Psychosomatic Disorders of the Middle Age in Japan

Abstract

Mild depression can be considered as one of the representative disorders among the middle aged in Japan today. However, this disorder is not neurotic depression in the usual sense of the term, but rather belongs to a mild type of endogenous depression of the monopolar type.When occurred in the middle age, it is characterized by lack of exernal inhibition and easily overlooded by other people. Therefore we are suggesting that this depression be called "endogenous, not-psychotic depression." This disorder is frequently found particularly in the urban areas.Generally speaking, an outstanding charateristic of endogenous depression in Japan is that there is a considerable degree of unanimity as to its premorbid personality in many patients.Above all, the melancholy-syntonic personality (Tellenback) is often observed in the monopolar type of depression. The author summarized the charateristics of this disorder as 1) obsessive concern for orderliness, 2) ability to maintain smooth relationship with other and 3) identification with the tradition-honored value system. These are, however, the characteristics of the middle age and not of adolescence. This deserves attention when we deal with psychosomatic disorders of the middle age.Why is it that this diagnostic prerequisite is not so important in western countries while it is in Japan? It may be related to the socio-cultural conditions of Japan. That is, under these conditions, the individual is considered a good person when he does not assert himself and always needs to be assured by the value of other people, particularly by the value cherished by the society which consists of undistinguished average people. At any rate, it is useful to pay attention to the premorbid personality when we diagnose psychosomatic disorders of the middle age.