ltd., personal fees from Jansen Pharmaceutical K. K., personal fees from Lundbeck Japan K.K., personal fees from, Daiichi Sankyo Co., Ltd., personal fees from OCTAWELL Co., LTD., and personal fees from Taisho Pharmaceutical Co., Ltd. The other authors declare that they have no competing interests that could affect this study.

: Informed consent was orally obtained from all patients and their family or guardians.

: This study was approved by the Japan Institute for Health Security (Approval No. JIHS-G-003042). Patient data from the hospital were registered with the approval of the Ethics Committee of Tokai University Hospital (Approval No. 18R214). For the analysis of the data from the registry study, this research was reapproved by the Ethics Committee of Tokai University Hospital (Approval No. 24R171). This study was conducted according to the Declaration of Helsinki and Ethical Guidelines for Medical and Biological Research Involving Human Subjects.