"The Stress-Circular Syndrome" with a Manifestation of Depressive State in the Middle-aged Patients

Abstract

Owing to a distinguished progress in industrial and technological achievemetn contributed by middle-aged men after the World War II, people in Japan seem to be confronted with a dilemma between seeking for higher economic life and suffering from multifarious distress caused by psychosocial frustrations. Chonsequently depressive state has become prevalent as one of the most popular symptoms in the psychosomatic area for the middle-aged patients.Recently such depressed middle-aged patients with liver function disorder and glucose intolerance are coming to our out-patient clinic. We can put them in a new concept of "Stress-Circular Syndrome" to explain this characteristic illness. Clinical specificity and etiological mechanism of this syndrome were studied retrospectively from bio-psycho-socio and ethical viewpoints.The results of the study revealed that the Stress-Circular Syndrome was consisted of the following four clinical features;(1) the presence of psychosocial stress prior to the onset, (2) three main objective signs which are alcoholic liver dysfuction, nutritional diabetic state and depressiveness, (3) so called "Viscious Circle" in connection with mutual relationships among stress, and symptoms through maladapted behavior of alcohol abuse, (4) specific premorbid personality traits such as perfectionism, meticulousness, rigidity in view, etc.In coping with such patients complaining those symptoms, comprehensive therapeutic approaches were practiced. They are considered to be indispensable in order to break the viscious circle, to correct erroneous view of life and to establish a new life sytle.