Studies on the Comprehensive Medical Treatment of Peptic Ulcers(4) : Effects of psychosomatic treatment on the prevention of relapse of gastric ulcers

Abstract

In connection with a series of studies on the comprehensive medical treatment of peptic ulcers, the authors have previously reported : (1) results of studies on the basic mechanisms of ulcer healing, (2) the influence of psychoneurotic factors on the healing process of gastric ulcers and (3) the influence of minor tranquilizers on the psychoneuroendocrine functions and the healing process of ulcers in patients with gastric ulcer. This report deals with the prevention of relapse of gastric ulcers in psychosomatic cases. A long-term study, 4-lO years, was undertaken on a total of 27 patients with psychosomatic recurrent gastric ulcers. The patients were classified into two groups, a group of 10 cases with medical treatment and a group of 17 cases with psychosomatic treatments. The control period was laid down as the duration from healing to relapse on each case to evaluate the effects of the therapy. The healing was determined by endoscope. The results were as follows : 1) Psychosocial factors were divided into seven groups, such as stress of life events, domestic and life problems, interpersonal problems, work related problems, gluttony, irregular meals and sleep, and general character. Depression was also an etiology in gastric ulcer relapse. Each consisted of two basic factors, actual (external) component and character (internal) component. 2) Psychosomatic treatment for the prevention of relapse of gastric ulcers was effective in 53% of the cases studied. Insight therapy, supportive therapy, autogenic training, and/or environmental readjustment were effective for the cases that relapsed due to the actual external etiology. But they were little effective for the cases with hyperadaptation and with poor self control of behavior. 3) Preventive signs of gastric ulcer relapse in the cases studied were found gastric juice secretion, blood pressure, and biorhythm of serum cortisol. These results support the usefulness of psychosomatic treatment as better than medical treatment in the prevention of relapse in psychosomatic cases with gastric ulcers, and point to the possible mechanism of effectiveness.