1999 Volume 39 Issue 3 Pages 251-257
In considering psychosomatic medicine for the 21st century from the standpoint of psychiatrists, a report on the present status of psychosomatic medicine together with a proposal is presented with focus on general hospital psychiatry and psychosomatic medicine. It cannot be denied that the approach taken by psychiatrists to date in psychosomatic medicine has been inadequate in Japan. The large contributory factor involved is the fact that in Japan the practice of psychosomatic medicine has primarily belonged to mental hospitals. With this as background, the Japanese Society of General Hospital Psychiatry was established in 1988 and as one of its main activities, efforts have been made by psychiatrists to substantiate and develop psychosomatic medicine. In the survey conducted after the establishment of the Society, it was found that the outpatient clinic of general hospital psychiatry responsible for psychosomatic medicine had made a steady development. We have also made efforts toward the substantiation of psychosomatic medicine through the introduction of biofecdback medical care in general hospital psychiatry. This experience of ours and the results of questionnaire survey have suggested that the greatest barrier against the future development of psychosomatic medicine is the problem of medical care economy. We propose that re-recognition and re-evaluation be made of the role of "general hospital psychratry in shouldering the responsibility of psychosomatic medicine" in the coming 21st century and look forward to substantiating psychosomatic medical care system with other departments of medicine and to strengthening the backup in medical care economy.
