Abstract
The number of persons suffering from stress and stress-related disorders is increasing due to the rapid structural changes in socio-economic, educational and medical systems. While the social needs for psychosomatic medicine (PSM) have increased reflecting the era of changes, there are many issues to be resolved. I have introduced 4 themes and discussed from the viewpoint of further development of PSM. 1) Although several hypotheses regarding the etiology and concept of treatment for asthma have been proposed and changed during the past 4 decades, we had made continuously effort to study the mind-body connection and to improve psychosomatic treatment. We have reported the conditioned histamine release and involvement of hypothalamus in allergic reaction in animal experiments. In addition to these studies, we have demonstrated that long term remission of asthma might occur without the recovery of atopic disposition in the natural course of asthma and due to psychosomatic treatment. We made progress in the methodology for the investigation of psychosocial factors, and psychosomatic treatment of asthma, and published it in the book "Guideline for diagnosis and treatment of psychosomatic diseases" in 2002. 2) Occupational mental health promotion has become an urgent issue at work in the recent years. At present, we are engaged in the research and development of new stress management systems, improved method of active listening and the publishing of education programs and manuals for suicide prevention. It is thought that industrial medicine is one of the new fields for further development of PSM. 3) Although PSM have now faced with financial problems in the practice under the policy for suppression of medical expenses, I believe that establishment of a specialty system for authorized physicians including PSM and reward reflected this system may resolve this problem. 4) The demand and role of PSM is speculated to increase in the 21st century according to the increase of stress and stress-related diseases. We should make an effort to improve our therapeutic mind and technical skill for treating of PSD and also some mental dysfunction, and to research the mechanism of mind-body connection to keep the specialty as psychosomatist, for the further development of PSM.
