抄録
In this study, the author compared the results of psychosomatic treatment with those of somatic treatment in adult patients who had been suffering from asthma and treated for more than 3 months at the Department of Psychosomatic Medicine, Kyushu University. With these patients a follow-up study was conducted over the period of more than 3 years.The subjects were divided into two groups according to their attitudes toward psychosomatic treatment. The psychosomatic group consisted of 93 patients who accepted our pyschosomatic approach. The control group consisted of 73 patients who did not accept our psychosomatic approach but continued only somatic treatment.The process of psychosomatic treatment consisted of the following stages : 1) Somatic treatment and establishment of psychosomatically oriented doctor-patient relationship. 2) Psychophysiological stabilization brought by a decrease in pathological inner tension and an experience of the disappearances of symptoms. 3) To facilitate understanding of psychosomatic correlations. 4) To help modify distorted perception and inadequate (superficially adaptive) bahaviors or to learn a new mode of adaptation. 5) Termination of psychosomatic treatment.The results are summarized as follows : 1. Comparisons were made between the two groups as to age, type and severity of asthma, allergic factors and psychosocial factors, etc. There were no significant differences between the two groups.2. According to the follow-up study, 37 of 93 patients in the psychosomatic group and 6 of 73 patients in the control group showed complete remission or marked improvement. There was a significant difference between the two groups.3. Furthermore, the therapeutic results of the psychosomatic group were evaluated in relation to which stage where the treatment was terminated or discontinued. Twenty-three of 30 patients who had terminated the treatment at the fourth or fifth stage showed complate remission or marked improvement, while 14 of 63 patients who had discontinued at the second or third stage.In conclusion, it was proven that psychosocial factors were related to the intractability of asthma and that the psychosomatic approach was of value in treating so called "intractable asthma". It is most important for the therepist to help the patient become aware of the inner mechanisms prior to recurrence of asthmatic attacks and to modify his distorted perception and inadequate (superficially adaptive) behavior patterns in his daily life.
