精神疾患患者は若く見えるのか？精神科医が解説します。

Hello, good evening. I'm Takahiro Haga, a psychiatrist. Today, I'd like to discuss a topic related to appearance with you all. The theme is: "Do people with mental illnesses look younger or older than their actual age?" In my home visits, I've noticed that many patients with mental illnesses look younger than their age. For example, I'm sometimes surprised to hear that someone is 50 years old, saying, "They looked about 40." Moreover, many seem not just 2 or 3 years younger, but around 10 years younger. Of course, this is my subjective opinion. If you say, "That's just your impression," you're right. So, I looked into whether there are any studies or papers on whether people with mental illnesses tend to look younger or older. First, considering why they sometimes look younger, one major factor is their limited social experience. Of course, there are also people who continue to work in society, repeatedly taking leave and returning to work while dealing with depression or other mental illnesses. Such individuals may have actually experienced a great deal of hardship. On the other hand, those who spend long periods at home due to mental illness, or those living in limited environments such as workshops, may have fewer opportunities to experience complex interpersonal relationships and negotiations within society. It's often said that "life experience shows on your face." Hardship, for better or for worse, is reflected in one's expression and demeanor. As people work in society and navigate various interpersonal relationships, they naturally learn to read between the lines, hide their true feelings while maintaining a cheerful demeanor, and negotiate. As a result, communication becomes more complex, and a certain "maturity" emerges in their expressions and demeanor. Conversely, those with less experience in such complex social situations may, for better or worse, be less two-faced, somewhat simple, and appear childlike. In other words, it's not so much that they "look young," but rather that they "look childlike." Another significant factor is ultraviolet (UV) radiation. Those who spend long hours at home or have few opportunities to go outside have less exposure to UV rays. Ultraviolet (UV) radiation is significantly linked to skin aging. Some studies suggest that daily sunscreen use is a major factor in how young someone looks. In other words, living a lifestyle that minimizes UV exposure can slow down skin aging, resulting in a younger appearance. During home visits, I sometimes encounter patients with remarkably fair and translucent skin. Even men can have fair skin with few blemishes or wrinkles. While I'm not condoning social isolation, I believe that reduced UV exposure contributes to less skin aging. However, research also suggests that individuals with mental illness may actually appear older than their age. One study I found, published in 2017 by a Swiss group, compared individuals with mental illness to those of the same age without, with a third party evaluating their perceived age. The results showed that those with mental illness appeared significantly older. Thus, objective research has shown that people with mental illness tend to look older. The main reason for this is likely the impact of stress. Schizophrenia and depression, for example, place significant stress on the brain and body. Prolonged periods of intense tension, anxiety, depression, sleep disturbances, and disrupted sleep patterns put a strain on the body. If the stress response continues, it can affect blood vessels and skin, potentially accelerating aging. In other words, I believe two forces are at work in the appearance of people with mental illness. One is that their limited social experience and reduced exposure to ultraviolet light may make them appear younger or even childlike. The other is that mental stress and disrupted lifestyles make them appear older. The dominant force likely influences their overall appearance. For example, even if someone with a mental illness spends a lot of time at home, if they exercise regularly, eat three balanced meals a day, and get enough sleep at night, they might appear younger. On the other hand, I believe that those who experience prolonged, intense stress, disrupted sleep, and poor eating habits tend to look older. My impression is that those with relatively mild conditions who can attend outpatient appointments regularly, those receiving psychiatric care while working, and those receiving psychiatric care while also being treated for physical illnesses may appear somewhat older due to the effects of fatigue and stress. Conversely, among those with severe mental illnesses whom I encounter in psychiatric hospitals like Matsuzawa Hospital or through home visits, some appear younger than their age. Of course, this is merely my clinical impression and does not apply to everyone. However, the question of whether people with mental illness look younger is no...