心身医学的接近における諸問題

―内科医と精神科医の協力をめぐつて―

抄録

At the department of internal medicine in our Hospital, we experienced psychosomatic approach with the cooperation of psychiatrist for about 3 years, and the following are summarized as the result of the discussion:
1) Doctors of internal medicine should expect to the psychiatrists not only “psychiatric” but also “psychosomatic” cooperations, and the psychiatrists should have interests to the psychosomatic medicine as well.
2) With the cooperation of psychiatrists, many psychiatric patients may be found among the patients of internal medicine as the neurosis, psychosomatics even psychotics showing somatic symptoms as their main symptoms.
3) Psychological resistance of the patient shown against the examination of psychiatrist could be a step to approach to the patient, so the doctor of internal medicine should study about the corelationship between psychological and physical conditions, and the doctor should know the understanding of disease by the patient, degree of want of therapy, and relationship between the doctor and the patient in order to treat the resistance of the patient properly.
4) In order to perform adequate treatment with the cooperation of internal medicine and psyehiatric medicine, the both should be combined at the point of psychotherapeutic attitude, and daily exchange of communication should be kept on closely.