Human Circadian Rhythms and Psychosomatic Complaints(Biorhythm and Psyshosomatic Medicine)

Abstract

In modern society, different working shifts have evolved to enhance productivity and provide diversification. As a result, the "work shift" system, which ensures 24-hour productivity, accounts for 30% of the working population, making appropriate health management an issue. Many studies have been reported on the relationships between shift work and various diseases. The best-documented health consequences of shift work are the three major symptoms, i.e. -fatigue, gastrointestinal disorders and sleep-wake disorders. Recently, it has been increasingly noted, as a results of advances in chronobiology, that symptoms related to rotating shift work are psychosomatically morbid conditions based on the circadian rhythm disorders. In particular, a disturbance in the sleep-wakefulness rhythm resulting from irregular working hours is reported to cause physical, psychological and social stress, and gastrointestinal, cerebrovascular and musculoskeletal disorders. In the present study subjects who worked continuous or irregular shifts and who visited psychiatric departments with physical symptoms resulting fro!n sleep disorders were examined from the view point of the disturbed circadian rhythms. The subjects were 174 rotating shift workers (39 male and loa female) who were examined in a psychiatric setting for somatic including disturbed sleep and wakefulness. Of them, 142 (36 male and 106 female) had physical symptoms such as insomnia, autonomic dysfunction, gastrointestinal, musculoskeltal and so on, and required psychiatric examination (Psychosomatic group-group PS). Thirty-two (3 male and 29 female) were diagnosed as having neurosis and/or depression. (Neurotic group-group N). The PS group was examined for clinical features, course and prognosis, and 20 of them who showed characteristic features received (1) psychological tests, (2) investigation of the sleep-wake rhythm through a long-term sleep diary, and (3) determi-nation of body temperature rhythm. In the PS group, incidence of immodithymia was the highest, followed by nervous, syntonic, narcissistic and histrionic, viscous, autistic personalities, in order. A disorder in sleep and wakefulness was the most significant symptoms, gastrointesti-nal, cardiovascular, respiratory, muscular and skeletal symptoms, in this order. In addition, PS group showed higher psychosomatic scores than the established norms in the psychological test (MMPI). Initial analysis of the body temperature data indicated that the PS group exhibited more irregular desynchronization in comparison to the control group.